From:

XXXXXXXXXXXXX

TF-3, C3 Block, XXXXXXXXXXXXXXXXXXXXXX,

XXXXXXXXXXXXXXXXXXXXX.

To:

The Senior Branch Manager,

LIC of India, XXXXXXXXXXX Branch.

Respected Sir,

Subject: Cancellation of my LIC Policy number, XXXXXXXXXXXX (New Jeevan Anand Plan)

I have received subject policy through courier from the Agent Sri XXXXXXXXX on DD-MMM-YYYY. Upon my perusal I found the Terms & Conditions of the said Policy is not satisfactory to me. Hence, I request your good self to kindly cancel the policy and refund the amount (Rs. ######/-; Rupees XXXXXXXXXX XXXXXX XXXXXXXX XXXXXX Only) deposited with your office in connection with the policy as per entitlements. I have attached the original policy herewith for necessary action at your end.

Thanking You,

Yours Sincerely,

XXXXXXXXXXXXXXXXXXXXXX

Date: