Stock Holding Corporation of India Limited

Registered office : 301, Centre Point, Dr. Babasaheb Ambedkar Road, Parel, Mumbai – 400012
VER 1.0 301014
Visit us at : www.shcilestamp.com
Form - 4 [See rules 24,26(2) & 29]
Application Form For e-Stamp Certificate /Additional e-Stamping Certificate
For Government of Punjab Date : / /20

ACC ACC Id

Document Description Article Stamp Duty Amount ` Indian Rupees only

Property Description / Property Address (not exceeding 100 characters)

(not exceeding 100 characters)

Consideration Amount (if any) `
Details of First Party and Second Party / Authorised Person
Name & Address of (name not exceeding 50 characters)
First Party
Phone
Name & Address of (name not exceeding 50 characters)
Second Party
Phone
Name & Address (name not exceeding 50 characters)
Purchaser/
Authorised Person Phone

Stamp Duty Paid by ( Tick) q 1st Party q 2nd Party

Stamp Duty Payment Details
Mode of Payment q Cash q Cheque q DD q Pay-Order q NEFT q RTGS q Account to Account Transfer

Cheque / DD / Pay-Order / NEFT / RTGS / Account Details Cash Deposit `

Bank Name Branch Name Cheque /DD /PO /UTR /REF/Account No. Deno. Pieces
1000 X
500 X
100 X
50 X
20 X
10 X
5 X
Rupees ( in Words ) : 2 X
1 X
Total
1. Please submit the duly filled and signed form along with stamp duty amount at the e-Stamping counter 2. Stamp Duty amount should be rounded off to the nearest Rupee.
3. The correctness of Article type and Stamp Duty amount cannot be confirmed at the e-Stamping counter 4. Once the e-Stamp is generated no modifications/changes are
possible, so carefully check the preview of the e-Stamp and only then sign the preview 5. Cancellation charges are applicable as levied by the State Government 6.While
generating Additional e-Stamp Certificate details of the base certificate cannot be changed

I have read and understood the above instructions and the above information furnished by me is true to the best of my knowledge, thus, the:
(i)  e-Stamp Certificate of above amount may please be issued/or (ii)  additional e-Stamp Certificate of the above amount, in continuation of previous
Certificate No. __________________________________ dated __________________ may please be issued.

Date : Signature of the Purchaser / Authorised Person :

(For Office use only)
To be filled by USER To be filled by SUPERVISOR
SUBIN Certificate Number IN
Acknowledgement of e-Stamp Certificate to be kept by the ACCs

The e-Stamp Certificate of ______________________________________has been received by Sh./Smt./_______________________________________________________

today on ______________.

Signature of the Purchaser / Authorised Person : ----------------------------------------------------------

---------------------------------------------------------------"-----------------------------------------------------------------------"-------------------------------------------------------------- "-----------------------------------------------------------------
SHCIL E-Stamping Receipt (To be filled in by the client)
Name of Stamp Duty
Stamp Duty Paid by q 1st Party q 2nd Party
Purchaser/Authorised Person
q Cash q Cheque q DD q Pay-Order q NEFT
Stamp Duty Amount ` Type of Payment
q RTGS q Account to Account Transfer
Cheque/ DD/ PO/ UTR/ REF/Account No. Date: / /20

Bank Name Branch Name

Counter Signature with Seal

Note: Once the e-Stamp has been generated, payment cannot be cancelled or refunded by SHCIL or ACC. The refund or allowance for 'spoiled' or 'misused' or 'not required for
use', e-Stamp Certificate can be made by the Collector of the District in accordance with Chapter-VII of Punjab e-Stamp Rules, 2014.