SURVIVING MEMBER CERTIFICATE APPLICATION
Deceased place-of-death record: __________.
Applicant: __________, __________, relationship __________. Deceased: __________, died __________ at __________, certificate __________, last residence __________. Jurisdiction: __________.
Authority: __________, __________. Purpose: __________.
FAMILY RECORD
Surviving members: __________. Predeceased close family: __________. Family tree: __________. Other claimants: __________. Minor status: __________.
Relationship evidence: __________. Testamentary status: __________. Property: __________. Movables: __________. Liabilities: __________. Documents: __________.
REQUEST
Issue the surviving-member certificate for the stated administrative purpose without treating it as a judicial grant over disputed estate rights.
APPLICANT CONTACT
Relationship/capacity: __________.
LEGAL BASIS
Punjab: A single universal statutory route for every surviving-member certificate was not confirmed from the sources used. The authority named for the stated departmental purpose receives and decides the application; the precise Punjab section, fee, timeline and appeal route must come from that service.
Chandigarh: A single universal UT statutory route for every surviving-member certificate was not confirmed. The named departmental authority receives the application; for Chandigarh sector property, the Estate Office succession/transmission file remains separate under the 1952 Act and 2007 Rules.
PERSONAL DATA NOTICE
This notice is given under the Digital Personal Data Protection Act, 2023.
The purpose of collecting personal data in this Surviving Member Certificate Application is to identify the deceased, applicant, heirs or nominees, establish the property/estate record and support the stated succession or transmission process.
The record will be held by __________ and may be shared with the applicant, other heirs/claimants, competent court, revenue/estate/development authority, society, bank or professional directly involved in the stated succession process.
If the matter does not proceed, the personal data will be retained for 90 days and then erased. If the matter proceeds, the record will be retained for the matter plus 12 months, except where a statute requires a longer named retention period.
A person named in this document may request correction or erasure where the purpose has ended, withdraw consent for future consent-based processing, or raise a grievance by writing to __________. The record-holder should acknowledge and reply within 30 days.
Data minimisation: this document does not collect a full Aadhaar number, an Aadhaar-card copy, a password or bank credentials.
Personal-data instruction: __________.
SIGNATURE
Applicant: __________