Addendum to a Proposal under Section 6 of the Married Women’s Property Act,

1874 (MWPA).

1. Beneficiary details:

Sr. Name of the Beneficiary Date of M/ Relation % of share

no. ( wife and children only) birth F entitlement
(not to exceed
100)

(Note: Appointment of beneficiaries under the MWPA will be subject to the relevant
personal law applicable to the Proposer)

2. Trustee details:

Sr. Name of the Trustee Date Nature of Consent of the Witness - Signatur
no. (Major only) of Trusteeship Trustee Name & Address
birth (Single/Joint/ (Please affix ( Major only)
Survivor/ signature)
Alternate)

(Note: Please indicate 'NA' for 'Not Applicable'. In case of Alternate Trustees, the Order
of the names appearing will be considered as the order of preference)

3. Please indicate 1 address for communication with Trustee(s):

___________________________________________
Page 1
Declaration:
The Policy is supposed to be effected for the sole and absolute benefit of the
abovementioned beneficiaries. Under the provisions of Section 6 of the MWPA, I declare
that the policy shall have the same incidents as are prescribed in the said section 6 of
MWPA, as if the section had been incorporated in the policy and neither I nor my estate
shall have any interest in the same.

I request the policy to be issued under the provision of MWPA for the absolute benefit of
the beneficiary aforesaid in the manner aforesaid and I hereby appoint the Trustee(s) as
defined above in the specified capacity, to be the Special Trustee(s) to receive the policy
monies and to hold the same in trust for the said beneficiaries under the provisions of
the said Act and in case all/any of the said Special Trustee(s) dies or declines to act or
become incapable to act or disqualified from acting under the law or cannot act as a
Special Trustee for any reason whatsoever, I shall have power by a Deed to fill in the
vacancy by appointing a new Trustee or in Trust for the said beneficiaries under the
provisions of the said Act.

Provided that I shall have the right to revoke the appointment of any of the aforesaid.
Special Trustees or of all of them and appoint others in their stead.

Loans can be obtained by the Trustees on the security of the policy under terms and
conditions applicable to the policy and upon all the beneficiaries attaining age of
majority.

The Consent of the said Trustee(s) to act is included in the table above.

Dated at on day of , .

Signature of Proposer Signature of Witness

Name & Address:

Note: In case the above details are filled in by any person other than the Proposer, the
Proposer is requested to certify as follows:

I hereby declare that the contents of this addendum have been fully explained to me and
I have fully understood the same. I further declare that I have understood the
significance of the proposed insurance contract and that all information provided by me
are true and factual and that I have not withheld any material information or fact within
my knowledge.

[Name(s) & Signature(s) of the Proposer]

Dated at on day of , .
Page 2
 ENDORSEMENT FOR A POLICY ISSUED UNDER THE
MARRIED WOMEN'S PROPERTY ACT, 1874

TO BE FILLED AT THE HO

This Policy has been issued under the provisions of Section 6 of the Married Women's Property Act, 1874
for the benefit of the Beneficiaries:

Sr. Name of the Beneficiary Date of Birth Relationship % entitlement

No.
1
2

jointly or the survivors or survivor of them, and

Sr. Name of the Trustee Date of Birth

No.
1

has been appointed as Special Trustee under the provisions of section 6 of the said Act to receive the policy
monies and hold the same upon the aforesaid Trust with power and authority to the said Trustee to obtain
any loan or loans (where the provisions of the policy provide for) on the security of the policy from HDFC
Life Insurance Company Limited, subject to the terms and conditions that HDFC Life Insurance
Company Limited may lay down from time to time and for the benefit of the aforesaid
beneficiaries provided they are all major and competent to contract and all of one mind and with power to
the Proposer:

(a) to appoint by a deed, a new Trustee or new Trustees in case either of the above named trustees or
declines or is disqualified under the law or becomes incapable to act or cannot act for any reason
whatsoever

(b) to revoke by a deed the appointment of the above named Trustees and appoint others in their stead.

For HDFC Life Insurance Company Limited

________________________
(Authorised Signatory)
Date:
Place: Mumbai

HDFC Life Insurance Company Limited [Formerly HDFC Standard Life Insurance Company Limited] (HDFC Life).
CIN: L65110MH2000PLC128245. IRDAI Registration No. 101.
Regd. Off: 13th Floor, Lodha Excelus, Apollo Mills Compound, N.M. Joshi Marg, Mahalaxmi, Mumbai - 400 011.
For queries or more information, call us on 1860-267-9999 (Local charges apply). DO NOT prefix any country code e.g. +91 or 00. Available Mon-Sat from 10 am to 7 pm | Email -
service@hdfclife.com | nriservice@hdfclife.com (For NRI customers only) | Visit - www.hdfclife.com