FORMS

Wednesday, November 9, 2016

WITHDRAWL OF LEGAL TENDER CHARACTER OF EXISTING Rs.500 & Rs.1000 BANK NOTES --- SB ORDER 12/2016








Annexure-1
Report from BO to SO as on 8.11.2016 (only for this date)
Sl No
Name of the BO
Denomination received from BO, which were available at the close of 8th November 2016 (D day)
Denomination at SO at the close of 8th November 2016 (D day)
Total
500
1000
Total
500
1000
Total










Name of SO                                                                                                                 Dated
Sl No
No of notes received for exchange
No of notes deposited in one's own account
No of notes deposited in other account
Total (A+B+C)
500
1000
Total (A)
500
1000
Total (B)
500
1000
Total ©












Name of the SPM _________________________________
Signature of the SPM ____________________________
Date:___________________
Place:_____________________

Report from HO to Divisional Office

Name of HO *                                                                                   Dated
1
2
3
4
5
6
Sl No
Denomination available as on close of 8th November 2016 *
Denomination received from SO, which were available at the close of 8th November 2016 (D day)*
No of notes deposited in one's own account at HO
No of notes deposited in other account at HO
Total (A+B)
500
1000
Total
500
1000
Total
500
1000
Total (A)
500
1000
Total (B)















* Information to be given for 8th November only. From 10th November this will be blank and information from column 4 to 6 only to be provided

Name of the Postmaster _________________________________
Signature of the Postmaster ____________________________
Date:___________________
Place:_____________________



Annexure-2


Request Slip for exchange of Withdrawn Old series of banknotes *
in denomination of Rs 500/- and Rs 1000/-

Name of the Post Office :_________________________________________________________
Name of the Tenderer
(In capital Letters)

Identity Proof Original to be shown at the counter
(Tick the one applicable)
Aadhar Card,  Driving License, Voter ID Card, Pass Port, NAREGA Card, PAN Card, 
Identity Card Issued by Government Department, Public Sector Unit to its Staff,
Identification  Number
(Number mentioned in the Identity Proof submitted)

Details of Withdrawn Old series Notes submitted for exchange


Denomination
No of Pieces
Value
Rs. 500


Rs.1000


TOTAL


Total value in words:

Signature of Tenderer

Place:
Date:


* To be supplied to members of public








Annexure-3
Format for reporting daily exchange of bank notes in the denomination of Rs 500/- and Rs.1000/- to the Divisional Office
Name of the HO/SO:__________________________       
The banknotes exchanged at the HO/SO  on _____________ are as under:
Denomination
Number of Pieces
Total value
Rs 500


Rs 1000


TOTAL



Name and Designation of the Post Office In-charge _________________________________
Signature of the Post Office In-charge ____________________________
Date:___________________
Place:_____________________
Statement enclosed in Annexure-3B, Annexure -3C & Annexure -3D




Annex-3A
Format for reporting to Circle Office on a daily basis the exchange of bank notes in the denomination of Rs 500/- and Rs.1000/-  at the branches of the post office
Name of the PMG:____________________________
The bank notes exchange\d during the day ___________________ are as under:
Denomination
Number of Pieces
Total value
Rs 500


Rs 1000


TOTAL



Name and Designation of the Reporting Officer _________________________________
Signature of the Reporting Officer ____________________________
Date:___________________
Place:_____________________



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