Email: jhairene0704@gmail.

com

Date: August 28, 2019

Mam/sir
St. Peter life plan

RE: Insurance Policy Number: N13608497A/Owner: Jane Dalupang-David/Insured: Gerardo S.

Dalupang

To whom it may concern:

I am writing to make a change to the insurance policy described above. For reference, the policy
number is: N13608497A.

There should be a change made to the primary beneficiary.

The primary beneficiary was Gerardo S. Dalupang. The new primary beneficiary is Dylan Jaede
D. David. This new primary beneficiary change is made due to marriage.

If there is a specific form that must be filled out, please send it to the email address at the head
of this document. Otherwise, please send a confirmation that the changes have been made.

If you have any questions or anything you would like to discuss with me further, please feel free
to contact me.

Sincerely,

JANE DALUPANG-DAVID
Email: jhairene0704@gmail.com

Date: ______________

Mam/sir
St. Peter life plan

RE: Insurance Policy Number: N13608497A/Owner: Jane B. Dalupang

To whom it may concern:

I am writing to make a change to the insurance policy described above. For reference, the policy
number is: N13608497A.

There should be a change made to the surname of the policy owner. The policy owner will still
be the same individual, but their name has legally changed. The prior name was Jane B.
Dalupang. The new legal name is Jane D. David. This name change is made due to marriage.

If there is a specific form that must be filled out, please send it to the email address at the head
of this document. Otherwise, please send a confirmation that the changes have been made.

If you have any questions or anything you would like to discuss with me further, please feel free
to contact me.

Sincerely,

JANE DALUPANG-DAVID