LIFE INSURANCE CORPORATION OF INDIA
Kusarcode, Poovathoor. P.O
Agency Code. 4168578N
The Senior Branch Manager,
Life Insurance Corporation of India,
In consideration of having granted and agreed to grant me advances from time to time
against the commission that if may be entitled to in respect of bussiness completed by me for the
purpose laid down in the scheme of advances to agents formulated by the Corporation and as it
may be amended by the corporation from time to time . I here by agree to pay/the interest on
each of the advances from the date thereof at the rate which is in force from time to time under
scheme and / I hereby irrecoverably direct, authorities and empoer you to recover the amounts
of all such advances and interest as may be outstanding form time to time in full from the commission
accounting due from time to time in full form the commission accruing due from time to time
hereby agree that in case I fail to submit within two months from the date of grant of any advance,
the receipt, vovcheres, etc that may be relevant in respect of each advance in proof of having utilised
the advances for the purpose for which it was granted, the outstanding advance shall be recoverable
from me in twelve monthly instalments together with interest at @ 12% per annum payable half yearly
or such enhanced rate as may be in force at the relevent time under the scheme.
And I hereby agree that if in any year I do not qualify for continuance of membership
of Chairman’s/ ZM’s/ DM’s/ BM’s club of agents and become a mamber iof a lower grade of
club or become ineligible to become a member of any of the above clubs of agents , I shall from
the date of such change pay interest @12% per annum payable halfyearly or such other rate of
interest as may be decided upon by the corporation from time to time for advance under the
scheme, on the amount of advance then outstanding against me which is excess of the amount of
advance if any to which I might be entitled ti under the scheme as a member of a lower grade or
as an agent ineligible to be a member of any such club.
And I hereby agree and undertake to make all such applications as may become
necessary from time to time to renew my licence to work as an insurance agent and to obtain the
requisite Licence from time to time as may be necessary to enable me to receive and take such
commission and not to do any act or thing where by any such licence may be revoked or where
by I may be prevented in lay in any way from receiving and recovering such commission in future.
And I hereby future, agree that on termination of my agency either by death or any causes what soever any outstsanding balance of the advance made by the corporation with interest theron will be a first charger on any money payable by the corporation to me to my heirs, assignees or nominees in respect or renewal commission or any account whatsoever.
Dated at Nedumangadu this 13th day of December 2011.
Agency Code : 4168578N