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.