SENIOR CITIZEN BOND

 

                              Private Placement of Bonds in the nature of

    Secured Redeemable Non Convertible Debentures (NCD’s) aggregating Rs. 10 Crores.

No. of NCDs applied for________________(In words____________________________________ Amount Rupees___________________(Rupees_________________________________________ ________________________________________________________________________________ Cheque / DD No._______________________ dated___________drawn on____________________

Applications must be made for a minimum of one debenture and in multiples of one thereof.

 

 

 

 

 

 

1. APPLICANT’S NAME IN FULL ______________________________________(SOLE/FIRST) Father’s Name__________________________________________Age_________________________ Address________________________________________________City_________________________ Pin____________Tel No.____________________________Status____________________________

 

 

 

 

 

 

JOINT APPLICANT(S) Name______________________________________________Age___________________________ Name______________________________________________Age___________________________

 

 

 

 

Specimen Signature Sole/First Applicants_____________________________Pan No.__________________   Second Applicants_______________________________   Third Applicants________________________________