CONVERSION OF EXISTING POLICIES INTO e-POLICIESKARVY Insurance Repository Ltd., Hyderabad Dear...
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CONVERSION OF EXISTING POLICIES INTO e-POLICIES The Manager, KARVY Insurance Repository Ltd., Hyderabad Dear Sir/Madam I would like to convert my existing insurance policies into electronic form www.kinrep.com eIA Available - eIA No. eIA Not Available*, I would like to open a e-Insurance Account with Karvy. Please find enclosed e - Insurance Account opening form along with all supporting documents. PAN / UID Please find here with my Insurance Policy numbers under various Insurance Companies for conversion. Policy Number Insurance Company Name ACK NOWLEDGEMENT I here by certify that particulars given herein are true, correct and complete to best of my knowledge and belief. I authorize KINREP to send any policy and account related information throught email and SMS on the contact details given by me.I understand that my physical policy document will be null and void once the policies credited to my Karvy Insurance Account. Place Date d d m m y y y y Name Signature Received with thanks from Mr. / Ms.___________________________________________________________________________________________________ -with eIA / PAN / UID No. _________________ a request for conversion of existing policies in to e - Policies and sub-docs for eIA opening (Check box if applicable) Place Date d d m m y y y y AP / Insurer Seal & Signature * Please visit www.kinrep.com for the list of Insurers associated with us. Enclosurers [Applicable only if e - Insurance Account Number not available.] * e - IA Opening Form Identity Proof [PAN / UID] Address Proof Age Proof Cancel Cheque Copy
Transcript of CONVERSION OF EXISTING POLICIES INTO e-POLICIESKARVY Insurance Repository Ltd., Hyderabad Dear...
CONVERSION OF EXISTING POLICIES INTO e-POLICIESThe Manager,KARVY Insurance Repository Ltd.,Hyderabad
Dear Sir/MadamI would like to convert my existing insurance policies into electronic form
www.kinrep.com
eIA Available - eIA No.
eIA Not Available*, I would like to open a e-Insurance Account with Karvy. Please find enclosed e - Insurance Account opening form along with all supporting documents.
PAN / UID
Please find here with my Insurance Policy numbers under various Insurance Companies for conversion.
Policy Number Insurance Company Name
ACKN
OWLED
GEME
NTI here by certify that particulars given herein are true, correct and complete to best of my knowledge and belief. I authorize KINREP to send any policy and account related information throught email and SMS on the contact details given by me.I understand that my physical policy document will be null and void once the policies credited to my Karvy Insurance Account.
Place Date d d m m y y y y Name Signature
Rece
ived w
ith th
anks
from
Mr. /
Ms._
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__-w
ith eI
A / PA
N / U
ID N
o. __
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___ a
requ
est f
or co
nver
sion o
f exis
ting p
olicie
s in t
o e - P
olicie
s and
sub-
docs
for e
IA op
ening
(Che
ck bo
x if a
pplic
able)
Pl
ace
Date
dd
mm
yy
yy
AP / I
nsur
er Se
al &
Sign
atur
e
* Pl
ease
visit
www
.kin
rep.
com
for t
he lis
t of In
surer
s as
socia
ted w
ith us
.
Enclo
sure
rs [A
pplic
able
only
if e - I
nsur
ance
Acco
unt N
umbe
r not
avail
able.
]*
e - IA
Ope
ning F
orm
Ide
ntity
Proo
f [PA
N / U
ID]
Addr
ess P
roof
Age P
roof
Canc
el Ch
eque
Cop
y
