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/3/023-7-1/2
37-K, Block-6, P.E.C.H.S., Karachi - 75400 - Pakistan. Phone # (021) 111-EFU-111, 111-338-111
Client Service Call Center (021) 111-EFU-CSD, 111-338-273, Fax: (021) 34537519, Email: csd@efulife.com, 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/3/023-7-2/2
37-K, Block-6, P.E.C.H.S., Karachi - 75400 - Pakistan. Phone # (021) 111-EFU-111, 111-338-111
Client Service Call Center (021) 111-EFU-CSD, 111-338-273, Fax: (021) 34537519, Email: csd@efulife.com, Website: www.efulife.com
