Lic Reassignment Form Sample Filled • Proven

: Clearly state that the reassignment is in consideration of the repayment of the loan.

"Full repayment of loan amount" or "Nil" (if done for love/affection) Rajesh Kumar (Your Full Name) Policy Number Sum Assured ₹5,00,000 Date of Original Policy 15th January 2018 Place & Date Mumbai, 10th May 2026 Witness Signature Must be signed by a third party (not a relative) Step-by-Step Instructions for Filling lic reassignment form sample filled

This section informs LIC that the policy is being handed back to the original owner. Enter your unique 9-digit LIC policy number. To: Mr./Ms. [Your Full Name]. : Clearly state that the reassignment is in

Usually filled as "Repayment of Loan" or a specific sum of money. Reassign To: [Your Name], the Assured. lic reassignment form sample filled