Affidavit cum Indemnity Letter (For Threshold Limit)
In
respect of payment of balance in deposit accounts / contents of safe deposit locker/
safe custody articles of deceased person;
(To
be stamped with the duty payable for affidavit & Indemnity bond)
I/We
Mr/Ms/Miss --------------------------------------------------------------------
(name/names of the claimants), (s/o, w/o, d/o)----------------------------------------------------------------------,
aged, -----------address,
------------------------------------------------------------------------------------------------------------do
hereby solemnly affirm and state as follows.
1.
I/We am/are the legal
heirs of Mr/Ms/Miss (name of deceased
account holder) __________________________and the deceased is my/our (father/mother/wife/husband/son/daughter
etc.)
2.
I/We further state
that I/We the following legal heirs are the only legal heirs entitled to claim
the balance deposit/amount /jewels/ ornaments and other valuables the contents
held in the locker/safe custody:-
P.T.O
-2-
|
Sr. No.
|
Name
|
Age
|
Relationship to the
deceased
|
|
1.
|
|
|
|
|
2.
|
|
|
|
|
3.
|
|
|
|
|
4.
|
|
|
|
|
5.
|
|
|
|
|
6.
|
|
|
|
|
7.
|
|
|
|
3.
I/We further state
that the deceased was holding an account (hereinafter referred to as “the
account”) (specify the account details) ------------------------------ in
-----------------branch of Bank of India (herein after referred to as “the
Bank”). At the time of the death of the deceased the account was having a
credit of Rs ------------------------------------ (balance amount in the
account) which includes interest up to-------------------------------------------------------------(date
of payment) amount to Rs.-------------------------------------------------------(amount
being now paid)
4.
I/We affirm that I/We
am/are the sole legal heirs of the deceased who are entitled to receive the
amount standing in the credit of the account belonging to the deceased.
5.
I/We have requested
the bank to make the payment of the amount standing in the credit of the
account belonging to the deceased together with interest thereon as applicable
to shri/smt ------------------------------ being one of the legal heirs for and
on behalf of all the legal heirs.
OR
I/We have requested the bank to
hand-over contents of the safe deposit locker/items held in safe custody to
Shri/Smt. ------------------------------------------being one of the legal
heirs for and on behalf of all the legal heirs.
6.
I/We are aware that
the Bank has agreed to settle our claims relying on this affidavit and I/We
agree to indemnify the bank in respect of such payment or delivery of the
contents of items in safe deposit locker or held in safe custody against any
claim made by any person for the amount standing to the credit of the account
of the deceased.
P.T.O
-3-
7.
I/We for ourselves
and my/our respective heirs, executors and administrators jointly and severally
agree, affirm and undertake that the bank, its successors and assigns and its
managers, agents, officers and servants and their respective estates and
effects are and shall from time to time and at all times hereafter be
kept safe and saved harmless and indemnified for and in respect of such payment
and against all actions, losses, cost, charges, expenses and demands whatsoever
in respect of the said payment or delivery of the contents of items in safe
deposit locker or held in safe custody.
All the averments made herein before
are true and correct and I/We put my/our signature/mark on this Day of 26 at in
the presence of .
Signatures(s)
of deponents. (claimants)
Affidavit to be attested by Notary Public
){kind=link}
0 Comments