Affidavit for share transmission

AFFIDAVIT
I, <name> S/D of <name of >  resident of <address> do solemnly swear and sincerely state as under :
1.	That <nos> shares having distinctive no. From < > to <>  of the face value  Rs.<> (<>) each are standing registered in the name of late <>  in the books of the Company <>
2.	That < >  died on <date>
3.	That <    > left behind the following heirs.
		Name			Age	Relationship
	i
	ii
	iii
	iv
4.	The above mentioned shares were the separate and self acquired property of the deceased.
5.	That the deceased <> left no other heir than those mentioned in paragraph 3 of this affidavit and that the persons mentioned in the said paragraph 3 are his only heirs.
6.	That I, therefore request the  Company  to transmit the aforesaid equity  shares standing registered in the name of <>, for which dependents at sl no.(s) i, ii and iii mentioned at paragraph 3 have no objection and without production of succession  certificate or letters or administration or probate
<place>
<date>			Signature of Deponent
Verification
I, the above named persons verify that the statements contained in the above paragraphs are true to the best our knowledge and belief and that no material have been concealed.
<place>				Signature of deponent
<date>