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LIC Life Certificate Format

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EXISTENCE CERTIFICATE FOR LIC OF INDIA

To,
The Manager -P&GS,
LIC of India,
6th &7th Floor
Jeevan Prakash Building,
25 K.G. Marg, New Delhi-110001

Annuity No.: ___________________________________________________________________

Master Policy No.: _______________________________________________________________

This is to certify that Shri/Smt ____________________________________________________,

Emp. No. ____________________ whose signature is attested below, is alive today the _______

(day) of ____________ (Month) 20______(Year).

Signature of annuitant

Certified by:

Signature
Name
Address/Seal

This certificate is to be countersigned /certified by Gazetted officer/LIC Class -I officer/Registered


medical practitioners/ Bank Manager/ NTPC Executive (in case of NTPC employees) etc

The scanned copy of the counter-signed/ certified existence certificate can also be sent to
bo_g103annuity@licindia.com

Phone: 011-23350678, 011-23314970, 011-23354037, 011-23310976

Note: Single existence certificate can be used for multiple annuities

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