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FORM OF APPLICATION FOR CANCELLATION OR VARIATION OF NOMINATION PREVIOUSLY MADE IN RESPECT OF SAVINGS CERTIFICATES UNDER SECTION 6 OF THE GOVERNMENT SAVINGS CERTIFICATES ACT, 1959

..... is form will be filled in by the holder/s and submitted with the certificates to the Postmaster of the office where the certificate stands registered) To The Postmaster Sir, Under provisions of Section 6(1) of the Government Savings Certificates Act 1959, I/We . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .the holder(s) of Savings Certificates detailed below, hereby cance .....

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..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(name and full address) as the person to receive the sum due thereon in the event of my/our death during the minority of the nominee(s). 3. The certificates detailed below are enclosed. Sl. No. of Certificates Denomination Date of Issue Office of Issue Address . . . . . . . . . . . . . . . . . . . .....

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