DEED OF ASSIGNMENT OF POLICY OF LIFE INSURANCE BY WAY OF GIFT WITH RESERVATION

This deed of assignment made the………..day of………between AB of, etc. (assignor), of the one part and CD of, etc. (assignee), of the other part witnesses that in consideration of natural love and affection between the said AB and CD, the said AB does hereby and here under transfer and assign as and by way of gift to the said CD all the benefits of and all moneys now due or shall hereafter become payable under the Policy of Insurance No…………dated…………on the life of the said AB provided always that in the event of the said CD predeceasing the said AB the benefit of and right to receive moneys under the said policy shall to all intents and purposes revert to the said AB as if this assignment had never been made nor intended. And that the said AB do hereby covenant with the said CD that the said policy is still in force and further that the said AB has not charged nor encumbered the same in any way and furthermore there is no injunction or prohibitory order against him from assigning the same in the manner hereunder effected.
In witness, etc.
Signed, sealed and delivered                                                                          AB