Annexure 15 - NOC from Surviving Holder for Premature withdrawal

of TD

I/We,Mr./Ms. ________________, aged ____years, residing at ……………… ……………………

…………… ………….. do solemnly declare and state as under:

1. That my/our _________________________________ (relationship to be

mentioned)Mr./ Ms.__________________ (hereinafter referred as ‘said deceased’)
expired at …………….. ………. on ……the day of …………. 20 _ _intestate and the Notarized
copy of the Death Certificate of deceased is attached.

2. That said deceased was maintaining Term Deposit Account/s No/s.

________________Jointly with Mr./Ms.___________ (Surviving Holder) and
under________________ Mode of Operation (MOP) with …………….. Branch of Kotak
Mahindra Bank Ltd. The said Term Deposit/s has/have balance of Rs. ____________
(Rupees …………………………………… Only) as on date.

3. That the following are the legal heirs of the said deceased:

Sr. Name Age Relationship with deceased

No
1
2

3. I/We, the legal heir (s) of the deceased, declare that I/we do not have any objection
for the premature withdrawal of said Term Deposit/s to Surviving Holder.

I/We hereby declare and confirm that above statement is true and correct to the best of my
knowledge and nothing has been concealed thereof.

Executed and delivered by

Mr/Mrs.…………………………… }

Signature of Survivor

Enclosures:
1. Death Certificate.

KMBL/Apr-2015/V1.0
Kotak Mahindra Bank Ltd. CIN: L65110MH1985PLC03813 Registered Office: 27 BKC, C 27, G Block, BandraKurla Complex, Bandra (E), Mumbai - 400 051.www.kotak.com

KMBL/Apr-2015/V1.0