FORM OF LETTER OF INDEMNITY. (for Lost / Mispalced Annuity Cheque/s under Individual Pension Plans) To, The Life Insurance Corporation of India. Dear Sir, Re: Policy No./s____________________________ _________________________________________ _________________________________________ On the Life of _____________________________ You had issued to me on _______________, Cheque/s bearing no/s._________________________________________________________________for Rs.________________(Rupees___________________________________________) drawn on the ______________________________________Bank as payment of annuity amount due to me. AND WHEREAS the said Cheque/s has been lost or misplaced. AND WHEREAS upon my representation that the said Cheque/s has been lost or misplaced and has not been transferred or dealt with by me in any manner and on my undertaking that if the said Cheque/s is found, it shall be returned to you for cancellation. You have agreed at my request to issue me the duplicate Cheque/s in lieu of the said lost or misplaced Cheque/s on my giving you this Letter of Indemnity. NOW in consideration of the promises for myself, my heirs, executors and administrators agree and undertake from time to time and at all times hereafter to indemnify and keep you and the Life Insurance Corporation of India harmless and indemnified from and against all claims, demands, actions, liabilities and expenses which may be made or taken against or incurred by you or the said Life Insurance Corporation of India by reason of the issue of such duplicate Cheque/s or in respect of the said Cheque/s No/.s_____________________________________________________. Dated :at _________________this _____day of _________________________. Yours faithfully, ___________________ (Annuitant's Signature) Witness : Full Name :_______________________ Signature :________________________ Occupation :______________________ Address :_________________________ _________________________________ (No other attestation is necessary)
