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Subject: Claim Payment Reissuance Request Cum Declaration Kharif-2022 and Rabi 2022-23

The document is a request for the reissuance of rejected crop insurance claim payments under the PMFBY/RWBCIS schemes for Kharif-2022 and Rabi 2022-23. The insured farmer provides details of their application numbers, bank account information, and reasons for the reissuance request. The farmer declares the accuracy of the information provided and agrees to hold responsibility for any issues arising from the reissuance process.

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803 views1 page

Subject: Claim Payment Reissuance Request Cum Declaration Kharif-2022 and Rabi 2022-23

The document is a request for the reissuance of rejected crop insurance claim payments under the PMFBY/RWBCIS schemes for Kharif-2022 and Rabi 2022-23. The insured farmer provides details of their application numbers, bank account information, and reasons for the reissuance request. The farmer declares the accuracy of the information provided and agrees to hold responsibility for any issues arising from the reissuance process.

Uploaded by

bvn0085
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

PMFBY- Claim payment Reissuance request cum Farmer Self declaration

To

Agriculture Insurance Company


Cabin No-7 3rd Floor ,Agro Mall ,Sector-20
Panchkula 134117
Subject: Claim Payment Reissuance Request cum declaration Kharif-2022 and Rabi 2022-23
R/Sir/Madam
I bearing crop insurance application nos. as enclosed under Table.
am/are giving this request letter cum declaration towards. reissuance of the rejected claim payment as
was issued against the aforesaid application nos. towards payment of eligible claim under PMFBY/
RWBCIS crop insurance scheme.
Through this declaration, I would like to request the insurance company for reissuance of the rejected
claim payment in the bank account as mentioned below under Table. Payment reissuance request
details.
Table : Payment reissuance request details (Self- Declaration)
Sr. Crop insurance Insured Reissuance Reissuance Reissuance Tick appropriate
no. application no.(s). Farmer Bank name Bank account Bank IFSC Reissuance reason
name no. Code
1 1.Change in IFSC
code

2.Incorrect account
no/FarmerName/
Adhar No. filled at
the time of
enrolment

3. Aadhar payment
unsuccessful

I hereby declare that the above declaration is true in all respects and that I agree that above information
shall form the basis of claim payment reissuance through National Crop Insurance Portal Digi Claim
process and which I understand is subject to successful verification of the revised bank account as shared
in this declaration. I agree to hold myself/ ourselves responsible/ liable for any loss that you may incur in
case of a failed reissuance payment due to my/our own negligence or otherwise in providing the
reissuance Bank account no/ Aadhar no. details. Supporting documents enclosed herewith:
1. Copy of front and last page of bank passbook duly signed and stamped by the Bank with its IFSC
code clearly mentioned on it
2. Copy of front and last page of Aadhar card in case of reissuance in Aadhar linked bank account no.
I also authorize Agriculture insurance Company to recover the amount of double payment .if any due to
me/us in the exceptional eventuality of both original and reissuance payment becoming successful . I also
agree that receipt of the reissuance claim payment fully discharges Agriculture insurance company from
all obligation in r/o the subject matter
Regards
Name of Insured Farmer

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