REFUND FORM 
                              Name of the Deposit Party:- 
         __________________________________________________________________
         No. & Date of                  No. & Date of               Remarks 
         Cheque/Demand     Amount of    Supply Order/    Amount of          
         Challan with     the deposit   Acceptance of    Refund 
         which the                      Tender/Rate      claimed.           
         deposit was                    Contract 
         made.                          relating to 
                                        the deposit. 
         __________________________________________________________________
             1                2             3               4          5    
         __________________________________________________________________ 






                    Received Rs._________________________________           
                    (Rs.___________) from the Pay & Accounts Office         
                    Min. of Works and Housing and Supply, New Delhi         
                    Mumbai/Chennai/Calcutta. 
                    Station: 
                    Date:                      
                                              Signature of the Deposit      
                                              party claiming the refund.    
                                             (Revenue Stamp to be           
                                              affixed where necessary) 

                    ____________________________________________________    
                                    For use in Accounts Office. 
                    Voucher No.      Classification       Amount of Bill    
                    Pay Rs._____________________________________________    
                    to__________________________________bank/Treasury       
                    Auditor         Accountant            Gazetted