| To |
|
The Mandal
Revenue Officer
.........................................Mandal
Hyderabad,
A.P. |
|
Sub:
Application for Issue of Legal Heirs Certificate/
Family
Members Certificate -
Requested -
Regarding. |
| Respected Sir, |
|
I beg to submit that
my.................................................................................................
R/o.H.No.....................................................................................................................................................................................
expired
on...............................................................He/She
as a pentioner.....................................................................
He,
She was expired while in service working as a
...................................................................................................
in
the office of
the....................................................................................................................................................................
I
have applied for legal Heirship certificate to submit the same
at......................................................for
getting to claim the
benefit for claiming Department
inner
benefits. life time arrears appointment of my
.......................................................
Smt./Sri./Kum.....................................................
to
you for verification, I may kindly be issued a Residential
Certificate.
On receipt of the Certificate from Mandal Oficer, I will submit the
same......................................................................
for
the purpose of..................................................................................................................... |
| Name
of the Family members are given below: |
| Sl.No. |
Name
of the family members |
Age
Years |
Relationship
with
the deceased |
Remarks/Status |
| 1. |
|
|
|
|
| 2. |
|
|
|
|
| 3. |
|
|
|
|
| 4. |
|
|
|
|
| 5. |
|
|
|
|
| 6. |
|
|
|
|
| 7. |
|
|
|
|
|
|
I
therefore humbly request your good self to issue the in Legal Heir ship
Certificate/Family member Certificate
and
submitted death certificate No...............................dated...........................................and
pension payment slip/service
certificate of his/her
deceased of submitted herewith for
kind per ................ and necessary
action. |
|
|
| Dated: |
Yours
Faithfully |
| Name: |
(
) |
| Address: |