POSTAL LIFE
INSURANCE
DECLARATION FORM
(In
Case of Sum Assured Exceeding Rs.5, 00,000/-)
I ……………………………………Designation-……………………… Office-…………………………... declare that -
(a) My
age is not exceeding 50 years as on next birth day.
(b) The
minimum premium paying period of the last policy, which makes the sum assured
as Rs.10, 00,000/- will be 10 years.
(c) Aggregate
outgo against payment of premium/ contribution of GP/CPF, Income Tax,
installment of housing loan and other payment does not exceed 60% of my monthly
income.
(d) I
have not surrendered any PLI policy in the past.
Signature of
Immediate Superior Signature of Proposer
Seal and Date
Date-
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