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download lic market plus surrender form pdf

sDP 50.000-12/12
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LIFE INSURANCE CORPORATION OF INDIA
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Apptication for Surrender /Discounted Value
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The Sr. Branch Manager
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LIFE INSURANCE CORPORATION OF INDIA
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Sir/Madam,
Dear
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Re.: Policy No.
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| intend to surrender my above Policy. Kindly pay me the same
...1 intend to have it dicounted value. Kindly pay me
My above mentioned policy will mature on........
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the same.
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Note : In case the policy is assigned, the application must be signed by the assignee.
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Yours faithfullY,
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Delete where Inapplicable
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(at which cheque is to be Posted)
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Beceipt or the Surr
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surrender/Discounted value (inclusive of case Value of Bonus)
D.A.B. Refund
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