THIS ASSIGNMENT made at ……………on this ………day of 20 …between A son of Shri ……………
resident of ……………(hereinafter called “the Assignor”) of the ONE PART and B son of Shri ……….
resident of ……………………..hereinafter called “the Assignee”) of the OTHER PART.
WHEREAS
(1) [P1]By a policy of Life Insurance issued by- the Life Insurance Corporation of India …………………
office , ………………being No ……………dated, the ……… on the life of assignor, the sum of Rs
………………is assured to be Policy paid on ……… maturity or to his nominee, heirs, executors,
administrators, legal, representatives or assigns after his death, subject to payment of the annual
premium of Rs . ……….
(2) [P2]The assignor has agreed to assign the said policy of insurance in favour of the said B for a sum of
Rs . ………..

NOW THIS DEED WITNESSES AS FOLLOWS:
In consideration[P3] of sum of Rs ……………paid by the said B (the receipt whereof the said A does
hereby admit and acknowledge), the said Assignor as the beneficial owner hereby transfer and assign
unto and to, the use and for the.benefit of the assignee the above policy together with the benefit. of said
sum of Rs …………… thereby assured together with bonus,benefits and other moneys thereof to
be had, recovered or obtained under the said policy. TO HAVE AND TO HOLD the same unto
and to the use of the assignee absolutely and the assignor hereby covenant with the assignee that the
said policy is now valid and in force and that the assignor shall regularly pay the premia under the said
policy of insurance to the Life Insurance Corporation of India and the Assignor shall not do, execute or
perform or knowingly suffer anything whereby the said policy may become void or voidable or the
assignee or his heirs, executors, administrators, legal representatives or assigns may be prevented from.
receiving the moneys thereby assured or any bonus, benefits and other sums thereunder.
IN WITNESS WHEREOF, the assignor and the assignee have executed this deed of assignment on the
date and year first above mentioned.
………………. ……………..
Assignee Assignor
WITNESSES
1.
2.

[P1]Assignor obtained Life Insurance
[P2]Agreement to assign the policy to assignee
[P3]Consideration