FORM C
Certificate of interest
[See paragraph 7(4)]

State Bank of India, Branch . .
Site Restoration Fund Scheme, 1999

Name of the deposit office
Deposit Account No.
Name and address of the depositor :
Certified that gross interest amounting to Rs. (in figures) (Rupees )
(in words) has been credited to the above deposit account during the financial year ended 31st March, .
Place :
Date : Signature of Officer-in-Charge
(Seal)