Golden Forests India Ltd — Please Register GFIL New Claim Form @ GFIL Committee System/KFintech System/Karvy System. Full Complete Information has been furni

Address: Committee – GFIL, Main Building, Golden Forests (India) Ltd. VPO Jharmari, Via Lalru, Ambala-Chandigarh National Highway-22, Tehsil Dera Bassi, Distt.

Dear Sirs,
Good Day To All,
Please Register GFIL New Claim Form @ GFIL Committee System/KFintech System/Karvy System. Full Complete Information has been furnished.
COMPANY (GFIL/GPL) DEPOSIT ACCOUNT NUMBER DEPOSITORY NAME NOMINEE NAME DEPOSIT AMOUNT
GFIL SEC 3920 KULKARNI R NEELAKANTH USHA R KULKARNI 1890/-
Thanks and Regards,
Kulkarni R Neelakanth
Mob [protected] [protected]
[protected]@gmail.com, [protected]@yahoo.co.in,

GFIL NEW CLAIM FORM (for new registration) (KFINTECH 809781 GFIL APPROVAL RTH2896570F)
____________________________________________________________________________ PART A – Deposit Details
1. Company Name - GFIL / GPL (please tick) GOLDEN FORESTS (INDIA) LTD
2. Deposit Type - Fixed / Recurring (please tick) FIXED
3. Depositor’s name KULKARNI R NEELAKANTH
4. S/o, D/o, W/o S/O MR NEELAKANT JIVAJI KULKARNI
5. Account no. SEC 3920 DT 22/01/1994
6. Receipt No. 39025 DT 22/02/1994
7. In case of Fixed Deposit FIXED DEPOSIT
7 (a). Amount Deposited IRS.1890/-
7 (b). Date of Deposit 22/01/1994
7 (c). Date of Maturity 22/01/2019
8. In case of Recurring Deposit NA
8 (a). Installment amount
8 (b). Total No. of Instalments deposited
9. Nominee’s name MRS USHA R KULKARNI
10. Nominee’s relationship with Depositor WIFE
PART B – Claimant’s Details
(Claimant’s Status - Sole Depositor _// Joint Depositor / Nominee / Legal Heir (Please tick) SOLE DEPOSITOR
11. Name KULKARNI R NEELAKANTH
12. S/o, D/o, W/o S/O MR NEELAKANT JIVAJI KULKARNI
13. Present Address H.NO. 30 AASHEERWAD, 2C MAIN ROAD, METAGALLI LAYOUT, MYSORE 570016, KARNATAKA, INDIA SE 61611
14. District State PIN MYSORE 570016
15. Mobile number [protected] [protected]
16. Email ID [protected]@gmail.com [protected]@yahoo.co.in
17. Amount received back from company (if any) NIL
18. AADHAR (optional[protected]
19. PAN AXDPK1419M
CANARA BANK (SYNDICATE BANK) KULKARNI R N
SB A/C [protected] IFSC CODE CNRB0011701 MICR CODE[protected] DOB 27/05/1955
MOB [protected] [protected] CUST ID[protected] VV MOHALLA MYSORE BRANCH
(if disbursement amount is above Rs 50, 000)
PART C – General Instructions and documents to be enclosed
1. In case of Fixed Deposit – Original or Notarised photocopy of Fixed Deposit receipt issued by the
company be enclosed
2. In case of Recurring Deposit - Original or Notarised photocopy of first and last installment receipt
issued by the company be enclosed
3. All the claimants must enclose cancelled cheque or copy of bank passbook showing bank name,
A/c holder name, A/c No. and IFS Code.
CANARA BANK (SYNDICATE BANK) KULKARNI R N
SB A/C [protected] IFSC CODE CNRB0011701 MICR CODE[protected] DOB 27/05/1955
MOB [protected] [protected] CUST ID[protected] VV MOHALLA MYSORE BRANCH
4. If first depositor is dead (in case of joint deposit), the claim be filed by second depositor
alongwith death certificate of first depositor.
5. If depositor (s) is(are) dead, the claim be filed by nominee(s) printed on the receipt alongwith
death certificate of depositor (s).
6. If all the depositor (s) and nominee(s) are dead, the claim be filed by legal heir alongwith
following documents:
A. death certificate of depositor(s) & nominee(s) and legal heir certificate issued by the competent authority, If the disbursement amount is less than or equal to Rs.20, 000/-
B. Death certificate of depositor(s) & nominee(s) and Succession Certificate issued by the
competent authority, If the disbursement amount is more than Rs.20, 000/-
7. Where disbursement amount is above Rs 50, 000, PAN card must be enclosed.
Declaration:- I hereby declare that the information given above is correct & true and nothing is false or concealed therein.
Date 11/06/2021 Signature of Claimant