SMALL SAVING SECTION

SMALL SAVING SECTION

APPLICATION FOR "MAHILA-PRADHAN KSHETRIYA BACHAT YOJNA"

(Application for R.D. Agency)

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(Appointing Authority)

Subject:- Application for appointment as an Authorised agent.

Sir,

I request that I may be appointed as an authorised agent MAHILA-PRADHAN KSHETRIYA BACHAT YOJNA for canvasing and securing deposites in 10-year Post Office Cumulative Time/5-year Recurring Deposite Accounts on commission(at such rate as may be notified by Govt. of India from time to time) in the ---------------------------- area, Municipal House No./Plot No.-----------------to ---------- which consists of ------------------families.

I agree to abide by all the rules and regulations regarding the appointment of Authorised Agent at present in force and as may be amended from time to time under the above said Agency scheme.

I shall provide a security of Rs.100(Rs. One hundred only) in shape of 7-year National Savings Certificate duly pledged to President of India.

The Agreement (Form ASLAAS-3) will be executed by me immediately on hearing from you about the approval of my appointmentas an Authorised Agent.

I enclose herewith, In triplicate, my specific signature.

Yours faithfully

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Place:---------- Name and full address of the applicant

Date:---------- ------------------------------------------------

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FOR USE BY DISTRICT SAVINGS OFFICER

Memo No.----------------------------------------- Dated:--------------------------------Forwarded to-----------------------------------------

----------------------------------(Appointing authority)

Recommeded that the following applicant may be/may not be appointed as an authorised agent on account of the following reasons:

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Signature---------------------

(District Savings Officer)

Place:------------

FOR USE OF APPOINTING AUTHORITY

Appointed as recommended by the District Savings Officer, National Savings ----------------------------------------------------

approved/not approved.

Place:---------- Signature:-------------------------

Date:----------- (Designation of Appointing Authority)

(Also attach 1.Agreement form 2.Guaranters 3.Character Certificate 4.Declaration 5.No objection Certificate )