1. From:
M. Benedict William,
Superintendent,
District Elementary Educational Office,
Theni.
To:
The Superintendent Of Pos.,
Theni Division,
Theni 625531.
Sir,
Sub: PLI Policy No. TN-274218-CS – reg.
My PLI Policy No. TN-274218 is matured from the month of March 2015. I have
enclosed the following documents.
1) Xerox copy of Policy Document (Original is in the Post Office)
2) Pay recovery Certificate
3) Loan Pass Book
Kindly close my account and settle the amount as early as possible.
Yours Faithfully,
(M. BENEDICT WILLIAM)
Theni,
.05.2015.

2. PREMIUM RECOVERY CERTIFICATE
It is to certify that Rs.1750/- (Rupees One thousand seven
hundred and fifty only) has been recovered as PLI monthly premium
from Shri. M. Benedict William, Superintendent, District Elementary
Education Office, Theni for the PLI No. TN-274218-CS for the period
from July 2013 to March 2015 from his salary.
District Elementary EducationalOfficer,
Theni.
Theni,
.05.2015

3. Department of Posts, India
Post Office Insurance Fund
Application for claim for Maturity Value of EA/AEA/YS/Children Policy
1. Policy Number TN-274218-CS
2. Date of acceptance 20-.March- 2005
3. (a) Date of Maturity February-2015
(b) Date of Survival benefit due
(In case of AEA Policies)
--
4. Sum Assured Rs.2,00,000/- (Rupees Two Lakhs Only)
5.
(a) Name of the Insurant M. BENEDICT WILLIAM
(b) Address
Superintendent,
Office of the District Elementary Educational
Officer,
Theni.
6. Designations and Address of Pay
Drawing & Disbursing Officer during
last 12 months
(in case of deduction of premia from pay)
DISTRICT ELEMENTARY EDUCATIONAL
OFFICER, THENI.
OFFICE OF THE DISTRICT
EDUCATIONAL OFFICER, THENI.
7. Name of the Post Office where the
premia were paid during last 12 months
(in case of payment of premia in cash)
--
8. (a) Name of the Post Office through
which payment of Maturity value is
desired
THENI POST OFFICE.
(b)Name of the Head Post Office. Head Post office, Theni.
9. Loan Details (Account No.) L-274218
(a) Loan amount taken Rs.1,80,000/-
(b) Principal amount Out standing Rs.1,80,000/-
(c) Interest amount out standing Rs.
10. Documents attached
(a) Original Policy Document
(b) Premium Receipt Book (PLI Pass Book)
(c) Pay recovery Certificate
(d) Loan Pass Book
(e) Any other document
(Signature of the Insurant)
Name: M. BENEDICT WILLIAM
Phone No: 9842573456
Station: Theni
Date: .5.2015

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