Da Forms: Da-1 To Annexure-15 Page 25
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35ANNEXURE-9
Form of Inventory of Contents of
Safe Deposit Locker Hired from The South Indian Bank Ltd.
no
(To be used where there is
nomination or survivorship clause)
The following inventory of contents of Safe Deposit Locker No. ______________
located
in
the
Safe
Deposit
Vault
of
The
South
Indian
Bank
Ltd.,
________________________Branch at _____________________________
* hired by Shri/Smt. __________________________ (deceased) in his/her sole
name
* hired by Shri/Smt. (i) ______________________________ (deceased) jointly with
(ii) ______________________________
(iii) ______________________________
was taken on this _______________ day of _________________ 20_____.
Sr.
Description of Articles in Safe
Other Identifying Particulars, if
No.
Deposit Locker
any
For the purpose of inventory, access to the locker was given to the legal heir(s)/a
person mandated by the legal heirs and the surviving hirers
• who produced the key to the locker.
• by breaking open the locker under his/her/their instructions.
(delete whichever is not applicable)
The above inventory was taken in the presence of:
Legal hiers to deceased joint hirer(s)/person mandated by legal heirs
1. Shri/Smt. _______________________
_______________
Address ________________________
(Signature)
Shri/Smt. _______________________
_______________
Address _______________________
(Signature)
and
Shri/Smt.____________________________________
______________
Survivors of joint hirers
(Signature)
Address _________________________
Contd…2
25
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