To,
……………………..
Life Insurance Corporation of India
……………………..
Dear Sir,
Re: Assignment: Policy No . ………………..
I, B, son of Shri …………………….resident of ………………hereby give you notice that I have assigned
the policy No . …………………dated ………………issued by you in my favour, in favour of Shri son of
Shri …………………resident of …………………and have transferred all my rights, title and interest
hitherto accruing to me to said Shri …………………….and assign absolutely.


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