POSTAL LIFE INSURANCE COMPANY LIMITED

Head Office: 2nd Floor, ECO Postal Staff College, G-8/4, Islamabad.
KYC FORM FOR EXISTING PLI POLICIES
Date ______________________

Policy Number________________________________ Field Unit ___________________________________

Client ID ____________________________________ Issuance Branch ______________________________

Total Premium for the year _____________________________ Payment Frequency ____________________________

(Annual/Bi-Annual/Quarter/Month)
Personal Information
1a. Title _______ (Mr./Mrs./Ms.) 1b. Gender _______ (Male/Female)

2. Full Name (as per CNIC) _______________________________________________________________________________________

3. CNIC No. _______________________________________________ 4. NIC Issue Date ______________________________

5. CNIC Expiry Date ___________________________________

6. Father's/Husband's Name: ____________________________________________________________________________________

7. Date of Birth ___________________________ 8. Place of Birth (City) __________________________

9. Nationality ____________________________ 10. Residency ________________________________

11. Do you hold more than one Nationality / Residency? If Yes, please specify other,

12. Nationality ____________________________ 13. Residency _______________________________

14. NTN No. ______________________________ (if available)

15. Residential Address________________________________________________________________________________________

___________________________________________________________________________________________________________

16. Mobile No.___________________ 17. Residential Phone No._______________ 18. Email __________________(if available)
Financial Information
19. Occupation (Tick the relevant box)
Salaried Person Businessman Self Employed Agriculture
Retired Landlord Student House Wife
Any Other (please describe)
20. Source of Income (Tick the relevant box)
Salary Business Income Investment/Saving Rental Income
Retirement benefits Agriculture Income Spouse/Parent/Sibling
Any Other (please describe)

21. Designation________________________________ 22. Name of Employer/Business _____________________________________

23. Nature of work/business ___________________________________ 24. Estimated Annual Income ______________________________

25. Office/Work Address________________________________________________________________________________________

Documents required to be attached
1. Copy of CNIC
2. Evidence of Income/Source of fund (In case Total Annual Premium is Rs.100,000 or above)
Salaried Business/Investment/Saving/Rental/Retirement benefit/Agriculture/Others Spouse/Parent/Sibling
1 Salary Slip 2 Bank Statement 3 Income tax return 4 Statement of Investment 5 Evidence of relative source of income
|------------------------ Any one of the above --------------------------|
1. Stamped and signed salary slip of employer (not older than 30 Days) 4. Original statement of Investment issued by a financial institution OR
2. Stamped and signed Bank Statement of 6 months OR 5. Evidence of relative source of income (Any relevant evidence from 1 to 4)
3. Copy of Income Tax return of the last tax return OR
 Declaration by Client
I hereby declare that the information given above is true and I have not withheld/concealed any material information.
(‫کرتی ہوں کہ مندرجہ باﻻ جوابات ہر لحاظ سے درست ہيں اور ميں نے کوئ بهی اہم معلومات چهپانے کی کوشش نہيں کی‬/‫)ميں تصديق کرتا‬

Date: ____________________
Client's Signature
Report to the concerned Asst.Supt(F)/Asstt.Director (F) PLI
I have personally checked/examined the KYC form and found it correct as well as in order in all aspects.
Asstt. Supdt. (F) Asstt. Director (F)
Name __________________________________ Name ____________________________________

Stamp Stamp

Signature _______________________________ Signature _______________________________

Date ________________________ Date ________________________