H- 022255 Êòé Èâ¨å Ç°ïÆà Äê÷¸ ï¼ÀåںàºëÉ 157 Éæ¾ø ïÀåó ¡å¨îºø ÀºòÆ

General 157
(A4* S. & E.) 74/08
(Internet Version)

“Íú•¨Š ï¾å Àå¾ ÂÉ´ Ìͺø¨Æ¨à ” ï¼¾ ïÈÌ ¢ÈàõŠ ¨ø×Ä

APPLICATION FOR A CERTIFICATE OF “NO CLAIM”
(ºåɨåÈè¨ ¾øȽå×¾à ̊¾à½ïƾà Àĸ¨à À嗃Ž ¨ø×Ä Àè¸Ì
è Æú.)
(To be used only in the Case of Temporary Officers)
¡â¨Æ ............................
..................................................................................... ¡ÄåºñåâÊïÆà ïÈਊ ïɺ´Æú. No.

THE SECRETARY TO THE MINISTRY OF ........................................................................................................

ïÄÍú Àͺ ¾Ä ̿;à ɾ ¾øȽåÖÆå *(§Íêïª¾à ¡Æ —Æ ÆêºëÉ ºøï¾ ÇæÀèÆÈà ................................................... ¨ Äê¼È¨à ÍæÇ Æú)
—Ìè¾à ÌèÆõÄ Éª¨ùŠ ̊ÀìÚ¸ïÆ¾à ¢Ëà´ ¨Ç ºøï¾ ÂÉ ¼ §Íêïªà ÃåÇïÆà ºøï¾ ÌèÆõÄ Äê¼Èà ÌÍ/ ïÍåà ¶ê ÂåÍúÇ ÌŠÂ¾à½ïÆ¾à §Íê —Ìè¾à
¾øÉæǼú ïÈÌ ª¸¾à ÍúÈÉê ïÀ¾àÉå ºøï¾ ÂÉ ¼ ÄÄ Ìͺø¨ ¨Ç•. :-
I certify that the following officer has fully discharged all liabilities (except for a sum of Rs........................................................
due from him)* and correctly accounted for all cash and/ or stores in his custody :-
ÀåÌà ïÀåº ÌŠÂ¾à½
¡æÀ §ÀàÀêïŒ °å.¢.Âæ. ïƾà ïÉ¾à ¨Ç¾ ȼ
¾Ä À¼—Æ ¡â¨Æ ÀåÌà ïÀåïºà ºæ¾àÀºà Èæ°Ç ¡â¨Æ
Name Designation Security ¡â¨Æ Deposit Ledger
Bond No. N.S.B. No. assigned to
Pass Book No. Pass Book

2. “Íú•¨Š ï¾å Àå¾” ÂÉ´ Ìͺø¨Æ¨à ¾ø¨ëºà ï¨å´ ¡æÀ Äê¼È ¡åÀÌê ¼ûÄ´ ¡ÉÌÇ ï¼¾ê Ä澗.
Please issue a certificate of “No Claim” and authorize the release of the security.

..........................................................................
¼ú¾Æ
....................................... ï¼Àåںàºë Àò½å¾øÆå.
Date
Head of Department.
* ï¾å ªæÎïÀïºåºà ïŠ É®¾ ¨Àå ¼Ä¾à¾ * To be deleted if not applicable.