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    Certificate of Existence Claim Form - 01112019-1

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    Richard moses
    This document is a certificate of existence for an annuity policyholder. It contains the policyholder's personal details like name, address, phone number, and ID proofs. It certifies that the annuitant was alive on a particular date and was seen in person by a certifying authority like a gazetted officer. It also contains a note of authority for updating the annuitant's bank details to receive the annuity payments and an Aadhaar consent clause.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Certificate of Existence Claim Form - 01112019-1

    Uploaded by

    Richard moses
    170 views1 page
    This document is a certificate of existence for an annuity policyholder. It contains the policyholder's personal details like name, address, phone number, and ID proofs. It certifies that the annuitant was alive on a particular date and was seen in person by a certifying authority like a gazetted officer. It also contains a note of authority for updating the annuitant's bank details to receive the annuity payments and an Aadhaar consent clause.

    Original Title

    Certificate of Existence Claim Form_01112019-1(1)

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    © © All Rights Reserved

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    This document is a certificate of existence for an annuity policyholder. It contains the policyholder's personal details like name, address, phone number, and ID proofs. It certifies that the annuitant was alive on a particular date and was seen in person by a certifying authority like a gazetted officer. It also contains a note of authority for updating the annuitant's bank details to receive the annuity payments and an Aadhaar consent clause.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    170 views1 page

    Certificate of Existence Claim Form - 01112019-1

    Uploaded by

    Richard moses
    This document is a certificate of existence for an annuity policyholder. It contains the policyholder's personal details like name, address, phone number, and ID proofs. It certifies that the annuitant was alive on a particular date and was seen in person by a certifying authority like a gazetted officer. It also contains a note of authority for updating the annuitant's bank details to receive the annuity payments and an Aadhaar consent clause.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    CERTIFICATE OF EXISTENCE

    Policy/ Master Policy No:

    Annuitant No.:

    Name of Annuitant:

    Address:

    Phone No: Mobile No:

    Email Id:

    Aadhar no.

    Signature of Annuitant
    (Self Attested ID Proof to be submitted)
    I_________________________________________________________hereby certify that Shri/Smt ____________________________________
    (Annuitant’s name) son/daughter of _______________________________was alive on D D M M Y Y Y Y and having personally
    seen him/her.
    Name of Certifying Authority:

    Designation and Seal:

    Address:

    Date: D D M M Y Y Y Y
    Seal and Signature of Certifying Authority

    (Please attach self attested address proof if any change of address is required, request for Address change has to be submitted in person at any of
    the branches of SBI Life Insurance Co. Ltd.)
    Acceptable address proofs - Passport, Voter's ldentity Card issued by Election Commission of lndia, Driving License, Aadhaar Card / Letter issued by
    the Unique identification Authority of lndia, Utility bill which is not more than two months old of any service provider (electricity, telephone, postpaid
    mobile phone, piped gas, water bill), Property or Municipal tax receipt, Bank account / Post Office savings account statement, Others (please specify)
    _____________________________________________________________
    (This Form should be signed by the Annuitant before a Gazetted Officer / Registered Medical Practitioner with Registration No. / Post Master /
    Head Master of the School / Officer of SBI Life above Assistant Manager / Authorized person of Group Master Policyholder / Bank Manager or
    Officer with his Specimen Signature with Seal)
    Note of Authority* (Please attach a pre-printed cancelled cheque leaf OR self attested copy of bank passbook in case of bank details different from
    recorded one. If no change please just mention the details below without any proof)
    I __________________________________________________ (Annuitant’s Name) hereby authorize SBI Life Insurance Co. Ltd. to credit the annuity
    amount to my bank account as per details given below.
    Account No:

    Type of Account: IFSC Code no:

    Bank Name:

    Branch Address:
    Aadhaar Consent:
    I, < Name of the Customer> , hereby give my voluntary consent to SBI Life Insurance Company Limited (SBI Life) and authorise
    the Company to obtain necessary details like Name, DOB, Address, Mobile Number, Email, Photograph through the QR code available on my
    Aadhaar card / XML File shared using the offline verification process of UIDAI. I understand and agree that this information will be exclusively
    used by SBI Life only for the KYC purpose and for all service aspects related to my policy/ies. I have duly been made aware that I can also use
    alternative KYC documents like Passport, Voter's ID Card, Driving licence, NREGA job card, letter from National Population Register, in lieu of
    Aadhaar for the purpose of completing my KYC formalities. I understand and agree that the details so obtained shall be stored with SBI Life
    and be shared solely for the purpose of issuing insurance policy to me and for servicing them. I will not hold SBI Life or any of its authorized
    officials responsible in case of any incorrect information provided by me. I further authorize SBI Life that it may use my mobile number for
    sending SMS alerts to me regarding various servicing and other matters related to my policy/ies.
    *Disclaimer - Please note direct transfer to be made only if otherwise possible and allowed by banks as per banking regulations, EFT will be
    possible only if either a cancelled cheque leaf is attached or above stated account details are attested by branch manager of the bank where the
    bank account is being maintained. SBI life will not be responsible and liable for any losses occurred due to incorrect account details provided
    by policyholder.
    SBI Life Insurance Company Limited: Registered and Corporate Office: Natraj, M.V. Road & Western Express Highway Junction, Andheri(East), Mumbai- 400 069. Tel.: (022) 61910000.
    Central Processing Center: 7th Level (D-Wing) & 8th Level, Seawoods Grand Central, Tower 2, Plot No. R-1, Sector-40, Seawoods, Nerul Node, Navi Mumbai- 400 706.
    Tel.: (022) 66456000. IRDAI Registration No. 111. CIN: L99999MH2000PLC129113. Toll Free No. 1800 267 9090 (From 9.00am to 9.00pm). Visit: www.sbilife.co.in E-mail: info@sbilife.co.in

    Page 1 of 1 CLM/LB/Ver 1.04 / 11-19

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