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Get Form 25 A Funeral Expenses Claim

having Insurance No……….. and last employed as…………. Son/wife/daughter of……………….. by………………….. (name of last employer). I, ……………………… (name of claimant) son / wife / daughter of ……….. aged …………. years being the eldest surviving member of the family of the deceased insured person, whose particulars are given above declare that I incurred an expenditure of Rs. …………… necessary for the funeral of the said deceased person.

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