GENERAL ACCIDENT INSURANCE PROPOSAL/KYC FORM
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(Prepare & Upload with a file editor under the headings; SN, LOSS, DETAILS).
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ParentSiblingSpouseIn LawOther
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Please provide the following:
I/We, hereby declare that the above particulars and answers are true and complete in every respect, and that no information has been suppressed or withheld. I/We further declare that if such statements and particulars are in the writing of any person other than myself/ourselves such person shall be deemed to have been my/our agent for the purpose of filing the form.