Declarations -page 3

	Download Declaration form (PDF Format)

GUIDELINES FOR SUBMISSION OF FRESH DECLARATION FORMS

1.	Photocopy / download the Declaration Form and take sufficient number of copies as per requirement, in A4 size
2.	Get it filled in by the Insured Person (no blanks please)
3.	Get dispensary options, family changes etc., reviewed and supply latest position
4.	No photograph is required at this stage.
5.	Affix signature / thumb impression (Insured Person / Employee).
6.	Affix countersignature (Employer).
7.	Prepare a covering list of all declaration forms obtained (Branch or Unit-wise if applicable).
8.	Submit declaration forms with covering list to appropriate Branch Office by 20th September 2009.
9.	Follow this drill for existing Insured Persons with insurance number already allotted.
10.	In case of new entries, continue to submit conventional declaration form (with photo) and obtain insurance number before the above exercise.
11.	Submit data in electronic form in a CD, wherever possible.