ER-0148

BN-160,LM97
EASTERN RAILWAY

LEGAL HEIR CERTIFICATE

Department __________________________ Office ______________________

Legal Heir Certificate for ________________________________________ dues

We hereby certify to the best of our knowledge and belief that the

total value of the Estate of ____________________________________________

designation _____________________________ Ticket No. _____________________

of _______________________________ is under ` ____________________________

and that (Name) _________________________________________________ is the

legal recipient, whose designation is given below, of the sum of `

____________________________ representing the amount standing to credit of the

Estate in respect of ____________________________________________ .

Dated ______________________ ____________________________________

Signature of the Legal Recipient

____________________________________ Signature of marks of the certifying

Signature of Witness parties
( Supervisor or other Officer )

Name ___________________________________ 1 st ___________________________

Designation ______________________________ Designation __________________

Station _____________________ Office ______________________

2nd __________________________

Designation _________________

Office _______________________

Date : ___________________ Countersigned _________________________

Head of Deptt. ________________________