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........ [ ] Electronic Transfer for (Amount) ……………………. …………………………………. (Rupees........ ..only) In case, investment exceeds Rs. 50,000 in cash, PAN number 4) Depository participant details (to avail of option to hold the bond in demat form) Depository Name DP / Client ID NSDL [ ]; CDSL [ ]; For NSDL, enter 8 digit dp ID followed by 8 digit client ID, For CDSL enter 16 digit client ID 5) Bank Details (for Interest/Redemption payment) Bank Name: Account No.: Type of Account: ( ) Saving Branch Name: IFSC Code: ( ) Current 6) Declaration: I/We hereby declare and undertake that (i) my/our aggregate investment in Sovereign Gold bonds does not exceed 500 Grams during the financial year 2015-16 and (ii) the Information furnish in this application form is correct, (iii) I have read and understood the details of information for the investors as well as rights and duties of investors (copy attached). The agent/bank has explained the features of the scheme. Signature (1st Applicant)* DATE: Signature (2nd Applicant) Place: * in case of Thumb imp....

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....ading of exchanges/NDS-OM shall be notified. The holders of the said securities shall be entitled to create pledge, hypothecation or lien in favour of scheduled banks. Branches of all the scheduled commercial banks, and designated Post offices Instructions for Investor/ Applicants a) Application should be complete in all respects. b) Incomplete applications may be rejected or delayed till full particulars are available. c) In case the application is submitted by a Power of Attorney (POA) holder, please submit original POA for verification, along with an attested copy. d) In case the application is on behalf of a minor, please submit the original birth certificate from the School or Municipal Authorities for verification, together with an attested copy. e) Please note that nomination facility is available to a Sole Holder or all the joint holders (investors) of an SGB. f) In case nominee is a minor, please indicate the date of birth of the minor and a guardian can be appointed. g) Nomination facility is not available in case the investment is on behalf of minor. h) Please provide bank account details for receiving payment through Electronic mode i) Please not....

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....जयते भारत सरकार Government of India राष्ट्रिक स्वर्ण बंधपत्र (सॉवरेन गोल्ड बॉण्ड)- 2015-16 SOVEREIGN GOLD BONDS-2015-16 Certificate Number- मैं एतद द्वारा प्रमाणित करता/करती हूँ कि श्री / श्रीमती गोल्ड बॉण्ड), 2015-16 के कुल प्रारंभिक निवेश Rs.. (सॉवरेन गोल्ड बॉण्ड ), 2015-16 के प्रारंभिक निवेश पर प्रति वर्ष सà....

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....¤°à¤£à¤¾à¤²à¥€ आधारित है अतः हस्ताक्षर आवश्यक नहीं। This is a system generated certificate and does not require any signature. Form 'D' [See paragraph 15] NOMINATION I/We (Name and address), for the loan the holder/s of Stock certificate/BLA No hereby nominate the following person/s who shall on my/our death have the right to the Government securities/Bonds and receive payment of the amount for the time being due on the Government securities / Bonds specified below: PARTICULARS OF NOMINEE: Date Amount Date of Full name with Date Relation- Particulars of issue Rs. repayment expanded initials and of birth ship to holder/s of bank account address of nominee in case of minor To be filled in case if nominee is minor: As the sole nominee above is a minor on this date, I/We appoint Shri/Smt./Kum to receive the amount for the time being due to the above Government securities/Bond in the event of my/our death during the minority of the said nominee If the nomination is in substi....