FORM IV

(See Section 8(4) and Rule 9)

Place :
Date :

The Registrar of Chits,

Dear Sir,

In terms of sub-section(4) of Section 8 of the Chit Funds Act, 1982 (Central Act No. 40 of 1982) we hereby seek approval for appropriating sum of Rs. ___________ (Rupees ________________________________in words) company. This withdrawal has
been necessitated by the following circumstances:

(Here state the circumstances under which withdrawal from the reserve fund has become necessary).

2. We enclose for your information a copy each of the profit and loss account and the balance sheet for the last two accounting years as also a proforma of the balance sheet and profit and loss account for the current year ended______20___ . A true copy of the resolution passed by the managing Committee / Board of Directors on the for appropriation of the said sum from the reserve fund is also enclosed. We shall be glad to furnish such further information as may be required by you.

3. We remit herewith a sum of Rs ____________(Rupees __________________________ only) being the fees prescribed for the purpose.

4. We shall be glad if you will kindly grant us permission to withdraw a sum of ___________________ from the reserve fund.

Yours faithfully,
Chairman
Secretary
* (for and on behalf of Company)

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* enter the name of the applicant / company.