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 OFFICE OF THE
PATCHHARA GRAM PANCHYAT
COOCH BEHAR-I PANCHAYAT SAMITY
P.O PATCHHARA, DIST. COOCH BEHAR, PIN- 736157

MemoNo....................................... Date........./.........../......................

LEGALHEIRSHIP CERTIFICATE

In This sense, I am informing you that I, Sri. Rajkumar Debnath, S/o Lt.
Birbhadra Debnath alias Bir Nath Deb., residing at Vill. Bara Nalangi Bari, P.o.
Patchhara, P.s. Kotwali, Dist. Cooch behar, Pin- 736157. My father died 30 years
ago, leaving me. And my mother died before my father. So he has no heir except
me.

Warishan of heavenly Birbhadra Debnath alias Bir Nath Deb.

Sl. No. Name Relation Current Stutus

1. Sri. Rajkumar Debnath Son Alive

I do here by declare that all the above statement are true and correct. If I
write wrong information then the responsibility will fall on our gram Panchayat
and Prodhan.

Besides, there is no heir of the deceased. They ary my local residents. I

know them. As far as I know the details are true.

Signature of the Applicant Signature of the Gram Panchayet

Pradhan
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