POST OFFICE SAVING BANK


APPLICATION FOR NOMINATION OR CANCELLATION OR VARIATION OF NOMINATION
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Name of Post Office		 .......................................
Account No.



* I/We the depositor (s) of savings / Cumulative Time Deposit / Recurring Deposit 1/2/3/5 years Time Deposit account No. ........................................... hereby nominate the persons(s) named below, under sectrion 4 of the Government Saving Bank Act, 1873 to be the sole recipent(s) of the amount standing at the credit of the said account.

 


Name & address of nominee
Date of birth

Name and address of person who may receive the said amount during the nominee's mionority
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The names(s) of nominee(s) may not be entered in the passbook.


This nomination supersedes the previous nomination made in respect of the said account which standsregistered under No................................. or ..................................................... date .........
3 .*@
No nomination has been previously made in respect of the said account which is in force.