Application to start family permin

Name:- ______________
Date :- _______________
File Address:- __________
The chief/ Branch Manager.
State Bank of India
_________ Branch
(Branch mile hand over the application to PPG Difee at Dto)
Dear sir,
Family perm in
Will deep sorrow , I am to covey that my husband Shri Bishwanath Datta
.P.F Index no :-112852__________or__________

The relive Date cal fate (original fr verficalun) is Shaw by _____________is

enclose fr yur infer mating and recover. He was drawing she perinea form
your Branch bring bane A/c 20 : 30054332882 A copy of the invoice of per
mine family issued byte bank at time of reference I am beneficiary member
of the deceased per mine for drawing family penman and cavity the I am
not re married I shall lterefre be if my mill peered crag to man payment of
family perm in to me will affect fr my pan cord .________/______ fr you
reference your fritnfwls (_________)
_____: 1 copy of _/___ cased 2 life ceil f____3 copy pan card
4.______________5. Copy Deal conlifide 6.dten of undertake 7 copy to
penman format advice.

Xerox copy __ be _ attested) copy to secretary, ____ pr mine Assoc , at(unit

at

Sera pure, mil ___________ to look in the mates and cragged to gat family
at an and_

____________

Signature

Associate Mantra No. so 1926

 LETTER OF UNDERETAKING BY THE FAMILLY PERMINER

The chief/Branch Manager

State Bank of Indian

__________ Branch

Dear, sir

I________________________, wife of Biswanath Dutta , repaid at 130/ periapt Shan Chandra Rood
Bangur park po : Rishra Dist : Hooghly, p: 712248 Undertake as under :

In cwiderelior of your having at nay react agreed to make payment of per mine due to me e very month
by credit to my account mille yen the undersigned, agree and undertake to refuse or make good any
amount to which I an not entitle. ________heresy untaken and agree to Did myself and my _______
secessions, exec tans and ___________to indemnify the bank from again not any loss , suffered or
_________ by the bank so crealitive my per mine to my accent under the scheme and to firth min pay
name __________________anttarige the Bank to recover amount due
by______________________________ to me in the possess of the Bank I hereby agree the is
_________ to exorcise erne ____a prior no the right of set of or account of any wrong excess or over
payment need to my account again the _____________ standing to my create in the account and /on in
any obtuse account in my name /on any other f__________/_____held or came to ____ on my be help
by the bank years firth

(signature)

Name :-_____________

Address :________________

Wlnesses :________________

(1) SIGNATURE :_______________

Address :- ____________________

(2) _______________
(3) _____________
_______________