Date: Automatic update

Air mark Section ………. Unique number (79/80)

…………. Bank Ltd

Address.

Subject: Release of Fixed Deposit Lien

Dear Sir/Madam,

With reference to letter issued from ……………. insurance co. ltd dated …………. I would like to
request you to release of mention lien Fixed deposit account in favor of ……… insurance co. ltd maintain
in your esteem organization.

Table/Detail of FD

Timely corporation regarding same will be appreciated.

With Regards Stamp NIA

Ram Koju or Arya Rawal (Based On selection)

Assistant Director
Nepal Insurance Authority
 Date: Automatic update

Air mark Section ………. Unique number (79/80)

…………. Bank Ltd

Address.

Subject: Lien of Fixed Deposit

Dear Sir/Madam,

With reference to letter issued from ……………. insurance co. ltd dated …………. I would like to
request you to lien the mention Fixed deposit account in favor of Nepal Insurance Authority maintain in
your esteem organization.

Table/Detail of FD

Timely corporation regarding same will be appreciated.

Stamp NIA

With Regards Regards,

Ram Koju or Arya Rawal (Based On selection)

Assistant Director
Nepal Insurance Authority