Da Forms: Da-1 To Annexure-15 Page 18
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35ANNEXURE-4.
AFFIDAVIT
We,
(1)____________________________,
Son/Wife/Daughter
of
___________________, aged _____ years, occupation _________________, and
resident
of
________________,
(2)
____________________________,
Son/Wife/Daughter of ___________________, aged _____ years, occupation
_________________,
and
resident
of
________________,(3)____________________________,
Son/Wife/Daughter
of
___________________, aged _____ years, occupation _________________, and
resident of ________________, do solemnly affirm and state as follows:-
We hereby solemnly affirm and declare that Sri ____________________,
Son/Wife/Daughter
of
______________
who
was
residing
at
____________________________________________ expired on _____________
and we are his/her only legal heirs entitled to succeed to the estate of deceased.
We also confirm and declare that to the best of our knowledge and belief the said late
____________________________ died intestate, i.e. without executing any Will.
DEPONENTS
Solemnly affirmed at ______________ on this _________________ day of
__________, and the deponents signed before me.
NOTARY
18
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