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Union of India - Section

Section 19 in The Sovereign Gold Bond Scheme 2016-17 - Series I

19.

All other terms and conditions specified in the General Notification of Government of India, Ministry of Finance (Department of Economic Affairs) vide number F. No.4(13)-W&M/2008, dated the 8th October, 2008 shall apply to the Gold Bond issued under this scheme.Application form for Sovereign Gold Bond 2016-17 - Series I(Put √ wherever required)
Name of Receiving Office                           Name of Branch :                  
Mode of Subscription   Cash   Cheque/ DD   Electronic Transfer        
  Grams of Gold Applied for Cheque/ Demand Draft Drawn on (Name of the Bank & Branch) Cheque/ Demand Draft Dated
         
(In Figures)  
(In words)  
Amount: Rs. (in figures) (in words)
                  ____________________________________________________________________________________
PAN number if applicable                                              
Applicant status:Resident Individual [ ], Trusts [ ], Charitable Institution [ ], University [ ], others [ ], Please specify: _____
Applicant(s) Detail(in block letters) Existing RBI Investor ID, if any
First/ SoleApplicant's Name in Full                          
                         
                                                             
                                Date ofBirth (minor)                    
Second Applicant's Name in Full
                                                           
                                                           
Passport/Aadhar/ PAN/ TAN/ Voter ID No. (any one of the above)                                  
Guardian (in case of minor)
                                                           
                                                           
Passport/Aadhar/ PAN/ TAN/ Voter ID No. (any one of the above)                                  
First/ Sole Applicant's/ Guardian's Address in Full (Do Not Fill in Name Again)
                                                           
                                                           
                                                           
Contact Details
Phone                           Fax                          
Email                                                        
BankParticulars For Payment of Interest Warrant/ Redemption
AccountHolder Name  
Bank Name  
Account No.Branch Name/ Address {|
                                   
|-| IFSC Code|
                   
|-|||}
  Account Type SB Account Current Account
Nominee details – Nomination Form (as applicable) to befilled and attached
Depository participant details(to avail of option tohold the bond in demat form)
Depository Name   NSDL   CDSL   (For NSDL, enter 8 digit dp ID followed by 8 digit client ID,For CDSL enter 16 digit client ID)
DP/ Client                                
Declaration:I/ We hereby declare and undertake that (i) my/ our aggregate investment in Sovereign Gold Bonds 2016-17 - Series I does not exceed 500 Grams during the financial year 2016-17 and (ii) the Information furnished in this application form is correct, (iii) I have read and understood the details of information for the investors as well as rights and duties of investors (copy attached). The agent/ bank has explained the features of the scheme.
Signature Signature Signature
1stApplicant 2ndApplicant Guardian
Date {|
               
| Places|
                                     
|}
  Date,Bank Stamp & Signature of the authorized official of thebank/ Post Office
In case of thumb impression, attestation by two witness
  Thumb Impression
Witnesses:  
Name of 1st Witness _________________________ Name of 2nd Witness _________________________
Address ___________________________________ Address ___________________________________
___________________________________ ___________________________________
___________________________________ ___________________________________
Signature __________________________________ Signature __________________________________
H.U.F. declaration (mandatory, if applicant is Karta of HUF)
I,..........................................................................................residing at the address given against First Applicant, dosolemnly affirm that I am the Karta of the Hindu Undivided Familyand as such have full powers to sell, endorse, transfer orotherwise deal in the Sovereign Gold bonds 2016-17 – SeriesI, standing in the name of the HUF.
Specimensignature for and on behalf of the HUF (name of the HUF)...............................................................................................................
Place ____________________  
Date ____________________ (Signature of the Karta with seal of HUF)
For Office use only
Date of receipt of Application (DD/MM/YYYY) BLA No. CIF No. Date of Credit to Govt. A/C (DD/MM/YYYY) Nomination registered on (DD/MM/YYYY) HUF declaration obtained (Y/N) Total limit declaration obtained (Y/N) NEFT/ECS mandate obtained (Y/N) Any other information
                 
Instructions for Investors/ Applicants
(a)Application should be complete in all respects.
(b)Incomplete applications may be rejected or delayed till full particulars are available.
(c)In case the application is submitted by a Power of Attorney (POA) holder, please submit original POA for verification, along with an attested copy.
(d)In case the application is on behalf of a minor, please submit the original birth certificate from the School or Municipal Authorities for verification, together with an attested copy.
(e)Please note that nomination facility is available to a Sole Holder or all the joint holders (investors) of an SGB.
(f)In case nominee is a minor, please indicate the date of birth of the minor and a guardian can be appointed.
(g)Nomination facility is not available in case the investment is on behalf of minor.
(h)Please provide bank account details for receiving payment through Electronic mode.
(i)Please notify the change of bank account, if any, immediately.
(j)Post Maturity Interest is not Payable.
(k)Indicate your date of birth.
Rights of the Investors
(a)Holding Certificate will be issued to the investor.
(b)The interest on the bond is paid half-yearly. The servicing of the Interest will be done through the bank account provided in the Application form or through the A/c linked to the de-mat, as the case may be.
(c)Application forms for investments under Sovereign Gold Bonds 2016-17 - Series I are available on the website at www.rbi.org.in/finmin.nic.in
(d)A sole holder or all the joint holders may nominate maximum of two nominees to the rights of the bonds.
(e)The nomination will be registered at the Office of Issue and a Certificate of Registration will be issued to the holder.
(f)The nomination can be altered by registering a fresh nomination.
(g)The existing nomination can be cancelled by a request to the Office of Issue.
(h)The investor is entitled to receive repayment amount within five clear working days from the date of tender of application for early redemption.
In case the bank does not comply with the above, you may lodge a complaint in writing in to the nearest office of Reserve Bank of India as under: