FORM No. 39
[See Chapter XV, paragraph 347, note]
(Bill for Repayment of deposits)
_____ Treasury month of_____, 19 .
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HEAD OF SERVICE CHARGEABLE |
_____DEPOSITS |
VOUCHER NO._____ OF PAYMENTS |
LIST OF |
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Original Number ___ |
Date of Deposit ___ |
Name of Depositor |
Amount originally deposited Rupees |
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In this space a translation of the receipt form into Hindi should be given. |
Received this _____, day of_____, 19 , the sum of rupees _____ paise_____ being the amount payable_____ on account of the deposit described above Claiment’s Signature |
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Examined and entered. |
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Accountant |
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Treasury |
Stamp, if required. |
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Pay Rupees |
Passed for payment |
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Treasury Officer. |
Rs._____________________ |
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Judge, Magistrate or Collector |
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