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December 28, 2016

FPB DECLARATION FORM

FPB DECLARATION FORM

                Received back the used up passbook of account no: ----------------- which has been cancelled, along with the fresh passbook issued in lieu thereof bearing the same account no.

                                                                                                                               

Date:

                                                                                                                                                Signature of Customer
                                                                               

                                                                                                                                            (NAME IN BLOCK LETTERS)

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