SB-41 : Application for issue of duplicate pass book

POSB (CBS) MANUAL – RULE-46 & PRESCRIBED FORM IN PP.253 (RATE CHANGED FROM RS.10- TO RS.50 + GST i.e. RS.59-)

APPLICATION FOR ISSUE OF DUPLICATE PASS BOOK

SI.No.	Description	To be filled by Depositor
1.	Account Number and type of National savings Scheme
2.	Account Type (Minor/Person of unsound mind, Single/Joint A/C
3.	Name of Post Office in which Aocount stands with SOL ID.
4	If account stands at BO, Name of BO
s	Name of Account Holder(s)
	Name of Husbilncf/Father/Mother/Guardian
7	Address of acoount holder(s) at time of opening account
8.	Present address of account holder(s)
9.	Date of opening of account and office at which it was originally opened if different from col 3
10.	Date and particulars of the last transation of account
11.	Balance at credit after the last transaction
12	Name of the PO from which the account was last transfered.
13	Date and circumstances of loss of Pass Book and result of efforts made to traced it out
14	Whether loss was reported to Police and if so with what result.
15	Remarks if any

(i) Particulars given above are true to the best of my knowledge and duplicate pass book may please be issued.

(ii) I shall surrender this passbook (in case of duplicates issued in lieu of of torn and spoils one).

(iii) The prescribed fee (Rs 50 + GST) has been paid through receipt No…………dated……………(Please score out if exemption has been granted).

Note:

1. Submit the self attested copies of the KYC Documents.

2. In case of Joint Account, signature of all Joint account holders required,

Signature/Thumb/Impression of account Holder(s)

Particulars as given in the application have been verified with the rerecords.

Signature SPM/PM with designation stamp

Part II

Duplicate pass book may be issued/ may not be Issued.

Signature of Post Master with designation stamp

Part- III

Duplicate passbook of Account No————————with balance Rs.———- receoved on———————-.

Signature/Thumb/Impression of account Holder(s)

Date Stamp of PO

Witness (in case of illiterate depositor(s))

Signature of witness
Name and Full Address of witness.