Form of Claim For Maturity
Form of Claim For Maturity
1. Policy No. :
Date of Acceptance: 2. a) Date of Maturity: b) Date of Survival benefit due: (in case of AEA policies) 3. Sum Assured: 4. Name of Insurant: `
Address
Pin Code 5. (A) Designation and address of: (i) Drawing and Disbursing Officer during last six months (In case of deputation of premia from pay)
Designation
Address
Pin Code (B) a) d) Name of the Post Office where premia were paid during last six months. (In case of payment of premia in cash) b) e) c) f)
6.
7.
For payment through cheque, please provide following information about your Post Office/Bank account:-
Account No. :
Documents Attached: a) Policy document. b) Loan Repayment Receipt Book if loan was taken. c) Premium Receipt Book d) Certificate of Pay Disbursing Officer regarding recovery of premia from pay for the last six months. e) Any other document Date: