(FORM – C)
[See Para 11(iv)]
8% RELIEF BONDS, 2002 NOTICE OF CANCELLATION OF NOMINATION
I ______________________________________________________ (Name and address) do hereby cancel the
nomination dated ____________________________ made by me in respect of the following Bond Ledger
Account and registered by the Public Debt Office/ branch of the authorised Public Sector Bank on the
______________________ (date).
Particulars of the Relief Bonds
Date of Issue Bond Ledger Account No. Amount Rs.
Place and Date ___________________________ Signature / Thumb impression of the
holder
Signatures and addresses of the witnesses :