APPLICATION FOR LEGAL HEIR CERTIFICATE

To
The Mandal Revenue Officer,
-----------------------------------------------------District.
Respected Sir,
Sub:- Issue of Legal Heir certificate- regarding.
I R/o ------------H.No.-----------------------------------------------------------------------I am Legal Heir of deceased person who is expired on ---------------------------------------the following family members are legal heirs of Shri Late:---------------------------------------------------------------------------------------------------.
Sl.No.
Name
Relationship with
Age
Deceased person
- -- ------------------------ ------------------------------- --------------------- ------------------- -----

-------------------------------- ------------------------------- ---------------------------------- -------I request your kind authorities to issue us legal heir certificate at an early date.
Thanking you,
Yours faithfully,

Encl: Affidavit
2.Death Certificate
3.Service certificate
of deceased if He/she were an employee.

AFFIDAVIT
I ..S/o Sri . Aged about
years, having an occupation of , resident
of do hereby solemnly affirm and state on oath as follows:
I am the deponent herein, as such I am well acquainted with the facts of this affidavit.
I submit that my ..(relationship to be mentioned) namely
..(givename of the deceased) who was working
.. (give details of occupation of the deceased) has expired on
..(date) leaving behind surviving legal heirs as under:
Sl. No. Names

Age

Relationship with the deceased

Status (married/unarried)

1
2
3
4
5

I further submit that the above mentioned are legal heirs only.
Hence, I swear this affidavit in order to obtain legal heir certificate from the concerned
Mandal Revenue Officer for the service benefits of my .(give relation
ship with the deceased).
The above facts are true and correct to the best of my knowledge and belief. Hence this
affidavit.
DEPONENT
Sworn and signed before me on this
..day of ..month
year at ..place.
NOTARY