FORM 1A
[See rules 6 and 18(1)]
INDIAN POSTS AND TELEGRAPHS DEPARTMENT
Form of application for purchase of National Savings Certificates (VI Issue) by non-resident or
person who is not resident in India
Serial No……………. …….
1. I/We hereby apply for the purchase of National Savings Certificates (VI Issue) as detailed below:

PARTICULARS OF CERTIFICATES REQUIRED *

Denomination (Rs.)	Number of certificates	Total face value Rs.	Type of joint certificates required ('A' or 'B' type)
5,000
1,000
500
100
50
Total

*To be filled only for joint-holding.
 Joint 'A' type certificate is payable to both holders jointly or to the survivor; joint 'B' type is payable to either or survivor.
† (a) in my/our name(s) $
 † (b) on behalf of minor $
 Date of birth of minor
(*) Certificate to be made encashable by father/ mother/ either parent/ legal guardian of the minor.
 (c) ( ** )in the name of $......................... through……………….. [Name and address of bank branch]
†Strike out (a)/ (b)/ (c) if not applicable.
$Give in block capital name(s) with aliases, if any, address and country of residence.
(*) Strike out any or all of the alternatives, if not required.
(**)For a scheduled bank on behalf of client having Non-resident (External)/ Foreign Currency (Non-resident) Account with the bank.
* 2. I/We tender herewith towards the purchase price of the certificates applied for:
(a) Cheque No……………..dated …………..in favour of the Postmaster …….......[Name of post office] for Rs……………(Rupees …………..….) drawn on my/ our………………………… Non-resident (External) Account No……. with……. [Name and address of bank branch in India]
 ** (b) Demand draft/pay order No. ……. dated ………………..in favour of the postmaster….. [Name of post office] for Rs………..(Rupees ……………………) issued by…………………..….. [Name and address of bank branch in India] by debit to non-resident (External) Account No……………….… or by withdrawal of equivalent funds from foreign currency (Non-resident) Account No………………..of……………….. [Name(s) and address of applicant(s)] together with a certificate from the said bank confirming that the draft/ pay order has been issued by debit to or withdrawal from the account referred to above.
 (c) Demand draft No…….. dated…………….in favour of the postmaster…………..….. [Name of post office] for ***……. drawn by………………………..[Name and address of bank in a country outside India] on……… [Name(s) and address of its branch or correspondent bank in India]
 (d) A sum of Rs. ………………….(Rupees…………. ) in cash together with foreign inward remittance certificate/ bank certificate indicating conversion of foreign exchange in rupees/bank certificate indicating that the funds have emanated from my/ our Non-resident (External) Foreign Currency (Non-resident) Account No……………….. Issued in my/our favour by…………. [Name and address of the bank concerned]
*Fill up (a)/(b)/(c)/(d), as the case may be and delete the rest.
**For applicant(s) or for a scheduled bank or on behalf of client applicant(s).
***Amount in Indian or foreign currency, as the case may be, in words and figures.
3. I/We agree that-
* (a) in cases where the Post Office requires a bank certificate showing the source of funds out of which the certificates are to be purchased, the certificates will be issued to me/us only on receipt of such bank certificate by the Post office;
 ** (b) in cases the proceeds of the cheque/demand draft are less than the face value of certificate(s) applied for, certificate(s) may be issued for the maximum possible total face value within such proceeds;
 $ (c) in case such proceeds one more than the face value of certificate(s) applied for, certificate(s) may be issued as applied for; and
 $ in either case, any balance amount of the proceeds may be refunded to…………. [Name and address of person] who is hereby authorised by me/us to receive the same, or
 (d) credited to my savings account No…….. in post office savings bank…………….[Name of Post Office]
* Applicable where the required bank certificate is not submitted with the application.
** Applicable only for cheque/draft expressed in foreign currency.
$ Delete (c) or (d), as the case may be.
4. * I/We declare that * I am/we are citizen(s) of India/person(s) of Indian origin.
Note: A person shall be deemed to be of Indian origin if he, or either of his parents or any of
his grand-parents, was born in undivided India.
5. * I/We agree to abide by the National Savings Certificates (VI Issue) Rules, 1981.
6. * I/We do/do not require identity slip.
 Note: No identity slip shall be issued to a person other than the one authorised, vide
paragraph 1(b) above in case of purchase on behalf of a minor.

Signature	Signature [or thumb impression
(not thumb impression) of the person(s) authorised,	(if illiterate) of applicant(s)] **

 if any, as per paragraph 1(b) above

Date			Date
Address			Address

 *Strike out portions not applicable.
 **If the applicant is illiterate, his father's name may also be given.
 * The certificate(s) and the identity slip may be made over to Shri/Smt…………….Agent (Authority No………………..) or messenger who presents this application.

	Signature [or thumb impression
	(if illiterate) or investor(s)]
	Date

 *To be signed or thumb impression affixed only when the investor does not take delivery of certificates personally.
 7.Received the certificate(s) detailed above $ and identity slip.

$$Marks of identification of applicant(s)	Signature or thumb impression of purchaser or his agent/messenger (in case of authorised agent his Authority No. should be given)
	$$ Specimen signature(s) of applicant(s)

 $Cross out, if the identity slip is not required.
 $$To be furnished if identity slip is required under paragraph 6 and if the application is submitted through an agent, messenger of scheduled bank.
 $ 8.Under provisions of section 6(1) of the Government Savings Certificates Act, 1959, I/we ,the holder(s) of Savings Certificates(s) mentioned in this application, hereby nominate the person(s) mentioned below who shall, on my/our death, become entitled to the Savings Certificate(s) and the amount due thereon to the exclusion of all other persons:-

SI. No.	Name(s)of the Nominee(s)	Full address	Date of birth of nominee, if minor

 $Strike out portions not applicable.
As the nominee(s) at Serial No.(s)………….. above is/are minor(s), I/we, appoint Shri/Smt./Kumari…………………….. [Name and full address] as the person to recieve the amount due thereon in event of my/ our death during the minority of the nominee(s).

Signature and full address of witness		Signature [or thumb impression(if illiterate) of holder(s)]

TO BE COMPLETED BY THE POST OFFICE

SI. No. of certificate	Issue price Rs.	Date of encashment of certificate	Initials of postmaster	Remarks like transfer issue of duplicates, etc., and initials of postmaster
Total

TOTAL NUMBER OF NATIONAL SAVINGS CERTIFICATES (VI ISSUE)

* Amount realised Rs.
Certificate(s) issued for Rs.
Amount refunded as per paragraph 3(b) Rs.

Date
			Signature of postmaster

 *In case of investment by cheque/ demand draft in foreign currency.