Account Closure/Premature Closure Form (Sb-7A) : Must Accompany This Form Payment Order Application Side

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SPECIMEN OF FORM

ACCOUNT CLOSURE/PREMATURE CLOSURE FORM (SB-7A)


. . _ PAS S BOOK MUST ACCOMPANY THIS FORM
APPLICATION SIDE
(To be filled by depositor)
Name of Post Office
Type of acc ount- SB /RDITD/MIS/NSS (tick the required
category)
Account No .

Date :Please pay to self/messenger whose name and


signatures are given be low) the sum of Rs .
(In
words) Rs.
(In figures) shown as ba lance
in my passbook plus/minus interest/recoveries as
admissible under the rules

PAYMENT ORDER
(For office use on ly)
Date
Payment deta il
Principle amount Rs .
+ Interset due Rs ._..,.-,- Recovery of overpaid
Interest Rs .
- Deduction if any Rs .
(in case of premature closure)
Total Amount du e Rs .
Pay Rs...,(In words)

_
_
_
_
_
_

(In figures)

Signature of Postmaster
Signature or thumb impression of depositor

Date Stamp

ACQITTANCE
(to be filled by depositor/mes senger)

Name of Messenger
Signature of Messenger

Received
Rs..:-:-_ _..,...-_..,.-:c_ _ ...,(both in words and figures .)

Signature or thumb impress ion of depositor


(Requ ired O"Y if payment is requi red throug h me ssenger)

~I'---

Signature or thumb impression of depositor


Initia l of PA

Initial of APM

I Date

___L

_
__l

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