Form V

FORM V Sl.No

Amount

Name and Address of Creditors

Date of Incurring Liability

Details if Transaction

Date: Note: 1) Individual item of loans not exceeding three months emoluments of Rs.1000/ whichever is less ,need not be included. 2) In column (6) information regarding permission if any obtained from of report made to the competent authority may also be given. 3) The Terms emoluments means pay and allowance received by the govt.Servent. 4) The Statement should also include various loans and advances available to govt.servents like advance for purchase of convance, house building advance etc.. other than advances of pay and travelling allowance ( advance from the general provodent fund and loans of life insurance policies fixed Deposit)