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Anplication Resubmission Forrn

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Tc/Name: l4l4ALjI4l4
lqar/ qld flq/Father/Husband Name:
4i1
iiq lilrli/Date of Birthr 15 08 I990
rllAddress 1: :,
-: e
Pondil
qar/Address 2: PONDIL
fndr/Distnct: Au{gL 1
1ii +lB,/pnrcode : EELIZL
qTw/Siare, !]!el: ,lB qr rrr*x ol/Sign
across the photo
dr 3rF rar I./CRN No., 2307310066280i-R
$ im,iti iAIa/cRN Date,
AdIT 3IfqN fr}g i{ GFT/CuTTeDI Aadhaal Seeded BanKI DAKSHIN BIHAR GRA}{IN BANK
s-.rIt4Fa - i]- \- ,.l L^. Dorp I , I/ 0 ,l

]lq ril<q/qdfeq oe ar sir/Madam,

q IAMAL ALAI,,l:lF,FE-d EFli qi 1+, n qAa n rr 4=T
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I
IAN{AL ALAM do hereby.,nish to resubmil Lhe follo\\,ing claims, ivhere I have been
communicated deficiencies. I acknor{lcdge thal. lhe fbllou,lnqr clairns i,vill be processed fufthcr
,'_or,rnq 1..h. d.r" tutri-nad ll m-.

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 qlqql / Declaration
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(lb be uade by the depositor)

i TAN,IAL ALA.NI loqdT{ Ei,rn 4{iT ifu q Humara lndia CrediL Cooperative Socictv Linited oT rIfr
]Ilfidrr l".T.df/{<E 6 r,tr r+ fi3rr.er.rr -fl.{ ]i.i;s fr-Caittr.l.i] 3nqcc (cRN No 23073100662801-R ) q
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I iAl4AL AL{M
hereby de.larc that I am a genuine depositor/ncmbe. of EgEq!g-!44!g-.ll!edi]
Cooperative So{rietv Limited and ha\.c made legitimal.e deposits in this/these So(riety(ies) as per
the details gi\reo my applicatioD form (CRN NO 23073100662801-R )submitted in the CRCS
Sahara Jlefund Portdi.

2.tsc{s trir IFnr +fi ."r-lrfirlt efq l?em n eq sir vS i dr ti aqi qq :ir eli or qE er+q l?qr t :o qrt di
il tm Hurnara India Crcclit Cooperal.ive Societv Lrmite.l tt dq 3rq i FErr ;Ec olffiftq M ia.,
cn*r.=; qeE1rl{ {fiq{d ,rcffii sgE4 ft., "r'rqr:{ dt ecl{ 5134 itBc qn3iiqllZq @t F , qiaqn +r err ;i
t
FiI'q 22.03.2or2 [{A ,l{ Ed T.drr,J$ 6l3i.rtfas M
ft., t<wn fi Ecn ii l?{rsr 29.03.2023 c.ii }
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2. The aforesaid infbrmation crlvcn above is true aDd correct Lo the best ofn1y knowledgc and
bclief an{i I have provided true proof of my deposit and dai r- The said deposit(s) were made by
n1e in the Humara li1dia Credi out oi my legitimate income befole
22-A:J.2022 in case of Sahara Credit Cooperative Soclety Ltd., Lucknow, Saharayn Universal
!iuliiprr?ose Society LLd., Bhopal and Hurnara india Llrcdit C.roperal.ive Society Ltd., Kolkata and
befole 29.03.2023 in case of Slars Mdtipurpose Cooperative Society Ll.d., Hyde.abad an(i in
compliance u,ith relev:lnt Income Tax Laws-

3..i q6 3nicr (CRN No 23073100662801 R ) F'i3T{F\,H R+,3 {fl{ ite i

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3.I arr re subrritting this application (CRN No 2307:1100662801-R ) ln r-esponse to thc deficiency
iDtination received lrom the CRCS Sahara Refuncl Portal. I understand that the CRCS-Sahara
Relund Portal (Resubmission) shall p.ocess only lhose claims for which l have updated the
informatlon in this Portal and gelerated this resubnissior application fbrm. I also ondeNtand that
the processing of the claims in this poital shall be based on the infbrmation alreadv shared by the
Sah.rra Sociel.ies Lo CRCS for. the CRCS-Sahala Refurd Pofial.

a.cii + q1q ftig $ {{ir qE iilda qr lie4r F aa eLii t d { oq.qrs sfti (]?d {t.s 6l
sqf6 ericn ,1{] + *.€
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4.ll any of the inlbrmation giver by me in the above appli.ation fonn is subsequentl,v proven to be
incorrect or false, I hereby underlake to retum the retunded amount along \ ith the applicable
interest to 'Sahara CRCS Refund Account' and indemnify the "Sahara CITCS RefuDd Account' to
tilc said extent. I shall also not puNue Lhe claim ir othel fotums to the exteDt it is settLed by the
'Sahara-CRCS Refund AccouDt'.

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 | c AL _AM.q6ql E l} JnBq grm- (Frrd 50,000/- irm) llF {{i 6T 3tFltc +s i=dl * 1} ;nr gr <rct
IA\{ r
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T{i e iP qlt d EFnirn rFilltr drtfiq !-Jffi :F Frrr qrfl lA! d, eJ qd o)l or-lqfu tE E t,@ as@nfrl
w ary, ffi g;z ait aul 50,oaa/- tl 3tQo l) "rn

*5. I_IA\! t 4I4l4 alJree that receiving pafi pavment (Upto I50,000/-) does rol mcan that the
eolire claim has been accepted and if r-equired, I would furnish sLLch documelt.s as may be
requiied for fu her processing of clai.ns and I have Do obiecti.jfl if iliese documenis afe share
wrth rele\,anl statutory aulhorltles-(*Applicable for depositors, whose aggregate elain
aniouDt is nlore than Rc.50,OOO/-)
6.{s+ 3rif!i6, flffi esiqdr zn ftear rrgd 6i een { orT{ a a5er 1t,F't ffi+a zn 3nqirfqa Eiiq ed ,.1 q sfllrld
tEn

6.Fufiher, I shall also bc liable ibr any civil or criminal acljon in accordance \,vith law in case of
any ialsehood or nlisrepreserltation.

odfg/Date, Sun Dec 15 qqIf,df fl E={drerySl gnature

'2024 of ljopo.t'ot: '-- -a;1 t-
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u
. Ha*""c. .,Fr@dl 6T
q/Name of
DepositoT: TAMAL ALAM

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