Section 5(1)(a) in Public Debt (Annuity Deposit Certificates) Rules, 1966
(a)a statement containing the following particulars:(i)the period for which annuities have been drawn;(ii)the place at which the annuity deposit certificates was, for the time being, enfaced for payment of annuities;(iii)the circumstances attending the loss, theft, destruction, mutilation or defacement; and(iv)whether the loss or theft was reported to the police;