Annexure A B C SBI

Annexure A
LETTER OF DISCLAIMER
(To be stamped as per the Stamp Act applicable to the State)
The Branch Manager
________________
________________
Dear Sir,
*Account No.
in the name of Shri / Smt. / Kum.

Balance
With reference to the above account(s),I / We the following legal heirs of the late Shri / Smt./Kum.
(Name of the deceased account holder) have to advise that we have no interest in the above assets
and as such we have no objection to your paying the balance amount lying in the above account(s)
with you in the name of the aforesaid
Shri/Smt./Kum.
(name of the deceased account holder) to Shri / Smt. / Kum.
1.
2.
3.
4.
Such delivery of the payment of the balance in the above account(s) would be completely binding on
us and we will not question the Bank’s action in so doing if any proceedings. I/ We also undertake to
bind ourselves, our heirs and legal representatives not to revoke the declaration made herein.
Sr. Name(s)of the Claimants Age Signature

No
Signed before me this____________________ day of _________________20___
Notary
(Public/ Magistrate)
Annexure B
AFFIDAVIT
(To be stamped as per the Stamp Act applicable to the State)
I/We __________________________S/D/O ____________________________________

Residing at __________________________________and ________________________
S/D/O______________________ residing at ____________________________________ do
hereby make oath*/solemnly affirm and say as follows:
That Shri/Smt./Kum. (Name of the deceased) hereinafter,
referred to as “the deceased” died intestate on _______at ______________________
2. That we know the deceased and his/her family since the last years.
3. That at the time of his death the deceased left surviving him/ her the following persons who
according to the law by which they are governed, are the only legal heirs of the deceased entitled to
succeed to the estate of the deceased on an intestate succession:
Sr. No Name(s) of the claimants(who relinquish their right Age(yrs.) Signature
4. That I am not related in any manner whatsoever to the deceased or any of the above-mentioned
persons nor have we any claim or interest of whatsoever nature in the estate of the deceased.
5. That we are informed, and we verily believe that the deceased has left certain deposits*/assets with
the ______ _____Bank branch, to which the above-mentioned
persons are entitled to claim.
6. That we are making this solemn declaration sincerely and conscientiously believing the same to be
true and with full knowledge that it is on the strength of this declaration that the____________ Bank
branch, has agreed at our request to make payment of the amount of the deposits/
to deliver the assets to the above mentioned persons without insisting on production by them of a
grant of legal representation to the estate of the deceased from a competent Court.
Sworn*/solemnly affirmed at this _________

Day of
1._________________
2._________________
In the presence of before me

*(Delete whichever is in applicable) Judge/Magistrate/Notary
Annexure C
LETTER OF INDEMNITY
(To be duly stamped as per the Stamp Act applicable to the State)
(Letter of Indemnity with respect to payment of Balance in the Deceased Constituents Account
without production of Legal representation)
To,
The Branch Manager
__________________________
__________________________
IN CONSIDERATION of your paying or agreeing to pay us,

Insert here the names of the claimants
1. ____________________________________________________________________
2. ____________________________________________________________________
3. ____________________________________________________________________
4. ____________________________________________________________________
5. ____________________________________________________________________
The sum of Rupees_________________________ standing at the credit of Saving Bank/Current/R.D

Account No etc. with your Bank in the name of Shri/ Smt./ Kum._______________________________
since deceased, without production of Letter of Administration or a Succession Certificate to his/her
estate, we
Insert here the name(s) of the suret (y/ies)
1. ___________________________________________________________________________
2. ___________________________________________________________________________
do hereby for ourselves and our heirs, legal representatives, executors and administrators, jointly and
severally UNDERTAKE AND AGREE to indemnify you and your successors and assign against all claims,
demands, proceedings, losses, damages, charges and expenses which may be raised against or
incurred by you by reasons or in consequence of your having agreed to pay / or paying me / us the
said sum as aforesaid.
Signed, Sealed and delivered by the above named on this day of

two thousand .
SIGNED AND DELIVERED by the above named
1. 2. 3.
4. 5.
(heir(s)/claimant(s)of the deceased)
SIGNED AND DELIVERED by the above named
1. 2.
(sureties)

Annexure A B C SBI

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Annexure A

in the name of Shri / Smt. / Kum.

Sr. Name(s)of the Claimants Age Signature

Signed before me this______ day of _20_

I/We S/D/O __________

Sr. No Name(s) of the claimants(who relinquish their right Age(yrs.) Signature

Sworn*/solemnly affirmed at this _________

In the presence of before me

IN CONSIDERATION of your paying or agreeing to pay us,

The sum of Rupees_________________________ standing at the credit of Saving Bank/Current/R.D

Insert here the name(s) of the suret (y/ies)

Signed, Sealed and delivered by the above named on this day of

SIGNED AND DELIVERED by the above named

(heir(s)/claimant(s)of the deceased)

SIGNED AND DELIVERED by the above named

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