FORM FOR ABSOLUTE ASSIGNMENT OF POLICY
I/We,_______________________________________________________________ the holder of the Life Insurance Policy No.__________________________
issued by ICICI Prudential Life Insurance Company Limited (‘the Company’) do hereby absolutely transfer and assign the right and benefits of the said
Policy in favour of Mr./Mrs./M/s. ______________________________________________________________________ being my ________________________
(relationship) whose marital Status is ________________________________ and whose DOB is ____________________________________ (marital status &
DOB required only if the assignee is individual) and residing at / having their office at _____________________________________________________________
I/We note that the assignment shall be complete and effectual upon the execution of this endorsement but that it shall not be operative as against the
Company until a notice in writing of this assignment and either the said endorsement or the instrument itself or a copy there of certified to be correct by
both the assignor and the assignee or their duly authorised agent has been delivered to the specified office(s) of the Company.
I/We hereby declare that the assignee’s receipt of the benefits under the Policy shall be a valid and sufficient discharge of the Company.
The Assignor has duly executed the endorsement on the Policy, and the signature/thumb impression is of the Assignor affixed on the date place herein
Please select the applicable option:
1. Assignment out of love and affection:
Assignment to blood relatives /spouse
Assignment to others (eg: To a friend)
2. Assignment for a valuable consideration of Rs. _____________________________________________(Consider