LIC JEEVAN DHARA
NON PAYMENT OF ANNUITY

Dear Sirs,

Sub-; Policy No.230190725 under JEEVAN DHARA POLICY of life assured of SURESH KUMAR BHATT .

The subject policy is matured and dur for annuity installment w.e.f. Jan. Option form and C.C.S. MANDATE FORM duely filled and signed and sent to LIC OF INDIA, KANPUR CITY BRANCH NO.1, KANPUR on 28th Oct.2009 alongwith letter for change of my residential address mentioned below. Though, I did not receive any related form from them. I regret to inform you that after sending the above said option form and mandate form by myself on 28th Oct. I have not received any infomation from the other end.

Kindly take necessary action in this regard and arrange to get me the annuity payment at the earlest under advice to me.

Thanking You

Yours Sincerely

SURESH KUMAR BHATT

4D/1 FLAT NO.10,

JAGDISH VIHAR,

LALA LAJPAT RAI ROAD,

BELI AVENUE,

ALLAHABAD-211002