ASSIGNMENT OF POLICY OF LIFE INSURANCE BY NOMINATION
(For endorsement on policy)
I, AB of, etc. holder of Policy No.............. issued by the Life Insurance Corporation of India pursuant to section 39 of the Indian Insurance Act 1938, do hereby nominate CD of, etc. as the person to whom the money secured by this Policy of Insurance shall be paid in the event of my death and request the Life Insurance Corporation to register this my nomination and issue a written acknowledgment thereof in accordance with section 39(3) of the said Insurance Act.
Signed	                                                                              AB