ASSAM SCHEDULE-III(Sec-l)FORM NO.

81
CERTIFICATE OF TRANSFER OF CHARGES

No. Date:

1.The Commissioner & Spl. Secy. To the Govt. of Assam, PW Bldg &NH Department, Dispur
2.The Commissioner & Spl. Secy.To the Govt. of Assam, PWD(Roads) Department, Dispur
3.The Accountant General Assam Guwahati
4.The Chief Engineer, PWD(NH Works) Assam,Chandmari,Ghy-3.
5.The Superintending Engineer, PWD Nalbari NH Circle, Nalbari
6.The Treasury Officer, Sivasagar.
7.The Branch Manager, State Bank of India, Sivasagar Branch
8.The Executive Engineer, PWD, Sivasagar NH Division, Sivasagar.
9.The person concern

Ref.:

Sir,

With reference to Rule 145 of the Assam Financial Rules,I/We the undersigned have the honour
to report that I/We have this...............day of ............................................................. at
.........................O’clock in the forenoon respectively delivered over and received charge of the office of
the......... .............. .. .. .... ........ .................. .............in the........district as per orders issued vides
Notification No....................................... .......... ..................by Under Secretary to the Govt. of Assam,
P.W.Bldg & NH Department, Dispur.

RELIVING OFFICER RELIVED OFFICER

I have occupied the official residence allotted to me with effect from ................................
of.................
To be struck out and initiate when there is no official residence

RELIVING OFFICER

Name (in block letter)..............................................................................................I have vacated

the official residence allotted to me with effect from.......................................day of................................

RELIVED OFFICER

Name(in block letter). .................................................................................................................................

And with reference to Rule 82(a)(vil)of this Assam Financial Rule 19"hReliving officer acknowledged to
have received ......... ...........of the permanent advance and that the full amount of such advance is due
from and accounted for by me.

RELIVING OFFICER ;Signature

Designation