P.O. S.B. Manual Vol. III - India Post

77FORM -E[See sub-paragraph (1) of paragraph 12)NOMINATION UNDER THE PUBLIC PROVIDENT FUND SCHEME, 1968ToThe Agent/manager,State Bank of…………………..…………………………………….I………………………………………………………….hereby nominate the person (s)mentioned below to whom to the exclusion of all other persons, in the event of my death, theamount standing to my credit in the Public Provident Fund Account No………………………….atthe time of my death would be payable.Serial No.Name (s) of thenominee (s)Full address (es)Date of birth ofnominee (s) incase of minorProportionateamount for eachnominee* As the nominee (s) at Serial No.(s)……………………………..specified above is/are minor (s), Iappoint Shri/Smt/Kumari………………..…………………..(Name and full address) to receive thesum due under the said account in the event of my death during the minority of the nominee(s).Signature of witnessName and address:Signature or thumb impression ofSubscriber/guardianDate………………FOR THE USE OF ACCOUNT OFFICEThe above nomination has been registered on…………………………and an entry made inthe passbook.Date………………………..* Delete if not applicable.Signature of Accounts Officer