FORM A
[See para II(ii)]
(Brokers Stamp with address)
Form of Application for 10 per cent Relief Bonds, 1993

I/We………….(full name/s in block letters) herewith tender cash/draft/cheque/matured Relief Bond/s for Rs…………..(Rupees…………….) being the subscription amount for 10% Relief Bonds, 1995, and request that the Bond/s may be issued to me/us in the form of stock certificate/promissory note.
2. This application has been made by me/us in my/our personal capacity or as Guardian * /Karta of HUF.
3. * I wish to make a nomination in respect of the Bond(s) applied for. The prescribed nomination form is enclosed. * I do not wish to make a nomination in respect of the Bond applied for at present.
4. ** I wish to draw interest on maturity/half-yearly at the Reserve Bank of India/State Bank of India/State Bank of ……………………
First applicant Name and Address with date                  Second applicant Name and Address with date                                                (Signature)                                                (Signature)

                       
*Delete what is not required.
**Interest will be payable at the office of RBI of issue, branch of SBI or its Associate Bank conducting Government Treasury Business.
FOR OFFICE USE ONLY
Special Current Account                                                  Credited on (Date)
(Signature)
P. Manager/Branch Manager
(Rubber Stamp of receiving office)
Notes:
(1) The application should be in multiples of Rs. 1, 000. Cheque/draft should be drawn in favour of the Bank receiving the application and at the place at which the application is tendered.
(2) The application shall bear the signature/thumb impression of the applicant, the thumb mark should be witnessed by two respectable persons.
(a) Where the applicant is an individual the application shall be signed by the individual himself or by some person duly authorised by him in this behalf;
(b) Where the applicant is a Hindu undivided family, the application shall be signed by the karta and where the karta is absent from India by any other adult member of such family;
(c) Where the application is on behalf of a minor, his/her date of birth, guardian's name and relationship may be indicated below:
(i) Date of birth of minor ;
(ii) Guardian's name/Relationship;
(3) The nomination may be made in Form 'B' or as near thereto as may be. A nomination made by a holder may be varied by a fresh nomination in Form 'B' or may be cancelled by giving notice in writing to the Public Debt Office in Form 'C'. Every nomination and every cancellation or variation thereof shall be registered at Public Debt Office of Issue and shall be effective from the date of such registration.
(4) The Bond in the form of stock certificate/promissory note will be issued in the name of the individual/Hindu undivided family as described by its name (HUF), as the case may be.
(5)    (i) Where the subscription is in the form of matured Relief Bond/s held in the name of the applicant, the Bonds will be issued for the amount due under such bond in multiples of Rs. 1, 000.
(ii) A matured Relief Bond, tendered as subscription for 10% Relief Bonds, 1995, will be discharged by the holder or his duly authorised representative.
(iii) Subscription in the form of matured Relief Bond/s, will be accepted provided the same is/are not under notice of stoppage.
(iv) The balance if any, on matured Relief Bond/s tendered for conversion into 10% Relief Bonds, 1995, after adjusting towards subscription in terms of sub-paragraph (i) above will be paid to the holder.