Deed of assignment of a life insurance policy as collateral security

[On an e-stamp certificate of the value chargeable under the transfer entry of the State schedule, in the name of the Assignor]

DEED OF ASSIGNMENT OF POLICY OF LIFE INSURANCE BY WAY OF COLLATERAL SECURITY

THIS DEED OF ASSIGNMENT is made at [Place of signing the deed] on this [Day of the month the deed is made] day of [month, year]

Between

[Name of the policyholder], son / daughter / wife of [Assignor's father's or husband's name], aged about [age] years, residing at [Assignor's residential address], holding Permanent Account Number [PAN], hereinafter called the “Assignor” (which expression shall include his heirs, executors, administrators and legal representatives), of the One Part;