Form 'D' Application Form For Loan Under The Public Provident Fund Scheme
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1FORM ‘D’
[See Paragraph 10]
APPLICATION FORM FOR LOAN UNDER THE PUBLIC PROVIDENT FUND SCHEME, 1968
To
The Chief Manager / Manager
Bank of India
_____________________ Branch
Sir,
1.
I wish to avail a Loan from my Public Provident Fund Account No.______________________, a
sum of Rs._____________ (Rupees _____________________________________________
Only), which I undertake to repay with Interest, within a period of 36 months as prescribed in
Paragraph 11 of Public Provident Fund Scheme, 1968.
2.
I had availed a Loan of Rs._______________ (Rupees ________________________________
Only), on __.__.____ (Date) which has been repaid in full with Interest on __.__.____ (Date).
3.
*Certified
that
the
amount
sought
to
be
withdrawn
is
required
for
the
use
of
_____________________ ________________________ who is alive and is still a Minor.
*(To be given only when a withdrawal is sought from a Minor’s PPF Account)
4.
The Passbook is enclosed.
…………………………..
Date : __________
Signature or Thumb Impression
of the Subscriber / Guardian
----------------------------------------------------------------------------------------------------------------------------- ---------------
FOR OFFICE USE ONLY
Date of Initial Subscription
:
__.__.____
Amount available in PPF Account
:
Rs.______________________
Amount available for Loan in accordance with
:
Paragraph – 10 of the Scheme
:
Rs.______________________
Amount of Loan Actually Sanctioned
:
Rs.______________________
Date : __________
Branch / Manager
----------------------------------------------------------------------------------------------------------------------------- ---------------
Received a sum of Rs.______________ (Rupees ________________________________ Only), by way
of Loan from Public Provident Fund Account No._________________________
HERE AFFIX
REVENUE
STAMP
Date : __________
…………………………..
Signature or Thumb Impression of the Subscriber / Guardian
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