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. ________________________