INDEMNITY BOND

THIS INDEMNITY BOND made and executed in exercise of the executive power of the date
this …………………….. day of ……………………………. 195

BETWEEN THE GOVERNOR OF ANDHRA PRADESH hereinafter called the

(“Government” which term shall include his successors in office) of the one part; AND(1)
………………………… Son of ……………………………….. aged ……………………..
years, occupation ……………………………………………………………………….. residing
at ………………………………. AND (2) ……………………………………………… son of
………………………………………. Aged …………………… years, occupation
…………………………………………………. Residing at ……………………. Hereinafter
called the “Suretics” (which term shall include their heirs successors and legal representatives) of
the other part ;

WHEREAS Shri ……………………………. Son of …………………. Employee of the

……………………… Department, Government of Andhra Pradesh who was a subscriber to the
Andhra Pradesh Life Insurance Fund (hereinafter referred to as the “Fund”) died on……………
leaving behind him surviving heirs (sons, daughters, etc.,), (1) ………………………………..
(2) …………………………………….(3) ……………………..………………… etc.,

AND WHEREAS a sum of I.G Rs…………………………………….. (in words) was

payable to the said subscriber at the date of his death by the fund.

AND WHEREAS the said heirs have applied to the Government to pay to him / her /
them the said sum of Rs. …………………………………………. (in words) and the
Government have agree to pay the said sum on his/her/their producing an Indemnity Bond with
two sureties.

AND WHEREAS we, the above named, have agreed to stand sureties for the said heir or
heirs;

NOW THEREFORE this deed witnesseth as follows : --

1. That we, the above named Sureties shall indemnify and keep indemnified the
Government against all claim, suits, proceedings, actions, costs, charges and
expenses, which shall or may be referred, instituted or arise in consequence of the
Government paying the said sum of Rs……………………………………… (in
words), to the said heir or heirs.

2. That we the above named, sureties further declare that if the Government suffers
any , we shall make up such loss. In the event of default on our part, the
Government shall be at hereby to recover the amount of loss from our person and
property under the provisions of the Hyderabad Government Demands Act (IV of
1308 Fasli) or under any other law for the time in force in that behalf.
IN WITNESS WHEREOF we, the above, sureties, have affixed our signatures
on the date and year herein above written in the presence of the following two
witnesses :-

WITNESSES :

Signature of the first surety.

Signature of the second surety.