Sunteți pe pagina 1din 1

Declaration regarding loss of policy

I ______________________________ S/o, D/o _________________________________hereby declare that the policy/ies No. ______________________________ has/have been lost and not mortgaged with any Bank, Firm, Third Party or any financial institution towards any loan.

Signature of subscriber

/Attested/ Signature of certifying Gazetted Officer Name, Designation and Office seal

S-ar putea să vă placă și