INDEMNITY BOND

(From an Indane Customer losing Subscription Voucher)

This bond is executed on the _____ day of December 2012 by BISHESHWAR
NATH SINGH, (hereinafter called the Customer/Indemnifier) in favour of Indian Oil
Corporation Limited, Patna (hereinafter called the Corporation) under the terms and
conditions hereinafter mentioned.
WHEREAS the Customer has deposited an amount of Rs. 500 (Rs. Five Hundred
Only) with M/s PARVATI GAS AGENCY SIWAN, the authorized Corporation’s
distributor towards the issue of gas connection in his favour and a subscription
voucher was issued in favour of the Customer by the aforesaid distributor, recording
therein the details of equipment loaned to him and also the amount received by the
Distributor, and
WHEREAS the customer desirous of obtaining the gas connection without deposit
being an employee of Indian Oil Corporation Limited, has approached the Distributor
with a request to reimburse the said amount of Rs. 500 on the basis of Indemnity
Bond and without the production of the original Subscripton Voucher, the same
being lost/misplaced by him.
Now in consideration of the Distributor having made the payment of Rs. ______
(Rs.______________________________________) as above, the customer agrees
to indemnify and save harmless the Distributor and the Corporation from al
losses/claims/damages/suits and/or action which may arise out of the payment
having been so made.
The Customer further declares that he has not received any of the payment
pertaining to the above transaction, and in case, his/her any of the representatives
or assignees receive such payment at any such future date, the Corporation and the
Distributor shall be fully indemnified against such payment and any other incidental
expenses which the Corporation/Distributor may have to bear for the recovery of the
aforesaid amount.
The Customer further declares that he shall surrender the Subscription Voucher to
the Distributor in case he finds the same at a later date.
Before Me

Signature of Indemnifier/
Customer

Notary/Judicial Magistrate