Form No
3815
Life Insurance Corporation of India
To
all to whom these presents shall come ________________________________________
________________________________________________________________________
(Name
of All Payees & Surety)
____________________________________________________________________________
(Name
of all residence of Payee/s)
____________________________________________________________________________
Inhabitants send
Geetings wheres a Policy of Insurance Numbered ___________________ for Rs.
____________________ we granted on
_________________________by the Life Insurance Corporation of India,
established by the Life Insurance Corporation Act, 31 of 1956 (hereinafter
referred to as the Corporation) on the life of ________________________________________
(Name of
Policyholder)
and
whereas _____________________ (Policy No. or Assignment Deed Dated)__________
which was in the possession of ___________________________ has been lost or misplaced. (Name
of Policyholder)
And whereas the
said Corporation has on the said _____________________________________
(Name of all Payees & Surety)
undertaking to
enter into with the said corporation a Coaenemt of the nature herein after
appearing agreed to pay to the said
________________________________________________
(Name or Names of
Payees)
_________________the
value of the said Policy viz. Rs_____________ now know yet and these presents
witness that in pursuance of the said agreement and in consideration of the
said corporation having agreed to pay
the value of the said policy to the said _________________
(Name or
Names of Payees)
(the receipt
where of is hereby acknowledged) they
the said_____________________________
(Name or Name of
Payee/s & Surety)
hereby
for themselves, their heirs, executors or administrators Convenant with the said
Corporation,
its successors and assigns that the said _________________________________
(Name or Name of Payee/s & Surety)
their
heirs, executors or administrators will from time to time and at all times save
and keep harmless and indemnified the said corporation, its successors and
assigns of and from all actions, suits, costs claims and demands of whatever
nature and kind so ever which may be instituted, preferred, claimed to be made
against the said Corporation, its successor or assignees by any persons or
person by reason of his, her, their possession of or right to the said original
______________________________
[
Pol. No. or Assignment Deed Dated]
In
witness whereof the said __________________________________________________
(Names
of Payee/s & Surety)
______________________________________________________________________________
have here into
put their hands at _________________this _________day of ___________2017.
Signed and
delivered by the said __________________________________________________
(Names
of Payee/s & Surety)
In
the presence of: (1)______________________
Signature
Full
Signature of witness (1)______________________ (2)_____________________
Signature
Designation: ________________________
Signature
Address
:_____________________ of surety________________________________________
Full Signature
of witness (2) _________________ Designation __________________
Designation
__________________ Address_____________________
Address:
______________________
Note : If this
Bond is signed in vernacular one of the attesting witnesses should be requested
to certify that the contents of this Bond were explained to the party in vernacular
before execution.
