NameAddress:……………………………………………………………………………

Date: 14/10/2015

LIC OF INDIABR. No. ……..Address

Sub: Request for Change Of AddressRef:. Policy No:.

Dear Sir,

I am writing this letter to inform you that I have moved from my apartment to a new place and I would like you to put it in your records .Please forward all the correspondences in future to the address given below

Name: Address: Phone No:

Kindly assist to change my address as per above in my LIC Policy No………..& oblige.

Thanking you,

Sincerely

Name