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Lic New Agent

This document is a bio-data form for a new Life Insurance Corporation of India agency, detailing personal information, nominee details, qualification, language proficiency, present occupation, and references. It also lists required documents for submission, including copies of certificates, identification, and photographs. The form includes a section for the applicant's signature.

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licbhaskar25
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27 views3 pages

Lic New Agent

This document is a bio-data form for a new Life Insurance Corporation of India agency, detailing personal information, nominee details, qualification, language proficiency, present occupation, and references. It also lists required documents for submission, including copies of certificates, identification, and photographs. The form includes a section for the applicant's signature.

Uploaded by

licbhaskar25
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

LIFE INSURANCE CORPORATION OF INDIA

CHIEF LIFE INSURANCE ADVISOR – BHASKAR CHANDRA SAHU


Code: M0090593
Mob No: +91 8249915818
BIO-DATA FOR NEW L.I.C. AGENCY
(Personal Details)
Name :-
Father’s/Husband’s Name :-
Present Address Permanent Address
AT :- AT :-

PO :- PO :-

VIA :- VIA :-

P.S :- P.S :-

DIST :- DIST :-

PIN :- PIN :-
Date of birth(DD/MM/YYYY) :

Gender(Male/Female) :

Category(Gen/SC/ST/OBC) : Paste one passport


size photo here
Nationality(Indian/Other) :

Religion(Hindu/Muslim) :

Mobile No.(Any) :

E-Mail ID(Any) :

Marital Status (Married/


Unmarried/Widow/
Widower/Divorce) :

Nominee Details
Nominee Name Age Relation

Qualification Details
Degree Board/University Year of Passing Grade % of Marks
Read Write Speak
Language Known (Hindi) :-

(English) :-

(Odia) :-

Present Occupation :-

Give name and address of two responsible persons (not relatives or employees of the corporation)
For the purpose of reference.
1) 2)
Name :- Name :-
AT :- AT :-

PO :- PO :-

VIA :- VIA :-

P.S :- P.S :-

DIST :- DIST :-

PIN :- PIN :-

REQUIRED DOCUMENTS

a) Xerox copy of H.S.C Certificate-2pc


b) Xerox copy of +2 Certificate-2pc
c) Xerox copy of +3 Certificate-2pc
d) Xerox copy of Voter ID Card-2pc
e) Xerox copy of PAN card-2pc
f) Xerox copy of Aadhar card-2pc
g) Xerox copy of Bank Passbook (any nationalize bank-2pc)
h) 4 numbers of recently passport size photography-4pc
i) Registration Fee and Exam Fee- RS 650

Signature

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