Date: To, Unique Mercantile India Ltd 2nd Floor, Unique House, Old High Court Lane, Ashram Road, Ahmedabad 380009. Dear Sir/s, This is with reference to a policy purchased by me with the following particulars: PolicyNumber —: Name 5 Plan Name Policy start date Policy end date This is to inform your that | agree to receive 50% of my due amount within the next Days & restructure my balance amount to be paid in 2 /3 yearly instalments with bank interest. | shall not raise any further concern related to this plan in the future Jam showing my interest to purchase LiveUniqueLife Product worth Rs. Agree to deduct from my due maturity amount. Regards, Signature: Witness : Name Name : Date 5 Date : ing License/PAN Card/Any Other aDate: To, Unique SMCS Ltd 3 Floor, Unique House, Old High Court Lane, Ashram Road, Ahmedabad 380009. Dear Sir/s, This is with reference to a policy purchased by me with the following particulars: Policy Number Name Plan Name Policy start date Policy end date This is to inform your that I agree to receive 50% of my due amount within the next Days & restructure my balance amount to be paid in 2 / 3 yearly instalments with bank interest. | shall not raise any further concern related to this plan in the future. Jam showing my interest to purchase LiveUniquelife Product worth Rs, Agree to deduct from my due maturity amount. Regards, Signature Witness : Name Name Date ei Date: Encl; Copy of Driving License/PAN Card/Any Other