(38283) For Prizes above Rs.

200/-
(Form PB-23B) and upto Rs. 10,000/- to
be used at P.D.O.S.
The Chief Manager,
State Bank of Pakistan,

Dear Sir,
PRIZE WINNING BONDSCLAIM FOR PRIZES

I forward herewith the National Prize Bond particularized below and

request you to kindly arrange for the payment of the prize money as the number
of the enclosed Bond has been declared in the Prize List of . . . . . . . . . . . . . .
draw held on the . . . . . . . . . . . . . . . . . . : -- (Number of draw)
(Date of draw)
Denomination of Bond . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
Series and No. of Bond . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
Date of Issue ........................................... .
Place of Issue ........................................... .
Amount of Prize money claimed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I am, therefore, entitled for the prize of Rs. . . . . . . . . . . . . . which may please
be paid to me at the State Bank of Pakistan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Name of City In Block Letters)

I declare that the above-mentioned Bond was purchased by me on or before

the .......................................................
(Date)
Yours faithfully,

Identity Card No.

(Please Enclose Photo Copy) Signature / Thumb Impression
- - of the Claimant

Address of the claimant:

Present .......................... Full name of the Claimant . . . . . . . . . . . . . . .
Permanent . . . . . . . . . . . . . . . . . . . . . . . . in Block Letters
Date: .......................... ....................................
Nationality . . . . . . . . . . . . . . . . . . . . . . . . . .

FOR OFFICE USE:-

Claim for Rs.
In order
Paid Cash
Pay Cash Stamp