Da Forms: Da-1 To Annexure-15 Page 34
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35ANNEXURE-15
Form of Inventory of Contents of
Safe Custody with The South Indian Bank Ltd.
no
(To be used where there is
nomination or survivorship clause)
The
following
inventory
of
articles
left
in
Safe
Custody
with
______________________
Branch
of
The
South
Indian
Bank
Ltd.,
by
Shri/Smt.
____________________________(deceased) under an agreement/receipt dated
______ was taken on this _______________ day of _________________ 20_____.
Sr.
Description of Articles in Safe
Other Identifying Particulars, if
No.
Custody
any
The above inventory was taken in the presence of:
Legal hiers or a person mandated by legal heirs
1. Shri/Smt. _______________________
_______________
Address ________________________
(Signature)
2. Shri/Smt. _______________________
_______________
Address _______________________
(Signature)
2. Witness(es) with name, address and signature:
Shri/Smt. ___________________________
_______________
(Signature)
Address: _______________________________
Shri/Smt. ________________________________
_______________
(Signature)
Address : _________________________________
Contd…2
34
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