Appendix E

(particulars to be filled up at the time of applying withdrawal from the Scheme)

    Received a sum of Rs.................. (Rupees .................. Only) from the Air Force Naval Housing Board as refund of money on cancellation of my registration of the Scheme, vide crossed Account Payee Cheque No.................... dated .................. of ..................................... (Bank).

Name .....................................
Rank ....................................
Service No. ....................................
Regn No. ....................................
Banker's Name and Account No. ..................
Postal Address....................