(2)

Details of assets/securities/deposits are as follows:

Ref. No. Description Issuing Date Date of Amount/Value

Maturity
Bank Account Type: Savings
(Being Account No. 06060100005019) Rs. 2,01,154.27/- + Interest

(Total Amount/Value in words Rupees Two Lakh One Thousand One Hundred Fifty- Four
Point Two-Seven with Interest)

Name Occupation State whether Residential address Office Date

claimants/other address
heirs/Sureties/Executors/
administrators
i) Radharani Housewife Claimant Budbud, Purba -
Das Bardhaman -713403
(W.B)
ii) Sanjib Service Claimant Near Girls School, -
Kumar Das Budbud, Purba
Bardhaman -713403
(W.B)
iii) Ranjit Das Daily-Wage- Claimant Budbud, Purba -
Labour Bardhaman -713403
(W.B)
iv) Surajit Das Daily-Wage- Claimant Saheb Pukur, Budbud, -
Labour Jharul, Purba
Bardhaman -713403
(W.B)
v) Amal Contractual Surety Sukantanagar,Budbud, -
Chatterjee Worker Purba
Bardhaman -713403
(W.B)
vi) Bidhan Teacher Surety Budbud, Purba -
Kumar Dutta Bardhaman-713403
(W.B)

We undertake to notify immediately the Bank of any change in our above address/es

Date: __________________________

1. ………………………………………..

Signature:
2. ………………………………………..
Claimant
s
3. ………………………………………..

4. ………………………………………

.5 ………………………………………..

Surety
6. ………………………………………..