Annexure – IV.
CHECK – LIST OF DOCUMENTS

1.  Accounts with Nomination clause or Joint account with survivor clause:

Sl. No.

Documents to be obtained

1

Copy of Death Certificate (Verified with Original).

2

Proof of Identity of the nominee (Such as Ration Card, Election ID Card, PAN Card or Passport or any other satisfactory proof of Identification acceptable to the Bank).

3.

Application to be used when account has nomination/ joint account with survivor clause – (Annexure – VI)

4

Receipt – (Annexure – VIII)

5

Declaration in case funds are settled in favour of a Minor – (Annexure – IX)

 

Annexure – V

1.  Accounts without Nomination or Joint account without survivor clause:

Sl. No.

Documents to be obtained

1

Copy of Death Certificate (Verified with Original)

2

Proof of Identity (Such as Ration Card, Election ID Card, PAN Card or Passport or any other satisfactory proof of Identification acceptable to the Bank or proof of authority of legal heir(s) Where ever applicable)

3.

Application to be used for other than nomination/joint account with survivor clause – (Annexure – VII)

4

Letter of Indemnity – (Annexure – X)

5

Letter of Disclaimer – (Annexure – XI)

6

Affidavit – (Annexure – XII)

7

Receipt – (Annexure – VIII)

8

Declaration in case funds are settled in favour of a Minor – (Annexure – IX)

9

Opinion Report on Surety – (Annexure – XIII)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

Annexure – VI

APPLICATION FOR DECEASED CLAIM

(To be used when account has nomination or is a joint account with survivor clause)

From

------------------------------------------

-----------------------------------------

------------------------------------------

 

To Branch Manager,

State Bank of Hyderabad,

------------------------ Branch.

 

Dear Sir,

 

Re: Deceased Account of Late Shri / Smt……………………………………………

       Account No……………………………….

 

I / we advise the demise of Shri / Smt…………………………………………  on. …………………...  He / She holds the above account (s) at your branch.  The account is in the name(s) of. ………………………………………………………… ……………….……………………………………………………………………………..

 

A. In case of Nomination.

I,   ………………………………………………………….Son /daughter of Shri……………

………………………………….. Residing at (Full Address) …………………………

……………………………………………………………………………………………… am (i) the registered nominee in the above account (s).

(ii) The person authorized to receive payment on behalf of Master / Miss ………………………………………………… who is the nominee in the above account(s) and is a minor as on the date of this claim.

 

Please settle the balance in the account in the name of nominee.  I / We receive the payment as trustee(s) of the legal heirs of the deceased.

B.  In case of joint account.

I / we request you to delete the name of deceased person and continue the account in my / our name(s) with same mode of operations.

 

I we submit photocopy of the following document(s) together with originals.  Please return the original to us after verification.

 

Death Certificate issued by ……………………………………………………………..

Identity proof (required in nomination cases) …………………………………………

 

Yours faithfully,

Place:                             

Date:

(Claimant(s))

 

 

 

 

 

 

 

 

 

 

 


 
Annexure – VII.

APPLICATION FOR DECEASED CLAIM

(To be used for cases other than (nomination / joint account with survivor clause))

From

------------------------------------------

-----------------------------------------

------------------------------------------

 

To Branch Manager,

State Bank of Hyderabad,

------------------------ Branch.

 

Dear Sir,

 

Re: Deceased Account of Late Shri / Smt……………………………………………

       Account No……………………………….

 

I / We advise the demise of Shri / Smt………………………………………… ………….   on ………………….. .  He / She holds the above account (s) at your branch.  The account is / are in the name(s) of ………………………………………………………………………………

…………………………………………………………………………………………………..

I / We lodge my / our claim for the balances with accrued interest lying to the credit of the above named deceased who died intestate.  I / We am / are the legal heirs of the above named deceased and lodge my / our claim for payment as per the bank’s rules and discretion.  The relevant information about the deceased and the legal heirs are as under.

 

1. Names in full of the parents of the deceased:

Father:………………………………………………………………………………………….

Mother:…………………………………………………………………………………………

2. Religion of the deceased:…………………………………..

3.  Details of living (i) Husband (ii) Wife (iii) Children (iv) Father (v) Mother (vi) Brothers (vii) Sisters (viii) Grand Children.  If Hindu Joint Family, the name and address of the Karta and Co-parceners with their respective ages.

 

Full Name with Address              Occupation        Relationship with     Age

                                                                                   Deceased                                 

 

(I) --------------------------------------------------------------------------------------------------------

 

(II)--------------------------------------------------------------------------------------------------------

 

(III)-------------------------------------------------------------------------------------------------------

 

(IV)-------------------------------------------------------------------------------------------------------

 

(V)--------------------------------------------------------------------------------------------------------

 

(VI)-------------------------------------------------------------------------------------------------------

 

Cont…2

 


 

Annexure– VII.

Page No :2:

 

4. Name or Names of the Guardian (s): ………………………………………………. ……………………………………………………… of the minor children of the deceased depositors………………………………………

 

(A) Whether Natural Guardian/Court appointed Guardian:  ……………………….. ……………………………….

 

(B) Whether Guardian appointed by a Court of Law in India, if so attach a certified copy or duly attested copy of such Order:………………………………  …………………………………….

 

(C) In whose custody the Minor / Minors is / are: …………………………………. ………………………………………….

 

5.  Claimant(s) name(s) and address in full:

(i)                ______________________________

(ii)               ______________________________

(iii)              ______________________________

I / we submit the following documents.  Please return the original death certificate to us after verification.

 

1. Death Certificate (Original + Photocopy) issued by:……………………………… …………………………………….

2.  Letter of Indemnity:

 

We request you to pay the balance amount lying to the credit of the above named deceased to ……………………………………………………………………. ………………………………………………… On my / our behalf.

 

I / We hereby solemnly affirm that the above statements are true and correct to the best of my / our knowledge and belief.

Yours faithfully,

 

Name of the Claimant                  Address                                  Signature

 

1

 

2

 

3

 

4

 

5

 

6

 

Place:

Date:

 

 

 

 

 

 

 

 


 

 

Annexure –VIII.

 

 

 

RECEIPT

 

Received with thanks from State Bank of Hyderabad, ____________________ Branch, a sum of Rs.____________ (Rs. _______________________________)

vide Banker’s Cheque No. _________________ dated ________________ in favour of _____________________________________________________ in full and final settlement of my / our claim as successor on the balance in ______________ Account(s) No(s).­­­____________________________________ standing in the name of the deceased Shri / Smt.________________________  _____________________________________________________.  I / we do not have any other claim from the Bank henceforth.

 

 

  

Place:

Date:                                                                                 

 

         

                                                (Signature of all legal heirs Over a revenue stamp)

 

 

 

 

 

 

 

 

 

Annexure –IX.

 

DECLARATION IN CASE FUNDS ARE SETTLED IN FAVOUR OF A MINOR

 

 

I _______________________________________________ father and natural guardian of  ____________________________________ hereby certify that the proceeds of your Banker’s Cheque No.____________ dated__________ favouring ____________________________________ issued by you in settlement of the balance in account number ______________________ of Late ___________________

_______________________ will be utilized for the benefit of the minor only.

 

 

 

Signature of Natural Guardian or

Guardian appointed by the Court.

 

 

 

 

 

 

 

 

 

 

 


 

Annexure – X.

 

(To be 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,

State Bank of Hyderabad,

…………………...Branch.

 

IN CONSIDERATION OF YOUR PAYING OR AGREEING TO PAY ME / US.

 

1). __________________________________________________

      

2). ___________________________________________________         

                          

3). ___________________________________________________ 

 

4). ____________________________________________________ 

              (Insert here the name(s) of the Claimants)

 

The sum of Rupees._________ (Rupees. ______________________________)

Standing at the credit of Savings Bank / Current Account / R.D. / T.D Account etc., No.____________________________________ with your bank in the name of Shri. / Smt. ____________________________________________________

Since deceased, without production of Letters of Administration or a Succession Certificate to his / her estate or a Certificate from the Controller of Estate Duty to the effect that estate duty has been paid or will be paid or none is due I / we       1. __________ _____________, 2. _____________________, do hereby for myself / ourselves and my / our heirs, legal representatives, executors and administrators jointly and severally UNDERTAKE TO 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 consequences of your having agreed to pay  or paying me / us the said sum as aforesaid.

 

SIGNED AND DELIVERED

BY the above named on this ___________ day of

______________two thousand _________________.

 

1. ___________________________ 2. _______________________

 

3.___________________________ 4. ________________________

( Heirs / Claimants of the deceased )

 

1.       _____________________________, 2. __________________________

(Signatures of Sureties)

 

 

 

 

 

 

 

 

 

 


Annexure – XI.

 

             (To be stamped as per the Stamp Act applicable to the State)

 

LETTER OF DISCLAIMER

 

 To

The Branch Manager,

State Bank of Hyderabad,

_______________ Branch.

 

Dear Sir,

 

Re: Account No. _________________________ in the name of Late. Shri / Smt. / Kum.__________________________________________________ Balance Rs. _____________ With reference to the above account(s), I / we 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 Late Shri / Smt. / Kum. _________________________________( Name of the deceased account holder) to Shri / Smt. / Kum. 1.________________________ 2. __________________________

 

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 doing so if any proceedings.  I / we also undertake to bind ourselves, our heirs and legal representatives not to revoke the declaration made herein.

 

Sl. No.         Name(s) of the Claimant(s)                         Age           Signature

 

1. ______________________________________________________________

 

2.  ______________________________________________________________      

 

3. _____________________________________________________________

 

4.  _____________________________________________________________

 

5.  ______________________________________________________________

 

 

Signed before me on This ______ day of _________ Two thousand _______________.

 

Seal

Notary Public / Magistrate.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

Annexure – XII.

 

                  (To be duly stamped as per the Stamp Act applicable to the State)

 

AFFIDAVIT

I / we (1) _____________________________________________________ son of ___________________________ and (2) _____________________________ son of ____________________ residing at (1) __________________________ and (2) __________________________ do hereby take oath* / solemnly affirm and say as follows:

1. That Shri / Smt. / Kum ___________________________________________

(Herein after 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/her 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.

Sl No.      NAME                AGE                      Relationship with the Deceased.

 

1)______________________________________________________________.

 

2)_____________________________________________________________.

 

3)_____________________________________________________________.

 

4)_____________________________________________________________.

 

That we are 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 State Bank of Hyderabad ____________________ 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 State Bank of Hyderabad ______________________ branch, has agreed at our request to make payment of the amounts 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  ______two                           1. ______________________

thousand_________________ In the

presence of ____________________                   2. ______________________

 

                                                   

        

SEAL                                                                                               Judge / Magistrate / Notary. 

 

 

 

 

 

 

 

 


Annexure – XIII.

 

OPINION REPORTS ON THE SURETY NO.

 

1.Name in full :

 

2. Address:

 

3. Academic Qualifications:

 

4. Age:

 

5. Occupation:

(If employed, Please state the name of

 the employer and since when employed)

 

6.  Present monthly income / salary (Attach the

Salary certificate, if income is by way of salary)

 

7.  Number of Dependents:

 

8.  Personal Assets:

 

 A) Immovable property viz., land/building/flat

   Etc. give details acquisitions, present value etc

B)  Investments (Fixed Deposits, Shares etc. if any.

C) Life Insurance policies if any:

D)  Other Assets:

E)  Details of bank accounts, if any (Name and 

Address of bankers with account numbers

(Current/ Savings ) to be furnished.

 

9.  Personal Liability if any:

 

10. Please indicate whether surety id related

      To the Claimants (Yes / No)

11. Period for which claimants are known.

 

I confirm that all the statements made by me in this application are true and correct and have been made by me.

 

Place:

Date:

Signature of the Surety

 

Remarks of the Divisional Manager / Branch Manager.

 

 

 

Date:                                                                                               Divisional Manager/

                                                                                                        Branch Manager.