PLEDGER’S LETTER OF AUTHORITY

To
The Secretary
Karassery Service Co-op. Bank Ltd.,
Karassery P.O. Mukkam - 673 602

Dear Sir,

Sub : My Gold Loan No.................................... dated ....................... for Rs................................

I .............................................................................................................................................
.................................................................................................................................................................
request you to kindly handover to Sri/Smt.........................................................................................
................................................................................................................................................................
who is related to me as ........................... the under mentioned jewels pledged by me in your Bank under
Gold Loan No ........................................ dated ................................... for Rs................................. on
payment of the full amount with interest due thereon upto the date of delivery and on my own responsibility
on account of my personal inability to approach you in person for purpose of receiving the said ornaments.

I hereby agree that the Bank shall not be held responsible in the event of dispute and / or for any loss
arising from so delivering the ornaments to the messenger/representative irrevocably authorized by me,

1) Description of the jewels to be handed over :

2) Name and Signature of the representative :

3) Name and Signature of witnesses: 1)

2)

The signature of Sri/Smt ....................................................................................... is attested by me.

The token issued to me by the Bank relating to the gold loan is returned. I hereby declare that in connection
with the above the Bank shall not be responsible in any way whatsoever.

Place: Sign :
Date : Name of the borrower :

KSCB/GL04/01