FORM JK/ED-12 [See rule 17(4)] Voucher No................... Renewal Statement Approved for the issue of stamps (detailed in col. 6) of the value of Rs...........................................(both in words and figures) and certified that the stamps described below, the renewal whereof has been allowed/have been destroyed/have been deposited in the double lock of the treasury. Place Dated Commissioner. ______________________________________________________________________________ Name Description of Value of stamps Date of Authority Description Value of stamps tendered in word and Application for of fresh applicant or renewed figures for renewal renewal stamps to be issued 1 2 3 4 5 6 7 Issue fresh stamp (described in col. 6 above) of the value of Rs..........................(both in words and figures). District..................... Dated....................... Head Treasury Clerk. Treasury Office Fresh stamps for the value of Rs........... (in words and figures) Received dated..................... Signature of Recipient.
