WHEREAS Shri A, son of Shri……………resident of…………….is indebted to me for a sum of
Rs……………..under a bond dated ……………..AND WHEREAS I am, willing to assign a sum
of Rs . ………………. out of the said sum of ……………..due from Shri A under the bond dated
……………..to Shri. B.
Now I……………..of ……………..hereby assign unto B son of………………….resident of
……………..a sum of Rs ……………..and the B……………aforesaid is now entitled to receive
the sum of Rs…………… as aforesaid from the said A and give discharge therefor under his
receipt.
The aforesaid A has consented to this assignment and has subscribed his signature
hereto.
Dated at…………….. this ……………..day of…………….. 20……………..
…………….. ……………..
A

C