Scribd
Upload
4K views

PLI Address Change Form

The applicant is requesting to change their address and contact details for their insurance policy. They provide fields to fill in their name, policy number, current and permanent addresses, contact phone numbers, email, Aadhaar and PAN numbers. They must attach address proof documents according to Know Your Customer norms with their application.

Uploaded by

bsobanbabu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
4K views

PLI Address Change Form

The applicant is requesting to change their address and contact details for their insurance policy. They provide fields to fill in their name, policy number, current and permanent addresses, contact phone numbers, email, Aadhaar and PAN numbers. They must attach address proof documents according to Know Your Customer norms with their application.

Uploaded by

bsobanbabu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

Application for Change Address and contact Details

(Please fill in the columns in CAPITAL letters)


Name of Insurant.

Policy Nos

Address Type : Communication


Address

Address

Village

Taluka

City

District

State

Pin Code
STD / Area E- Mail
Landline Number Mobile Number
Code Id

Aadhaar No:

PAN

Address Type : Permanent


Address

Address

Village

Taluka

City

District

State

Pin Code
STD / Area E- Mail
Landline Number Mobile Number
Code Id

Documents attached*
Address Proof (as per KYC norms)

Signature of Insurant

You might also like