FORM 3
[See rule 15(2)]
INDIAN POSTS AND TELEGRAPHS DEPARTMENT
Form of application for cancellation or variation of nomination previously made in respect of savings certificates under section 6 of the Government Savings Certificates Act,1959
(This Form will be filled in by the Holder and submitted with the Certificate to the Postmaster of the office where the Certificate stands Registered)

Serial No. .
To
The Postmaster,
SPACE FOR POSTAGE STAMPS
Under provisions of section 6(1) of the Government Savings Certificates Act, 1959, I, ,the holder of Social Security Certificates detailed in para 3 below, hereby cancel the nomination previously made by me in respect of these certificates and registered in your office under No. dated .
In place of the cancelled nomination, I hereby nominate the person(s) mentioned below, who shall, on my death, become entitled to the certificate(s) and to be paid the sum due thereon to the exclusion of all other persons :
Sl.No. Name of the nominee Full address Date of birth of nominee
in case of minor
2. As the nominee(s) at Serial No above is/are minor(s), I appoint the following
person(s) to receive the sum due thereon in the event of my death during the minority of the nominee(s).
Name of the nominee Name and address of the person appointed
3. The certificates detailed below are enclosed :