APPENDIX 18 C

STATEMENT OF PARTICULARS OF IEC NUMBERS ISSUED FOR THE PERIOD ___________

Sr.No.	Name	Address	IEC No.	Date of Allotment
[1]	[2]	[3]	[4]	[5]

Note: The periodicity of the submission of the above information by the IEC issuing authorities shall be on monthly basis and the information shall be submitted to the concerned office of RBI by the end of the week succeeding the fortnight.