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    Form 3264 Nomination

    Uploaded by

    anurag655
    The document is a nomination form for a life insurance policy. It nominates a specific individual, identified by their name, relationship to the policy holder, and address, as the beneficiary to receive the money secured by the policy in the event of the policy holder's death. The policy holder signs and dates the form in the presence of a witness, who also signs to verify the contents were explained and the signature was affixed in their presence.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Form 3264 Nomination

    Uploaded by

    anurag655
    1K views3 pages
    The document is a nomination form for a life insurance policy. It nominates a specific individual, identified by their name, relationship to the policy holder, and address, as the beneficiary to receive the money secured by the policy in the event of the policy holder's death. The policy holder signs and dates the form in the presence of a witness, who also signs to verify the contents were explained and the signature was affixed in their presence.

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    The document is a nomination form for a life insurance policy. It nominates a specific individual, identified by their name, relationship to the policy holder, and address, as the beneficiary to receive the money secured by the policy in the event of the policy holder's death. The policy holder signs and dates the form in the presence of a witness, who also signs to verify the contents were explained and the signature was affixed in their presence.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1K views3 pages

    Form 3264 Nomination

    Uploaded by

    anurag655
    The document is a nomination form for a life insurance policy. It nominates a specific individual, identified by their name, relationship to the policy holder, and address, as the beneficiary to receive the money secured by the policy in the event of the policy holder's death. The policy holder signs and dates the form in the presence of a witness, who also signs to verify the contents were explained and the signature was affixed in their presence.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    I,_______________________________________________________________________________ The Assured under the within Policy ; hereby nominate under section 39 of the Insurance Act, 1938,

    My (relationship) ___________________________Named _________________________________ Aged _____________________years and whose address is ________________________________ As the person to whom the moneys secured under the Policy shall be paid in the event of my of death. Signed at __________________________this______________________ day of____________2000 WITNESS

    ( Signature in English)

    ( Signature of Life Assured)

    Full Name :___________________________

    Designation :__________________________

    "Certified that the contents of the above nomination hace been explained by me to the Assured _________________________ In vernacular and that he/she affixed his/her Signature/thumb impression thereto in my presence afther throughly understanding the same".

    Address :_____________________________ _____________________________________

    (Signature of witness)

    (Seal)

    INSTRUCTIONS

    1.

    A Nomination can be made only by the holder of a Policy on his own life, i.e. only by the Life Assured. After filling up the blanks as may be necessary in the form of Nomination printed on the reverse, the Assured should copy it out on the back of the policy. The certificate of the witness should also be copied out if the signature of the Life Assured is not in English (see 3 below). The Assured must affix his signature to the endorsement in the presence of a witness. If the Assured be not conversant with English, he/she should sign the endorsement before an English knowing witness and if he/she be illiterate he/she must affix his/her thumb impression to the endorsement before a Magistrate, S.E.M. or Gazetted Officer, an Officer or Development officer of atleast 3 years standing or confirmed Development officer recruited from the Agents, who were DM. or BM. Club members before joining or Development officers recruited from agents who were ZM or Chairman's club members provided he/she is fully satisfied about the identity of the person(s) executing the endorsement. In such cases the witness should sign the certificate in the endorsement. Immediately after a nomination has been effected by an endorsement, the Policy must be sent to the servicing office of the Corporation for registration of the Nomination. A Nomination will Not be effectual unless it is communicated to and registered by the Corporation. If the nominee be a minor, it is advisable to appoint, in the manner prescribed by the Insurance Act, an Appointee to receive the moneys secured by the Policy in the event of the Assured's death during the minority of the nominee. A form of Appointment of Appointee with instruction can be had from the corporation on application.

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    F No. 3264 NRPP/500x100/5/96 Padsx100/2/95

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