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Format of Application for Locker Surrender

Birth Certificate Affidavit FormatTo,
______________ Branch

Locker Surrender/Discharge Certificate

I/we hereby certify that I/we have this day withdrawn all the property belonging to us, stored in locker number _______, key bearing number ____ leased on _______, and that the locker and its key are hereby surrendered in token of termination of the lease.


(Name & Signature of hirer/s)

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