irdai registration no. 101. - hdfc life...irdai registration no. 101. regd. off: lodha excelus, 13...

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HDFC Standard Life Insurance Company Limited. CIN:U99999MH2000PLC128245. In partnership with Standard Life Plc. IRDAI Registration No. 101. th Regd. Off: Lodha Excelus, 13 Floor, Apollo Mills Compound, N. M. Joshi Marg, Mahalaxmi, Mumbai - 400 011. For queries or more information, call us on 1860-267-9999 (Local charges apply). DO NOT preﬁx any country code e.g. +91 or 00. Available Mon-Sat from 10 am to 7 pm | Email - [email protected] | [email protected] | Visit -www.hdfclife.com (For NRI customers only) Policyholder First Name Policyholder Middle Name Policyholder Last Name IRDAI SIGN HERE Place: ______________ Signature : Date: _____________ Place: ______________ Signature : SIGN HERE

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Page 1: IRDAI Registration No. 101. - HDFC Life...IRDAI Registration No. 101. Regd. Off: Lodha Excelus, 13 th Floor, Apollo Mills Compound, N. M. Joshi Marg, Mahalaxmi, Mumbai - 400 011. For

HDFC Standard Life Insurance Company Limited. CIN:U99999MH2000PLC128245.In partnership with Standard Life Plc. IRDAI Registration No. 101.thRegd. Off: Lodha Excelus, 13 Floor, Apollo Mills Compound, N. M. Joshi Marg, Mahalaxmi, Mumbai - 400 011.

For queries or more information, call us on 1860-267-9999 (Local charges apply). DO NOT prefix any country code e.g. +91 or 00. Available Mon-Sat from 10 am to 7 pm |

Email - [email protected] | [email protected] | Visit -www.hdfclife.com(For NRI customers only)

Policyholder First Name Policyholder Middle Name Policyholder Last Name

IRDAI

SIGN HERE

Place: ______________ Signature :

Date: _____________ Place: ______________ Signature :

SIGN HERE

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