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‘Avoid Policy Rejection. 7 HDC Online Addendum - HDFC Bank aaa ts form £ Life Tobe filled tor Assisted Online Business | Csreruiy. ee ‘Application Number |. HOFC Life agent have ensured that this form is (Eitri propos form number) completed ater dscussing and agreelngo the proposed CBI OWIE SIF AU CIG! | serancepin PE ‘* HDFC Bank OD/Cheque/Last four digits of Credit Card No/Online Ret =F} ‘= Incase of Fund Transfer, please mention existing policy[_J}—W [AEE L_] Note: Only HNFCEonkinstamerts vm alloned. There mths adebita the HOFCbankgerountaf playholer or proper aierent from; ‘Premium amounts inline withthe customer’ profile and account balance: (7f Yes *= Policy Holder (proposer it citterent from policyholder) Is KYC/ AML compllant with HDFC Bank: [Ves * Customer’sincome decared fo the investmentisin ine with the bank profile ofthe customer: [Yes Senin * Customes signatures onthe poposlmatches wih the bankrecordsforelechannels ony, the confirmations thatcustomer signature matches onal polnts where the customerhas signed, [7{ ves [neve slisheat’ Cherm spcose(oe Tala TsT@ Tol L111 Jemnayee cove: DECLARATION BY SUPERVISOR. ‘confirm that have spoken to/met the customer for thislifeinsurance proposal, [STARE confirm thatthe customeris aware of all product features and thatthe policy is soldintine with the customers requrements SWATI KOCHH, | confirm thatthe entire sales solitatin from leat generation, vannaBackyp Branch Mana product festurestocesureafsalehasheen doneby ROAlcertfedstaf. Emp. Code 1 S3752: Nishaak Shr spcose OP URISTIGLLLLL tk Nawar-1443 ES eI So DS {Sari thet have spoken tomet the customer for thislif insurance proposal confirm thatthe customers amare ofal) product features and] Crore KY 14 in ne withthe customers requirement. The premium paying capacity of the customer for the sald proposel has bee established, Name. EEE 8BH/ Business Head Approval forPoies> = 2lac ves] WoL] AomuaizedPreriamtaen ‘BBH/Business Head Approval taken on Date: Qoo0o00o00o0 Agprvelmal copy tached ves] wo (Uplaading approval allcopy s mandatory) ‘ApprovalinitatedBy OEE Employee Code Bags cay ny eee 910 3 tm TNR ete Mlb om Scanned with CamScanner

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