1. No category

PNB - New Business Checklist Version 1.0 - NO CORRECTIONS ALLOWED IN THIS CHECKLIST
Application Number:
PNB Branch Name:
Mark  or 
Generic Check Points
1
All questions in the application form have been filled and completed by the customer
2
Application form has been signed by the customer
3
Below listed supporting documents have been provided by the customer as per the acceptable list of proofs(Please tick
against documents received )
1. DOB Proofo
2. Identification Proof o
3. LatestAddress Proof o
4.Recent Photograph o
5. Income Proof (Financial Assessment Form etc)o
6.PAN Copy collected (Premium>=50,000)o
Any Alterations/corrections/cuttings/overwriting/rubbing/usage of whitener in the following sections which are part of the
application form have been verified by me and countersigned by the customer? (Please tick relevant checkbox )
1.Any section related to Person Insured oPolicy Owner o Nomineeo Appointeeo
2.Previous Life Insurance Policy Details has been mentioned in the application form o
4
3.Medical details & Family History of Proposed Insured: o
Mention Question No.(if any mentioned question is ticked yes): __________________________
4.Product Details has been mentioned in the application form:
o
2.Term
o
o
4. Premium
o
5.Rider Details
o
6. Fund Options o
7.Frequency
o
5.Declaration,Agreement & Authorization section has been counter signed by the customer o
1. Name of the Product
3. Sum Assured
5
Third party declaration has been provided if the Initial premium payment is made by anyone other then by PI /PO
This is to certify that the details in the application # ___________________ and attached documents have been verified with originals and authenticated by me.
SP Name
Seal of Bank Branch
SP Sign
SP Code
Date
Time