AFFIDAVIT CUM NO OBJECTION CERTIFICATE FOR OBTAINING

SURVIVING MEMBER CERTIFICATE

I SMT. ANJU SHARMA Wife of Shri Anil Kumar D/o Late Shri Rajender Kumar Sharma
R/O H.No. 37, Nasirpur, Ghaziabad, U.P. 201001 do hereby solemnly affirm and declare as
under:
1. That Late SH. RAJENDER KUMAR SHARMA Son of Lt. Sh. Mihi Lal expired at
Delhi on dated 20.03.2022 and death was registered with MCD. Death Certificate No.
MCDOLIR-0222-3103120911 on dated 05.04.2022 is attached.
2. That after the death of my father Late SH. RAJENDER KUMAR SHARMA, the
following are the surviving members in the family.
__________________________________________________________________________
S. No. Name Aged Relationship with the
Deceased
1. SARVATI DEVI _68__ Wife
2. ANJU SHARMA _43_ Daughter
3. SHASHI BALA _41_ Daughter
4. SANJAY KUMAR SHARMA _36__ Son

3. That none other than the mentioned above is the surviving members in the family.
4. That I have no objection whatsoever in issuing the surviving member certificate
in the name of applicant.
5. That surviving member certificate is required for submission in the concerned Bank of
the deceased and govt. departments.
6. That this is my true statement.
Deponent
Verification:
Verified at Delhi, this 25 th day of May 2022 that the contents of the affidavit are true &
correct to the best of my knowledge and belief and nothing has been concealed therein.
Deponent
 AFFIDAVIT CUM NO OBJECTION CERTIFICATE FOR OBTAINING
SURVIVING MEMBER CERTIFICATE

I SMT. SHASHI BALA Wife of Shri Deepak Sharma D/o Late Shri Rajender Kumar
Sharma R/O H. No. H-3A, Block H, Mansarovar Park, Near Shiv Mandir, Delhi – 32 do
hereby solemnly affirm and declare as under:
1. That Late SH. RAJENDER KUMAR SHARMA Son of Lt. Sh. Mihi Lal expired at
Delhi on dated 20.03.2022 and death was registered with MCD. Death Certificate No.
MCDOLIR-0222-3103120911 on dated 05.04.2022 is attached.
2. That after the death of my father Late SH. RAJENDER KUMAR SHARMA, the
following are the surviving members in the family.
__________________________________________________________________________
S. No. Name Aged Relationship with the
Deceased
1. SARVATI DEVI _68__ Wife
2. ANJU SHARMA _43_ Daughter
3. SHASHI BALA _41_ Daughter
4. SANJAY KUMAR SHARMA _36__ Son

3. That none other than the mentioned above is the surviving members in the family.
4. That I have no objection whatsoever in issuing the surviving member certificate
in the name of applicant.
5. That surviving member certificate is required for submission in the concerned Bank of
the deceased and govt. departments.
6. That this is my true statement.
Deponent
Verification:
Verified at Delhi, this 25 th day of May 2022 that the contents of the affidavit are true &
correct to the best of my knowledge and belief and nothing has been concealed therein.
Deponent
 AFFIDAVIT FOR OBTAINING SURVIVING MEMBER CERTIFICATE

I SH. SANJAY KUMAR SHARMA Son of Lt. Sh. Rajender Kumar Sharma R/o C-4/24,
Sudama Puri, Gali no.1, Near Ajit Chowk, Gamri Extn., Bhajanpura, Delhi – 53, do hereby
solemnly affirm and declare as under:
1. That Late SH. RAJENDER KUMAR SHARMA Son of Lt. Sh. Mihi Lal expired at
Delhi on dated 20.03.2022 and death was registered with MCD. Death Certificate No.
MCDOLIR-0222-3103120911 on dated 05.04.2022 is attached.
2. That after the death of my father Late SH. RAJENDER KUMAR SHARMA, the
following are the surviving members in the family.
__________________________________________________________________________
S. No. Name Aged Relationship with the
Deceased
1. SARVATI DEVI _68__ Wife
2. ANJU SHARMA _43_ Daughter
3. SHASHI BALA _41_ Daughter
4. SANJAY KUMAR SHARMA _36__ Son

3. That none other than the mentioned above is the surviving members in the family.
4. That surviving member certificate is required for submission in the concerned Bank of
the deceased and govt. departments.
5. That this is my true statement.
Deponent
Verification:
Verified at Delhi, this 25 th day of May 2022 that the contents of the affidavit are true &
correct to the best of my knowledge and belief and nothing has been concealed therein.
Deponent
 AFFIDAVIT CUM NO OBJECTION CERTIFICATE FOR OBTAINING
SURVIVING MEMBER CERTIFICATE

I SMT. SARVATI DEVI Wife of Late Shri Rajender Kumar Sharma R/o C-4/24, Sudama
Puri, Gali no.1, Near Ajit Chowk, Gamri Extn., Bhajanpura, Delhi – 53, do hereby solemnly
affirm and declare as under:
1. That Late SH. RAJENDER KUMAR SHARMA Son of Lt. Sh. Mihi Lal expired at
Delhi on dated 20.03.2022 and death was registered with MCD. Death Certificate No.
MCDOLIR-0222-3103120911 on dated 05.04.2022 is attached.
2. That after the death of my father Late SH. RAJENDER KUMAR SHARMA, the
following are the surviving members in the family.
__________________________________________________________________________
S. No. Name Aged Relationship with the
Deceased
1. SARVATI DEVI _68__ Wife
2. ANJU SHARMA _43_ Daughter
3. SHASHI BALA _41_ Daughter
4. SANJAY KUMAR SHARMA _36__ Son

3. That none other than the mentioned above is the surviving members in the family.
4. That I have no objection whatsoever in issuing the surviving member certificate
in the name of applicant.
5. That surviving member certificate is required for submission in the concerned Bank of
the deceased and govt. departments.
6. That this is my true statement.
Deponent
Verification:
Verified at Delhi, this 25 th day of May 2022 that the contents of the affidavit are true &
correct to the best of my knowledge and belief and nothing has been concealed therein.
Deponent