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Re-Assignment Form: Notice of Assignment of Policy No

The document is a re-assignment form for a life insurance policy. It notifies the manager of the policy servicing department that the original policyholder has reassigned the policy to a new individual. It provides the policy number and includes signatures of the original policyholder and new assignee. The original policy document is attached for registration of the new assignment.

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462 views1 page

Re-Assignment Form: Notice of Assignment of Policy No

The document is a re-assignment form for a life insurance policy. It notifies the manager of the policy servicing department that the original policyholder has reassigned the policy to a new individual. It provides the policy number and includes signatures of the original policyholder and new assignee. The original policy document is attached for registration of the new assignment.

Uploaded by

sarsmajor
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Re-Assignment Form

To The Manager Policy Servicing SBI Life Insurance Co. Ltd. Central Processing Center, Kapas Bhavan, Plot No.3A, Sector No.10, CBD Belapur, Navi Mumbai -400614 . Dear Sir, Notice of Assignment of Policy No :______________________ Date:

I/We hereby give you notice that I/we have reassigned the above Policy to Mr/Ms __________________ The original Policy Document is sent herewith. 2. Please acknowledge receipt of this Notice and return the Policy Document after registering the reassignment in your books. Yours truly,

Signature of the Policyholder Name:. Address:.

Encl: Original Policy Document.

Form of Re-Assignment for valuable of consideration under the Policy: I/We _________________________________________________________________the assignees, in consideration of the sum of Rs........ repaid to us by ________________________________the receipt of which we do hereby acknowledge as beneficial owners reassign to __________________________________________________________________ the Assured, his heirs, Executers, Administrators and assign the policy of Assurance on his life granted to him by the SBI Life Insurance Co. Ltd., assuring the sum of Rs and numbered Policy No:_______________________ and bearing date the DOC date day of -...... 20 and the sum assured thereby and all other moneys benefits and advantages to be received there under. Signature of Assignee. Place: Date: Signature of the witness: Name of the Witness: Occupation: Address: Signature of Assignor/s with his/their designation/s and official seal or Rubber stamps

SBILifeInsuranceCo.Ltd, "Natraj",M.VRoad&WesternExpressHighwayJunction,Andheri(East),Mumbai400069 CentralProcessingCenter,KapasBhavan,PlotNo.3A,SectorNo.10,CBDBelapur,NaviMumbai400614 PS-23/Ver1.3/24.03.2011 Page 1 of 1

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