PHILATELIC DEPOSIT ACCOUNT

APPLICATION FORM

Simply complete this form and return it to us to set up your mail order account with us.

PERSONAL DETAILS

No :.....................................Rank :..............................Name of the applicant:...................................................................

Mailing Address : ..........................................................................................................................................................

...........................................................................................................................................................

Pin .............................................................

Name of recipient (if different from above):....................................................................................................................

Delivery Address :..........................................................................................................................................................

...........................................................................................................................................................

Pin .............................................................

Mode of Payment (minimum Rs. 200/-)

Part II Deposit in SB A/C No. 001444

Bank Cheque(Delhi Cheque only)*

Demand Draft*

Postal Order*

No.................................................Date:........................................Amount...........................

* Payable to OIC (Phil) , 1 CBPO

(Please tick)

ORDER FORM

Date : Signature of applicant.

N.B.

1.      Please ensure that there is sufficient balance in your a/c to ensure regular receipt of new issues.