surrender form - takaful - adamjee life...zakat declaration form (to be made on a stamp paper of...
TRANSCRIPT
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SURRENDER FORM
Surrender Type
Declaration
Reason for Surrender / Withdrawl
Certificate SurrenderAdhoc SurrenderPartial Certificate WithdrawalPartial Adhoc WithdrawalAmount PKR ___________________Amount in words ______________________________________________
Financial ReasonsUnsatisfactory Returns Unsatisfactory ServiceOthers ___________________
Pay Out Confirmation
Documents Required
Do you want your Pay Out through;
Direct Transfer in IBFT Account Cheque
Account Title / : ____________________________________________________________________________________________Account Number / : __________________________________________________________________________________________Bank Name / : ______________________________________________________________________________________________
I ________________________________________ holding Certificate #_______________________________with Adamjee Life - W.T.O hereby put forward the request of surrender /Withdrawal of/from my certificate and demand for payment of the resulting value (If any) after adjusting for all applicable charges*.I am aware of any financial loss that I might incur as a result.I declare that the information above is true to the best of my knowledge and belief.
Complete Original Certificate Documents (For Complete Surrender Cases)Zakat Declaration Form (To be made on a stamp paper of PKR.20/- duly notarized)
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د�دارى � ��� ���� �� ��
د�دارى ��ك � ا��
د�دارى ��� ���� �� �� ��وى ��
د�دارى � ��ك � ا�� �وى
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�ادا� ��
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*Surrender Fees of Rs.350/- applicable
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ا�ؤ�� �
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�م �� � � � ��
�� �� �ار �
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��� ا�� � � �ر�� �� (�� �� � (ا� �
ادا� ر� � � �ں �� / � ��� �� �ں . اور ر� / ر� � دا� در�ا�� � د�دارى / وا� � _________ � ��� ���� �� �� ������ ��_______________________ ��
� �� �� اور � ���� ��ت �م ���� ��رہ �ى �� � �ں �� / � ��� �ار �
ا� �� اور �ں دار ذ� ا�/ا� �� � �ا �� � �� �
� ا� � �رہ �� ��� � �� � � �م � .�� � � � ��
_________________________Signature/Thumb impression of Certificate Holder
_________________________Bank Appoval
_________________________Adamjee Life Appoval
�رى � � �
�� �رىآد� � � � �ن�� ��
� � د�/ا�� � �� � ��� ���� �� ��
� �� � 350/- رو� ��
� � * د�دارى
�ات� د�و�� ��
�د�دارى)�� �ات (�ّ
� د�و�� ��� ���� �� �� ا� ّ�
� �ہ ���� � ��ى اور �� � �� �ر �
�� � � � � �� ا��� � ����� 20 /- رو� � �رم (� �ا� � ڈ�� ز�ة
�رم د�دارى
�� ��ں (ر� �� �ں (ر�
�ان د��
-
-
-
(
((
Incase of Partial Certificate withdrawal (Single Premium Plans) the sum covered will be reduced by the same amount as that of partial withdrawal amount. )(
-
If No (Please provide Zakat Declaration Form)
Zakat Deduction �� ز�ٰة
Do you want Zakat to be deducted from your surrender proceeds? � �� �� � �وا�� �� � ز�ٰة آپ � ��
Yes Noں� ��
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�� �رم ا��� �ز�ۃ �
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؟
Adamjee Life - WIndow Takaful Operations3rd Floor, Adamjee House,I.I. Chundrigar Road, Karachi - 74000 PAKISTAN
ADAMJEE LIFE WINDOW TAKAFUL OPERATIONS
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���ر���م �� � �ن � �رڈ �� � را�
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Date / : ____________
Plan / : ____________
Email Address / : ______________________________________________________________________________________
CNIC / : _____________________________ Contact Number / : __________________
Certificate Number / : ___________ Name of Participant / : _____________________
Page 3 of 3
Adamjee Life Assurance Co. Ltd.The Forum, Suite No. 323, 3rd Floor, Plot G-20,Block 9, Clifton, Karachi - 75600 PAKISTAN
PENALTY CHARGES - BANCCA
*Surrender Charges vary from product to product and the year in which the policy is surrendered / withdrawn. Year wise Surrender Charges for each product are as under:�
�� ��وڈ� �� .� �ں �(� ر� � �� �� � د�ارى � ����� �� �) � � �ل � اور �وڈ� دو�ى � �وڈ� ا�� � � �ر�� � ��: د�دارى �ر�� � د�دارى � �� ز�� درج � � �ر�� � د�ارى
Future Assure - Old
Wealth Assure
Waseela Zindagi
Invest Assure
Save & Assure - Old
Future Assure - New
Save & Assure - New
Shelter for Life - Plus
Shelter for Life - New
Invest for Life
Shelter for Life - Maximizer
Shelter for Life - Old
Wealth Optimizer
Tameer Education & Marriage Plan
Tahaafuz
Khushali Mustaqbil
100% 50% 25% 15% NIL NIL
Year 1 Year 2 Year 3 Year 4 Year 5 Year 6
100% 50% 25% 15% NIL NIL
100% 50% 25% NIL NIL NIL
100% 50% 25% NIL NIL NIL
100% 50% 25% NIL NIL NIL
100% 50% NIL NIL NIL NIL
100% 50% NIL NIL NIL NIL
25% 15% NIL NIL NIL NIL
100% NIL NIL NIL NIL NIL
NIL NIL NIL NIL NIL NIL
100% 100% NIL NIL NIL NIL
Initial 11 Months 3% 12 - 23 Months 2% NIL NIL NIL
Plan�ن
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0.5% in first six months only. Nil Afterwards��
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� �� �ر�� د�دارى
ADAMJEE LIFE ASSURANCE CO.LTD
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� ��100% 50% NIL NIL NIL NIL
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� ��50% 25% NIL NIL NIL NIL
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Page 2 of 3
Adamjee Life Assurance Co. Ltd.The Forum, Suite No. 323, 3rd Floor, Plot G-20,Block 9, Clifton, Karachi - 75600 PAKISTAN
PENALTY CHARGES - AGENCY / OTHERS
*Surrender Charges vary from product to product and the year in which the policy is surrendered / withdrawn. Year wise Surrender Charges for each product are as under:��� ��وڈ� �� .� �ں �(� ر� � �� �� � د�ارى � ����� �� �) � � �ل � اور �وڈ� دو�ى � �وڈ� ا�� � � �ر�� � ��: د�دارى �ر�� � د�دارى
� �� ز�� درج � � �ر�� � د�ارى
Secure Munafa
Secure Mustaqbil
Super Sarmaya
Cover for Life
Invest and Secure
100% 50% NIL NIL NIL NIL
Year 1 Year 2 Year 3 Year 4 Year 5 Year 6
100% 50% 25% NIL NIL NIL
Initial 11 Months 3% 12 - 23 Months 2% 24 - 30 Moths 1% Nil Afterwords
Plan
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100% 50% 25% NIL NIL NIL��
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100% 50% 25% 15% 10% NIL��
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3% �� ا�ا�11 ����� 2% �
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�ل �ل � �ل دو�ا �ا ��
�ل � �ل �� �ل ����اں �
*
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ADAMJEE LIFE ASSURANCE CO.LTD
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/ AGENCY�� ا��
/ OTHERS� د��