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Pal Peugeot Ltd - Claim Form

• Customer Information Updation Form - Individual customers
• Customer Information Updation Form - Non-Individual customers
• Customer Information Updation Form - Joint customers

• FATCA/CRS Declaration Form - Individual
• FATCA/CRS Declaration Form - Non Individual
• FATCA Certification

• Nomination form for Lockers
• Nomination form for Accounts and Deposits

• Annex 1 - Claim form for accounts with nominee / survivorship clause-
• Death Certificate of the account holder(s)
• Copy of Death Certificate of nominee(s) (if applicable).
• Officially Valid Document of the claimant(s)
• Annex 10 - Acknowledgement Receipt for deposit accounts

*Additional document mandatory for settlement of FD without premature withdrawal mandate. (MOP ERS/ARS/FRS)

• Annex 16 - (No Objection Certificate (NOC) from the legal heir for premature closure of FD)

Settlement amount up to ₹2 crores:

• Annex 2 - Claim form for accounts without nominee / survivorship clause
• Death Certificate of the account holder(s)
• Officially Valid Document of the claimant(s)
• Annex 3 - Bond of indemnity
• Annex 4 - Letter of disclaimer / No objection from non-claimant legal heir (if applicable)
• Legal Heir Certificate issued by a competent authority OR Annex 5 - Declaration/Affidavit regarding the legal heir(s) of the deceased depositor(s) by an independent person who is well known to the family of the deceased, is not a party to the claim
• Annex 10 - Acknowledgement Receipt for deposit accounts

Settlement amount above ₹2 crores:

• Annex 2 - Claim form for accounts without nominee / survivorship clause
• Death Certificate of the account holder(s)
• Officially Valid Document of the claimant(s)
• Succession Certificate/Letter of Administration/Court order
• Annex 10 - Acknowledgement Receipt for deposit accounts

OR

• Annex 2 - Claim form for accounts without nominee / survivorship clause
• Death Certificate of the account holder(s)
• Officially Valid Document of the claimant(s)
• Annex 3 - Bond of indemnity along with surety
• Annex 4 - Letter of disclaimer / No objection from non-claimant legal heir (if applicable)
• 1. Legal Heir Certificate issued by a competent authority OR
  2. Annex 5 - Declaration/Affidavit sworn before a Notary Public / Judge / Judicial Magistrate regarding the legal heir(s) of the deceased depositor, by an independent person who is well known to the family of the deceased, is not a party to the claim
• Annex 10 - Acknowledgement Receipt for deposit accounts

A. With nomination - In the event of death of both / all joint account holders, the balance outstanding at the time of death of the depositors will be paid to the nominee

• Annex 1 - Claim form for Accounts with nominee / survivorship clause
• Death Certificate of the account holder(s) (mandatory)
• Copy of Death Certificate of nominee(s) (if applicable).
• Officially Valid Document of the claimant(s)
• Annex 10 - Acknowledgement Receipt for deposit accounts

B. Without nomination - In case of death of both/ all joint account holders, the balance outstanding will be paid jointly to the legal heir(s) of all the deceased depositors

Settlement amount up to ₹ 2 crores:

• Annex 2 - Claim form for Accounts without nominee / survivorship clause
• Death Certificate of the account holder(s)
• Officially Valid Document of the claimant(s)
• Annex 3 Bond of indemnity
• Annex 4 - Letter of disclaimer / No objection from non-claimant legal heir (if applicable)
• Legal Heir Certificate issued by a competent authority. OR Annex 5 - Declaration/Affidavit regarding the legal heir(s) of the deceased depositor(s) by an independent person who is well known to the family of the deceased, is not a party to the claim
• Annex 10 - Acknowledgement Receipt for deposit accounts

Settlement amount above ₹ 2 crores:

• Annex 2 - Claim form for Accounts without nominee / survivorship clause
• Death Certificate of the account holder(s)
• Officially Valid Document of the claimant(s)
• Succession Certificate/Letter of Administration/Court order
• Annex 10 - Acknowledgement Receipt for deposit accounts

OR

• Annex 2 - Claim form for Accounts without nominee / survivorship clause
• Death Certificate of the account holder(s)
• Officially Valid Document of the claimant(s)
• Annex 3 - Bond of indemnity along with surety
• Annex 4 - Letter of disclaimer / No objection from non-claimant legal heir (if applicable)
• 1. Legal Heir Certificate issued by a competent authority OR
  2. Annex 5 - Declaration/Affidavit sworn before a Notary Public / Judge / Judicial Magistrate regarding the legal heir(s) of the deceased depositor, by an independent person who is well known to the family of the deceased, is not a party to the claim
• Annex 10 - Acknowledgement Receipt for deposit accounts

• Annex 1 - Claim form for Locker with nominee / survivorship clause
• Death Certificate of the account holder(s)
• Copy of Death Certificate of nominee(s) (if applicable).
• Officially Valid Document of the claimant(s)
• Annex 6 - Inventory form and Acknowledgement for Safe Deposit Lockers

• Annex 2 - Claim form for locker without nominee / survivorship clause
• Death certificate of the deceased locker hirer
• Officially Valid Document of the claimant(s) /beneficiaries
• Succession Certificate/Letter of Administration/Court order
• Annex 6 - Inventory form and Acknowledgement for Safe Deposit Lockers

OR

• Annex 2 - Claim form for locker without nominee / survivorship clause
• Death certificate of the deceased locker hirer
• Officially Valid Document of the claimant(s) /beneficiaries
• Annex 6 - Inventory form and Acknowledgement for Safe Deposit Lockers
• Annex 4 - Letter of disclaimer / No objection from non-claimant legal heir (if applicable)
• Annex 8 - Bond of indemnity with respect to delivery of contents of Safe deposit locker
• 1. Legal Heir Certificate issued by a competent OR
  2. Annex 5 - Declaration/Affidavit, in sworn before a Notary Public / Judge / Judicial Magistrate regarding the legal heir(s) of the deceased depositor, by an independent person who is well known to the family of the deceased, is not a party to the

A. With nomination - In the event of death of both / all joint locker hirers, the nominee(s) will be allowed to access the locker and remove the contents

• Annex 1 - Claim form for Locker with nominee / survivorship clause
• Death Certificate of the account holder(s)
• Copy of Death Certificate of nominee(s) (if applicable).
• Officially Valid Document of the claimant(s)
• Annex 6 - Inventory form and Acknowledgement for Safe Deposit Lockers

B. Without nomination - In the event of death of both / all the joint locker hirers, all the legal heirs (or any one of them as mandated by all legal heirs) would be allowed to access the locker and remove the contents

• Annex 2 - Claim form for locker without nominee / survivorship clause
• Death certificate of the deceased locker hirer
• Officially Valid Document of the claimant(s) /beneficiaries
• Succession Certificate/Letter of Administration/Court order
• Annex 6 - Inventory form and Acknowledgement for Safe Deposit Lockers

OR

• Annex 2 - Claim form for locker without nominee / survivorship clause
• Death certificate of the deceased locker hirer
• Officially Valid Document of the claimant(s) /beneficiaries
• Succession Certificate/Letter of Administration/Court order
• Annex 6 - Inventory form and Acknowledgement for Safe Deposit Lockers
• Annex 4 - Letter of disclaimer / No objection from non-claimant legal heir (if applicable)
• Annex 8 - Bond of indemnity with respect to delivery of contents of Safe deposit locker
• 1. Legal Heir Certificate issued by a competent OR
  2. Annex 5 - Declaration/Affidavit, in sworn before a Notary Public / Judge / Judicial Magistrate regarding the legal heir(s) of the deceased depositor, by an independent person who is well known to the family of the deceased, is not a party to the

Deposit Accounts

• Annex 2 - Claim form for Accounts without nominee / survivorship clause
• Copy of WILL
• Death Certificate of the account holder(s)
• OVDs of the claimant
• Annex 3 - Bond of indemnity
• Annex 4 - Letter of disclaimer / No objection from non-claimant legal heir (if applicable)
• Annex 10 - Acknowledgement Receipt for deposit accounts

For Safe Deposit lockers

• Annex 2 - Claim form for locker without nominee / survivorship clause
• Copy of WILL
• Death Certificate of the account holder(s)
• OVDs of the claimant
• Annex 6 - Inventory form and Acknowledgement for Safe Deposit Lockers
• Annex 4 - Letter of disclaimer / No objection from non-claimant legal heir (if applicable)
• Annex 8 - Bond of indemnity with respect to delivery of contents of Safe deposit locker
• 1. Legal Heir Certificate issued by a competent authority OR
  2. Annex 5 - Declaration/Affidavit, in sworn before a Notary Public / Judge / Judicial Magistrate regarding the legal heir(s) of the deceased depositor, by an independent person who is well known to the family of the deceased, is not a party to the claim

1. Annex 2 - Claim form for without nominee / survivorship clause
2. Death certificate of the deceased depositor(s)
3. Officially Valid Document of the claimant(s)
4. Probate WILL / Succession certificate / Letter of Administration / Court order
5. Annex 10 - Acknowledgement Receipt for deposit accounts
6. Annex 6 - Inventory form and Acknowledgement for Safe Deposit Lockers

PPF Account with nomination

1. Form 11 – Annexure
2. Copy of death certificate of subscriber
3. Form E for details of nominee(s) or as per updated in Bank records
4. Self-attested ID proof or PAN copy with branch OSV.

PPF Accounts without nomination 

Claim amount up to 5 lakh

1. Application Form 11 -(Annexure)
2. Copy of Death Certificate of the subscriber
3. Self-attested ID proof/PAN copy with branch OSV
4. Pass Book or Deposit Receipt/original Statement of Account
5. Affidavit in Form-13 (Annexure) on stamp paper
6. Letter of Disclaimer in Form-14; (Annexure) on stamp paper
7. Bond of Indemnity in Form-15 (Annexure) on stamp paper.

Claim amount above Rs 5 lakh

1. Application Form (Form-11) (Annexure)
2. Death Certificate of subscriber
3. Succession Certificate or Letter of Administration /An attested copy of the Probated Will of deceased subscriber issued by High Court
4. Self-attested proof of identity / PAN copy with branch OSV.

Mandatory: Death Certificate, duly attested by Notary Public/Gazetted Officer/Original. In case Death Certificate is issued abroad, then it must be attested by Indian Embassy/Indian Consulate.

Documents required for Transmission – Joint Holder Case:

1. Transmission Form duly filled and signed by the surviving holder
2. In case the surviving holder’s Demat Account account is with another DP, then the Client Master List (CML copy) is required
3. Self-attested PAN copy of the surviving holder.

Documents required for Transmission - Nominee Case:

1. Transmission Form duly filled and signed by the Nominee. In case there is more than one Nominee, then each Nominee should submit a separate Transmission Form
2. If the Nominee’s Demat Account is with another DP, then the Client Master List (CML) should be attested by the respective DP with signature and stamp
3. Self-attested Pan copy of the Nominee
4. Account opened before 2016 – Nominee Indemnity is required (Only for NSDL Cases)
5. Account opened post 2016 – ID proof submitted at the time of nomination should be provided.

Documents required for Transmission (Without Nominee or Survivor) - Legal Heir with less than 15 lakhs holdings:

1. Transmission Form duly completed by Legal Heir/s. In case there is more than one Legal Heir, then each Legal Heir should submit separate Transmission Forms
2. Self-attested PAN copy of legal Heir/s
3. In case the Demat Account is with another DP, then the Client Master List (CML copy) should be in crystal format
4. A Notarised Affidavit, from all Legal Heir/s made on a non-judicial stamp paper of an appropriate value, to the effect of the identification and claim of legal ownership to the Securities; (in case the Legal Heir/s/Claimant/s are named in the Succession Certificate or Probate of Will or Will or Letter of Administration or Legal Heirship Certificate (or its equivalent certificate), issued by a competent Government Authority, an affidavit from such Legal Heir/s/Claimant/s alone, will be sufficient
5. Copy of the Succession Certificate (in terms of the Indian Succession Act, 1925), evidencing the rights of the Legal Heir/s/Claimant/s, attested by the Legal Heir/s/Claimant/s subject to verification with the original, or duly attested by a Notary Public or by a Gazetted Officer; Or Copy of Letter of Administration Or Copy of Court Decree Or Copy of Probate* of Will (*Probate of Will shall only be insisted on, if applicable in the terms of the Indian Succession Act, 1925) Or Copy of the Will Or Copy of the Legal Heirship Certificate or its equivalent certificate issued by a Competent Government Authority, duly attested by a Notary Public or by a Gazetted Officer or attested by the Legal Heir/s/Claimant/s subject to verification with the original, to be accompanied with a notarised Indemnity Bond and a No Objection from all the Legal Heir/s/Claimant/s stating that they have relinquished their rights to the claim for transmission of Securities, duly attested by a Notary Public or by a Gazetted Officer
6. In case of non-availability of documents mentioned in Point No. 5, the following should be submitted along with documents mentioned in Point No. 1 to 4;
   • Notarised Indemnity Bond made on a non-judicial stamp paper of an appropriate value from all Legal Heir/s/Claimant/s to whom the Securities are transmitted
   • No Objection Certificate/s from all Legal Heir/s/Claimant/s, clearly relinquishing their rights to the claim for transmission of Securities, or Copy of Family Settlement Deed duly executed by all Legal Heir/s, duly attested by a Notary Public or by a Gazetted Officer (as an alternate to the No Objection certificate/s).

Documents required for Transmission (Without Nominee or Survivor) - Legal Heir with more than 15 lakhs holdings:

1. Transmission Form duly completed by Legal Heir/s (mentioned in court order). In case there is more than one Legal Heir, then each Legal Heir should submit a separate Transmission Form
2. Self-attested PAN copy of legal Heir/s
3. In case the Demat Account is with another DP, then the Client Master List (CML copy) should be in crystal Format
4. A Notarised Affidavit, from all Legal Heir/s made on a non-judicial stamp paper of an appropriate value, to the effect of identification and claim of legal ownership to the Securities; (in case the Legal Heir/s/Claimant/s are named in the Succession Certificate or Probate of Will or Will or Letter of Administration or Legal Heirship Certificate (or its equivalent certificate), issued by a competent Government Authority, an affidavit from such Legal Heir/s/Claimant/s alone, will be sufficient)
5. Copy of the Succession Certificate (in terms of the Indian Succession Act, 1925), evidencing the rights of the Legal Heir/s/Claimant/s, attested by the Legal Heir/s/Claimant/s subject to verification with the original or duly attested by a Notary Public or by a Gazetted Officer; Or Copy of Letter of Administration Or Copy of Court Decree Or Copy of Probate* of Will (*Probate of Will shall only be insisted on, if applicable in the terms of the Indian Succession Act, 1925) Or Copy of Will Or Copy of Legal Heirship Certificate or its equivalent certificate issued by a Competent Government Authority, duly attested by a Notary Public or by a Gazetted Officer or attested by the Legal Heir/s/Claimant/s subject to verification with the original to be accompanied with a notarised Indemnity Bond and a No Objection from all the Legal Heir/s/Claimant/s stating that they have relinquished their rights to the claim for transmission of Securities, duly attested by a Notary Public or by a Gazetted Officer.