(1)
(38216)
(Form PB-23)
FOR THE PRIZES
UP TO RS. 18.506/-
Instructions regarding documents required with claim form:
The Chief Manager,
State Bank of Pakistan,
SBP BSC (Bank),
a) Original Prize bond duly signed at back side by the claimant (2 si!;natures).
bJ Photocopy of the Prize Winning Bond duly signed at back side by t,~e clairr.ant (2 signaturss).
cJ Photocopy of Valid CNICISNfC. Claimant is required to bring original CNICfSNIC at the time of
payment. If CNICISNIC is expired, attested copies of NAORA receipt'token and ex,:ired CNICI
SNiC may be attached, otherNise claim will not be entertained except claimant is above fi!;e 6S
(for senior citizen only.)
dj Signature on original and copy of prize bond as at (a&bj socve should be same as
appearing on CNIC/SNIC of the claimant.
e) Claim for prize money should be lodged by the holder l1erseiflhimself.
Dear Sir,
PRIZE WINNING BONDS -- CLAIM FOR PRIZES
Won in Draw No.
I submit herewith the National Prize Bond(s) of Rs.
dated
_
particularized below, and request you to kindly arrange for payment of prize money»
Series
Sr.
No.
Bond Number
Date of
Issue
I
I
1
2
I
Amount of Prize Money Claimed
(Rs.)
Place of
Issue
I
I
II
3
I
I
I
4
5*
I
Total Amount
* For more
than five (05) Bonds overleaf may be used.
Computerized National Identity Card /SNIC No.
~~
__ ~~
__ ~~
__ -L __ ~~
__ ~~
__ ~
I declare that the above mentioned bond/s was/were purchased by me on or before the
__ L-~
__ ~~
--rr:"",,-
20
(date)
Yours faithfully,
Signature/Thumb Impression of the Claimant
Present Address:
Full name of Claimant
in Block Letters:
-----------------------
Penn anent Address:
_
Nationality:
Date:
_
Claim for Rs.
in order
_
_
Cell/phone No:
FOR OFFICE USE
Pay Cash
A.T.O
Received
Rs.
T.O.
prize money
(Rupees
along with
(and Face Value of bonds, if applicable)
of
only),
Prize Winning Bonds (if applicable).
PAID CASH STAMP
Signature/Thumb
Impression ofthe Claimant
(2)
Series
Sr. No.1
Bond Number
Date of Issue
Place ofIssue
I
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Total Amount
Amount of Prize Money Claimed
(Rs.)