DEPARTMENT OF POSTS, INDIA
Application for the issue of Duplicate Savings Certificates in lieu of loss theft, destructions, mutilation or defecement of the Savings Certificates in the custody of the holder vide rule 566 of P&T Manual Vol. VI Part (II)

From............................................
To,
The Postmaster
...................................
Sir,
I/we ...................................... request you to issue duplicate certificates in lieu of the lost/ destroyed / stolen savings certificates
detailed below of which I am / we are the holder. I am/ we are hereby furnishing the following information which is true to the best of my/ our
knowledge.
I) Particulars of Certificates
a) Name of the issue of the certificate .................................
b) Serial No. of the certificates .................................
c) Date of issue .................................
d) Denomination .................................
e) Name of office of issue ..................................
f) Type (Single/Joint A/B) ..................................
II) How the above noted particulars of the certificates could be ascertained -
III) Circumstances in which the loss/theft/destruction -
IV) Whether identity slip was issued, if yes the same is to be enclosed -
V) Date of furnishing first report of the certificates to the Police Station/ Post Office of registration -
VI) Result of Police enquiries
Signature of the holder
Name..................................
Date ............................ Address...............................
CERTIFICATE OF IDENTIFICATION
I, ................................ do hereby certify that.............................................. is/are known to me and has/ have signed this application in my
presence.
Signature of the Identifying
Full Address...........................
Holder / Holders known to me identified accepted.