Wednesday, April 24, 2013

Revised deceased claim forms for PO Savings Schemes



                                                         (1)
FORM FOR CLAIM OF BALANCE IN THE  SAVINGS  ACCOUNT   
                               OF DECEASED  DEPOSITOR
     (Application for closure of  Savings/RD/TD/MIS/NSS Account by Nominee/Legal Heirs)
To,
The Sr PM/PM/SPM
____________________________________________________________
Subject- Application for Withdrawal/ Closure of Account
Sir,                    
     I/We___________________________________________________________________________________________________________________________________________________________________________________    the Nominee(s)/Legal Heir(s) of Late Shri/Smt _____________________ __________________________________, the Depositor of the Savings/ RD/TD/MIS/NSS  Account No- __________________________________
_____________________________________________________________ _____________________________________________________________ standing at PO ________________ _______________________________ wish to Withdraw the entire amount standing to the credit of the deceased in the said account including interest admissible as per rules.
                                Please find enclosed:-
  I.      Certificate to the death of  the Depositor.
  II.     Pass Book of the Depositor.
*III.   Certificate in regard to the Death of the Nominee/Nominees appointed by the Depositor.
**IV.   Succession Certificate / Letter of Administration / Probate of  Will of the Deceased Depositor under the Provisions of the Indian Succession Certificate Act, 1925
@V.    Letter of Indemnity
@VI.  Affidavit
@VII. Letter of Disclaimer on Affidavit                                                                              
                                                                  
                     _______________________________________________
                     Signature or Thumb Impression of  Claimant / Legal Heirs
Date______________________
Place_____________________







                                                           (2)
Witness:
(1)______________________________(Signature)__________________________________________________________________________________________________________________(Name and Address)


(2)______________________________(Signature)__________________________________________________________________________________________________________________(Name and Address)
                                   (FOR USE OF POST OFFICE)
Witness Accepted

Signature of Sr PM/PM/SPM/BPM
(With Designation Stamp)

Withdrawal of Rs__________________________________________ only (Rs_____________________________________________________ only) is sanctioned which pertains to balance in the account of deceased inclusive of interest admissible as per rules.

                                                                                                               Signature of Sr PM/PM/SPM/BPM
                                                                                                                       (With Designation Stamp)




Received Cheque No ______________________ __________________   dated_______________________ for the sum of Rs______________only Rs_____________________________________________ _________only )
From _________________________________(Name of Post Office) as per details furnished above in the settlement of our claims.

Date__________________
Place_________________
                                      ________________________________________                                        
                                      Signature /Thumb Impression of the claimant(s)

*Delete wherever is not applicable.
**Strike off if there is valid nomination.
@To be produced by legal heirs, in absence of nomination(s) for claims exceeding prescribed limit of Rs 1 lac.
                                         
                                                         (1)
                                              ANNEXURE-I
                                  (LETTER OF INDEMNITY)
To,
The Postmaster
__________________________________________________(Name of the Post Office)

                               In consideration of your payment or agreeing to pay me/us ________________________________________________________ __________________________________________________________________________________________________________________________
[name(s) of the legal heir(s)], the sum of Rs_______________________only (Rupees__________________________________________________only)
Standing in the account No________________________ ___________ ___ under__________________________________________(name of scheme) with your Post Office in the name of _______________________________
without production of Letter of Administration  0r a Succesion Certificate to the estate of the deceased ________________________________________ (name of the depositor), I/we and we _______________________________ __________________________________________________________________________________________________________________________
_____________________________________________________  (sureties) 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 assigns against all claims, demands proceedings , loss damage, charges and expenses which may be raised against or incurred by you by reason or in consequence of having agreed to pay / or paying me /us the sum as aforesaid.

                               In witness whereof we have hereunto set my/our hands at this ______ __________________ day of ________________________ in presence of witnesses.

                                         
                   ___________________________________________
            Signed and delivered by the above named heirs of the deceased.

                               






                                                        (2)
          Signed and delivered by the above named sureties,
                       (Signatures, names and addresses)

1._________________________________________________________________________________________________________________________

2._________________________________________________________________________________________________________________________

                                 Signatures, names and addresses of witnesses,

1._________________________________________________________________________________________________________________________

2._________________________________________________________________________________________________________________________



ATTESTED
NOTARY PUBLIC


                                                        
                                                     



















                                                              (1)
                                                   ANNEXURE-II
                                                        (Affidavit)
To,
The Postmaster,
________________________________________(Name of the Post Office)
                                   I/we__________________________________________________________ __________________________________________________________________________________________________________________________
Husband/ wife of Late ___________________________________________ aged__________,aged____________,aged___________,aged____________
aged_____________ and aged _______________ sons/daughters of said Late ________ _______________________________________ ,resident of _____________________________________________________________ _____________________________________________________ do hereby declare and solemny affirm as under :
(1)  That I/we am/are the only heir(s) of the deceased ________________  __________________________ who died at ____________________ on______________________ I/we alone represent the estate of Shri/Smt_________________________________________________
(2)   That  the deceased ______________________________________ did not leave any will and therefore I/we are the only successor(s) to the estate of the said deceased.
DEPONENTS                                 1.__________________________________________________
                                 2.__________________________________________________
                                 3.__________________________________________________
                                 4.__________________________________________________
                                 5.__________________________________________________
                                 6.__________________________________________________
                                                                                                                   
                                                                                                                 DEPONENTS
  


                                                      (2)
Verification: I/we ,the above named deponents do hereby on solemn affirmation in _____________________________( name of place ) that the contents of this affidavit are true to the best of  my/ our knowledge and nothing materials have been concealed.
 Date_______________________
                                      
                                 1.__________________________________________________
                                 2.__________________________________________________
                                 3.__________________________________________________
                                 4.__________________________________________________
                                 5.__________________________________________________
                                 6.__________________________________________________
                                                                                                                                                                          
                                                                                                                  DEPONENT
ATTESTED

OATH COMMISSIONER








                                                  










                                                           (1)
                                              ANNEXURE III
                    (LETTER OF DISCLAIMER ON AFFIDAVIT)
To,
The Postmaster,
_________________________________________(name of the Post Office)
                             I/we (i)___________________________________________________ Husband/wife of _______________________________________,Resident of  ___________________________________________________________
_____________________________________________________________ (ii) _______________________son/daughter of ______________________ (iii) _______________________son/daughter of _____________________ (iv) _______________________son/daughter of ______________________ (v) ___________ ____________son/daughter of ______________________ (vi) _______________________son/daughter of ______________________
                            do hereby declare and solemnly affirm as follow:
(1)  That Shri/Smt ___________________________________ in estate on leaving behind us _________________________________his/her only heirs.
(2)  That I/we _________________________________heir(s) of our Late father/mother for my/ourselves and on behalf of my/our heir(s), executors, representatives and assigns to hereby relinquish our claims to the balance of Rs________________________________________
in account No ____________________________________________ ________________________________________________________       of ________________________________________(name of scheme)
at ____________________________________( name of Post Office) in the name of the estate of the objection whatsoever in the balance in the above referred account(s) together with interest, if any, accrued thereon being paid by the Post Office to Shri/Smt:
                               1.______________________________________________
                               2.______________________________________________
                               3.______________________________________________
                                             
          4.______________________________________________
                               5.______________________________________________
                               6.______________________________________________

                                                                                                         
                                                 (2)
DEPONENT VERIFICATION: I/we the above named deponents do hereby verify on solemn affirmation that the contents of this affidavit are true to the best of my knowledge and nothing material has been concealed .
Dated _____________________
                               1.______________________________________________
                               2.______________________________________________
                               3.______________________________________________
                                            
          4.______________________________________________
                               5.______________________________________________
                               6.______________________________________________

                                                                                                          DEPONENT
                            I identify the deponent(s) who is/are personally known to me and who has /have signed in my presence
Dated______________________

OATH COMMISSIONER                                                                                
                                                                                                                                                                              
















                                                          (1)
Claim Application Form for Settlement of Savings Cerertificates of Deceased Holder who died on  ___________________________________
       ( Where Nomination has been Registered with Post Office)
To,
The Post Master,
_________________________________________
Sir,
                                                    In connection with the settlement of claim of Post Office Certificates standing in the name of  deceased ___________ ________________________________________ in the books of ________________________________( name of Post Office ), I hereby claim the payment of  the value of  the Post Office Certificate(s) No _____________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________

                                                   In support of the claim, I hereby submit :
(i)                Proof of Death of the deceased issued by appropriate authority in original.
(ii)              Proof of Death of other nominee(s), if any issued by appropriate authority in original.
                                                  The nomination was registered at ________ ________________ ___  _______________________________ Post Office under Registration No(s)_________________________________________
_____________________________________________________________
Dated ________________________________________________________
                                                                                                           
                                                Yours Faithfully,
_______________________________________________________________________________________________________________________________________________________________________________________
                Signature or Thumb Impression of the Claimants if illiterate



Witness (1)_____________________( Signature)   
Address _________________________________              
________________________________________

Witness (2)______________________( Signature)  
Address _________________________________                
________________________________________
                                                              (2)
Witnesses accepted,

____________________                                                  
                                                                       __________________________
Signature of Sr PM/PM/SPM                                    Signature of the    
                                                                       Claimant/ Guardian appointed    
                                                                    to receive the amount on behalf of   
                                                                                  minor nominee(s)
                                                                   Address of the Claimant/Guardian
                                                                   ____________________________
                                                                   ____________________________

































                                                          (1)
Claim Application Form for Settlement of Savings Certificate(s) of the   
                                             Deseased Holder                                                                                      
       (Where the Claim is preferred on Legal Evidence of Heirship)
To,
The Postmaster,
_____________________________
Sir,
                          In connection with the settlement of claim of Post Office Certificate(s) standing in the name ( deceased )______________________ ____________________________________________________________
in the books of _________________________________________( name of Post Office),  I/We______________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________ ( state full relationship  ) of the deceased , who died on_________________,  hereby claim the payment of the value of the Post Office NSCs/KVPs Certificate no(s) ________________________________________________
_______________________________________________________________________ . In support of the claim, I hereby, submit the original/ certified / attested copy of the followings:
(i)                A succession Certificate granted by____________________________________________________                           under No  ________________________ dated________________                                               
(ii)              Probate of will granted by ________________________________ _____________________________________________________
(iii)            Letter of Administration the Estate of the deceased granted by _____________________________________________________
 under No ___________________dated_____________________         
                                                              Yours Faithfully,
                                                  _____________________________
                                                  _____________________________
                                                  _____________________________                                        
                                                  _____________________________
                                                     Signatures or thumb impressions     
                                                         of the claimant if illiterate
Witness (1) ___________________________________(Signature)
Address ______________________________________
_____________________________________________
Witness (2) ___________________________________(Signature)
Address ______________________________________
_____________________________________________
                                                           (2)
Witnesses accepted,

____________________
Signature of Sr PM/PM/SPM
                                                                                          
                                                               _____________________________
                                                               _____________________________
                                                               _____________________________
                                                               _____________________________
                                                                Signature of the Claimants/Guardian    
                                                                           appointed to receive the                
                                                                          amount on behalf of minor  
                                                                                          Nominee(s)
                                                                Address of the Claimants/Guardian
                                                             ______________________________
                                                             _______________________________  
                                                             _______________________________
                                                             _______________________________                            

NOTE- Whenever copies of the original documents are produced , the claimants should get them attested by a Gazetted Officer / Sarpanch Gram Panchayat.





















                                                           (1)
        Claim Application for Settlement of  Saving Certificate(s) of the   
                                deceased holder who died on ____________________                     (Where there is No Nomination or Legal Evidence and Total Amount of  
                   all certificates in the name of the dceased holder                                   
                                  does  not exceed Rs 1,00,000/-)
To,
The Postmaster,
______________________________
Sir,
                                         In connection with the settlement of the claim of Post Office NSCs/KVPs Certificate(s) standing in the name of the deceased ____________________________________________________________ ,
I hereby claim the payment of the value of the Post Office Certificate(s) detail of which is given below:
SL No
Scheme
Registration numbers and date of issue
Office of issue
Amount
1




2




3




4




5




6




7




8




9




10




                                             In support of the claim, I hereby submit:
(i)                Proof of Death of the deceased issued by appropriate authority in original.
(ii)              Letter of Indemnity in original duly attested by Notary Public.
(iii)            Affidavit and Letter of Disclaimer on Affidavit duly attested by Oath Commissioner.
                                                                                         Yours Faithfully,
                                                              ____________________________
                                                              ____________________________
                                                               ___________________________
                                                              ____________________________                    
                                                             Signature or thumb impression of                   
                                                                      the claimant if illiterate
                                                             Address_____________________
                                                             ____________________________
                                                             ____________________________                 


                                                          (2)
Witness (1) ____________________________(Signature)
Address________________________________________
_______________________________________________

Witness (2) ____________________________(Signature)
Address________________________________________
_______________________________________________



                                                       
































                                                         (1)
                                              ANNEXURE-I
                                   (LETTER OF INDEMNITY)
To,
The Postmaster
________________________________________(Name of the Post Office)

                               In consideration of your payment or agreeing to pay me/us________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________
name(s) of the legal heir(s)], the sum of Rs______________________only (Rupees_____________ ____________________________________only)
Pertaining to NSC/KVP certificate registered under Nos__________________________ ___________ ____________________ _____________________________________________________________ _____________________________________________________________
with your Post Office in the name of ___________________________
____________________________________________without production of Letter of Administration  0r a Succesion Certificate to the estate of the deceased __________________________________(name of the depositor), I/we and we___________________________________________________ _____________________________________________________________  (sureties) 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 assigns against all claims, demands proceedings , loss damage, charges and expenses which may be raised against or incurred by you by reason or in consequence of having agreed to pay / or paying me /us the sum as aforesaid.

                               In witness whereof we have hereunto set my/our hands at this ______ __________________ day of ________________________ in presence of witnesses.
                    ____________________________________________
                     ___________________________________________
              Signed and delivered by the above named heirs of the deceased.

                               





                                                              (2)
                  Signed and delivered by the above named sureties,
                                 (Signatures, names and addresses)

1.___________________________________________________________
   ____________________________________________________________
2.____________________________________________________________
   ____________________________________________________________

                                 Signatures, names and addresses of witnesses,

1._________________________________________________________________________________________________________________________
2.____________________________________________________________
   ____________________________________________________________


ATTESTED
NOTARY PUBLIC


                                                       
                                                     





















                                                       (1)
                                             ANNEXURE-II
                                                 (Affidavit)
To,
The Postmaster,
________________________________________(Name of the Post Office)
                                   I/we_________________________________________________________ _______________________________________________________________________ ___________________________________________________
Husband/ wife of Late ____________________________________________________ aged_____________,aged_______________,aged______________,aged____________
aged_____________ and aged _______________ sons/daughters of said Late ________ ________________________ ,resident of_______________ _____________________________________________________________ _____________________________________________________________ do hereby declare and solemnly affirm as under :
(3)  That I/we am/are the only heir(s) of the deceased__________________________ who died at_____________ ____________________ on______________________ I/we alone represent the estate of Shri/Smt ______________________________
(4)   That  the deceased________________________________________ did not leave any will and therefore I/we are the only successor(s) to the estate of the said deceased.
DEPONENTS                                 1.__________________________________________________
                                 2.__________________________________________________
                                 3.__________________________________________________
                                 4.__________________________________________________
                                 5.__________________________________________________
                                 6.__________________________________________________
                                                                                                                  
                                                                                                                 DEPONENTS
  

                                                          (2)
Verification: I/we ,the above named deponents do hereby on solemn affirmation in _____________________________( name of place ) that the contents of this affidavit are true to the best of  my/ our knowledge and nothing materials have been concealed.
 Date_______________________
                                      
                                 1.__________________________________________________
                                 2.__________________________________________________
                                 3.__________________________________________________
                                 4.__________________________________________________
                                 5.__________________________________________________
                                 6.__________________________________________________
                                                                                                                                                                          
                                                                                                                  DEPONENT
ATTESTED

OATH COMMISSIONER








                                                  










                                                           (1)
                                               ANNEXURE III
                   (LETTER OF DISCLAIMER ON AFFIDAVIT)
To,
The Postmaster,
__________________________________________________(name of the Post Office)
                             I/we: (i)___________________________________________________ Husband/wife of _____________________________________,Resident of _____________________________________________________________ _____________________________________________________________ (ii) _______________________son/daughter of ______________________  (iii) _______________________son/daughter of ______________________
(iv) _______________________son/daughter of ______________________
(v) ___________ ____________son/daughter of __________________ ___ (vi) _______________________son/daughter of ______________________
                            do hereby declare and solemnly affirm as follow:
(3)  That Shri/Smt _______________________________________died in estate on leaving behind us__________________________________ __________________________________________his/her only heirs.
(4)  That I/we _________________________________heir(s) of our Late father/mother for my/ourselves and on behalf of my/our heir(s), executors, representatives and assigns to hereby relinquish our claims to the NSCs/KVPs with maturity value of Rs___________________________________________ _______only
Is issued by  _________________________(name of the Post Office)  
in the name of the estate of the objection whatsoever in the balance in the above referred account(s) together with interest, if any, accrued thereon being paid by the Post Office to Shri/Smt::
DEPONENTS                               1.______________________________________________
                               2.______________________________________________
                               3.______________________________________________
                                            
          4.______________________________________________
                               5.______________________________________________
                               6.______________________________________________

                                                                                                        
                                                              (2)
DEPONENTS VERIFICATION: I/we the above named deponents do hereby verify on solemn affirmation that the contents of this affidavit are true to the best of my knowledge and nothing material has been concealed .
Dated _____________________
                               1.______________________________________________
                               2.______________________________________________
                               3.______________________________________________
                                          
          4.______________________________________________
                               5.______________________________________________
                               6.______________________________________________

                                                                                                          DEPONENTS
                            I identify the deponent(s) who is/are personally known to me and who has /have signed in my presence.
Dated______________________

OATH COMMISSIONER

                         

















                                                    (1)         
       Reconciliation Certificate in case of difference in name

                           Certified that the real name of the deceased depositor of PO SB/TD/MIS/NSS/RD Account or NSC/KVP Registration No _____________________________________________________________
__________________________________________________________________________________________________________________________
Was _____________________________________. He was also called by __________________________________________ ( name) . The name as mentioned in Pass Book/ NSCs/KVPs and death certificate is that of one and the same person viz. the deceased depositor.
                                                                                     
                                                                _____________________________   
                                                                _____________________________
                                                                _____________________________
                                                                       Signature of Claimants
                                                                ____________________________                                           
                                                                        Name in block letters
                                                                 Address- ____________________
                                                                  ___________________________
                                                                  ___________________________
                                                                               
Dated- ___________________




















                                                      (1)
            Sanction Memo of Deceased Claim in respect of NSCs/KVPs

From: _________________________
            _________________________(Name of PO)

Memo No_______________________ dated____________________
To,
Sri/Smt ________________________
_______________________________
_______________________________
Dear Sir /Madam,
                             Sanction of the undersigned is hereby accorded to the payment to you of the amount due on the Postal Savings Certificate(s) detailed below standing in the name of ___________________________ who is reported to have died on _______________________.
2.                                                   The amount due will be paid to you on your presenting the Savings Certificate(s) duly receipted for payment at the __________________________ PO on surrendering the original sanction order.
3.                                                   You are however , at your liberty not to accept payment of the amount due on the Savings Certificate(s) before the date of maturity entered therein, in which case the savings certificate(s) in question shall be transferred to your name subject to the condition laid down in the Rules governing the Savings Certificate(s) in question.
4.                                                   The sanction is valid for accepting payment or for getting the certificate(s) transferred in your name for a period of one year only from the date of its issue.
                                                                                  Yours Faithfully,

                                                                          
                                                                          ______________________
                                                                                Sanctioning Authority
                                                                                         Stamps

                                           







                                                    (2)                        
                             Details of Savings Certificate(s)

Certificate Nos
Denomination
Date of issue
Name of the office of Registration





































Copy forwarded to for information and necessary action—
1.     The Postmaster/SPM _____________________________PO . The date of payment may be communicated as soon as the payment is effected.
2.     The Director of Postal Accounts ___________________________. The value of the Post Office Certificate including interest accrued upto the last completed year, as the case my be, prior to the death of the holder does not exceed Rs 1000/2000/5000/10000/20000/ 50000/ 75000/100000 as per claimant’s statement in the claim application.
 *Score out which is not applicable.

                                                                      ______________________
                                                                           Sanctioning Authority
                                                                                  Stamps
















                                                      (1)
          ACKNOWLEDGEMENT OF CUSTMOR REQUEST

1.Name of Post Office where request is received _______________________________________________________
2.Date of receipt of request___________________________________
3.Time of receipt of request-__________________________________
4Name of Depositor/Holder __________________________________
5.SB/RD/TD/MIS/NSS/SCSS/PPF/NSC/KVP Account/Registration Nos- ___________________________________________________________
______________________________________________________________________________________________________________________
___________________________________________________________
6.Name of the Savings Schemes ________________________________ __________________________________________________________
7.Request No- _____________________ ( Sl No of Register in case of non computerised office )
Date Stamp of the PO
__________________




                                                                                
                                                              ________________________
                                                            Signature of the Postmaster/SPM