Declaration in the case of a Hindu male dying intestate
I, / aged / years, / son / of
residing at
do hereby declare and state as follow:
I knew the deceased / residing / at
for / the last
years. He died on / (give the date of death) at
(give the place of death) leaving
behind him the following heirs under the Hindu succession Act, 1956.
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Sl. No. / Heirs / Name & Age

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1.  Son/s

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2.  Daughter/s

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3.  Widow/s

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4.  Mother/adoptive mother

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5. Other Class I Heirs Viz.,

a)  Children of predeceased son/daughter

b)  Widow of a predeceased son

c)  Children of predeceased son of a predeceased son

d)  Widow of a predeceased son of a predeceased son (Mention in that order)

6. Other Class II heirs such as :

a)  Father

b)  Son's daughter's son

c)  Son's daughter's daughter

d)  Brother

e)  Sister

To my knowledge, the above named deceased died intestate. I know that I may be liable for damages to the Bank in case it turns out that the information given by me above is incorrect and the Bank is made liable for making any wrong payment on the basis of this declaration.

______

Signature

Place :

Date :

Witnesses :

Signature / : / Signature / :
Name / : / Name / :
Occupation / : / Occupation / :
Full Address / : / Full Address / :