1. That Late __________is my husband who expired on dated ________ (Death certificate enclosed).
2. That he had the following account with __________ (Bank Name) Bank, ___________ (Account Details)
3. That he left behind the following legal heirs :-
(1) _________(2) ________ (if any) all sons/daughters of late ____________son of _________& (3) ___________ wife of late _________________ all resident of ___________, Tehsil & Distt._______________,
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