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    Authority Letter For Cash Deposit

    Uploaded by

    Lalit Mohan Singh
    This document is an authority letter authorizing a third party to deposit cash on behalf of the policyholder towards an HDFC Life insurance proposal or policy. It provides details of the cash deposit such as denomination amounts and total, and includes signatures of the policyholder and depositor. The policyholder is unable to visit the branch personally due to the stated reason.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Authority Letter For Cash Deposit

    Uploaded by

    Lalit Mohan Singh
    1K views1 page
    This document is an authority letter authorizing a third party to deposit cash on behalf of the policyholder towards an HDFC Life insurance proposal or policy. It provides details of the cash deposit such as denomination amounts and total, and includes signatures of the policyholder and depositor. The policyholder is unable to visit the branch personally due to the stated reason.

    Original Description:

    HDFC BANK

    Original Title

    Authority Letter for Cash Deposit

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    This document is an authority letter authorizing a third party to deposit cash on behalf of the policyholder towards an HDFC Life insurance proposal or policy. It provides details of the cash deposit such as denomination amounts and total, and includes signatures of the policyholder and depositor. The policyholder is unable to visit the branch personally due to the stated reason.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1K views1 page

    Authority Letter For Cash Deposit

    Uploaded by

    Lalit Mohan Singh
    This document is an authority letter authorizing a third party to deposit cash on behalf of the policyholder towards an HDFC Life insurance proposal or policy. It provides details of the cash deposit such as denomination amounts and total, and includes signatures of the policyholder and depositor. The policyholder is unable to visit the branch personally due to the stated reason.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    PSNL408623041507

    Comp/June/Int/4514

    Authority Letter for Cash Deposit


    To,

    Date: DD/MM/YYYY

    The Manager,
    HDFC Standard Life Insurance Company Limited
    Branch Address
    Dear Sir/Madam,
    I, Mr/Ms/Mrs. __________________________________________________________________________________hereby authorise
    Mr/Ms/Mrs. ___________________________________________________________________________to deposit an amount of INR
    ___________________________by cash on my behalf at HDFC Life branch towards the proposal / Policy number
    ___________________________ taken by me. I am unable to visit the branch personally because______________________________
    ________________________________________________________(Reason)___________________________________________.

    Details of cash deposit


    Denomination

    Amount (INR)

    Payment for:

    1000 X

    New Application

    Rate Up

    Bounce

    500 X

    Bima Bachat

    Revival/Reinstatement

    100 X

    Short payment

    Renewal
    Top-up

    50 X
    Agent Licensing:

    20 X
    10 X

    Application Fees

    Exam Fees

    5X

    Franking Fees

    Training fees

    License Fees

    Coins
    PAN No: ______________________________________

    Total

    INR in words_________________________________________________________________________________________________
    Depositors contact no.: _________________________________________ Email ID: _______________________________________
    Address: ___________________________________________________________________________________________________
    If the depositor is an employee/FC, then please mention the employee/FC code ____________________________________________
    SIGN HERE

    SIGN HERE

    (Signature of the proposed Policyholder /Policyholder)

    (Signature of the Depositor)

    Declaration to be made by Third party where, the Policyholder has affixed his/her thumb impression/has signed invernacular /has not
    filled the application:
    I hereby declare that I have explained the contents of this application form to the Policyholder in_____________________________
    language and have truthfully recorded the answers provided to me. I further declare that the Policyholder has signed /affixed his/her
    thumb impression in my presence.
    Name : _____________________________________________________________________________________________________
    Address : ___________________________________________________________________________________________________
    DD/MM/YYYY
    Signature: _____________________________________ Date: ________________
    Place: ___________________________________
    HDFC Standard Life Insurance Company Limited. In partnership with Standard Life Plc. CIN:U99999MH2000PLC128245. IRDAI Registration No. 101.
    Regd. Off: Lodha Excelus, 13th Floor, Apollo Mills Compound, N. M. Joshi Marg, Mahalaxmi, Mumbai - 400 011.
    For queries or more information, Call 1860-267-9999 (local charges apply). DO NOT prefix any country code e.g. +91 or 00. Available all days from 9am to 9pm | Email service@hdfclife.com |
    NRIservice@hdfclife.com (For NRI customers only) Visit www.hdfclife.com

    For Office use only


    Branch Name: _______________________________________ FC/SDM/BDM Name: ____________________________________________________
    Client ID: _______________________________________ Received Date: ___________________ Receipt No: ________________________________
    Receivers Name: _____________________________________________________ Receivers Signature: ___________________________________

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