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Policy Surrender Form

The document is an application form for policy surrender from EFU Life Assurance Ltd, requesting the full cash value or a specific sum by surrendering units of the policy. It includes sections for consent on Zakat deduction, agreement to discharge the company from liabilities, and certification of entitlement to the policy proceeds. The form requires signatures from the policyholder and a witness, along with personal and contact information.

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568 views2 pages

Policy Surrender Form

The document is an application form for policy surrender from EFU Life Assurance Ltd, requesting the full cash value or a specific sum by surrendering units of the policy. It includes sections for consent on Zakat deduction, agreement to discharge the company from liabilities, and certification of entitlement to the policy proceeds. The form requires signatures from the policyholder and a witness, along with personal and contact information.

Uploaded by

hasanshehzad181
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

EFU LIFE ASSURANCE LTD

APPLICATION FOR POLICY SURRENDER

Policy Number Name of Policy Holder

Bank Branch

Bank Account Number

Reason for Surrender

In accordance with the Provisions and Conditions of the above policy, I / We hereby request EFU Life Assurance to pay:

Regular Unit

The full cash value of the policy through its total surrender.

A sum of Rs. by surrendering appropriate number of units. I/We understand that in this
event, the Sum Assured of the policy will be proportionally reduced.

OR /
number of units attached to the above policy through their surrender. I/We understand that
in this event, Sum Assured of the policy will be proportionally reduced.

Fund Acceleration Premium (FAP)

The full cash value of FAP units in the above policy through surrender.

A sum of Rs. by surrendering appropriate number of units allocated against FAP.

OR /

number of FAP units attached to the above policy through their surrender.

Consent on Zakat deduction

I/We wish to claim exemption of Zakat. The relevant sworn statement is attached.

I/We do not wish to claim exemption from deduction of Zakat. I/We understand that a sum equivalent to 2.5%
of amount payable has to be deducted as zakat.

Cont: Page2

CS/3/023-8-1/2
EFU Life House, Plot No. 112, 8th East Street, Phase 1, DHA, Karachi. Phone # (021) 111-EFU-111, 111-338-111
Client Service Call Center (021) 111-EFU-CSD, 111-338-273, Fax: (021) 34537519, Email: [email protected], Website: www.efulife.com
I/We agree that the above-mentioned payment made in my/our favor and sent by post or courier service to the address
men tio ne d b elow, will d ischa rg e th e C ompan y fro m a ny liab ilitie s a nd claims a rising un de r th is po licy.

I/We also hereby certify that I/We are entitled to the proceeds of the policy, and that the policy has niether in any way been
assigned or transferred, nor does any other person(s) have any right to the policy.

I/We understand that the surrender processing fees of Rs.500/- will be deducted from the cash value of my policy at the
time of full surrender of regular units.

I/We have already returned the policy documents to EFU Life Assurance Ltd.

Date Month Year Place

Signature of life assured:

(in case of a joint life policy, both lives need to sign)


(In case the signature has been changed, please provide both old and new signatures)

Correspondence
Address:

E-mail: Telephone No: Mobile No:

Witness:

Name of witness:

Signature of witness:

Computerized National Identity Card #

Correspondence
Address:

E-mail: Telephone No: Mobile No:

CS/3/023-8-2/2
EFU Life House, Plot No. 112, 8th East Street, Phase 1, DHA, Karachi. Phone # (021) 111-EFU-111, 111-338-111
Client Service Call Center (021) 111-EFU-CSD, 111-338-273, Fax: (021) 34537519, Email: [email protected], Website: www.efulife.com

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