NC 41
Department of Posts India
(OBVERSE)
APPLICATION FOR TRANSFER OF NATIONAL SAVINGS CERTIFICATES AS SECURITY
(vide Rule 19 of FDSC Rules 1962)
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Registration No…………………………… Serial No. and date of Original
application for Purchase of National
Savings Certificates
To
The Postmaster
………………………………………
Sir,
I/We …………………………………………………..…. (Name in Block Capitals) am/are required to deposit an amount of Rs……………………………. as security with …………………………………… (official designation of the gazetted officer of the Government or name of the Reserve Bank of India or a Scheduled Bank, Cooperative Bank, Registered Cooperative Society, Corporation, A Government Company or Local Authority). I/We therefore request you to transfer the under mentioned National Savings Certificate(s). Declaration or Duplicate Certificate(s) issued in lieu of lost certificates of which I/We am/are the holder(s) in favour of
…………………………………………………………………………………………………………………………………………… (Official Designation of the Officer or name of the Branch etc to whom the Certificates are being pledged as security.)
I/We agree that the certificate(s) shall be encashable by the pledgee when the security has been forfeited.
Particulars of Certificate or Declaration or Duplicate Certificates in lieu of lost Certificates
Serial No. of
Certificates
Date
Name of Office of
Issue
Denomination
Total Number of Certificates or Declarations/Duplicate Certificates ……………………
Yours faithfully
Address …………………………..
………………………….. Signature of Transferee(s) of
………………………….. Certificates
Dated :
Signature and Designation of Transferee (Pledgee) and seal of office
Dated :
(REVERSE)
Serial No.of Head/Sub Office
OBLONG MO STAMP OF HEAD/SUB OFFICE
Particulars of National Savings Certificates or Declarations or Duplicate
Certificates in lieu of lost Certificates issued to transferee(s).
(To be filled in by the Head/Sub Post Office)
Serial No. of
Certificates
Date
Denomination
Date of
discharge and
the initials of
the Postmaster
Remarks
(every change affecting
National Savings Certificate
such as transfer, spoilt, issue of
declaration or duplicate
certificate etc should be noted
here under the date and initials of
the Postmaster
Date : Signature of Head/Sub Postmaster
Note : Certificate can be transferred to be treated as security only to officers mentioned in Rule 19 of the Post Office Savings Certificate Rules 1969. Transfer of Certificates as security to private individual or Non scheduled banks, private Institutions other than those mentioned in the aforesaid rule is prohibited.