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Union of India - Section

Section 1950 in The Insurance Rules, 1939

1950. on the ..................day of................

Made on........................daythe..................at...................................Signaturein presence of (witness)...................SignatureName andaddress....................SignatureI................of............................in whose name the shares No..........................of your company stand in your share register, hereby, recognise in full the interest claimed in respect of the said shares and intoken thereof have countersigned the above declaration.Signed onthe........................day of the................................................SignatureIn thepresence of Witness.............................SignatureName andaddress............................Signature[Form V - GG] [Inserted by G.S.R. 1275, dated 28-5-1969.](See rule 17-AA)FromName.....................................Occupation...............................Address..................................ToThe Director.......................Insurance Co., Ltd.Dear Sir,In connection with shares No............................of your company standing in your share register in the name of (name).................... (occupation) ............................(address).........................I hereby solemnly declare that out of the above shares:-
(i)I am the sole beneficial owner of shares No. and I acquired the beneficial interest before the commencement of the Insurance (Amendment) Act, 1968 (62 of 1968), on the .................day of ...............
(ii)in respect of shares No...............................I and (name) (occupation).............................................(address) .................... and (name)........................................ (Occupation) (address).....................are joint beneficial owners, my interest in these shares being ................................... and was acquired limited to before the commencement of the Insurance (Amendment) Act, 1968 on the ..................day of................
Made on ................................. day the ............................ at ............................. in presence of (witness)...........SignatureName and address............SignatureI .............................of...................................in whose name, the shares Nos............................of your company stand in your share register, hereby recognise in full the interest claimed in respect of the said shares and in token thereof have countersigned the above declaration.Signed on the.......................day of the.......................In the presence of Witness..................SignatureName and address................................Signature]Form V - H(See rule 17-C)Statement Of The Bases Of PremiumsName of the insurer.............................
1. Basis:MortalityRate of interestExpensesBonus loading
The above basis is the basis underlying the premiums in Tables No ................................... of the prospectus dated ................................ issued by .......................................... Company Limited.
2. Basis:MortalityRate of interestExpensesBonus loading
The above basis is the basis underlying the premiums in Tables Nos ......... of the prospectus dated ........................... issued by............................Company Limited.I hereby certify that the bases underlying the premium rates offered by Company Limited are as set out above.Station ActuaryDateNotes