FORM No

FORM No. 42-H

(See Chapter XI, paragraph 250-A)

Bill for the refund of excess amounts paid by a loan in repayment of the principal of loan or/and interest thereon.

_____Treasury		Month of_____19 .
Heads of service chargeable	1. Major Head		Voucher no.———List of Month of———19
	2. Minor and Sub-Head
	3. Primary and Secondary units of payment for the appropriation.

Received the sum of Rs. _____ ( ______ being the refund of amount paid in excess in respect of the principal of loan_____(Give details of loan and its amount) and/or interest thereon sanctioned) by _____ in his letter no. _____ , dated _____ (attested copy enclosed).

Dated _____ 19 .	Signature
	Designation

(A) In case of payment at the Treasury.

Passed for payment of Rs. —————

Examined —————

Dated ————— 19 .

Treasury Officer.

(B) In case of payment at the Bank.

THE AGENT, STATE BANK OF INDIA —————

Please pay Rs.* —————

*To be stated in words and in figures.

————— Treasury.

Dated ————— 19 .

Treasury Officer.

Payee’s Discharge to the Bank

Received Payment.

Name—————

Office—————

For use in Accountant General’s Office.

Admitted.	Rs.
Objected to	Rs.

Reasons of objection—————

Auditor

Section Officer

Gazetted Officer.