Section 5(1)(a) in Public Debt (Annuity Certificates) Rules, 1954
(a)a statement containing the following particulars:(i)the period for which payments have been made;(ii)the place at which the annuity certificate was for the time being enfaced for payment;(iii)the circumstances attending the loss, theft, destruction, mutilation or defacement; and(iv)whether the loss or theft was reported to the police;