PAGE NO.2 DECLARATION. I solemnly declare that the particulars given above are correct.

I further undertake that if any particulars given by me are not found correct at any stage, I may be liable to any action that the Bank may like to take against me. ---------------------------------Signature of the employee Design _______________ Place of posting ___________ Dated ---------------For use at the branch/office/department I certify that I have seen the original documents and satisfied with the genuineness of the request. I recommend that a sum of Rs.________/- (Rupees ____________________) may be sanctioned to the applicant by way of educational stipend, in terms of Head Office, Circular No. ADMN/PER/74 dated 18-03-1974, a period of _______________ with effect from ________________. --------------------------------Signature of the employee Desig _______________ Place of posting _______ Dated -------------For use at Zonal Office/Principal Office/ Staff Relations, Head Office. In the light of particulars, as furnished and certified above the educational stipend of Rs.___________/. Per month sanctioned for a period of ____________ years, With effect from _______________. ____________________ Competent Authority Signature, designation & rubber stamp. Dated ____________ 1. Original copy for the branch/office/department. 2. II copies for the Zone/Principal Office/Staff Relations Department Head Office. 3. III copies for the Finance Division, Head Office. 4. IV copies for personal file of the employee.