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Govt. of India Ministry of Communication & Information Technology Department of Information Technology National Informatics Centre Assam State Unit Training Division, Tripura Road, Jayanagar chariali, Beltola, Guwahati – 781028, Assam, India. Phone : 91-361-[228277 & 226123] Email : [email protected], & [email protected] DEPOSITION FORM [Consumable/Non-consumable] [To be filled in triplicate] Place of Deposition : Date of Deposition : / /2002 Serial Qty. Brought No. Item Name Item Sl.No. Deposited from Remarks

Name of the Depositing Officer : Employee Code : Designation : Place of posting : [Signature of Depositing official] [For use of NIC, ASU Stores only]

The Items mentioned under Sl.No. _____ to Sl.No. _____ above has been received in good condition.

Signature of I/C Stores NIC, Assam State Uint, Beltola, Guwahati-28.

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