ESIC Dental College, Gulbarga

ANNEXURE – 6A FORMAT OF BOND (FOR UG – MEDICAL / DENTAL STUDENTS in ESIC Colleges) (To be executed on Stamp Paper of value asapplicable under Stamp Duty Act. Duly Notarized) KNOW ALL MEN BY THESE PRESENTS THAT We (1) (Mr./Mrs./Ms.) …………………………………. (herein-after called the Bounden) Son / daughter / wife of ……………………………. residing at (Residential Address………………………………………….) and (2) Shri / Smt. …………………………………. (herein after called ‘the Surety / Sureties’) son / daughter / wife of ……………………………………….. residing at (Here enter address) ………………………………………… do here by bind ourselves and each of us & our respective heirs, executors & administrators jointly and severally to pay to the Employees’ State Insurance Corporation (herein after referred to as ‘the Corporation’) on demand the total amount of Rs. 5,00,000 (Rupees Five Lakh only) with interest @ 12% towards failure to fulfill the obligation / for violation of the condition here-in- after mentioned. The bounden and sureties shall have the option to (i) furnish Bank Guarantee** amounting to Rs 5,00,000 (Rupees Five lakh only) 1 month before completion of internship, for a period of 14 months in favour of the Dean of the ESIC Institution in lieu of the amount, and original documents of the student would be retained by the Corporation pending the submission of Bank Guarantee; OR (ii) not furnish Bank Guarantee, as above, when original documents would be retained by ESIC till Bond conditions are met with, i.e. completion of service under bond or payment in lieu. The total obligation amount would not exceed Rs. 05 lakh at any stage. Signed this ................ Day of ............... in the year ................ by the bounden (Mr./Mrs./Ms.) ..................... and Surety / Sureties Shri / Smt. ………………………. Signature In the presence of witness*: 1. Signature (Name & Address with 1. Signature of BOUNDEN official seal) (Name & Address**, Photo ID No.) 2. Signature (Name & Address) 2. Signature of SURETY / SURETIES (Name & Address**, Photo