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    Death Claim Form With Nominee

    Uploaded by

    Deepak Gautam
    This document is an application for claiming the balance in a deceased person's bank account. It provides details about the deceased account holder and the claimant. It states that the deceased Shri/Smt. held an account at Union Bank that was either a joint account with survivor rights or had a registered nominee. It then provides information about the claimant and their relationship to the deceased. The claimant is requesting to either receive the balance as the registered nominee or have the deceased person's name removed from the joint account. Finally, it lists the documents attached - a death certificate and identity proof (for nominee cases) - and requests that the original documents be returned after verification while settling the claim.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Death Claim Form With Nominee

    Uploaded by

    Deepak Gautam
    899 views4 pages
    This document is an application for claiming the balance in a deceased person's bank account. It provides details about the deceased account holder and the claimant. It states that the deceased Shri/Smt. held an account at Union Bank that was either a joint account with survivor rights or had a registered nominee. It then provides information about the claimant and their relationship to the deceased. The claimant is requesting to either receive the balance as the registered nominee or have the deceased person's name removed from the joint account. Finally, it lists the documents attached - a death certificate and identity proof (for nominee cases) - and requests that the original documents be returned after verification while settling the claim.

    Original Title

    death claim form with nominee

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    © © All Rights Reserved

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    This document is an application for claiming the balance in a deceased person's bank account. It provides details about the deceased account holder and the claimant. It states that the deceased Shri/Smt. held an account at Union Bank that was either a joint account with survivor rights or had a registered nominee. It then provides information about the claimant and their relationship to the deceased. The claimant is requesting to either receive the balance as the registered nominee or have the deceased person's name removed from the joint account. Finally, it lists the documents attached - a death certificate and identity proof (for nominee cases) - and requests that the original documents be returned after verification while settling the claim.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    899 views4 pages

    Death Claim Form With Nominee

    Uploaded by

    Deepak Gautam
    This document is an application for claiming the balance in a deceased person's bank account. It provides details about the deceased account holder and the claimant. It states that the deceased Shri/Smt. held an account at Union Bank that was either a joint account with survivor rights or had a registered nominee. It then provides information about the claimant and their relationship to the deceased. The claimant is requesting to either receive the balance as the registered nominee or have the deceased person's name removed from the joint account. Finally, it lists the documents attached - a death certificate and identity proof (for nominee cases) - and requests that the original documents be returned after verification while settling the claim.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    At a glance
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    The document outlines the process and documentation required for settling deceased claims on bank accounts, including accounts with nomination and joint accounts.

    The claimant is required to submit proof of death such as a death certificate, identity proof of the nominee, and original documents which will be returned after verification.

    For a joint account, the bank will delete the name of the deceased person and continue the account in the name(s) of the surviving account holder(s) with the same mode of operations.

    ara d U Union Bank

    Annexure D
    Application for Deceased Claim
    (To be used when account has nomination or is a joint account with survivor clause)

    From

    To
    The Branch Manager,
    Union Bank of India
    Branch
    Dear Sir,
    Re: Deceased Account
    Late Shri/Smt ****e***************
    Account No (s) .**************°***
    .

    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

    .Son/daughter of Shri...
    **********osoresese********** *************e*******o******

    *******.************************ residing at...


    ***************************************************
    ***************************************************************a****************************** am
    (i) the registered nominee in the above account (s)
    (17) the person authorized to receive payment on behalf of Master/ Miss
    *******.****************a******.********e******e************. *******e******.
    .who is the nominee in the above account(s)
    and is a minor as on the date of the claim.
    Please settle the balance in the account in the name of the nominee. I/We receive the
    payment as trustee(s) of the legal heirs of the deceased.

    B. In the 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.
    1/We submit photocopy of the following document(s) together with originals. Please return
    the original to us after verification.

    Death Certificate issued by.

    ldentity proof (required in nomination cases)

    Place Yours faithfully,


    Date

    Claimant(s)}
    F.170A
    APPENDIX 18

    CLAIM FORM
    **

    [To be submitted by Nominee/s


    under Banking Companies (Nomination) Rules, 1985]

    I, Mr/Ms/Mx Nominee/ appointed on behalf of the minor nominee,


    hereby declare that I am the nomince/appointed on behalf of the minor nominee of the deceased
    Mr/Ms/Mx
    I further declare that I am nominated to claim the deposit moneys/safety locker with
    (Bank/Branch) by Mr/Ms/Mx
    deceased. The deposit moneys/_safety locker are held in Account No.
    /Safety Locker No. _ __ o f Mr/Ms/Mx
    deceased.

    Mr/Ms/Mx
    (Nominee lappointed on behalf of (Signature)
    of minor nominee)

    Address Date

    Witness*
    a. Magistrate or Judicial 1 Name
    Official Address
    or
    b. An Officer of the Central or State Government
    or Signature
    c. An Officer of a Bank or
    d. Two persons acceptable to Name
    the Bank Address

    (Strike out whichever


    is not applicable) Signature

    Manual on Settlement of Claims


    Organisation & Methods Division Page 76
    APPENDIX 16
    PROFORMA OF ACKNOWLEDGEMENT OF RECEIPT

    From

    To

    Corporation Bank,
    Branch.

    Dear Sir,

    My/our claim application dated . . .


    pertaining to securities deposited/pledged by late

    /We hereby acknowledge the receipt of the following securities in full settlement of my/our
    claim pertaining to the securities belonged to late . which were lying with you

    pledged/deposited as security.

    (Give details of Securities)

    Yours Faithfully,

    Place:
    Date:

    across Receipt stamp of


    ( To be signed
    Rupee One if value exceeds Rs.500/-)

    Manual on Settlement of Claims


    Division Page 74
    Organisation & Methods
    APPENDIX - 15

    PROFORMA OF DISCHARGE RÈCEIPT

    From:

    To:

    Corporation Bank,
    ** Branch.

    Dear Sir,

    My/our claim application dated .


    pertaining to deposits/accounts of late . .

    ------

    1/We have received in full settlement of my/ our claim on this . day of. . 20..a sum
    o n l y ) being the proceeds of the following
    of Rs. .(Rupees .
    deposits/accounts standing in the name of late . . *****""***

    (give hereunder the particulars of deposits/accounts)

    Yours faithfully,

    (to be signed across the receipt stamp of Rupee One wherever amount or value exceeds Rs.500/-)

    Place
    Date

    Manual on Settlement of Claims


    Organisation & Methods Division Page 73

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