FORM NO. 3-A

[See PARAGRAPH 99 (b)]

Form of Bond of Indemnity for drawing arrears of pay and allowances or pensions of deceased Government servants or pensioners

KNOW ALL MEN BY THESE PRESENTS that I,_____ (a)_____widow/husband/son/daughter of Shri/Shrimati_____ (b) _____, residing at_____(c)_____ (hereinafter called "the Obligor" which expression shall unless excluded by or repugnant to the context include his/her heir, executors, administrators and legal representatives), and I/we (1) _____ (d) _____son of _____ resident of _____and (2) _____(e)_____ son of _____resident of_____ Surety/Sureties on behalf of the Obligor (hereinafter called "the Surety" /"Sureties" which expression shall unless excluded by or repugnant to the context include his/their heirs, executors, administrators and legal representative) bind ourselves jointly and severally to pay to the Governor of Uttar Pradesh (hereinafter called "the Government" which expression shall unless excluded by or repugnant to the context include his successors and assigns) on demand and without a demur a sum of Rs._____ (f)_____(Rupees _____) for which payment well and truly to be made we bind ourselves firmly by these presents.

Dated this _____________day of _____________19_____________

WHEREAS the aforesaid Shri/Shrimati_____ (b) _____was at the time of his/her death in the employment of receiving a pension of Rs. _____from the Government.

AND WHEREAS the said Shri/Shrimati _____ (b) _____died on the _____day of _____19 _____ and there was due to him/her the sum of Rs._____ (f)_____ (Rupees_____) for pay and allowances in respect of his/her said employment /in respect of his/her said pension.

AND WHEREAS the above bounden Obligor _____ (a) _____claims to be entitled to the said sum as heir of her/his husband/wife/father, the said Shri/Shrimati _____(b)_____ but has not obtained letters of administration of or a succession certificate to the property and effects of Shri/Shrimati _____(b)_____.

AND WHEREAS the Obligor has satisfied the Government that she/he is entitled to the aforesaid sum and that it would cause undue delay and hardship if she/he were required to produce letters of administration of or a succession certificate to the property and effects of the said Shri/Shrimati_____(b) _____.

AND WHEREAS the Government desire to pay the said sum to the Obligor but under Government rules and orders it is necessary that she/he should first execute a bond with one surety/two sureties to indemnity against all claims to the amount so due to the said Shri/Shrimati_____ (b) _____ before the said sum can be paid to the Obligor.

NOW THE CONDITION of this bond is such that if after payment has been made to the Obligor, the Obligor or the Surety/Sureties shall in the event of a claim being made by any other person against the Government with respect to the aforesaid sum of Rs._____ (f)_____(Rupees_____) refund to the Government, the sum of Rs._____(f)_____(Rupees_____) and shall otherwise indemnify and save Government harmless from all liability in respect of the aforesaid sum and all costs incurred in consequence of any claim thereto THEN the above written bond or obligation shall be void but otherwise the said bond shall remain in full force effect and virtue. AND it is hereby agreed and declared that without prejudice to any other remedy the Government may on a certificate of the Secretary to the Government in the Administrative Department which shall be final, conclusive and binding on the claimant and/or the surety or sureties, recover all dues hereunder as arrears of land revenue.

IN WITNESS WHERE OF the parties hereto have hereunto set their respective hands the day and the year first above written.

Obligor in the presence of—

of—

(1) **_____(1st surety)

(2) ***_____(2nd surety)

Witnesses—(1) _____

(2) _____

*Signature of the obligor.

**Signature of the First Surety.

***Signature of the Second Surety.

Accepted for and on behalf of the Governor of Uttar Pradesh by_____†_____in the presence of ‡_____

NOTES—(a) Full name of the claimant.

(b) Name of the deceased Government servant/pensioner.

(c) Full address of place of residence of the claimant.

(d) First Surety.

(e) Second Surety.

(f) Amount of the claim.

†Name and designation of the Officer directed or authorised in pursuance of Article 299(1) of the Constitution to accept the bond for and on behalf of the Governor.

‡†Name and designation of witness.

NOTE—The Obligator as well as the Sureties should have attained majority so that the bond may have legal effect or force.