NF.

356
PPF FORM E
(See sub-paragraph 1 paragraph 12)

FORM OF NOMINATION UNDER THE PUBLIC PROVIDENT FUND SCHEME, 1968

To:
The Branch Manager
GHARAO BRANCH
.............................................
.............................................
JODHPUR
PANKAJ GARG
I ......................................................................................................................................
........................................................................................................................................
hereby nominate the person(s) mentioned below to whom to the exclusion of all other
person in the event of my death, the amount standing to my credit in the Public
Provident Fund Account No. ................................ at the time of my death would be
payable.

Sl.
No.
1

1.

Name(s) of the Nominee(s)

BABULAL GARG

Full Address(es)

Date of Birth of
nominee in case
of minor

Proportionate
amount for
each nominee

673,SCHEME NO. 10
ALWAR,RAJASTHAN

*As the nominee(s) at Serial No.(s)....................................................... specified above

is/are minor(s),I appoint Shri/Smt/Kumari ........................................................................
Address:...............................................................................................................................
.......................................................................................................... to receive the sum
due under the said account in the event of my death during minority of the nominee(s).
Signature of Witness:
Name and address :
Date :
Signature of Witness:
Name and address :
Date:

Signature or Thumb Impression of subscriber

-------------------------------------------------------------------------------------------------------------------------------------FOR THE USE OF ACCOUNTS OFFICE

The above Nomination has been registered on ........................................................ and

entry made in the Pass Book.

Date:
* delete if not applicable

Signature of Accounts Officer