Book Lost Form

Company Name(s): 
Documents: 

Dr. V.S. KRISHNA LIBRARY
ANDHRA UNIVERSITY,VISAKHAPATNAM
To
THE UNIVERSITY LIBRARIAN
Visakhapatnam
Dt
I have lost the Library Book bearing Ace. No ... : ....... ...... ........ .............. Call No ........... .......... .
Kindly let me know the costs. I have borrowed it on date .............................. ........ .
Permanent Address· Signature of the B"orrower :
Class/Subject/Dept .
Ticket No.:
(FOR OFFICE USE ONLY)
Dt . ........................... ..
To
THE ACQUISITION/PERIODICAL SECTION
The amount to be collected may please be intimated
Ledger No. 1/c Circulation Sectioll
To Dt . ........................... ..
THE CIRCULATION SECTION
Please collect a sum of Rs ................. as provisional deposit towards the replacement cost of the book/
journal including a sum ofRs. 20/- towards precessing charges.
Author :
Title:
Edition & Year: Price :
Edition & Year : Acced. on:
Publisher : 1/c Acquisitions Section ----------------------------------------
To
THE ACQUISITION SECTION
A sum of Rs. .. .. has been collected on ............ A.U.L. Receipt No ......... and included in the remittance
made in the State Bank of India/ A. U. Registrar's Office-Accounts Section, Yisakhapatnam under challan
dated .......... for Rs ......... .
A new copy may please be required and the balance, if any, be paid back to the borrower. The replacement
copy is enclosed herewith.
New Ace No. lie Circulation Section