GOVT. OF INDIA

NATIONAL SAVINGS ORGANISATION

APPLICATION FORM FOR APPOINTMENT AS AUTHORISED AGENT (S.A.S. AGENCY)

To______________________________

________________________________

Sir,

I desire to act as an Authorised Agent for the sale of 7-Years National Savings Certificates' Second, Third, Fourth and Fifth Issues 2,3 and 5 Year Time Deposites National Development Bond, 15-Year National Savings Annuity Certificates and other Small Savings Securities, which may be notified by the Govt. of India from time to time as securities which Authorised Agent may canvass.

a) My Full Name is-----------------------

b)My Father's Name is

c)My occupation is

d) My Business/Office address is

e) My Residential Address is

f) My age is --------Years

I declare that,

i) I am not a close relative (i.e. wife, husband, legitimate child or step child, father, mother, sister or brother) of a Gazetted Officer

working in Post and