FORM 1A
[See rules 6 and 18(1)]
INDIAN POSTS AND TELEGRAPHS DEPARTMENT
Form of application for purchase of National Savings Certificates (VII Issue) by
non-resident or person who is not resident in India

Serial No .
1. I/We hereby apply for the purchase of National Savings Certificates (VII Issue), as detailed below:
Particulars of Certificates required
Denomination (Rs.) Number of certificates Total face value (Rs.) Type, i.e., joint 'A' or 'B’
@
5,000
1,000
500
100
Total
@To be filled only for joint-holding.
Joint 'A' type certificate is payable to both holders jointly or to the survivor; joint 'B' type is payable to
either or survivor.
(a) in my/our name(s)
(b) on behalf of minor .
Date of birth of minor .
@ Certificate to be made encashable by father/ mother/ either parent/ legal guardian of the minor.
(c) ( ) in the name of through [Name
and address of bank branch]
Strike out (a)/ (b)/ (c) if not applicable.
Give in block capitals name(s) with aliases, if any, address and country of residence.
@ Strike out any or all of the alternatives, if not required.
For scheduled bank on behalf of client having Non-resident (External)/ Foreign Currency (Nonresident) Account with the Bank.
2. I/We tender herewith towards the purchase price of the certificates applied for:
(a) Cheque No. dated in favour of the Postmaster [Name of post office] for Rs. drawn on my/our Non-resident (External) Account No. with [Name and address of
bank branch in India]
(b) Demand draft/ pay order No. dated for Rs. in favour of the postmaster [Name of post office] for Rs. (Rupees ) issued by [Name and address of bank branch in India] by debit to Non-Resident (External) Account No. or by withdrawal
of equivalent funds from foreign currency (Non-resident) Account No. of
[Name and address of applicant(s)] together with a certificate from the said bank confirming that the draft/ pay order has been issued by debit to or withdrawal from the account referred to above.
(c) Demand draft No. dated in favour of the postmaster [Name of post office] for drawn by [Name and address of bank in a country outside India] on [Name and address of its branch or correspondent bank in india]
(d) A sum of Rs. (Rupees ) in cash together with foreign inward remittance certificate/ bank certificate indicating conversion of foreign exchange rupees/ bank certificate indicating that the funds have emanated from my/ our Non-Resident (External) Foreign currency (Non-resident) Account No. Issued in my/our
favour by [Name and address of the bank concerned]
Fill up (a)/(b)/(c)/(d), as the case may be, and delete the rest.
For applicant(s) or for a scheduled bank or on behalf of a client applicant(s).
Amount in Indian or foreign currency, as the case may be, in words and figures.
3. I/We agree that-
(a) in a case where the Post Office requires a bank certificate showing the source of funds of which the certificates are to be purchased, the certificates will be issued to me/us only on receipt of such bank certificate by the Post Office;
(b) in cas e the proceeds of the cheque/demand draft are less than the face value of certificate(s) applied for, certificate(s) may be issued for the maximum possible total face value within such proceeds;
(c) in case such proceeds are more than the face value of certificate(s) applied for, certificate(s) may be issued as applied for; and in either case, any balance amount of the proceeds may be refunded to [Name and address of person] who is hereby authorised by me/us to receive the same; or
(d) credited to my Savings Account No. in post office savings bank [Name of Post Office]
Applicable where the required bank certificate is not submitted with the application.
Applicable only for cheque/draft expressed in foreign currency.
Delete (c) or (d), as the case may be.
4. I/We declare that I am/we are citizen(s) of India/person(s) of Indian origin.
Note: A person shall be deemed to be of Indian origin if he, or either of his parents or any of his grand-parents, was born in undivided India.
5. I/We agree to abide by the National Savings Certificates (VII Issue) Rules, 1981.
6. I/We do/do not require identity slip.
Note: No identity slip shall be issued to a person at her than the one authorised, vide paragraph 1(b) above in case of purchase on behalf of a minor.
Signature (not thumb impression) of the person(s)
authorised, if any, as per paragraph 1(b) above
Signature [or thumb impression if illiterate, of applicant(s)]
Date . Date .
Address Address
The certificate(s) and the identity slip may be made over to Shri/Smt agent
(authority No. ) or messenger who presents his application.
Signature [or thumb impression, if illiterate, of investor(s)]
Date .
$ Strike out portions not applicable.
$$If the applicant is illiterate, his father's name may also be given.
To be signed or thumb impression affixed only when the investor does not take delivery of certificates personally.
7.Received the certificate(s) detailed above $ and identity slip.
@ Marks of identification of applicant(s)
Signature or thumb impression of purchaser or his
agent/messenger
(in case of authorised agent his Authority No. should be given)
@ Specimen signature(s) of applicant(s)
$Cross out, if the identity slip is not required.
@To be furnished if identity slip is required under paragraph 6 and if the application is submitted through an
agent, messenger or scheduled bank.
8. Under provisions of section 6(1) of the Government Savings Certificates Act, 1959, I/we
, the holder(s) of savings certificates mentioned in
this application, hereby nominate the person(s) mentioned below who shall, on my/ our death, become entitled to the savings certificate(s) and the amount due thereon to the exclusion of all other persons:
Sl. No. Name(s) of the Nominee(s) Full address Date of birth of nominee, if
minor
Strike out portions not applicable.
As the nominee(s) at Serial No.(s) above is/are minor(s), I/we, appoint
Shri/Smt./Kumari [Name and full address] as the person to receive the amount due thereon in event of my/ our death during the minority of the nominee(s).
Signature [or thumb impression (if
Signature and full address of witness illiterate), of holder(s)]
TO BE COMPLETED BY THE POST OFFICE
Sl.No. of
certificate issued
Issue price Rs. Date of payment of
interest
Date of
encashment and
initials of
postmaster
Remarks like
transfer issue of
duplicates, etc., and
initials of
postmaster
Total
TOTAL NUMBER OF NATIONAL SAVINGS CERTIFICATES (VII ISSUE)
Amount realised Rs. .
Certificate(s) issued for Rs. .
Amount refunded as per paragraph 3(b) Rs. .
Date .
Signature of postmaster
In case of investment by cheque/ demand draft in foreign currency.