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Form G

This document is an application form for nominees or legal heirs to withdraw funds from a deceased subscriber's Public Provident Fund account. It outlines the necessary enclosures required for the withdrawal, including death certificates and legal documents. The form also includes sections for the accounts office to sanction the withdrawal and for the claimant to acknowledge receipt of the funds.

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swarnimrastogi9
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59 views1 page

Form G

This document is an application form for nominees or legal heirs to withdraw funds from a deceased subscriber's Public Provident Fund account. It outlines the necessary enclosures required for the withdrawal, including death certificates and legal documents. The form also includes sections for the accounts office to sanction the withdrawal and for the claimant to acknowledge receipt of the funds.

Uploaded by

swarnimrastogi9
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Form G

[See sub-paragraph (6) of paragraph 12]


Application for withdrawal by Nominees/Legal Heirs under the
Public Provident Fund Scheme,1968
To

The Agent/Manager/Postmaster

……………………(Name of the Bank/Head Post Office)

I/we ……………………………..… the nominee(s)/legal heir(s) of


late……………………… the subscriber to Public Provident Fund Account
No…………………., wish to withdraw the entire amount standing to the credit of the
deceased in the said account.

Please find enclosed ;


(i) A certificate in regard to the death of subscriber
* (ii) Certificate in regard to the death of Shri ………………………….. and
Shri ……………………… also the nominee(s) appointed by the subscriber.
** (iii) Succession Certificate/Letters of Administration with attested copy of
probated will of the deceased subscriber issued by ……………….. High
Court.
@(iv) Passbook of the subscriber
@(v) Letter of indemnity.
@(vi) Affidavit
@(vii) Letter of disclaimer on affidavit.
Place _________ Signature(s)/Thumb impression
Date__________ of claimant(s)
FOR USE OF ACCOUNTS OFFICE
Withdrawal of Rs……………..(Rupees …………………………………..) is
sanctioned.
Date_________ Accounts Officer
RECEIPT TO BE SIGNED BY THE CLAIMANT (S)
Received the sum of Rs. ……………..(Rupees ……………………….……) from
the State Bank of ………………./Post Office. in full settlement of our claim.
Place _________ Signature(s)/Thumb impression
Date__________ of claimant(s)
*Delete if not applicable
**Strike off if there is a valid nomination
@To be produced by legal heirs, in the absence of nominations for claims upto Rs.1 lakh

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