FORM 1
[See rule 6]
Form of application for purchase of National Savings Certificates (VIII Issue)
Serial No……………..

To
The Postmaster,
I/We hereby tender Rs…………….(Rupees……………….only) in cash/by cheque No…………for purchase of National Savings Certificates (VIII Issue) of the type single/ joint A/ joint B.
(a) in the name(s) of…………………..and…………………………
(b) in the case of minor, his date of birth………………….encashable by the minor’s parent/ guardian Shri/ Smt
2. I/We nominate the person(s) named below who shall, on my/our death, receive payment.

SI. No.	Name of nominee	Full Address	Date of birth of minor nominee

3. I/We hereby agree to abide by National Savings Certificates (VIII Issue) Rules. 1989.
4. The certificates may be made over to my/our agent Shri/ Smt. ……………..Authority No. or messenger who present the application.
Signature and address of witness to nomination Signature/thumb impression of investor
Date……………..
Address…………..
Delete whichever is not applicable        
Received the certificate(s)
Signature of investor/messenger/authorised agent
Date…………..
TO BE COMPLETED BY THE POST OFFICE

SI. Nos. of certificates	Issue Price Rs.	Date of encashment	Initials of the postmaster	Remarks like transfer, issue of duplicate, etc., with initials
Total

Date :………………….         
Signature of Postmaster