PERFORMA OF AFFIDAVIT

Transcription

1 PERFORMA OF AFFIDAVIT Form of affidavit to be obtained from the adult heir of a deceased employee of the University who has died without making any nomination or will in relation to nominees either under Saving-Cum-Insurance Scheme, Gratuity or Provided Fund (to be executed on a General Stamp of Proper value, as prescribed by the Govt. of U.P from time to time and sworn before a Notary). AFFIDAVIT We, (a) aged years. w/o Late Mr. (b) aged years. s/o, D/o (c) aged years. s/o, D/o (d) aged years. s/o, D/o (e) aged years. s/o, D/o (f) aged years. s/o, D/o (g) aged years. s/o, D/o (h) aged years. s/o, D/o... ; and so on. (The name, age, with description of any other major legal heir of the deceased as per application succession law may also be added in this column). Solemnly affirm and state on both as under. 1. That Mr/Miss/Mrs... S/O,D/O,Mr./W/o, who was an employee of the Aligarh Muslim University, Aligarh being employed as...died intestate on. 2. That the aforesaid deceased left behind him his following legal heirs, including the mother if alive at the date of the death of the employee. S.No Name Relation Age Date Birth of Share Account No. With Bank Name *Samreen/LV/Format1

2 3. The out of the aforesaid of the deceased Master/Miss..is/are Minors, who have been living and are being brought up and maintained by Mr/Mrs who has not adverse interest against the said minor/minors. (In the case of male & married employees only). 4. That the said deceased employee left Mrs...as his window, who has not remarried herself after the death of the said deceased employee (In the case of male and married employees only.) 5. That the said deceased employee neither left any other windo except the aforesaid widow nor there are any other legible children from any other wife including judicial separated wife or a wife who may have ceased to so under the customary law of the community of the deceased employee, who also claim a share in the amount / amounts payable to the heirs of the said deceased employee. There are no legible children of any Pre-deceased son of the said deceased employee, who may be entitled to claim any share in the said amount/amounts. (Only in case of these employee according to whose personal law, adaptation may be lawful). 6. That the said deceased employee has also not left behind him any a doped son /daughter before his death. 7. That with the concurrence of the said major legal heirs i-e- deponents, No.., the above named deceased employees of the University I-e. Deponent has approached and requested the University for payment to monies payable under C.G.I.S/ G.S.L.I. Scheme /gratuity Provident Fund of the A/C,. of the; said deceased, for and also for the benefit and use of all the other legal heir(a) as well of the minor dependent legal heirs of the deceased. No proceeding in any court or before any Authority are pending in relation to nominees being claimed in above A/Cs of the deceased and no proceedings for appointment of guardian of the person and property of the minor heirs of the deceased have taken place. The deponents have no objections if the shares of minors be retained by the University for Payment to them on attaining their age of majority respectively. 8. That in order to properly safeguard the interest of the University and in consideration of payment of the said required amounts to the said of the deceased, as aforesaid deponents have delivered/ or are delivering their duly executed indemnity Bonds, as Principal Executants along with two permanent University Employees Surety and the deponents and the surest have there have thereby assured the University Authorities that they will keep the University fully Indemnified for releasing such payments to the widow of the deceased, and the in any circumstance would not lay any claim or raise any objection to such mode of payment and discharge and that payments/s the University in the above accounts to the window of the deceased be taken as payment made to all legal heirs of the deceased and the lawful claimants. *Samreen/LV/Format2

3 DEPONENT (S) S.NO. NAME : SINGNATURE VERIFICATION: We, the deponents above named, take oath/solemnly affirm and state at Aligarh on.. that the contents of pares 1 to 8 of the Affidavit are true to our personal knowledge that nothing contained therein is false nor anything has been concealed. So help us God. DEPONENT (S) S.NO. NAME : SINGNATURE *Samreen/LV/Format3

4 I N D E M N I T Y B O N D S This deed made on the. day.200. by Mrs.... W/O, S/O, D/O late Mr.. R/O herein after referred to as Principal (s) and, (i) (ii) Mr./Mrs..S/O,W/O,Mr./Mrs... employed as..in the Deptt of A.M.U Aligarh and, Mr./Mrs..S/O,W/O,Mr./Mrs employed as in the Deptt of A.M.U Aligarh herein after called the sureties. 2. Whereas Late Mr./Mrs. S/O, W/O,Mr./Mrs.... Ex. employee of Aligarh Muslim University Deptt of. Died on whereas the Principal.Mr./Mrs is one the heirs of the deceased. 3. And whereas in accordance with section 74(b) of the University Accounts Code as amended and notified vide Registrar Office Memo No C-111 EC (591) -5/807 date an anticipatory payment of Rs.(Rupees in words... only) has already been made to the Principal (s) after obtaining the approval of the Finance Officer. 4. And whereas in total /balance amount of Rs.(Rupees in words only) on account of arrears pay and allowance is payable to the legal heirs of the deceased and as per section 74(b) of the University Accounts Code the payment is to be made after submission of the INDEMNITY BOND for double the amount due for payment. 5. And whereas the Principal (s) is/are adult heirs and,... (Name of minor heirs) Is/are minor heirs of the deceased employee as shown in the affidavit dated filled by Mrs and as recorded in the service Book of the deceased employee and as empowered by the adult Principals (s) heir (s) to collect and receive the payment on account of pay and allowance/encashment of leave etc. from the aligarh Muslim University not only on their own behalf but also on behalf of and or account of the minor(s) heir(s) of deceased and for their benefits the Aligarh Muslim University has agreed to issue a cheque for Rs.. (Rupees in word...only) in favor of Principal No.. Mrs.W/O (late Mr in full and final discharge as provided under Rule (a) (b) of the University accounts Code. 6. Now these presents witness that in pursuance of the aforesaid agreement the Principal (s) and the Sureties jointly and severally agree and undertake to reimburse and indemnity the Aligarh Muslim University, Aligarh forthwith and demur any sum which the said university made to pat to the extent of Rs.. (Rupees in words.only) (Double the amount due for payment) on account of claim that may be made by any person or any minor/ minor children of the deceased together with cost and 10% per month. *Samreen/LV/Format4

5 7. And it is further agreed and declared that the liability of the sureties here-in after shall not in any way be impaired or discharged by reason of any forbearance act or omission of the University towards the principal whether with or without the consent or knowledge of the sureties nor it. Shall be necessary to sure the principal before suing or taking any action against the sureties or any one of the sureties. The University also reserves the right to adjust the claimable/payable amount from salary account of the sureties. In witnesses whereof the Principal and sureties have set their respectively hands on the date and year first above written. PRINCIPAL WITNESS: SURETIES 1. Sign: 1. Sign: Full Name: Name: Designation: Designation: Deptt : Deptt : Home address Home address 2. Sign: 2. Sign: Full Name: Name: Designation: Designation: Deptt : Deptt : Home address Home address Signature of the Officer attesting the signature of the Principal(s) sureties witness in whose presence the deed has been has been signed. SIGNATURE Chairman/Head of the department/office. *Samreen/LV/Format5

6 We solemnly declare that: DECLARATION OF SURITIES 0 1. W e a r e p e r m a n e n t e m p l o y e e s o f A. M. U A l i g a r h W e h a v e t a k e n s u r e t i e s o n l y i n t h e c a s e o f l a t e Mr. S/O Mr. Ex. Department/Office Aligarh Muslim University, Aligarh. 03. We have not taken surety in any other case before this case. 04. We shall not take any surety in other case later this case. God help me. S U R I T E S 1. Signature : Full Name : Designation : Deptt./ Office : Home Address : 2. Signature : Full Name : Designation : Deptt./ Office : Home Address : Signature & Seal Head of Deptt. / Office of Concerned employees *Samreen/LV/Format6