To, Date: May 14, 2012

Mrs. Seema Dhall

LIC OF INDIA
P&GS DEPTT.
DELHI DIVISIONAL OFFICE-I
JEEVAN PRAKASH (6TH FLOOR)
25, K G MARG
NEW DELHI-110001

Sub: Gratuity Claim Form of Mr. Raj Kishore (Death Case)

Reference: Master Policy No GGCA 332136

Dear Madam,

This is with reference of your mail dated 24th March 2012 regarding reason for delay of
submission of death claim form, We wish to inform you that we have submitted claim
papers on 2nd Jan 2010 addressing to Mr. M. K. Gupta. But in the absence of
supporting documents like Death Certificate it is been rejected by LIC Department.

Further, after death of Mr. Raj Kishore his wife went his native place and we don’t have
death papers with us. After rigorous follow up we have collected death papers and
finally we have submitted papers to you. Please find following details for your
reference:-

Company Name: Oyster Bath Concepts Pvt Ltd.

Name of deceased member: Late Shri Raj Kishore

Keeping in view the above mention facts you are requested to clear gratuity.

Kindly do the needful.

For Oyster Bath Concepts Pvt Ltd

Authorized Signatory
To, Date: May 31, 2012
Mrs. Seema Dhall
LIC OF INDIA
P&GS DEPTT.
DELHI DIVISIONAL OFFICE-I
JEEVAN PRAKASH (6TH FLOOR)
25, K G MARG
NEW DELHI-110001

Sub: Clarification of F & F of Late Raj Kishore

Reference: Master Policy No GGCA 332136

Dear Madam,

This is with reference to Death Claim of Mr. Raj Kishore and subsequent discussion held
with you. In this regard we would like to clarify that we have paid Rs. 17965/-
(including gratuity) against his Full & Final Settlement. Pls note that this amount has
been paid to Mrs. Babita (Wife of Late Raj Kishore) by cash as she does not have any
Bank Account.

Kindly clear his gratuity amount at the earliest.

For Oyster Bath Concepts Pvt Ltd

Authorized Signatory