FORM 'I' (See rule 8) Register of refund and renewals of damaged or spoiled entertainment stamps. Serial No. D a t e o f a p p l i c a t i o n f o r r e f u n d o r r e n e w a l W h e t h e r t h e a p p l i c a t i o n i s f o r r e f u n d o r r e n e w a l N a m e a n d a d d r e s s o f t h e a p p l i c a n t Date of purchase of stamps N u m b e r o f s t a m p s t e n d e r e d f o r r e f u n d o r r e n e w a l D e s c r i p t i o n o f s t a m p s ( d i f f e r e n t r a t e s ) F a c e v a l u e o f s t a m p s o f e a c h r a t e T o t a l v a l u e o f s t a m p s ( o f a l l r a t e s ) V a l u e o f s t a m p s r e t u r n e d i n r e s p e c t o f w h i c h r e f u n d o r r e n e w a l i s r e f u s e d F a c e v a l u e o f s t a m p s a d m i t t e d f o r r e f u n d o r r e n e w a l Amount deducted from the f a c e v a l u e o f s t a m p s a s p e r r u l e 6 o r R u l e 7 ( c ) N e t a m o u n t o f r e f u n d a l l o w e d o r a m o u n t i n l i e u o f r e n e w a l o f s t a m p s V a l u e o f s t a m p s a l l o w e d t o b e r e n e w e d H o w t h e r e f u n d o r r e n e w a l i s m a d e w i t h r e f e r e n c e t o i t s d a t e S i g n a t u r e o f r e c i p i e n t o f r e f u n d o r r e n e w a l o f s t a m p s A t t e s t a t i o n b y t h e O f f i c e r c o n c e r n e d R e m a r k s 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 [Published in Government Gazette (Supplement) No. 21, Series I, dated 21-8-1965]