Gen 29
Gen 29
Gen 29
ïªÉ¾ê Ⱦà¾åïªà ¾Ä
Name of Payee
Ìͺø¨Æ
Certificate
Äê¼Èà ¡åÀÌê ïªÑÄ´ ïÍàºë ÉÊïƾà ïÄÍú ¼æ¨àÉê¸ê ¨Çæ¸ê ¾øÉæǼú
Âɺà, ¦ïÌà ¡åÀÌê ïªÆ Æêºë Äê¼Èà ¢Íºø¾à ̿;à É ¡æºø ÀÖ¼ú ¡å¼åÆ
ª¸¾´ ¦¨ºë ¨Ç¾ ȼ Âɺà, ¦Ä Äê¼È ¨Èè¾à ÉïǨ ÈÂå 諭 ¾æºø
Âɺà ÄÄ ïÄÆú¾à Ìͺø¨ ¨Ç.
I hereby certify that the reasons given for making the refund are
correct and that the sum to be refunded was credited to revenue as
indicated above and the sum was not drawn previously.
* ¨ïÖïƾà ÈÂå ª¾à¾å ȼ ¡Æ Ìͺø¨Æ ¼ ï ÌÄ ¡Äê¸å ¡æº.
* ïÆåàªñ ï¾åï ¾ ¨Àå ÍÎ ÆêºëÆú.
* A certificate of credit from the Kachcheri is attached.
* To be ruled off if not applicable.
........................................................
¢ÈàÈéÄ ¨Ç¾ ï¼ÀåÚºï¾àºë Àò½å¾øÆå.
Head of Department making the Application.
¼ú¾Æ
Date
Ãå¸à¶åªåÇïƾà Ⱥà ÂÈÆ
Treasury Authority