Indemnity Format

(To be stamped as an indemnity, Stamp duty to as per applicable stamp Act.)

LETTER OF INDEMNITY WITH RESPECT TO PAYMENT OF BALANCE IN

THE DECEASED CONSTITIUENT’S ACCOUNT WITHOUT PRODUCTION OF
LEGAL REPRESENTATION.

To

ICICI Bank Limited

1) Insert IN CONSIDERATION OF your paying or agreeing to pay to us

Here ……………………………………………………….the sum of
Names of Rupees “ “standing at the credit of
The heirs of “ “ account No with your Bank in the name of
The …………………………., since deceased, without production of
Deceased Letters of Administration or a Succession certificate to his/her estate or a
To whom certificate from the Controller of Estate Duty to the effect that estate duty
Payment is has been paid or will be paid or none is due,
Made
2) State I …………………….son of ……………………….and
Here the …………………….. son of ……………………….and
Names of ……………………..daughter of……………………....
The heirs of
The
Deceased
(Including
Those who AND
Signed
Letter of Shri …………………. son ………………………residing at
Authority) …………………………………….. and Shri……………
…………. Son of ………………….. residing at
……………………….. do hereby for ourselves and our
State here heirs, legal representatives , executors and administrators,
Names of jointly and severally UNDERTAKE AND AGREE to indemnify
The you and your successors and assigns against all claims, demands,
Sureties proceedings, losses, damages, charges and expenses which may be
raised against or incurred by you by reason or in consequence of
your having agreed to pay/or paying to *me/us the said sum as
*the aforesaid.
Persons
Named in
(1)

SIGNED AND DELIVERED

By the above named
………………………….
(1)
(2)
(3)

(Heirs of the deceased)

SIGNED AND DELIVERED

By the above named
………………………..
………………………..
………………………..
………………………..
(Sureties)
In witness whereof, we have hereunto set our hands at …………………..

In the presence of……………………………………………………….on

This day of………………………………at Place Coimbatore

Names and addresses of witnesses:

1. 1.

2. 2.

(Signature of witnesses)