APPLICATION FOR SURRENDER OF POSTAL/ RURAL LIFE INSURANCE POLICY (Please fill in the columns in CAPITAL letters)
1.
Details of Policy to be surrender
i. Policy No. ii. Sum Assured `
iii. Date of Acceptance
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/
iv. Date of Maturity
/
/
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2. Name of Insurant (Mr./ Mrs./ Ms.) First Name
Middle Name
Last Name
3. Communication Address
Village City State
Taluka District Country
PIN
4. Details of loan taken on policy, if any i. Sanction Date:
/
ii. Amount of Loan:
`
/ /
iii. Date of repayment of loan:
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/
5. Reasons/ circumstances for surrendering policy _______________________________________________________ 6.
Name of the Post Office (if it is Sub Office, write the name of Head Office as well) at which the payment is desired.
i. Name of Sub Post Office ii. Name of Head Post Office 7. For payment of surrender value through cheque, please provide following information about your Post Office/Bank account:i. Account No. ii. Name of Post Office/ Bank iii. Branch Name: 8. (i) Designation and Address of Drawing and Disbursing Officer during last six months
Village City State ii.
Taluka District Country
PIN
Name of the Post Office where premia were paid during last six months.
a)
b)
c)
d)
e)
f)
Date:________________ Signature of Insurant Name: Phone no.: Office: Residence: Mobile no. :
Documents attached: (a) Policy document. (b) Loan Repayment Receipt Book relating to previous loan. (c) Premium Receipt Book. (d) Certificate of Pay Disbursing Officer regarding recovery of premia from pay for the last six months.
Page 1 of 1. Surrender Value form.pdf. Surrender Value form.pdf. Open. Extract. Open with. Sign In. Main menu. Displaying Surrender Value form.pdf. Page 1 of ...
Signature of the Life Assured /Proposcr/. Absolute/ Conditional Assignce. NOTE:" IIlitcratc pcrsons must affix their thumb marks which should bc identificd by the ...
their views. The fact is that to discount Muslim scholarship so completely, .... smoothed over by noting that the elder one had lived an extremely long life, often long ..... distance between the Muslim and Western viewpoints on this area of study.
Ele realmente. não se importa de partilhar o seu dinheiro, que estava lidando com as pessoas e os. Page 3 of 124. Sarah's surrender - Lynda Chance.pdf.
Lincoln Brewster. Key = G. Tempo 63. Verse 1 : G. D. C. I'm giving You my heart, and all that is within. Em. D/F#. I lay it all down for the sake of You my King. G. D. C. I'm giving You my dreams, I'm laying down my rights. Em. D/F# G. I'm giving up
tionD h s emerged until nowF emong the v rious situ tions in whi h surrender risk ppe rsD two frequent ones re the surrender of insur n e @in f t s vingsA.
