Annexure –II
Department of Posts, India
Name of the office..................................................................
LETTER OF AUTHORISATION
To
_______________________
_______________________
Designation of D.D.O.
I,___________________________________________________________(Name & Designation) being a Member of_____________________________________________(Name of Service Association) hereby authorize deduction of monthly subscription of Rs __________ per month from my TRCA starting from the month of July 2012 payable on 31/07/2012 and authorize its payment to the above mentioned service Association.
I hereby certify that I have not submitted authorization in favour of any other Service Association. If the above information is found incorrect, I fully understand that my authorization for the Association becomes invalid.
Station: Signature_____________________
Dated: - Name _______________________
Designation ____________________
.
To be filled by the Association.
It is certified that Shri/Smt ……………………………………………………………………………… is a member of …………………………………………………. (Name of Association.)
It is further certified that the above Authorization has been signed by Shri/Smt …………………………………………….. in my presence.
Signature____________________
Name (in Capital) ______________
of authorized Office bearer________
_____________________________
Signature
Name (in Capital)
of the member _________________