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Lic Neft Form

The document is a form from Life Insurance Corporation of India for policyholders to provide their bank account details to receive policy payments via NEFT electronic funds transfer. It requests the policy number, account holder name, bank name and address, account type and number, IFS code, mobile number, email, and enclosed proof of the bank account such as a cancelled cheque or bank passbook page. Policyholders must sign and date the form to authorize the change of payment method to direct deposit.

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NSO FOD SRO HISAR
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16K views1 page

Lic Neft Form

The document is a form from Life Insurance Corporation of India for policyholders to provide their bank account details to receive policy payments via NEFT electronic funds transfer. It requests the policy number, account holder name, bank name and address, account type and number, IFS code, mobile number, email, and enclosed proof of the bank account such as a cancelled cheque or bank passbook page. Policyholders must sign and date the form to authorize the change of payment method to direct deposit.

Uploaded by

NSO FOD SRO HISAR
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

LIFE INSURANCE CORPORATION OF INDIA

NATIONAL ELECTRONIC FUNDS TRANSFER – MANDATE FORM


To
LIFE INSURANCE CORPORATION OF INDIA
Branch: - .

Sub: - Receipt of policy payment through NEFT.


I am giving below the details of my Bank account for receiving policy payment through NEFT.

(1) Policy No/s

Name of policy holder/claimant: - ___________________________________________


(2) Bank Name :- _____________________________________________________
(3) Bank Branch Address :- _____________________________________________
(4) Account Type :- Savings/Current/Cash Credit/NRI :- ______________________
(5) Account No :-

(6) IFS Code :-

(7) Mobile Number :-

(8) E-Mail Id :- _______________________________________________________


(9) Are you willing to receive SMS/E-mail, on matters related to your LIC Yes No
policies:-
I have enclosed the following document to this effect. (Please √ appropriate item)
A. Cancelled cheque leaf

B. If cheque is not having the name of the bank holder then photo copy of the page of Bank
pass book containing details of Bank accounts number, IFS Code

________________________
Signature of the policy holder Date: - _____________
---------------------------------------------------------------------------------------------------------------------
(In case of change in Bank details, please fill this mandate form again and submit the same to
Our Branch Office)

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