LIFE INSURANCE CORPORATION OF INDIA
From
Prasanna. S
Pulliyil veedu
Kusarcode, Poovathoor. P.O
Agency Code. 4168578N
To
The Senior Branch Manager,
Life Insurance Corporation of India,
Nedumangad.
Dear Sir,
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
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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.
Yours faithfully,
Signature
Surety
Prasanna. S
Agency Code : 4168578N
Witness.
Monday, December 26, 2011
Friday, December 23, 2011
LIC policy bond lost Form No 3815 stamp paper 500/ (for maturity or surrender)
From. No. 3815
To all to whom these presents shall
come name ,address Inhabitants
send Greeting whereas a policy of Insurance Numbered 785204042 for Rs........................./- was
granted on …................... by the Life Insurance
Corporation of India established by the Life Insurance Act 31
of 1956(hereinafter referred to the Corporation) on the life of n.s NAME and WHEREAS 785204042,
.............. which was in the possession of n.s NAME has been lost due
to Eaten by white
ants. And whereas the
said Corporation has on the said NAME undertaking to enter
into with the said Corporation a covenant of the nature hereinafter
appearing agreed to pay the said NAME the value of the said
Policy, viz’ Rs................../- now
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know
he and these presents witness that in purchase of the said NAME (the receipt whereof
is hereby acknowledged) they the said NAME to hereby for themselves their heirs, executors or
administrators Covenant with the said Corporation, its successors and signs, that they the said NAME their heirs, executors or administrators will
from time to time and or at all times save and keep harmless and
indemnified the said Corporation , its
successors and assignees of and from all actions suits, costs claims and demands
of whatever nature and kinds ever which may be instituted, preferred , claimed
or made against the said Corporation, its successors or assignees by any person
or persons of his , her or their possession of right to the said original 785204042/......................
by reason of anything in relation to the premises. In witness where of the NAME have hereunto put their hands at Nedumangad this 7th date of
December 2015.
Signed and
delivered by the said NAME
Signature
In the presence
of:
1. Full Signature of Witness
Name and of witness :
Designation :
Address :
2. Full signature of Witness
Name and witness :
Designation :
Address :
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