Da Forms: Da-1 To Annexure-15 Page 30

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ANNEXURE-13
Form of Inventory of Contents of
Safe Deposit Locker Hired from The South Indian Bank Ltd.
{Section 45ZE (4) of the Banking Regulation Act, 1949}
(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 Nominee/ 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:
1. Shri/Smt. _______________________ (Nominee) _______________
Address ________________________ (Signature)
Shri/Smt. _______________________ (Nominee) _______________
Address _______________________ (Signature)
and
Shri/Smt.____________________________________
______________
Survivors of joint hirers
(Signature)
Address _________________________
Contd…2
30

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