The Manager Annexure A

___________________Branch
___________________Bank

APPLICATION FOR ENCASHMENT OF RS. 40,000/- DENOMINATION

NATIONAL PRIZE BONDS

PARTICULARS OF PRIZE BONDS HOLDER

Name

CNIC No. - -
Mobile No.
PARTICULARS OF NATIONAL PRIZE BONDS REPLACEMENT OPTIONS (please  one)
Denomination Rs. 40,000/- Premium Prize Bonds (Registered)
Total Pieces Special / Defence Savings Certificates
Total Value (Rs.) Encashment through Bank Account
BANK ACCOUNT DETAILS (in case of encashment through Bank Account)
Account Title Branch Name
IBAN
UNDERTAKING BY THE HOLDER
I hereby declare and accept that:
1. The National Prize Bond(s) presented by me for encashment is/are “Genuine”. In case the bond(s) is/are found
forged/tampered, the bank reserves the right to take legal action against me as per the relevant laws.
2. The information provided above shall be deemed to be true & complete and in case of any misinformation/incorrect
details of any nature whatsoever by me, I, solely shall be responsible for the losses.

Prize Bond Holder’s Signature (as per CNIC) Prize Bond Holder’s Signature (as per CNIC)
FOR BANK USE ONLY
Prize Bonds have been verified and found genuine. Accordingly, the application has been processed
as per the request of the holder (Please mention core banking system reference number):
Premium Prize Bonds (Registered)
Special / Defence Savings Certificates
Encashment through Bank Account
Remarks

Authorized Officer Authorized Officer