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General 103
*
RENEWAL OF CREDIT (A4 S. & E.) 5/69
(Internet Version)

...................................................................................................................................................................... ï¼ÀåںàºëÉ
Department
Ìͺø¨ ÀºòÆ
FORM OF CERTIFICATE

¡¨à Äê¼ïÈà ª¸¾/ Amount of Imprest .... .... .... Çæ./Rs.

¼æ¾à ¦É¾ ÉÉê®ÚÉÈ ª¸¾/ Vouchers now sent in for .... .... .... Çæ./Rs.
––––––––––––––––
ïÊàËÆ/Balance .... Çæ./Rs.
––––––––––––––––
ïÊàË ªú¸êÄ
ACCOUNT OF BALANCE

¨ƒïƒÖïÆà ï¾åïÍåºà Âæâ¨ëïŒ ï¾åïÍåºà ¡ïºà ºøï¾ ¨åÌè .... .... Çæ./Rs.
In Kachcheri or Bank or cash in hand

* ÄåÇæ ï¾å¨Î ﮨàÀºàÉÈ ïÍåà ¡æ¸æÉêŠÉÈ ïÍåà ª¸¾ .... .... Çæ./Rs.
* Account of Cheques or Orders uncahsed
––––––––––––––––
ÄêÝ ïÊàËÆ/Total Balance .... Çæ./Rs.
––––––––––––––––

¼ú¾Æ .....................................................................
Date
ï¼Àåںàºë Àò½å¾øÆå.
Head of Department.

* ¦¨à ¦¨à ﮨà ÀºòïÆà ïÍåà ¡æ¸ÉêïŠ ¡â¨Æ Íå Äê¼È ¡¾è¨à Àèï… Ì´Í¾à ¨Î ÆêºëÆ.
* Number and amount of each Cheque or Order to be stated overleaf.
H - 022255 (2004/10) Êòé Èâ¨å Ç°ïÆà Äê÷¸ ï¼ÀåںàºëÉ