(On Rs.

100 Stamp paper)

INDEMNITY BOND

I, ___________, _____(relationship) of Late __________________, resident of

___________________________________________________ hereby undertake to indemnify the
CRA/PFRDA/NPS Trust for any loss or detriment that may be caused on account of settling
the claim for withdrawal of accumulated pension wealth due on the death of my ____________,
Late _____________________, in my favour on behalf of other legal heirs of the said Late
________________ Viz., _________________________________.

Place: (______________)

Date: Signature of Deponent

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