Annexure -A

PREMIUM PRIZE BONDS APPLICATION FORM

STATE BANK OF PAKISTAN Date D D - M M - Y Y

BANKING SERVICES CORPORATION
REQUEST TYPE
_______________________ Office Purchase Encashment Transfer

APPLICANT PERSONAL INFORMATION

Details Applicant 1 Applicant 2
Name
CNIC/POC/
- - - -
NICOP
Mobile #

FOR NEW REGISTRATION ONLY

Bank Account Details
IBAN P K

Account Title

Bank Name Taxpayer Status Filer Non- Filer

Operating Instructions (For Joint Investment Only) Contact Person
JOINT-A: Payable to holders jointly or either with written
Name
consent of the other
JOINT-B: Payable to either or survivor Mobile

FOR PURCHASE OF PREMIUM PRIZE BOND

Number of Bonds Required Payment Details
Denom. Pieces Value (Rs.) Cash
25,000/- Cheque/Pay Order/DD No.
40,000/- Bank Name

Amount(Rs.) Signatures & Stamp of

Total Authorized Officer

DETAILS OF PREMIUM PRIZE BOND (For Encashment/Transfer)

Denom. Series From Serial Number To Serial Number No. of Bonds Date of issue Office of Issue

FOR TRANSFER PURPOSE ONLY

Details Transferee 1 Transferee 2
Name
CNIC/POC/
- - - -
NICOP
Mobile#
 Terms & Conditions
1. This Scheme is governed under Premium Prize Bonds (Registered) Rules 2017.
2. All payments with regards to Prize Money, Profit and Face value (as the case may be) will be credited to the bank account number
provided by the applicant in this application form. Any change in the account number, the applicant shall immediately inform the Bank.
3. Bank account number provided by the applicant must be in his/her own name cannot be of any other person whatsoever.
4. Accounts maintained with Islamic Banking Institutions (i.e. full-fledged Islamic Banks, Islamic Banking Subsidiaries of Conventional Banks,
Islamic Banking Branches and Windows of Conventional Banks) shall not be accepted for the purpose.
5. Face Value of Bonds will be credited to the Account Number provided in the application form. By opting the direct credit to Bank account, the
investor(s) authorizes the Bank / Office of Issue to credit the applicable amount in the Bank Account number available in the record of Office
of Issue.
6. The signature of applicant(s) must be as per the CNIC/SNIC/ NICOP/POC provided.
7. The facility of Transfer of Bonds shall only be available to individual investor(s). Transferor of bonds before the completion of six months
period either from date of issuance or date of last profit paid will not be paid any profit for the broken period. Transfer of prize winning
bonds from one person to another will only be allowed subsequent to settlement of outstanding prize money in the registered investor’s
account. After transfer of title, the Transferor shall relinquish all his claims in terms of principal, profit and prize money (if any).
8. Any cutting/overwriting/mutilation must be authenticated by the applicant with full signatures as per CNIC / SNIC/ NICOP/ POC. Further,
application form(s) with more than two cuttings/overwriting will not be accepted.
9. Any misinformation or incorrect details or concealment of facts of any nature whatsoever, the applicant shall be held responsible.
10. I/we have read & understood the terms & conditions as mentioned above and shall comply with the relevant rules and regulations in letter
&spirit.

I hereby declare that the information provided in this application form is true & complete.

Applicant 1 / Transferee 1 Applicant 2 / Transferee 2

Signature Signature

Name Name

DOCUMENTS TO BE ATTACHED WITH THE APPLICATION FORM

FOR PURCHASE FOR ENCASHMENT FOR TRANSFER
Copy of Valid CNIC/ SNIC/NICOP/POC of
Copy of Valid CNIC/ SNIC/NICOP/POC
Copy of Valid CNIC/SNIC/NICOP/POC Transferor.
Copy of Valid CNIC/ SNIC/NICOP/POC of
Account Maintenance Certificate
Original Premium Prize Bond duly Transferee.
mentioning IBAN number not older
signed on reverse. Account Maintenance Certificate
than one month (One time for
mentioning IBAN number of Transferee
registration purpose only).
(Not older than one month).

FOR OFFICIAL USE ONLY (Purchase/Transfer)

The following Premium Prize Bond(s) have been issued/transferred to the investor(s)
Denom. Series From Serial Number To Serial Number No. of Bonds Total Value Date of Issue

_____________________ ______________________ ______________________

Inputter Authorizer 1 Authorizer 2
FOR OFFICIAL USE ONLY (Encashment)
The particulars of Premium Prize Bond(s) mentioned above have been verified from our record and found in order in all respect.
The PPB(s) encashment amount of Rs.________________________ has been credited to the claimant’s registered bank vide FT no.
_____________________.

_____________________ ______________________
Inputter Authorizer

ACKNOWLEDGEMENT

I have received Premium Prize Premium Prize Bond(s) are transferred I authorize SBP BSC to credit the
Bond(s) purchased by me/us and registered on my name amount in my registered account in lieu of
Premium Prize Bond(s) encashed by me/us.
Applicant 1 / Transferee 1 Applicant 2 / Transferee 2

Signature Signature

Name Name