LETTER OF INDEMNITY

(To be executed on Non-judicial Stamp paper of appropriate value and notarized)

To,
Assessing Officer
Income Tax Department

Sir,
Sub: Request to Register as ‘Representative Assessee’ for Late Mr. /Mrs.
__________________________ [Permanent Account Number [•]].

1. I/We, the undersigned, hereby inform you that Mr. /Ms. /Mrs.
______________________________________, holder of Permanent Account Number [•],
resident of ______________________________________, (“Deceased”), died on
_________________ at ________________.

2. That, the Deceased died (tick the appropriate option):

o Intestate, i.e. without leaving behind a valid and enforceable will, and that in accordance
with the law of intestate succession as applicable to him/her at his/her time of death, the
Deceased left behind as his/her only surviving heirs, claimants or next of kin, the
following persons:

OR
o Deceased died leaving his/her last Will and Testament dated ________________and
(i) we the undersigned are the executors and beneficiaries thereof;
(ii) and further, that we are the only persons entitled to the estate of the Deceased, as
legal heirs:

S. Name PAN Number Address Relationship with Age

No. Deceased
 That out of aforesaid legal heirs, Master/Miss___________________ aged _____years is
a minor and he/she is being represented by his/her father/mother or Legal Guardian
Mr. /Mrs. __________________________________.

(Collectively referred to as “legal heirs”)

3. I/We affirm that I/we am/are the sole legal heirs of the Deceased and there are no orders, decrees,
judgments or ongoing proceedings before a court of law or other forum contrary to our claims as
legal heirs vis-à-vis the estate of the Deceased.

4. I/We have requested you, the Income Tax Department, to allow Mr. /Ms./ Mrs./
_______________________________________, being one of the legal heirs to the Deceased, to
act in capacity of the ‘Representative Assessee’ for the Deceased in accordance with Section 159
of the Income Tax Act, 1961, and allied provisions and rules, on my/our behalf and you have
kindly agreed to do so on my/our executing an indemnity as is contained herein, and on relying
on the information given by us herein believing the same to be true, complete and accurate.

5. In consideration therefore, of your approving our request in allowing Mr. /Ms./ Mrs./
_______________________________________ to act in capacity of ‘Representative Assessee’
for the Deceased in accordance with Clause 4 above, I/we, the legal heirs aforementioned, for
myself/ourselves and my/our respective heirs executors and administrators jointly and severally
hereby indemnify you, the Income Tax Department, and agree to keep indemnified and hold the
Income Tax Department saved, harmless and defended for all time hereafter from and against all
losses, claims, legal proceedings, actions, demands, risks, charges, damages, costs, expenses,
including attorney and legal fees and penalties whatsoever which may be initiated against the
Income Tax Department, or be paid, sustained, suffered or incurred by the Income Tax
Department howsoever, as a consequence direct or indirect by reason of the Income Tax
Department having agreed at my/our stated request. If called upon by the Income Tax Department
to do so, I/we shall join any proceedings that may be initiated against the Income Tax Department
and I/we shall defend at our cost any such proceedings. Further, I/we shall initiate such
proceedings as may be considered necessary by the Income Tax Department, if called upon by the
Income Tax Department to do so, in order to protect the Income Tax Department’s interests and
to further and perfect the indemnity granted hereby in favor of the Income Tax Department.

IN WITNESS WHEREOF:
Dated this ___ day of ______________20____.

Signed and delivered by the legal heirs:

Name of Legal Heir Signature

 Before me
NOTARY PUBLIC