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CANCELLATION OF NOMINATION

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.... initials and address of nominee Date of birth in Relation- case of minor Ship to holder/s [PART II SEC. 3(i)] Particulars Of bank account To be filled in case if nominee is minor: As.. on this date, I/We appoint Shri/Smt./Kumari the sole nominee above is a minor to receive the amount for the time being due to the above Government securities/Bond in the event of my/our death during....

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....cial.. I/We.. dated.. [See paragraph 16] CANCELLATION OF NOMINATION .(name and address) do here by cancel the nomination ..(date) vide Registration .made by me/us in respect of the following Stock certificate/Bond Ledger Account No., and registered by the Public Debt Office/branch of the Agency bank on.... No....... Particulars of the Stock Certificate/ Bonds Date of Issue Nomenclatur....

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....erest or share in the inscribed of ………………………. percent Government Loan of ………………….. amounting to `......... as specified on the face of this instrument together with the ...(transferee/s), his/her/their* executors, administrators or assigns, do freely accept the stock certificate number.................

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