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Surrender Application 01

The document is a proforma for the surrender of a life insurance policy from the State Life Insurance Corporation of Pakistan, detailing the necessary steps and declarations required by the Zonal Head. It includes information on the policyholder's interview, the explanation of financial benefits, and the acknowledgment of receipt of the surrender value. Additionally, it outlines the deductions and final net payable amount to the policyholder.

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2K views3 pages

Surrender Application 01

The document is a proforma for the surrender of a life insurance policy from the State Life Insurance Corporation of Pakistan, detailing the necessary steps and declarations required by the Zonal Head. It includes information on the policyholder's interview, the explanation of financial benefits, and the acknowledgment of receipt of the surrender value. Additionally, it outlines the deductions and final net payable amount to the policyholder.

Uploaded by

sabirslic730
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF or read online on Scribd
oe Sthy PA sied! : weal b 7 > bast V2 ierles ist ve Sy KAP MLA RECs : Geet: te photos APt fle wile Hedi feist Sains ent obs/ Fst Me Syl 6 aber Ly! EA il or ‘a 7 UN THI ee St diate fs a ‘be Labs! il lie ‘si-108 STATE LIFE INSURANCE CORPORATION OF PAKISTAN. SARGODHA ZONE PROFORMA FOR SURRENDER OF POLICY Policy No. Name of Table/Term Surrender Policyholder Value Undertaking by the Zonal Head I hereby declare that following steps were taken in connection with the application for surrender of the policy, particulars of which are given above. 1. Personal Interview was given to the pélicyholder by the Zonal Head or. Sector Head on this behalf on ______________at 2. Facility of loan was offered to the policyholder in the interview. 3. All future financial benefits of the policy on maturity were explained to the policyholder in the interview. 4. Weare satisfied that the policyholder is not surrendering the policy to take out a new policy on the advise of some unscrupulous element and suffering a loss in the process by depriving himself of the financial benefits of the policy which-he wants to surrender. 5. (Only in case of auto paid up policy). The policyholder was persuaded to get his policy re-instated, . 6. The policyholder still wants to surrender the existing policy because of the following reasons. “ Name: Designation: __20nal Head __ Zone. Date: SARGODHA ZONE, Pre-Receipt for the Surrender Value of Policy No. On the Life of. Sum Assured Commencement Date. Wwe STATE LIFE INSURANCE CORPORATION OF PAKISTAN do hereby acknowledge receipt from the STATE LIFE INSURANCE CORPORATION OF PAKISTAN at its principal place of business Sargodha of the sum of Rs. ( Rupees being the Surrender Value including the Surrender Value of Bonuses of the afore-said policy. which policy is herewith delivered into the said Corporation to be “canceled. This acknowledgment isin full and final settlement of all my claims on the afore-mentioned policy. the said Corporation having discharged of all its liabilities. 1) Tama Muslim Non-MuslinvChirstian 2) Lam acitizen of Pakistan. 20 Signed at, this date day of Surrender Value including of Cash Value of Bonuses Rs. DEDUCTIONS: i) Automatic Non-forteiture/ Automatic Premium Debit____Rs. Rs. ii) _ Interest on above. Rs. Rs, Difference in premium due to increase in age. = Rs. Rs. iv) Interest thereon____momo_ Rs. Rs. v) Zakat @ 2.50% Rs. Rs Total (to v) Balance Surrender Value: Rs LESS vi) Policy Loan outstanding. Rs, vii) Interest thereon Rs. Total (vi to vii) Rs viii) Suspence Amount Rs, ‘Net Payable: WITNESS SIGNATURE OF THE ASSURED oR THE ASSIGNEE ( Official Seal to be affixed if assignee is a Bank or a firm) Please give your National Identity Card Number Without which we are unable to issue the cheque Bank A/c No.. Name & Address of the Bank.

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