INDEMNITY TO DRAWER OF LOST CHEQUE
To _________________________________ In consideration of your having this day given me a second cheque for Rs _______________being the amount of a previous cheque No _____________ dated _____________ drawn by you in my favour which I have lost, I hereby undertake to refund to you the said sum of Rs ________________ in the event of the earlier cheque being presented to and paid by your bankers within _______ months and to indemnify you against all expenses which may be incurred by you in relation thereto.
Dated ______________
Signed____________
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