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.
Sl. 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
Sl. 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