[Resolved]  Lic / Policy No. 58766310 — For Revival

Date:- 26th April, 2009

S. MANJIT SINGH 136, North Idgah Colony,
Agra - 282 010 (U.P.) Cell. No. +[protected] Ph. No.[protected]

TO,
THE REGIONAL MANAGER
CHIEF REGIONAL MANAGER DEPARTMENT
LIFE INSURANCE CORPORATION OF INDIA
NORTH CENTRAL ZONAL OFFICE
16/98, M.G. ROAD
KANPUR (U.P.)

Ref : Our Policy No. 58766310 Infavour of S. Manjit Singh R/o 136, North Idgah Colony,
Agra - 282 010 from Dholpur House, M.G. Road, Agra- 282 001 (Branch Code: 265)

Sub: An Application for Revival the Policy No. 58766310 Amount Rs. 50, 000 Yearly
Premium Installment For Rs. 692.50 date of Issue 15th July, 1981 to 14th July, 2008
Infavour of S. Manjit Singh R/o 136, North Idgah Colony, Agra - 282 010

Respected Sir,

As per above, you are kindly requested to Revive the Policy as Mentioned Address.

(1) As per Current Status of above Policy since 2002 we could not deposit the annual premium of this policy by mistake & Communication gap to deposit the Yearly Premium
Installment. When the Yearly Premium Installment is 692.50 Only

(2) The Original Policy Bond in Your Dholpur House Branch as a Mortgage under the request for loan on above Policy Ready reference of Our Letter Dt. 18th Nov, 1999 &
Recd by your Office dt. 26th Nov, 1999.(A Xerox Copy of Letter, Premium renewal
Receipt for Rs. 727.50 (Premium Amount 692.50+ 35.00 is Including Late fees) Dt. 30th March, 1999 enclosed herewith )

(3) Our (Three) 3 Previous Policies was running before asper above policy & (3) Three Policies was running afterwards infavour of S. Manjit Singh Which are Up to Date get the Full final & assured amount & Detail as Follows:-

S. No. Policy No. Assured Amount Terms Maturity Date
1 26736852 20, 000.00 75-20 [protected]
2 46298186 20, 000.00 75-20 [protected]
3 46308296 25, 000.00 14-20 [protected]
4 58814201 10, 000.00 75-20 [protected]
5 58815664 30, 000.00 75-20 [protected]
6 58815665 25, 000.00 76-25 [protected]

4) As Per Current Status of Mentioned Policy Dt. 23rd Jan, 2009, There is No. Payment history for this policy & the Second one Dt. 23rd April, 2009, there is Claim / surrender history record is amount payable for Rs. 10, 677.00. Deduction Amount for Rs. 12, 663.00. It is to Inform you that we could not get amount till date from LIC of India, Branch Code :- 265, Dholpur House, Agra. (Xerox Copy of Both Current Status enclosed herewith for your ready reference.)

You are Kindly requested to please revive our above mentioned Policy & We are ready to pay the Up to Date amount with Interest (Premium Amount + Loan Amount with Interest ) as Per LIC Norms / Terms & Condition.

Hope you will Consider Our Application, an early action shall be highly appreciated.

With regards

Thanking You
Yours Sincerely
MANJIT SINGH

ENCLOSED : 3 (Three) Scanned Copies.