SPECIMEN OF FORM
ACCOUNT CLOSURE/PREMATURE CLOSURE FORM (SB-7A)

Pay Rs.(In figures)
(In words)
Please pay to self/messenger whose name and
signatures are given below) the sum of Rs. (In
words) Rs. (In figures) shown as balance
in my passbook plus/minus interest/recoveries as
admissible under the rules
PASSBOOK MUST ACCOMPANY THIS FORM PAYMENT ORDER
APPLICATION SIDE (For office use only)
(To be filled by depositor) Date
Name of Post Office Payment deta il
I Principle amount Rs.
Type of acc ount- SB/RDITD/MIS/NSS (tick the required + Interset due Rs.
category) - Recovery of overpaid
Account No. Interest Rs.
- Deduction if any Rs.
Date:- (in case of premature closure)
Total Amount due Rs.
Signature of Postmaster
Signature or thumb impression of depositor Date Stamp
ACQITTANCE
Name of Messenger (to be filled by depositor/messenger)
Signature of Messenger Received
Rs.:
(both in words and figures.)
Signature or thumb impression of depositor
IDate
Initial of PA Initial of APM I
Signature or thumb impression of depositor I(Required O"Y if payment is required through messenger)