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
Date : / /20
For Government of Punjab
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)

Area of Property (Choose any one)

1. Acre Kanal Marla Sarsahi 4. Square Yard
2. Bigha Bishwa Biswasi 5. Square Meters
3. Square Feet 6. Not Applicable

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 (ü 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
2000 X
500 X
200 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) q e-Stamp Certificate of above amount may please be issued/or (ii) q 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.