DECLARATION

                                                           Annexure-II

                     No.13/01/2010-SR
              Ministry of Communications - IT
          Department of Post - India, SR Section

                LETTER OF AUTHORIZATION


To
The Superintendent of Post Offices,

............................
(Designation of Divisional Head)

     Through the DDO/Postmaster................... HO


 I ...................................... (Name and designation)

being a member of ............................... here by authorize
for deduction monthly subscription of Rs.30/-( Rupees thirty only) per
month from my saray starting from the month of July 2012, payable on
31-7-2012 and authorize its payment to the above mentioned service
Association.

         I here by certify that I have not submitted authorization
in favour  of any other Service Assoication.  If the above information
is found incorrect,  I fully understand that my authorization   for the
association becomes invalid.

Station :                         Signature :

Date     :                        Name of the member:
                                  Designation :

---------------------------------------------------------------------------

                      To be filled by the Association

 It is certified that Shri/Smt ........................................ is a

member of ..........................................................

 It is further certified that, the above authorization has been signed by

Shri/Smt............................................ in my presence


Signature :                         Signature :

Name (in capitals)                 Name (in capitals) ...............
of the member                      of authorized office bearer
                                     (Divisional Secretary)

                    Divisional Head's Attestation