APPLICATION FORM ADVANCE FOR THE PURCHASE OF MOTOR/MOTOR CYCLE/MOTOR BOATS 

 

(PLEASE SCORE OUT THOSE NOT APPLICABLE)

 

1. FULL NAME AND DESIGNATION _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

2. PERMANENT OR TEMPORARY _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _  _ _ _ _ _ _

 

3. AMOUNT OF ADVANCE REQUIRED _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

4. MONTHLY SALARY OF THE APPLICANT-

 

   (a)  Basic pay _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

   

   (b)  Dearness allowance _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

   (c)  Special and/or official pay _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

   (d)  Other allowance _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _  _ _ _ _ _ _ _

 

5. DATE OF SUPERANNUATION OF APPLICANT _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

6. NAME AND DESIGNATION OF THE SURITIES, IF ANY _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

7. DATE OF SUPERANNUATION OF THE SURETY _ _ _ _ _ _ _ _ _ _ _ _ _ _ _  _ _ _ _ _ _ _ _ _ _ _ _

 

8. PARTICULARS OF ANY ADVANCE TAKEN PREVIOUSLY _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

     (a)  Number and date of sanctioning order _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

     (b)  Amount sanctioned _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _  _ _ _

 

     (c)  The date on which it was repaid in full interest _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

9. WHETHER THE ADVANCE HAS BEEN REFUSED IN THE PAST _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

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                                                                                            SIGNATURE OF THE APPLICANT

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DECLARATION

 

I, _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ do hereby declare that I have read the rules regulating the grant of motor car/motor cycle etc. advance and will abide by them and that if delay executing the mortgage bond or taking out insurance beyond the period mentioned in the rules I shall be liable to repay the entire advance in one lumpsum at once.

  

                                                                                                  SIGNATURE OF THE APPLICANT

CERTIFIED that the entries against items two and four are correct.

              CERTIFIED also that it is necessary that the applicant should use a car in discharge of his duties for the convenient transaction of Government business.

 

                                                                                      SIGNATURE AND DESIGNATION OF THE 

                                                                                                 FORWARDING OFFICER.