Board Resolution

(For Employer-Employee Insurance )

[To be obtained on the letterhead of the Company]

CERTIFIED TRUE COPY OF THE RESOLUTION PASSED BY THE BOARD OF DIRECTORS OF THE
____________________________________________ (COMPANY NAME) IN ITS MEETING HELD ON
_____________(DD/MM/YYYY) AT ITS REGISTERED OFFICE.

“RESOLVED THAT in keeping with its growing tradition of looking after its employees, the Company
proposes to purchase life insurance Policies from Max Life Insurance Company Limited and pay life insurance
premiums in respect thereof, on the lives of the following [persons/categories of persons]:
Sum Plan (Type of
Sl. Proposal
Category of Person Designation Assured Premium Policy/Riders/Opt
No Number
(Rs.) ions)
[Give the category of
1 persons or name of the
persons]

[Give the category of

2 persons or name of the
persons]

[Give the category of

3 persons or name of the
persons]

[Give the category of

4 persons or name of the
persons]

“RESOLVED FURTHER THAT the Company shall formulate and adopt rules which shall become part of
every policy Contract with Max Life Insurance Company Ltd.”

“RESOLVED FURTHER THAT Mr. _________________________[give designation] and Mr.

__________________________, ___________________ [give designation] of the Company be and are hereby
severally authorized to sign the proposal forms or any other necessary deed and documents and to take all such
steps on behalf of the Company, as may be deemed fit and necessary.”

“AND THAT Mr. ________________________________, _________________ [give designation] and Mr.

____________________________________, ______________________ [give designation] of the Company be
and are hereby severally authorised to remit premiums, renew, assign or transfer the policy (ies) and to give
notice of assignment or transfer to the Insurer on behalf of the Company.”

Certified to be true
For ______________________________
Name:
Designation:
Specimen Signature of Mr.__________________
Date:
Place: