Annexure II

Oeclaration of continued Non-Resident Status for Exemption from GST to NRI/FNIOIOCI

.' '. i p;... • , ,..

(to b~ submitted in Cash Sec~ion)

Name of the Policyholder

1

Status (NRII FNIOI OCI) 1 ·1 Country of Residence

1

Policy Numbers
1--

Sank Account Details (from which Premium will be paid)

Bank Name
NRE
Account No. IFSC 1

I, , undertake that, as on date, __ I __ / , I hold

the status of NRI/FNIO/OCI and am a resident of (country of residence).
I wish to avail GST exemption on Renewal Premium Payment, and I shall inform Life Insurance
Corporation of India about the change in my residential status from NRI/FNIO/OCI to Resident Indian, if
any. I will be responsible to indemnify Life Insurance Corporation of India in case of any loss that may
arise in relation to the above.

Kindly grant me exemption from GST as per Section 2(6) of IGST Amendment Act, 2018 for Export of
Services.

Signature
Name
Date
E-Mail 10
Mobile Number ~_~~~~_