FORM-B (CENTRAL) FORM-B (CENTRAL)

(See sub paragraph (3) of paragraph 4) (See sub paragraph (3) of paragraph 4)
PUBLIC PROVIDENT FUND SCHEME, 1968 PUBLIC PROVIDENT FUND SCHEME, 1968
COUNTERFOIL 1 COUNTERFOIL-2

SUBSCRIBERS COPY BANKS COPY

SBI BRANCH NAME : Date:__/__/20__ SBI BRANCH NAME : Date: ___/___/20___

NAME OF SUBSCRIBER: NAME OF SUBSCRIBER:

PPF A/C NO : PPF A/C NO :
AMOUNT OF DEPOSIT CASH / CHEQUE AMOUNT OF DEPOSIT CASH / CHEQUE
SUBSCRIPTION* SUBSCRIPTION*

LOAN REPAYMENT* LOAN REPAYMENT*

INTEREST ON LOAN* INTEREST ON LOAN*

PENALTY / FEES* PENALTY / FEES*

TOTAL AMOUNT TOTAL AMOUNT

Amount In Words (Rupees_______________________
Amount In Words (Rupees____________________________________________)
_________________________________________)
DETAILS OF CASH DEPOSIT AMOUNT DETAILS OF CASH DEPOSIT AMOUNT
1000 X .00 1000 X
500 X .00 500 X
100 X .00 100 X
50 X .00 50 X
20 X .00 20 X
10 X .00 10 X
5 X .00 5 X
Cheque / Demand Draft No & Date
Cheque / Demand Draft No & Date: ... & //20
.. & //20
Bank / Branch on Which Drawn
Bank / Branch on Which Drawn: .
.

Depositors Signature Depositors Signature

Note:
(i) Cheque / DD in favour of SUBSCRIBER name and will be credited after
realisation of proceeds only on realisation date.
(ii) * Select the Proper type of payment as above
SBI FORMS BY 4577825