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State of Andhra Pradesh - Section
Section 16 in Andhra Pradesh State Prize Chits and Money Circulation Schemes (Banning) Rules, 1979
16. Names, occupations and residential addresses of the office bearers of such associate institutions.
I/We solemnly declare that the facts stated herein as also in the Annexure are true to the best of my/our knowledge information and belief.I/We certify that the particulars/information given herein, in so far as they pertain to the books and records of the Here enter the name of the applicant Institution............. have been verified from such books and found to be correct and complete in all respects.Dated this .................. day of ............. 1979 at ............Signature(s) of the President/Manager/Secretary/Authorised official of the institution.Name(s)Designation (s)Note:(i) if the space given against any of the items is inadequate for furnishing full particulars, the required information should be given in separate sheets indicating the cross references against the relative items of this statement.| Sl. No. | Name of the Scheme | Date of commencement of the Scheme | Date of maturity of the scheme | No. of members intended to be enrolled as per thescheme | No. of members enrolled and actually subscribing. |
| (1) | (2) | (3) | (4) | (5) | (6) |
| Amount of liability by way of prizes, if any, incash or kind offered during the currency of the scheme | Amount actually disbursed by way of prizes | Outstanding liability on account of disbursementof prizes. | Are subscribers who win prizes bound to paysubscriptions till maturity of the schemes? | ||
| (7) | (8) | (9) | (10) | ||
| Does the scheme contemplate refund of the amountspaid by the subscribers to them on maturity of the scheme | If the reply to the query in item 11 is in theaffirmative the amount of t9oall liability under each scheme onits maturity | Remarks | |||
| (11) | (12) | (13) |