SB 41
Department of Posts
Application for issue of Duplicate Passbook

1 Amount number and type (SB/CTD/TD)
whether minor public joint account etc and in
respect of CTD whether 5-10 or 15 years account
2 PO which account stands (with the name of HO
in brackets if the account is not at a HO)
3 Name(s) of Depositor(s)
4 Name(s) of father/husband/guardian/person
of authority operating accounts
5(i) Address of the Depositor(s) at time of
opening of the account
(ii) Present address of the depositor(s)
6 Date of opening account office at which
opened if different from that at Col.2
7 Date and particulars of the last transaction
in the account
8 Balance at credit after the last transaction
9 Name of the PO from which the account was
last transferred in the office shown at Col.2
where applicable
10 Date of circumstances of loss of passbook
results of efforts made to trace etc
11 Whether loss was reported to the police and
if so, with what results
12 Remarks
Affix Rs.2/- stamp as fee The particulars given above are true to the best of
my/our knowledge. A duplicate passbook may please
be issued to me. I shall surrender the passbook if
found, the fee of Rs.10/- has been paid by affixing
postage stamps, please score if exemption has been granted
Station :
Date : Signature(s) of depositor(s)
Guardian/personal Authority operating account
NB : If accurate information cannot be furnished in respect of column 1 to 8, available particulars may be
given.
FOR AFFIDAVIT USE
Part I
1 Has the account been traced in the ledger binder, index
to ledger cards/sub ledger and do the particulars furnished
by the applicant(s) tally with the records
2 Does the signature(s) of the applicant(s) tally with the specimen(s)
on record(s) if not has he/she been satisfactory identified
3 Is the register of undeliverable passbooks in safe custody and
the HO consulted and is the passbook available in the HO or
SBCO lying undelivered in the Sub Post Office?
4 If you consider further for laid down in rule 42 of chapter 6
of P&T Vol VI
5 If answer to 4 yes, result of enquiries made
Recommendation regarding a duplicate PB
Signature of APM/DPM (SB) HO
Date : with designation with stamp
Part – II Encl (In respect of application received from SO only)
1 Have the particulars of the accounts as given in the
application been verified with HO records
2 Is the register of undeliverable passbook in safe
custody and the safe custody at the HO been consulted
and is the passbook available in the HO
3 Recommendations of APM/DPM(SB) HO regarding
issue of the duplicate passbook
Signature of APM/DPM (SB) HO
with designation with stamp
Date :
Part III
Order of the Head Postmaster
Duplicate Passbook may/not be issued Signature of APM with designation stamp
Part IV Receipt for the duplicate passbook
Part V Received the duplicate passbook of account no………..
with a balance of Rs………..
Signature(s) of the Depositor(s)
Date stamp of the HO