FORM C
Certificate of interest
[ See paragraph 7(4)]
State Bank of India, Branch………………………………………….
Site Restoration Fund Scheme, 1999
Name of the deposit office
Deposit Account No.
Name and address of the depositor :
Certified that gross interest amounting to Rs……………………..(in figures) (Rupees…………….) (in words) has been credited to the above deposit account during the financial year ended 31st March,…………………….
Place :………….
Date :…………. Signature of Officer-in-Charge
(Seal)