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Affidavit for Death Claim Settlement in Banks

I, ___________wife of late __________resident of  ________, Tehsil & District _________, do hereby solemnly affirm and declare as under:-
1.    That Late __________is my husband who expired on dated ________ (Death certificate enclosed).
2.    That he had the following  account with __________ (Bank Name) Bank, ___________ (Account Details)
3.    That he left behind the following legal heirs :-
(1) _________(2) ________ (if any) all sons/daughters of late ____________son of _________& (3) ___________ wife of late _________________ all resident of ___________, Tehsil & Distt._______________,
4.    That the  deceased have no children of my aforesaid expect the mentioned above
DEPONENT
VERIFICATION:-
Verified that the contents of the above said affidavit are true and correct to the best of my knowledge and belief and nothing has been concealed therein.
Verified at ___________ on  this ____________
DEPONENT
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