FORM – 3
[See sub-paragraph (1) of paragraph 8]
(Application for Withdrawal)
To,
The Postmaster/Manager
…………………………………………………
…………………………………………………
Sir,
I ……………………………………………………………..(Depositor/guardian) hereby apply for
withdrawal from my account as per details below:-
Account Number:........................................................................................
Amount of withdrawal applied...........................................................
*Certified, that the amount sought to be withdrawn to be availed is required for the use of
………………………………………who is alive and still a Minor.
2. Please Credit the amount of withdrawal to my SB Account no. __________________standing
at ________________________________(Name of Account office).
or
Please issue a Demand Draft/account payee cheque
or
Please pay in cash (applicable if the amount is below permissible limit of cash payment).
3. I certify that all the conditions applicable under scheme for grant of withdrawal have been
complied with.
Necessary documents as applicable are attached as under:-
1.
2.
Date:- Signature or thumb impression of depositor/guardian
Attested By _____________________
(Attestation is applicable in case of thumb impression)
For office use only
Payment detail
Amount available in Account Rs. _________________________________
Date of Initial Subscription
Date on which last withdrawal was allowed
Total Amount granted for withdrawal Rs . (In figures)
(In words)
Date Stamp Signature of Postmaster/Manager
Acquittance
(to be filled by depositor)
Received Rs . __________(In figures) _____________________________(in words) By
cash/cheque/DD bearing no……………………….. dated…………………./by transfer to Account
No...............................
Date Signature/thumb impression of depositor/guardian
