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BANK CERTIFICATE OF PAYMENTS FOR DOMESTIC SUPPLIES

APPENDIX 22B - Old_Provisions - Appendix - DGFT - APPENDIX 22B - APPENDIX 22 B To ______________________________ (Name and address of Regional Authority). We ________________________ (Name and address of the domestic supplier) hereby declare that we .....

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DD No./ *Bank Ref. No. Date Amount [1] [2] [3] [4] [5] [6] [7] [8] * The Bank Reference Number would be applicable for documents routed through bank & payments released through banking channels. ** FOR value actual realized and date against suppl .....

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particulars are correct. Signature of the domestic supplier :........................................... Name in block letters :........................................... Place: :........................................... Date: Designation :....... .....

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