FORM VI

(See rule 12)

DECLARATION OF FULL SUBSCRIPTION OF CHIT TICKETS

Place:
Date:
To

The Registrar of Chits,

__________________
__________________

Dear Sir,

Vide your letter No. ___________________, dated the __________, you were pleased to
grant me previous sanction to commence/conduct a new chit amounting to Rs.__________with
the duration of __________months.

2. I have subsequently enlisted the required number of members and I hereby declare in
terms of sub section (1) of section 9 of the Chit Funds Act, 1982(Central Act 40 of 1982) that all
the tickets specified in the Chit Agreement have been fully subscribed.

3. I remit herewith a sum of Rs. (in

figures)__________Rupees__________________________________(in words) being the fees
prescribed for this purpose of filing this declaration.

Yours faithfully,

(NAME OF THE FOREMAN)

Foreman
for and on behalf of the Company/firm