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THT HATeT YaT fHTT HRM

Fi47T4far Corporate Oftice


254-260. arrTH HTÀ AVVai Shanmugam Salal
T3475 AIndlan Bank Hai arqHTT Welfare
AT tIP: 10.141.45.64
Dept

TET Royapettah, *Chennal 600 014 : 044-28134524/ Extn:


4787
HISTAIK AlLAHABAD :044-28134065
cohrmgsli@indianbank.co.in
GSLI DEATH CLAIM
SETTLEMENT
ZOP/LEGAL/D-CLAIM/2020/136 dated 30.01.2021
(ACKNOWLEDGEMENT/ RECEIPT)
Received from Indian Bank,
Service branch Chennai, an
amount of Rs.734543/-
Thousand Five Hundred and Rupees Seven Lakh Thirty Four
Forty Three Only being the Settlement
Late Mr/Ms. AVINASH Proceeds of GSLI Death Claim in
WAMAN DABHOLE SR No 22230 respect of
deceased on 13.07.2020.

WITNESSED BY:

(SIGNATURE& DESIG)

(Signature ofnominee(s)/Legal heirs)

DATE:

PLACE

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Pl
rdn ga Aet nu 69h440196s3
o Cedit thamnd A e n n nam

P a s i n t e Seme accour

Thog Y

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