DBS

[Paragraph 11B.5(e)]
A.D.Code No.............

Statement of operations on Diplomatic Bond Store accounts for the month of
................19............

Particular of
Sr. the Account Opening
Credits Debits
Closing
Remarks
No. Name of the Code no. Balance Amount Source of Cheque Amount Name of Balance
account Rs. Rs. funds Number Rs. the payee Rs
holder
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
Place: ......................
Stamp ...........................................................
Date: ...................... (Signature of Authorised Official)
Name .................................................
Designation .......................................
Name and Address
of Authorised Dealer ........................