Appendix 2 to

Annex G to

BGNSI 12.10

Dated 31 May 19

AWC/ GWAC, UK/ DVAC/ GVAC Location:	SELECT HERE

DECLARATION OF LOSS/MUTILATION OF AF B108 (LAL BOOK)

Number:	ENTER A/NO	Rank:	SELECT RANK

Regiment:	SELECT UNIT

Name:	ENTER FULL NAME HERE

Name of widow/son/daughter:	ENTER FULL NAME HERE

Pensioner/ Widow/ Eligible dependant’s Address:

Village/House No:	ENTER VILLAGE	Ward No/Street:	WARD/STREET
GP/NP/Town:	ENTER GP/NP/TOWN	Post Office:	POST OFFICE
Dist/County:	ENTER DISTRICT	Province/State:	ENTER ANCHAL
Tel:	ENTER TEL NUMBER	Email:	ENTER EMAIL

Please list all the documents you lost/mutilated in addition to AF B108

Click here to enter text

Please explain how the loss/mutilation occurred

Click here to enter text

Date of Loss	Place of Loss
SELECT DATE	enter TEXT

Declaration

☐ I declare that I have lost the document(s) mentioned above and that the circumstances are true.

☐ I certify that I have not given the lost document(s) to any unauthorized person.

☐ I have no reason to believe it has been obtained fraudulently by any other person.

Signature:	Date:	type/choose DATE