Application for purchase of social security certificates

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....         (iii) Application for withdrawal from Post Office Savings Bank.         (iv) Matured old certificate(s) for investment.         Total :         *Cross out, if not applicable. DECLARATIONS: 2. I hereby declare- (a) that I agree to abide by the Social Security Certificates Rules, 1982; (b) that I am of good health (see paragraph 6 below); (c) that I am not less than 18 years, and not more than 45 years of age ^3[***] in evidence of which I attach the document specified at item__________ of paragraph 7 below together with a copy** of that document; ^@(d) t....

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....e minority of the nominee(s). Name of nominee Name and address of person appointed         Witness: Name_________ Address___________ Signature of witness____________ ^GBP4. I require identity slip. ^$5. The certificate(s) (and Identity slip GBP) may be made over to Shri/Smt_____________ agent (Authority No______________,) ^1[***] GBPGBP Cross out paragraph 3, if nomination is not required.   GBP Cross out, if identity slip Is not required. For Identity slip if required, applicant's specimen signature and marks of identification must be furnished in the space below paragraph 8. $ Cross out, if the certificates and identity slip (where required) are to be received by....

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....ued to the applicant by LIC or PLI authorities. (vi) Life Insurance Policy (vii) Letter issued to the applicant by the LIC/Postal Life Insurance Authorities stating his date of birth as accepted by them.   Not to be returned to the applicant. (viii) True copy/extract of the applicant's service record kept by his employer____________(name and address of the employer) stating the applicant's date of birth as accepted by the employer; along with a letter/certificate (in original from the employer stating that he has accepted the said date of birth on the basis of standard proof. ^5[(ix) A statement in Form 5 made by the applicant in the presence of the Postmaster.]   8. Social Security Certificates previo....