RECEIPT

Received from State Bank of India, _______________________ Branch a sum of

Rs. ___________ (Rupees ________________________________________ only)
in connection with the full and final settlement of claim of the balances in Savings
Bank / Current Account / RD / TDR / STDR Account No(s)
_________________________ of Shri/Smt./Kum. ___________________________
who expired on / not traceable since __________________.

Name(s) Signature(s)/Thumb Impression on

Revenue Stamp

1. ______________________ _________________________

2. ______________________ _________________________

3. ______________________ _________________________

PLACE:

DATE: