AFFIDAVIT

I, _____ wife of late _____ R/o  _____, do hereby solemnly affirm and declare as under:-

1. That Late _____ is my husband who expired on dated _____ (Death certificate enclosed).

2. That he had the following  account with  _____Bank, _____  vide  _____

3. That he left behind the following legal heirs :-
(1) _____ (2) _____ all sons/daughters of late _____ son of  _____  & (3) _____ Wife of late  _____ All resident of  _____,
4. That the  deceased have no children of my aforesaid expect the mentioned above

DEPONENT

VERIFICATION:-

Verified that the contents of the above said affidavit are true and correct to the best of my knowledge and belief and nothing has been concealed therein.

Verified at  _____  on  this _____

DEPONENT