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PMNRF Credit Card/Chq/DD Form

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Forms for Contributing through Cheque/ DD or Credit card to the Prime Minister's National Relief Fund from the link http://pmindia.nic.in/relief.htm

Form for payment through Cheques & Drafts

Cheque /Draft No : ____________________

Bank Name : ____________Branch :_________

Amount : _________ Amount in Words : ___________________________________

Kindly mail your Cheques / Drafts along with this slip to the PMNRF,
Prime Minister's Office, PO Box No : 5411, New Delhi 110011.

All donations are 100% exempt under Indian Income Tax Act

Receipt for donations received shall be sent by Post..

Form for payment through Credit Cards

Name       : ________________________________________________
                  ( As it appears on the credit card)

Address   : ______________________________________________

PIN ________________ Country ___________________

Phone ______________ (Off)__________________(Res)

Card       : Diners / MasterCard / VISA / AMEX

Card No. : - - - - - - - - - - - - - - - -

Expiry Date : - -  /  - - - -

    MM    YYYY

Amount   : Rs --   US$--   Euro--   GBP--   ..........................

Currency                   Amount

Amount in Words : _____________________________________________________

Date of Birth : - - - - - - - -
of Card Holder DD MM YYYY

Email Address : ________________________

Please make this donation to the Prime Minister's National Relief Fund. I will at no stage dispute this donation and I confirm that this Credit Card belongs to me.

______________________

Signature

(As it appears on credit card).

Card holders either mail this slip to the PMNRF, Prime Minister's Office P O Box No : 5411 New Delhi 110011 or Fax this slip to FAX no 91-44-8202221.

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