Annexure 5a
Annexure 5a
Annexure 5a
ANNEXURE-5A
To be executed by all the major legal heirs of the deceased and two Sureties of substantial worth
2. We have further to inform you that he/she left behind him/her surviving as his/her only
heirs and next-of-kin the following ___________________________________
(name of heirs & next of kin)
according to the Law of Intestate Succession, applicable to ___________________________
by which Law he/she was governed at the time of
(Hindu, Muslim, Parsi, etc)
his/her death.
3. We have further to inform you that the balance standing to the credit of the
_________Account No.___________ is Rs._____________/- that there are articles lying in
the Safe Custody Account No._______/- that there are contents of Locker
No._____________ in the name of the said deceased.
4. We have therefore approached you with a request to pay the aforesaid sum lying to the
credit of the _______________Account/hand over the articles lying in the said Safe Custody
Account / Contents of the said Locker as mentioned above, to the undersigned Smt. /
Shri_________________________________________________
(Name of person whom to pay/handover)
(The person should be from amongst signatories only)
on our behalf without insisting on production of legal representations and you have kindly
agreed to do so on our executing an Indemnity as is herein contained and on relying on the
information herein given by us and believing the same to be true.
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5. In consideration therefore, of your having at our request agreed to pay the balance standing
to the credit of the aforesaid account/handing over the articles in the Safe Custody Account
/ Contents of the Locker to the undersigned
____________________________________________________we, the undersigned
(Name of same person whom to pay/handover)
________________________________ and ________________________________
(name of heirs & next of kin) (name of two sureties)
_________________hereby jointly and severally agree and undertake to indemnity and keep
indemnified, saved, defended, harmless you and your Successors and Assigns for all times
hereafter against all losses, costs, claims, actions, demands, risks, charges, expenses,
damages, etc. whatsoever which you may suffer and or incur by reason of your at our
request paying / handing over as mentioned hereinabove to the undersigned
__________________________________________
(name of same person whom to pay/handover)
the aforesaid balance of Rs.____________ standing to the credit of the aforesaid account /
articles lying in the said Safe Custody Account / Contents of the said locker without insisting
on production of legal representations.
Yours faithfully,
1. ___________________________________ ___________
2. ___________________________________ ___________
3. ___________________________________ ___________
4. ___________________________________ ___________
5. ___________________________________ ___________
NAME OF SURETIES
1. ___________________________________ ____________
2. ___________________________________ ____________
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