| 1. |
Name of the claimant (in block letters). |
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| 2. |
Father's name/Husband's name. |
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| 3. |
Complete address of the claimant in India |
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| 4. |
Complete address of the claimant and the depositowner (if different person) in Pakistan as furnished to theCourt.
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| 5. |
Registration number of the claim if earlierfiled with this office.
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| 6. |
Nature of the deposits : |
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(a) Civil Court Deposit. |
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(b) Minor's deposit in guardianship court if so,please state -
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(i) Name of theminor
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(ii) Age of theminor
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(iii) Name of theguardian
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(iv) Relationship ofthe guardian to the minor
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(c) Revenue Court Deposit |
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(d) Deposit lying with the court of Wards; ifso, please state -
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(i) Particulars ofmovable property involved.
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(ii) Value ofMovable property involved
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(iii) Date on whichthe property came under the superintendence of the Court ofwards.
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(iv) Annual incomefrom the property
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(v) Names of wards. |
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(vi) Amount ofmaintenance allowance granted to each ward.
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(vii) Period uptowhich maintenance allowance was paid to each ward.
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(e) Deposits lying with Manager, EncumberedEstates, if so, please state -
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(i) Full particularsof the Estate.
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(ii) Value of theEstate.
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(iii) Name of theowner of Estate.
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(iv) Number allottedto the Estate.
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(v) Date on whichthe Estate was taken over by the Manager, Encumbered Estate underhis superintendence.
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(vi) Annual incomeof the Estate.
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(vii) Name of wards. |
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(viii) Amount ofmaintenance allowance granted to each ward.
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(ix) Period uptowhich maintenance allowance was paid to be each ward.
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| 7. |
Particulars of deposit claimed. |
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From of Deposit |
No. of the Govt. Securities/Saving or CurrentAccount/Weight of Jewellery etc.
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Amount of deposit |
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(i) GovernmentSecurities, i.e., War Bonds Defence Savings Certificate, NationalSavings Certificates, P.O. Cast Certificates etc. . . . .
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(ii) BankDeposit/Fixed Deposit Receipts
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(iii) Post OfficeDeposit. . . . .
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(iv) Cash Deposit .. . . .
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(v) Jewellery . . .. . .
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(vi) Household goodsor stock-in-trade .
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Total |
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| 8. |
Name of the person who deposited the amount. |
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| 9. |
Names of the persons in whose favour the amountwas deposited.
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| 10. |
Names of all persons interested in the deposit whohave migrated to India, their respective shares and theirrelationship to the original depositor/claimant.
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Name of the personsinterested the deposit
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Address in India of persons interested in theclaim
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Amount of the share claimed/entitled to |
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1. |
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2. |
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3. |
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4. |
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| 11. |
Name of the court, Bank or Treasury where theamount/valuable documents was/were deposited.
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| 12. |
Date of deposit. |
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| 13. |
Exact name and place of the court in Pakistan withwhom or under whose orders the amount/valuable documents was/weredeposited.
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| 14 |
Number and year of the suit/case/appeal or otherproceedings before the court in connection with which deposit wasmade.
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| 15. |
Title of the suit or proceedings before the court,i.e. names of parties to the suit, such as A v. B with fullparticulars describing both the parties.
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| 16. |
Brief nature of the suit/case/appeal or otherproceedings and facts leading to the deposit being made into thecourt
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| 17. |
In case the person in whose name the deposit isshown by the court in Pakistan is dead, the interest or right ofthe applicant to the deposit in question.
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| 18. |
Documentary evidence in support of title(ownership) to the claim (please enclose attested copiesthereof), such as court's order, succession certificate etc.
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| 19. |
Whether payment of the deposit in respect of whichclaim is filed has been already received in full or in parteither from Pakistan or in India.
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| 20. |
Any other information which the claimant may liketo furnish.
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| 21. |
Rate of maintenance allowance granted by theCentral Claims Organisation, if any, and the period for whichpayment received.
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| 22. |
Total amount of maintenance allowance received sofar from the Central Claims Organization.
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| 23. |
Amount of maintenance allowance adjustedagainst/recovered from Compensation payable against claim forimmovable property, if any.
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| 24. |
Compensation application from number against whichthe maintenance allowance has been recovered.
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| 25. |
Name of Settlement Officer/Regional SettlementCommissioner who recovered the amount of maintenance allowance.
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| 26. |
Number of claims registered in the name of theclaimant for any immovable property left in Pakistan.
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(i)(ii)(iii) |
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| 27. |
Value of the share of the claimant in the aboveclaims, verified by the Claims Officer.
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(i)(ii)(iii |
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| 28. |
Compensation Application From numbers and name ofthe Settlement Officer with whom filed.
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(i)(ii)(iii |
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| 29. |
Amount of compensation payable to the claimantagainst claims referred to at item No. 26 above.
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(i)(ii)(iii |
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| 30. |
Amount of compensation so far received by claimant. |
(i)(ii)(iii |
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| 31. |
Amount of compensation yet due to the claimant, ifany.
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(i)(ii)(iii |
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