DECL, Wimess do hereby declare that the contents of the above declaration have been explained to the Declarent ARATION TO FORM. PART OF LIFE INSUI PROPOSED BY: dk LIFE OF: RANCE PROPOSAL NO.__ J understand that “State Life Insurance Corporation of Pakistan” may accept the prop insurance on my life with the expense condition that should the assured die during the curreacy of the policy due to any reason directly or indirectly attributable to Murder and / oF suicide, the ‘State Life's risk under the proposed policy, if and when issued, shall be restricted in the extant of premium paid only. | have clearly understand and agreed to this condition to be incorporate this Life Insurance Policy being proposed. also agree that the above condition shall be equally binding on my nomines =, here and as signe Declared at Lahore this __ dayof 200 DECEARANY LIFE PROPOSED i S/O. sind that she has signed after understanding the same, Dated: Name. Signature : Address,