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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:

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