FORM C
Department of posts
[See rule 10A]
Serial No…………
Form of application for cancellation or variation of nomination previously made in respect of savings certificates under section 6 of the Government Savings Certificates Act,1959

[This form will be filled in by the holder(s) and submitted with the certificates to the Postmaster of the office where the certificates stands registered]
To
The Postmaster,
Space for postage stamps
Under provisions of section 6(1) of the Government Savings Certificates Act,1959, I/we……………..the holder(s) of certificates detailed below hereby cancel the nomination previously made by me/us in respect of these certificates and registered in your office under No……………..date…………….
 * In place of the cancelled nomination, I/we hereby nominate the person/s mentioned below, who shall, on my/our death, become entitled to the certificate/s and to be paid the sum due thereon to the exclusion of all other persons.

SI. No.

Name of the nominee(s)

Full Address

Date of birth of nominee in case of minor

*To be filled in case of variation only
2. As the nominee(s) at serial………above is/are minor/s, I/we appoint Shri/Smt./Kumari…………..(name and full address) as the person to receive the sum due thereon in the event of my/our death during the minority of the nominee/s.
3. The certificates detailed below are enclosed.

SI. Nos. of certificates

Denomination

Date of issue

Office of issue

Address:                                                                                                Yours faithfully,
                        Signature (or thumb impression,
                        if illiterate) of holder(s)
 (In case of illiterate holder, father's
name should be given)
Witnesses :     
Name(1) :       
Address :        
Name(2) :       
Address :        
N.B.- In the case of illiterate holders, the witnesses shall be persons whose signatures are known to the post office.
Order of the Postmaster accepting the nomination.
Signature of Head/Sub-Postmaster