Place
Dated this day of 19 .
In the presence of—
Signature of the principal agent.
We1 (2) residing at in the taluka of ........... District sureties for the above-named that he/they shall do and perform, all that he/they has/have undertaken to do and perform, and in case of his/their making default there in, whereby bind ourselves, jointly and severally, to forfeit to the Governor of Maharashtra the sum of rupees
Place .....................
Dated this day of 19 .
In the presence of
Signatures of sureties.
Y-373-121
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