(AUTHORITY TO OPERATE ON LOCKERS)

To Place : Chennai
The Manager, Date :
Tamilnad Mercantile Bank Ltd.,
Porur Branch.
Chennai.

Dear Sirs,

Locker No....................................., Key No..................................

Password ….................................

I/We hereby authorise Mr/Mrs. …...................................................... to allow access to the above locker

for the purpose of depositing articles and removing articles thereof, from time to time.

Mr/Mrs/Miss................................................, whose specimen signature is attested hereunder.

Mr/Mrs/Miss …................................................. will quote the pass word relating to the above locker

everytime he/ she seeks access.

This authority shall continue in force until I/ We revoke it by a notice in writing delivered to you.

Yours faithfully,

Signature of Mr.

Hirer/s

Attested