FORM III - ACKNOWLEDGEMENT SLIP - Prevention of Money-Laundering (Forms, Search And Seizure or Freezing And The Manner of Forwarding The Reasons And Material To The Adjudicating Authority, Impounding And Custody of Records And The Period of Retention) Rules, 2005

FORM III [See sub-rule (2) of rule 8] ACKNOWLEDGEMENT SLIP Serial Number.................. Received a copy of the letter bearing Number................dated............ along with the reasons and the material containing pages.........from........[designation of the authority] on...........[date] at..........[time] [Signature of the Adjudicating Authority] Date: ................................................................................ [Name of the Adjudicating Authority] [Office seal] To .................................................................................... [Name and designation of the authority] Address....................................... ......................................................... .........................................................