Format for considering Guest tlouse allotnent

hthe Employee: AS HISH HARTI

0996647
i i UFE
INSURANCE CHRPORATION OF esignation & Cadre:
INDIA
ALMCS)
KHATLA drans4 6 M)
Guest Ilouse required at: 0ot
Purposeof the visit leasu TL Trie
Proposed date &time of arrival: 30los/2021 9:00 AM

31/o S/2o2 : oo AM
Proposed date &time of departure
No. of days GIl required (Max.3 days only) 1
Mobile No.: 19o 1o 8So 2 S
a b h a r t i&o@licindia,co
E-mail ID:
2
Total no. of guests occupying guest house:
Details of occupants:

No. D. of Dt. of
Name of the Guest Relationship AgeDependent
(as per OS Covid Covid
Manual) dose 2hd dose
(YN)

3 Y 2spk22/0l
ASHISH HARTISEL
SHEULT
MAJUMD E tE2r los/a1 o 8/o1/2

ASHISH BHARTI

(S)
MEIiager
ICI, Khatra Branch
T:TIGT

Branc/n

ASStt.

ànd submii a
proof
vaccination for veritication
dssure to produce my Office ID card & Covid IS
COpy of Gll allotment letter before check-in. I further assure that the data providied above
tully aware
LIC of India. I am
OTeCt and I will abide by the Guest Ilouse rules prescribe by be canceled, in cas
of Guest house is subiect to availability and /keattotinent can
ld dument
of Office exigencies/requirements. í assure I will send c nuayour RE
immediately for cancellation of booking, if I do nofure GHesr11gySP (s) ASHISH BHARTI
Asstt. Brancn lVa
Asstt. Branch Manager (S
Name & uT atra Branc
Designation of Employee: LICI, Khatra