LETTER OF UNDERTAKING

Description of property/Vehicle __________________________________________

I hereby acknowledge having received from THE ORIENTAL INSURANCE CO. LTD.
a sum of Rs._____________(Rs.________________________________________)
in full and final settlement of all my claim present or future under policy
No.___________________ for the year _______________ in respect of loss of my
above property/vehicle by theft which occurred on __________________.
In the event of the said property/vehicle being traced at a future date, I undertake to
take back the said property/vehicle and to treat the above payment as an advance
payment towards the said loss and the refund to THE ORIENTAL INSURANCE CO.
LTD. the full sum of Rs.___________________ on the undertaking that The
ORIENTAL INSURANCE CO. LTD. will indemnify me/us against the loss or damage
to the said property/vehicle which have occurred to it whilst it was not in my custody
or control.

Date :
Place:
Name(insured) _____________________
Address :__________________________
__________________________
Tel. No: __________________________