Page 66 - CURAJ Information Handbook for SC ST Cell

*(1) Name ______________________________
Signature__________________________

*(2) Name ______________________________
Signature__________________________

Signed and delivered by the above named
Surety in the presence of:
_______________________
_______________________
Signature (Surety)

*(1) __________________________
__________________________
*(2) __________________________
__________________________
Accepted _______________________________
__________________________________________
For and on behalf of the President of
India (the Accepting Officer will not
be less than Under Secretary to the
Government of India

* Witnesses are required to be Gazetted Officer only,
who will put their Official seals also, below their signatures.

(1) Full Name of the Awardee and address ________________________________________________________
__________________________________________________________________________________________________

(2) Full Name, Designation and address of the surety and relation, if any, to Awardee: _______
__________________________________________________________________________________________________

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