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    Harish Chand
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    This document is an addendum to an insurance proposal form for a female applicant not covered under India's National Maternity Scheme (NMS). It requests employment details including the applicant's name, current and previous employers' names and addresses, date of joining, salary, job nature, and evidence of employment such as salary slips, identity cards, and appointment letters. The applicant must declare that the provided statements are true and correct. The form must be witnessed by an agent and development officer.

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    This document is an addendum to an insurance proposal form for a female applicant not covered under India's National Maternity Scheme (NMS). It requests employment details including the applicant's name, current and previous employers' names and addresses, date of joining, salary, job nature, and evidence of employment such as salary slips, identity cards, and appointment letters. The applicant must declare that the provided statements are true and correct. The form must be witnessed by an agent and development officer.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    5 views1 page

    Cat 1 Fem

    Uploaded by

    Harish Chand
    This document is an addendum to an insurance proposal form for a female applicant not covered under India's National Maternity Scheme (NMS). It requests employment details including the applicant's name, current and previous employers' names and addresses, date of joining, salary, job nature, and evidence of employment such as salary slips, identity cards, and appointment letters. The applicant must declare that the provided statements are true and correct. The form must be witnessed by an agent and development officer.

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    of 1

    Life Insurance Corporation of India

    Female Life – Category I Addendum to Proposal


    (To be filled in by the female proponent who is employed in institution where NMS is not applicable)

    1. Name of the Life to be Assured :

    2 Name of present employer :

    Year of Establishment :

    Address & Telephone No. :

    3. Name of previous employer, if any :

    address & telephone no. :

    4. Date of joining :

    5. Salary per month :

    6. Nature of job :

    7. Evidence of employment :
    (attach zerox duly signed by the person)

    a. salary slip :
    b. Identity card :
    c. ESIS Card :
    d. Employer’s Certificate :
    e. Copy of appointment letter :
    f. Any other evidence (to be specific) :

    DECLARATION

    I, Mr/Mrs/Ms……………………………………………. Hereby declare that the foregoing statements are


    true and correct and shll form part of the proposal form for insurance on my life.

    Dated this day of 200 .

    (Signature of the proposer)

    Witnessed by:

    1. Signature of agent
    2. Signature of Development Officer.

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