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    English PB 23

    Uploaded by

    Sheeraz Rasheed
    1. The document is a prize money claim application form for winning prize bonds submitted to the State Bank of Pakistan. 2. It requests payment of prize money for winning prize bonds and provides details of the claimant such as name, CNIC number, address and bank account. 3. It also includes an undertaking by the claimant stating that the bonds are genuine, information provided is true, and any discrepancies found later will result in refund of the prize money released.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    English PB 23

    Uploaded by

    Sheeraz Rasheed
    795 views2 pages
    1. The document is a prize money claim application form for winning prize bonds submitted to the State Bank of Pakistan. 2. It requests payment of prize money for winning prize bonds and provides details of the claimant such as name, CNIC number, address and bank account. 3. It also includes an undertaking by the claimant stating that the bonds are genuine, information provided is true, and any discrepancies found later will result in refund of the prize money released.

    Original Description:

    Prize Bond Claim Form

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    1. The document is a prize money claim application form for winning prize bonds submitted to the State Bank of Pakistan. 2. It requests payment of prize money for winning prize bonds and provides details of the claimant such as name, CNIC number, address and bank account. 3. It also includes an undertaking by the claimant stating that the bonds are genuine, information provided is true, and any discrepancies found later will result in refund of the prize money released.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    795 views2 pages

    English PB 23

    Uploaded by

    Sheeraz Rasheed
    1. The document is a prize money claim application form for winning prize bonds submitted to the State Bank of Pakistan. 2. It requests payment of prize money for winning prize bonds and provides details of the claimant such as name, CNIC number, address and bank account. 3. It also includes an undertaking by the claimant stating that the bonds are genuine, information provided is true, and any discrepancies found later will result in refund of the prize money released.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    PRIZE MONEY CLAIM APPLICATION FORM - (PB-23)

    Date
    The Chief Manager,
    CHECK LIST (please mark )
    State Bank of Pakistan,
    SBP Banking Services Corporation Original and Copy of Prize Bond
    Photocopy of valid CNIC/SNIC (original seen)
    __________________________
    Two Signatures on reverse of Original & Copy of Prize Bond
    Dear Sir,
    I enclose herewith the _____________ Number of National Prize Bond(s) of Rs. _______________ denomination
    particularized below and request to kindly arrange payment of the prize money as the enclosed Bond(s) has/have been declared
    winning in draw mentioned there against.

    CLAIMANT INFORMATION
    Name
    (as per CNIC)

    CNIC/SNIC No. - - CNIC/SNIC Expiry Date

    Address
    Contact No.
    Taxpayer Status Filer Non-Filer Email ID
    PRIZE BOND DETAILS
    Prize Bond Details Date of Draw Place of Amount of Prize T-24 System ID
    S. No.
    Series Serial No. Issue No. Issue Money (PKR) (for office use only)
    1
    2
    3
    4
    5
    6
    7
    8
    9
    10
    Total Prize Money (PKR)
    MODE OF PAYMENT OF Up to PKR 18,500/- Cash only Bank Credit
    PRIZE MONEY PKR 93,000/- & above Bank Credit
    BANK ACCOUNT DETAILS
    Bank Name Branch Name
    Account Title
    IBAN P K
    UNDERTAKING
    I hereby declare and accept that:
    1. The National Prize Bond(s) presented by me for prize money claim is/are “Genuine”. In case the bond(s) is/are found forged/tampered, SBP BSC (Bank)
    reserves the right to take legal action against me as per the relevant laws.
    2. The information provided above shall deemed to be true & complete and any misinformation/incorrect details or concealment of facts of any nature
    whatsoever by me can result in legal action against me as per the relevant laws. In case of change in any of the aforementioned information including
    taxpayer status i.e. Filer / Non-filer, it shall be my responsibility to inform in writing the respective SBP BSC office immediately.
    3. The aforementioned bank account is maintained singly in my name at the bank as stipulated above.
    4. Any discrepancy found in the above bond(s) at later stage, the amount of prize money so released would be refunded by me.
    5. The Withholding Tax on prize money amount will be deducted at prevailing rates.

    ________________________________________ __________________________________________________
    Signature / Thumb Impression of the Claimant Officer/S.O. (Original CNIC/SNIC Seen by SBP BSC Official)
    DO NOT WRITE BELOW THIS LINE / FOR OFFICE USE ONLY
    No. :- KHI/LHR-_________________________________________________ PAID CASH STAMP (Upto Rs. 18,500/-)
    Date of receipt of claim ___________________________________________
    System generated acknowledgment receipt issued to claimant:
    YES (No.___________________) NO (Reason)_________________
    (PB-23) (To be filled by the SBP BSC Office). The particulars of Prize Winning Bond detailed below of Rs. __________________ denomination attached with the claim application have been verified from our
    record and found in order in all respect / not found in order. The condition of the Bond is accepted / is not accepted.
    Prize Bond Details Draw Amount of Withholding Tax Net Amount Bank Credit Details
    S. No. T-24 System ID
    Series Serial No. No. Prize Money Rate Amount (PKR) Payable (PKR) FT Number Date
    1
    2
    3
    4
    5
    6
    7
    8
    9
    10
    Total
    Prize money claim of aforementioned prize winning National Prize Bond(s) is admitted / rejected.

    Officer Senior Officer ACM (PBU) IMU Official DCM/CM Officer / Sr. ACM (PBU) IMU Official
    Officer
    CLAIMANT’S ACKNOWLEDGEMENT FOR OFFICE USE ONLY
    Received [please tick ( ) the relevant]: Payment made vide:
    I authorize SBP BSC office to credit the prize money amount as well as face value (if applicable) to my bank account as provided on obverse side. Bank Credit
    Cash Rs. ________________________ (Rupees______________________________________________________________________) for prize
    Cash
    money and face value/bonds (if applicable) against ________________ prize winning bonds.

    Claimant’s Signature -1 Claimant’s Signature -2 Signature Verified

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