(FORM A)
[See Para 9]

APPLICATION FORM FOR 8 % RELIEF BONDS, 2002

(Please read the instructions carefully before filling up the form)
(Please write in block letters and tick ( ) the appropriate box)
I/WE TENDER THE SUM/MATURED . %
RELIEF BONDS _____ BEING THE SUBSCRIPTION
TO 8 % RELIEF BONDS , 2002 AMOUNT OF
SUBSCRIPTION Rs.______
(Rupees ___________________________________)
PAID BY [ ] CASH [ ] CHEQUE [ ] D.D.
No._________ DATED ___________
DRAWN ON __________________________
(BANK/BRANCH)
MATURED BOND NO. _________
I/WE APPLY AS [ ] INDIVIDUAL [ ] KARTA OF
H.U.F. [ ] ON BEHALF OF MINOR
RELATIONSHIP WITH MINOR [ ] FATHER
[ ] MOTHER [ ] LEGAL GUARDIAN
MODE OF HOLDING :-
[ ] SINGLE [ ] JOINT [ ] ANYONE OR SURVIVOR
STATUS [ ] RESIDENT [ ] NON-RESIDENT
[ ] MINOR
BROKERS NAME :
CODE NO. :
ADDRESS :
FOR OFFICE USE ONLY
BROKERAGE PAID Rs.
APPLICATION NO.
DATED
DATE OF DEBIT OF
DRAWEE BANK
DATE OF TRANSFER
TO LINK CELL
DATE OF CREDIT TO
SPL. CURRENT A/C
DATE OF CREDIT TO
GOVT. ACCOUNT
G.P.NOTE NO.
BOND LED.
GER. A/C. No.
P.C.G.M. / BRANCH MANAGER
RUBBER STAMP OF RECEIVING OFFICE
WITH FULL ADDRESS
I / WE REQUEST THAT THE BONDS MAY BE ISSUED TO ME / US AS INDICATED BELOW :
[ ] BOND LEDGER ACCOUNT MAY BE [ ] GOVT. PROMISSORY NOTE OF
OPENED IN MY/OUR NAME DENOMINATION OF Rs. … … … …
[ ] MAY BE CREDITED TO MY/OUR (ISSUED ONLY AT THE OFFICES
BOND LEDGER ACCOUNT NO. … … … . OF RESERVE BANK OF INDIA)
I / WE WISH TO DRAW INTEREST ON MATURITY [ ] HALF YEARLY [ ]@
In case of credit to bank Account
NAME OF THE BANK BRANCH ______________
SAVINGS/CURRENT ACCOUNT NO._________
(Fill in the boxes using block letters leaving one box blank after each work)
FULL NAME OF THE FIRST APPLICANT / HUF/ MINOR
FULL NAME OF FATHER/MOTHER/LEGAL GUARDIAN (IN CASE OF MINOR) / KARTA OF HUF /
POWER OF ATTORNEY HOLDER
DATE OF BIRTH (IN CASE OF MINOR)
D M Y SEX : M. [ ] F. [ ]
(IN CASE OF MINOR)
Registration No. in case of Power of Attorney/ HUF already registered with Reserve Bank of India
ADDRESS (DO NOT REPEAT NAME) OF THE 1ST APPLICANT
STATE PIN
FULL NAME AND ADDRESS OF 2ND APPLICANT
FULL NAME AND ADDRESS OF 3RD APPLICANT
PERMANENT ACCOUNT NUMBER
FIRST APPLICANT
SECOND APPLICANT
THIRD APPLICANT
… … … … … … … … … … … … … … … … … … … … … … … … … …
SIGNATURE / THUMB IMPRESSION OF 1ST APPLICANT
+ SIGNATURE
NAME AND
ADDRESS
OF WITNESS
1) … … … … … …
… … … … … … … … … … … … … … … … … … … … … … … … … …
SIGNATURE / THUMB IMPRESSION OF 2ND APPLICANT
… … … … … … … … … … … … … … … … … … … … … … … … … … 2) … … … … … ..
SIGNATURE / THUMB IMPRESSION OF 3RD APPLICANT
NOTE : @ Interest on Government Promissory Notes will be paid by means of post dated interest
warrants attached to the Bonds and in the case of Bonds in the form of Bond Ledger
Account by credit to the bank account to the holder or by cheque/warrant.
+ In case of thumb impression.
H.U.F. DECLARATION FORM
(ONLY IF APPLICANT IS KARTA OF HUF)
I,
RESIDING AT THE ADDRESS GIVEN AGAINST THE FIRST APPLICANT, DO SOLEMNLY AFFIRM
THAT I AM THE KARTA OF THE HINDU UNDIVIDED FAMILY STYLED
( NAME OF THE HUF AND ADDRESS )
AND AS SUCH HAVE FULL POWERS TO SELL, ENDORSE, TRANSFER OR OTHERWISE DEAL IN
_________ % RELIEF BONDS ___________ STANDING IN THE NAME OF THE SAID HUF.
SPECIMEN SIGNATURE FOR AND ON BEHALF
OF THE HUF ( NAME OF THE HUF )
SIGNATURE OF THE KARTA
INSTRUCTIONS AND GUIDELINES FOR - RELIEF BONDS
1) There is no maximum limit for Investment in the Bonds.
2) Cheque/ draft towards subscription should be drawn in favour of the bank receiving the application and
payable at the place where the application is tendered. A matured Relief Bond in the form of
Promissory Note / Stock Certificate tendered as subscription will be discharged by the holder or his
duly authorised representative registered with RBI.
3) If the application is made on behalf of a minor by the legal guardian, a guardianship certificate granted
by a competent court under the provisions of Guardians and Wards Act (Act of 1890) should be
produced.
4) In case of minor applicant, a birth certificate issued by the Municipal or other competent authority,
church, Registrar of Birth/s or a Magistrate, Head of a Gram Panchayat or Head Master of a School -
disclosing the name and the date of birth of the minor should be produced in original (along with one
xerox copy) for verification.
5) Applications made in the name of Non-Resident Indians will be subject to Exchange Control
Regulations.
6) The application shall bear the signature/ thumb impression of the applicant/s. The thumb mark should
be witnessed by 2 respectable persons.
7) If the application is signed by a person other than the investor, a Power of Attorney authorising the
signatory should be submitted along with the application. The P.O.A. should contain express provision
to receive interest and the principal amount due under the Bonds and/or to negotiate or transfer the
Bonds. The P.O.A. should also be unconditional. In case the P.O.A. is executed abroad, it should be
attested by a Notary Public of the place where it is executed and notarised afresh in India (duly
stamped).
8) The Kartha of HUF making an application for Relief Bonds should submit a declaration in the form
annexed hereto.
9) The nomination may be made by a sole holder (other than a minor) in case of bonds in the form of
Bond Ledger Account in Form 'B' or as near thereto as may be. A nomination made may be varied or
cancelled by notifying PDO / branch of authorised Public Sector Bank in Form 'B' or 'C' as the case
may be. Every nomination made or variation thereof shall be registered at PDO/ branch of authorised
Public Sector Bank of Issue and shall be effective from the date of registration.
10) In case of applications made in the joint names of more than 2 persons, the bond/s interest warrants and
Payment Order/s will be issued in the name of the first applicant "and others" (without mentioning of
other joint holders).
11) The date of issue of bond in the form of Promissory Note will be date of receipt of subscription in cash/
draft or the date of realisation of cheque as the case may be. In the case of the bond in the form of Bond
Ledger Account, it will be opened from date of receipt of subscription in cash or the date of realisation
of draft or cheque. However, interest in the case of subscription received by way of draft will be
payable from the date of tender thereof.
12) Tax concession available under Relief Bonds are as under :
i) Income Tax - Interest on the bonds will be exempt from Income tax under Income Tax Act,
1961
ii) Wealth Tax - The bonds will be exempt from Wealth Tax under the Wealth Tax Act.
13) Bonds in the form of Bond Ledger Account will be transferable by execution of an instrument of
transfer. The transfer shall not be deemed to be complete until the name of the transferee is registered
as holder of the bond in the books of Public Debt Office / branch of authorised Public Sector Bank of
issue. The Bonds in the form of promissory note will be transferable by endorsement and delivery.
14) The bond is repayable after a period of five years from the date of issue. In case the investor/ holder
desires to reinvest the maturity proceeds he/she may do so by submitting a fresh application along
with the maturing Relief Bonds in the form of Promissory Note at least 30 days prior to the date of
repayment to the Public Debt Office of RBI. In the case of matured Bond Ledger Account, balance
therein can be re-invested at the office of issue (i.e. RBI or concerned bank branch).
15) Applications for Bonds in the form of Bond Ledger Account will be received at :
i) (a) Offices of the Reserve Bank of India at Ahmedabad, Bangalore, Bhubaneswar, Mumbai
(Fort and Byculla) , Calcutta, Guwahati, Hyderabad, Jaipur, Kanpur, Chennai, Nagpur, New
Delhi, Patna and Thiruvananthapuram.
(b) Branches of State Bank of India, Associate Banks and Nationalised Banks specified in
the Annexure 3 of the Government Notification.
ii) Applications for Bonds in the form of Promissory Note and applications for conversion of
current bonds issued under 9% Relief Bonds 1993, 10% Relief Bonds 1995 and existing 9%
Relief Bonds 1999 into bonds in the form of Bond Ledger Account under the 9% Relief Bonds
1999 will be received only at the offices of Reserve Bank of India, mentioned in (i) (a) above.
16) Brokerage at the rate of Re.1/- (Rupee one only) per Rs.100/- will be paid to the brokers registered with
Receiving Offices listed in Para 15 above and PPF and UTI Agents enrolled with them as also to
authorised banks on the applications tendered by them on behalf of their clients and bearing their
stamp.
17) Advances can be obtained from Banks against security of the Relief Bonds.
18) Where the subscription is in the form of matured Relief Bond/s (including Bond Ledger Account) held
in the name of the applicant, the Bonds will be issued / new Bond Ledger Account will be opened for
the amount due under such Bond/s in multiples of Rs. 1000/-.
19) The balance if any, on matured Relief Bond/s tendered for reinvestment into 9% Relief Bonds, 1999
after adjusting towards subscription in terms of sub paragraph 18 above, will be paid to the holder.
20) Subscription in the form of matured Relief Bond/s will not be accepted if the same is/are under
notice of stoppage.
21) Bonds issued under 9% Relief Bonds, 1993 , 10% Relief Bonds, 1995 and the existing 9% Relief
Bonds, 1999 which are not matured will be eligible for conversion into Bonds in the form of Bond
Ledger Account under 9% Relief Bonds, 1999 for the remaining tenure.