To, The Sr

To, The Sr. Accounts Officer Directorate of Small Savings & Lotteries, Govt. of NCT of Delhi, 5 th Floor, N-Block, Vikas Bhawan, New Delhi - 110002. Sub:- Request for surrender of MPKBY/SAS Agency Code No. SS/....... Sir, Please surrender my above mentioned agency with immediate effect. My particulars are as under:- 1. Agent’s Name (in Block letters) 2. W/o, D/o, S/o 3. Date of Birth 3. Present Ad (Extractive summary — verify with official source.)