FORM: 1

CERTIFICATE OF PUBLIC DEMAND FILED IN THE OFFICE OF THE CERTIFICATE OFFICE, DIST: Golaghat

No. of Certificate Name and Address of
Certificate Holder
Name and Address of Amount of public Demand Further particulars of the
Certificate Debtor (including interest if any public demand for which
and the fee paid under the certificate is signed.
Section -5 Sub any for
which the certificate is
signed and period for
which demand is due.

1 2 3 4 5
Assam Gramin Vikash Bank Diganta Nath Rs.8,08,534.60 Loan Account
Bengenakhowa Branch S/o Tarun Nath No. 7234300001236
Dist-Golaghat Kuhiyarbari, Bengenakhowa
Golaghat

I hereby certify that the above mentioned sum of Rs.8,08,530.60 (Rupees Eight lacs eight thousand five hundred thirty and sixty paisa) is due to the
above named.

I hereby certify that the above mentioned sum of Rs.8,08,530.60 (Rupees Eight lacs eight thousand five hundred thirty and sixty paisa) is justly
recoverable and that its recovery by suit is not barred by law.

Date this the 22nd Day of August 2022.

Certificate Officer
 FORM: 2
REQUISITION FOR CERTIFICATE [See section 5 under Bengal Public Demand Recovery act 1913]

To
THE CERTIFICATE OFFICER OF THE DISTRICT OF:GOLAGHAT

Name and address Name and address of Amount of public Demand for which the Name of the public Name and address
of Certificate Certificate Debtor requisition is made Demand for which this Of Guarantor (s)
holder is made

1 2 3 4 5
Assam Gramin Diganta Nath 1. Principal Rupees :- Rs.4,12,494.00 PMEGP- Small Business
Vikash Bank S/o Tarun Nath 2. Interest Rupees :- Rs.3,87,534.00
Bengenakhowa Kuhiyarbari, Bengenakhowa 3. Ad-Valorem Fee :- Rs.8,506.60
Branch Golaghat
Dist-Golaghat

4. Total Rupees:Rs.8,08,534.60

We request to recover the above mentioned sum of Rs.8,08,530.60 (Rupees Eight lacs eight thousand five hundred thirty and sixty paisa) which we are
satisfied after inquiry, is due from the said loan-ee in respect of PMEGP/SIRD/KCC/ Loan Verified by us on the 22nd day of August 2022.

Branch Head
Assam Gramin Vikash Bank
Bengenakhowa Branch

Memo No:
The Bakijai officer, Golaghat for favour of execution of the Certificate and realization of the amount mentioned above. After recovery, the same may kindly be
remitted to us. Interest @ 12.25% PA may be applied up to the date realization.