DECLARATION

Date :26/08/2022
Place :Kumhari

To
The Manager
Canara Bank
GA Section,
Raipur Regional Office
Raipur

Dear Sir,

SUB :: SCHEME FOR PROVIDING MOBILE HANDSETS TO EXECUTIVES FROM SCALE IV TO

SCALE VII, BRANCH HEADS AND SECTION HEADS/ ELIGIBLE OFFICIALS.

REF : HO CIRCULAR 18/2020 DTD.06.01.2020.

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I have availed Mobile phone facility in the existing scheme.

I hereby declare that I have purchased Mobile phone with configuration as specified in the
above-referred communication and request you to reimburse the eligible amount.

I undertake to bear the cost of repair, if any and not seek any replacement of mobile phone
from Bank in case of loss/damage till the completion of 3 years from the date of purchase.

Yours faithfully,

(R.VIVEK)

Name :R.VIVEK

Designation :SENIOR MANAGER; KUMHARI BRANCH (DP CODE:5305)

Staff No. :609799