Application for issue of a new pass book

To                                                                                                   Address of Applicant .................................
The Agent/Manager,                                                                        Date : ............................................
Bank Branch ..........................................
Bank's Address ......................................
                       Re : Applying for a new Pass book

Dear Sir,
        I have a Savings Account in your Bank which number is ...................................
Unfortunately my Pass Book was lost a few days back when I was out of station. Hence I request you to issue a new Pass Book in my name.Please also let me let me know if I am to perform any formality for this.
Your immediate action will be highly appreciated.
Thanking You I am,
                                                                                                                       Your's faithfully
                                                                                                                        ............................................
                                                                                                                        Specimen Signature