Annexure-III
Indemnity Letter
for payment of balance in account of deceased depositors
(To be used for cases other than nomination or is a joint account without survivorship clause)
Name:………………………………..
Address:…………………………
………………………………
…
………………………………
…
Date :
To:
Bank of India.
Chakan Branch.
Dear Sirs.
Re.: Payment of balance of Rs.__________ in the account of Mr./Mrs./Miss Manda Nivrutti
Yelwande -(Deceased)
1. Mr./Mrs./Miss Manda Nivrutti Yelwande had the Current Account
No……………….Savings Bank Account No. 060110110001807
/Fixed/Short/Monthly Income Certificate / Double Benefit
Deposit Account No. 060145110000895/Recurring Deposit Account No… with
your Bank.
2. Mr./Mrs./Miss Manda Nivrutti Yelwande .had expired on 12.11.2019 at Nighoje.leaving
at the time of his/her death the credit balance(s) in his/her respective account(s) as under :
(a) Current Account No. : Rs.
(b) Savings Bank Account No. : Rs.
(c ) Fixed/Short/Monthly Income
Certificate/ / Double Benefit Deposit
Account no. : Rs.
(d) Recurring Deposit Account no. : Rs.
Total : Rs……………………..
==================
3. I/We have represented to you :
(a) that the deceased died without leaving a Will and I/We the undersigned
(i) Baburao Nivrutti Yelwande (ii)____________.,
(iii)………………………………………………….etc.,
am/are the only heir(s) of the deceased according to the law of intestate succession
applicable to him/her
OR
(a) that the deceased died leaving his/her last Will and testament dated and we the
undersigned namely,
....................................................................................…………………
(Names of the Executors)
...................................................…………….………………………………
are the executors thereof; and that has he/she died without leaving the Will, We the
undersigned namely
Baburao Nivrutti Yelwande
(Names of the Heirs)
………………………………………………………………………………… would have been the heirs of the
deceased according to the personal law of
intestate succession applicable to him/her;
(b) that we do not intend to obtain any grant of legal representation to the estate of the
deceased;
(c) that we are the only persons entitled to the properties and assets of the deceased, as
such executors/heirs as on intestacy.
4. We have requested you to pay the said balance in the said account(s) to
all/……………………………………of us the undersigned
Mr. Baburao Nivrutti Yelwande
(Names of persons to whom payment is to be made)
which you have agreed to do on the faith and strength of and relying on my/our above
representation and on my/our executing such indemnity in your favour as is hereinafter
appearing.
5. In consideration of above premises, I/We so as to bind myself / ourselves jointly and
each severally and my/our respective heirs, executors, administrators, estate and effects
jointly and severally undertake and agree with you, your successors and assigns as follows:
(a) to keep you safe and indemnified against all claims, demands, actions, proceedings,
losses, damages, costs, charges and expenses ( the legal costs being between attorney and
client) which may be made or brought or commenced against you or be paid, sustained,
suffered or incurred by you howsoever, as a consequence direct or indirect of your paying the
said sum in the above accounts to me/us without insisting on a grant of legal representation
(b) to pay to you on demand the amount of any such losses, damages, costs, charges and
expenses together with interest at………%p.a. from the date of payment by you until
reimbursement by me / us.
Yours faithfully,
………………………….
Mr. Baburao Nivrutti Yelwande
In consideration of the premises, we the undersigned
...............…………………………………………………………………………………
[Name (s) of surety(ies)]
…………………………………………………………………………………………
jointly and severally guarantee to you, Bank of India, the payment of all moneys due under
the aforesaid indemnify by the executants thereof
1 Sarika Kailas Bhagat ___________________
2 Deepak Baburao Yelwande ___________________
Signature Name Address
Annexure-IV
RECEIPT
Received with thanks from Bank of India, branch, a sum of Rs._____________
(Rupees only, by Banker’s Cheque No. dated
in favour of Mr. Baburao Nivrutti Yelwande 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/Kum. Manda Nivrutti
Yelwande
. I/We do not have any other claim from the Bank henceforth.
Place:
Date:
(Signature of all the legal heirs @
Over a revenue stamp)
----------------------------------------------------------------------------------------------------------------
Annexure-V
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-
---------- favoring ------------------- issued by you in settlement of the balance in account
number ----------------- of Late----------------------------------------------will be
utilized for the benefit of the minor only.
Father and Natural Guardian
