FORM XVI

FORM – XVI 

 (See Section 23 and Rule 25) 

 Original 

 Duplicate                                   Receipts                                               Serial Number 

 Received from ________________ to the credit of ________________ the amounts detailed below in respect of the Chit Agreement registered under number of ______________ 200 ________. 

                                                                                                                            Rs.             ps. 

 Payment for current installment 

 Arrears of subscription (with details) 

 Penalty for overdue subscription 

 Fees for inspection of records 

 Other receipts (to be specified) 

           ______________________ 

 Total 

   ______________________ 

 (in words Rupees _______________________________________ only) 

 Date 

 

 for and on behalf of foreman 

 ……………………………………………………………………………………………............................. 

 Note: Strike out / delete whatever is not applicable. Insert the designation(s) as may be appropriate to the applicant.