A.P.T.C. Form

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A.P.T.C.

FORM 107
INDEMNITY BOND
This deed of Indemnity made on the ………………...……. day ……………………..…. Between
…………………………….. Son of ……………………..…… resident of ……………………………..
…………………………………..…. or ………………………………………………………………….
1……………….……….… Son of ……………….….. Resident of …………………………………...
2……………….……….… Son of ……………….….. Resident of …………………………………...
Carrying on business in Co-Partnership under the name and style of …………………………………….
at……………………….……………or………………..……….. a company registered under the Indian
Companies Act, 1913 / Companies Act, 1956 having its registered office at ……………………………..
(hereinafter called the Indemnifies which expression shall unless excluded by or repugnant to the
context be deemed to include his heirs, executors, administrators, legal representatives successors and
permitted assigns) of the ONE ART AND the GOVERNOR of Andhra Pradesh hereinafter called “the
Government” which expression shall unless excluded by or repugnant to the context be deemed to
include his successors or assigns) of the OTHER PART.

WHEREAS ON the ……………… day of …………… cheque no……………….. dated ……. On


…………….. (name of the Bank) for Rs…………………….. was drawn by ……………. In favour of
the indemnified.

AND WHEREAS the Indemnifier has represented to the Government that the said cheque has been lost
by him / during transmission by post to him.
Contd…….2.
AND WHEREAS at the request of the indemnifier the Government has agreed to issue a second cheque
for Rs…………………. Being the amount of the said previous cheque no ……….……. dated………….
Upon the Indemnifier giving such indemnity as hereinafter contained.
2. The Government agrees to bear the stamp duty, if any chargeable on those presents.
IN WITNESS WHERE OF THE Parties hereto have set and subscribed their respective hands
here unto on the ………………….. day and year first above written.
Signed by the Said Indemnifier in the presence of :-
1.

2.

Signed for and on behalf of the Governor of Andhra Pradesh by Sri……………………………………


(Name & Designation ) in the presence of.

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