AFFIDAVIT FOR THE DECLARATION OF LEGAL HEIRS OF DECEASED EMPLOYEE FOR CLAIMING PROVIDENT FUND AND OTHER SUPERANNUATION DUES
 
Before the Chief Officer  ………………..Bank ………………..
 
In the matter of payment of provident fund and other superannuation dues payable in respect of late Shri .............................
 
	Affidavit of Smt. A, aged about 	years, widow of late Shri  ………………..resident of  ………………..
 
I, Smt. A, aged about ………………..years, widow of late Shri ………………..	resident	of  ………………..do hereby solemnly affirm and state as follows:
 
1 .	My husband Shri  ………………..was working as ………………..in  ………………..and he died on 	at ………………..due to heart attack.
2.	That my husband has not made any nomination under the  ………………..Provident Fund Regulations to receive his provident fund and other superannuation dues in case of his death.
3.	That my husband Shri  ………………..died intestate leaving him surviving myself, and my two minor children, Master ………………..aged ………………..years and Master ..........................aged ………..years, as his only heirs under the Hindu law, by which he was governed at the time of his death.
4.	That apart from myself and the said two minor sons, no other person has any right or interest in the money/properties left by the late Shri ........................
5.	I am making this affidavit knowing fully well that on the strength of the same, the 	..........................will recognise my claim to receive the provident fund, superannuation dues and other amounts payable in respect of late Shri...................	on behalf of myself and as mother and natural guardian of the said two minor sons, namely Master ………………..and  ………………..as the only heirs of my husband late Shri  ………………..

I, Smt. A, the above named deponent hereby declare and verify that the contents of paragraphs 1 to 3 and 5 are true to my personal knowledge and the contents of paragraph 4 are based on legal advice which I believe to be true. Nothing material has been concealed and no part of it is false. So help me God.
 
	Verified at  ………………..on this ………………..day of ………………20  ………………..
 
Date: ………………..									Deponent
 
	Solemnly affirmed by the said Smt . 	at 	this 
	day of 
			Before me
			Notary Public