Annexure 1, 2, 3 and 3A for Post Offices in connection with Exchange of Rs.500/- and Rs.1000/

Annexure-1

Report from BO to SO as on 8.11.2016 (only for this date)

Sl No	Name of the BO	Denomination received from BO, which were available at the close of 8th November 2016 (D day)			Denomination at SO at the close of 8th November 2016 (D day)			Total
		500	1000	Total	500	1000	Total

Name of SO                                                                                                                 Dated

Sl No	No of notes received for exchange			No of notes deposited in one's own account			No of notes deposited in other account			Total (A+B+C)
	500	1000	Total (A)	500	1000	Total (B)	500	1000	Total ©

Name of the SPM _________________________________

Signature of the SPM ____________________________

Date:___________________

Place:_____________________

Report from HO to Divisional Office

Name of HO *                                                                                   Dated

1	2			3			4			5			6
Sl No	Denomination available as on close of 8th November 2016 *			Denomination received from SO, which were available at the close of 8th November 2016 (D day)*			No of notes deposited in one's own account at HO			No of notes deposited in other account at HO			Total (A+B)
	500	1000	Total	500	1000	Total	500	1000	Total (A)	500	1000	Total (B)

* Information to be given for 8th November only. From 10th November this will be blank and information from column 4 to 6 only to be provided

Name of the Postmaster _________________________________

Signature of the Postmaster ____________________________

Date:___________________

Place:_____________________

Annexure-2

Request Slip for exchange of Withdrawn Old series of banknotes *

in denomination of Rs 500/- and Rs 1000/-

Name of the Post Office :_________________________________________________________

Name of the Tenderer (In capital Letters)
Identity Proof Original to be shown at the counter (Tick the one applicable)	Aadhar Card,  Driving License, Voter ID Card, Pass Port, NAREGA Card, PAN Card,  Identity Card Issued by Government Department, Public Sector Unit to its Staff,
Identification  Number (Number mentioned in the Identity Proof submitted)
Details of Withdrawn Old series Notes submitted for exchange	Denomination No of Pieces Value Rs. 500 Rs.1000 TOTAL Total value in words:
Signature of Tenderer
Place: Date:

* To be supplied to members of public

Annexure-3

Format for reporting daily exchange of bank notes in the denomination of Rs 500/- and Rs.1000/- to the Divisional Office

Name of the HO/SO:__________________________       

The banknotes exchanged at the HO/SO  on _____________ are as under:

Denomination	Number of Pieces	Total value
Rs 500
Rs 1000
TOTAL

Name and Designation of the Post Office In-charge _________________________________

Signature of the Post Office In-charge ____________________________

Date:___________________

Place:_____________________

Statement enclosed in Annexure-3B, Annexure -3C & Annexure -3D

Annex-3A

Format for reporting to Circle Office on a daily basis the exchange of bank notes in the denomination of Rs 500/- and Rs.1000/-  at the branches of the post office

Name of the PMG:____________________________

The bank notes exchange\d during the day ___________________ are as under:

Denomination	Number of Pieces	Total value
Rs 500
Rs 1000
TOTAL

Name and Designation of the Reporting Officer _________________________________

Signature of the Reporting Officer ____________________________

Date:___________________

Place:_____________________