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Tata AIG General Insurance Company Ltd.
                                                                    ENDORSEMENT

           Endorsement No:              1                    Effective Date: 15/06/2011                      Expiry Date: 19/05/2012

           Attached to and forming part of Policy No.               0151291774 00




                                                                         A200



                       It is hereby declared and agreed that the Policy stands amended from 14:54 hours 15/06/2011
                       for:


                       The correct name of the insured is KIRAN and not as mentioned therein.
                       This has resulted in changes to the Policy with no change in Premium.


                       Subject to the Endorsements No(s) & Memorandum: A200,

                       All other terms and conditions of the Policy remain unaltered.
                                                               For Tata AIG General Insurance Company Ltd.




                                                                                     Atri Chakraborty
                                                                           National Head - Operations & Systems
                       Name : KIRAN .

                     Address: No. 36 , Ft No 1 , 2nd Floor,
                              Sri Durga Complex, Katarguppe
                              Main Road ,3 Stg, Bangalore.
                              BANGALORE, 560085
                              KARNATAKA




Tata AIG General Insurance Co. Ltd. Policy Holder Services, P. O. Box No. 9407, Chakala MIDC- Post Office, Mumbai 400093. TOLLFREE HELP LINE: 1 800 119966
                 (Regd Office: Peninsula Corporate Park, Nicholas Piramal Tower, 9th Floor, Ganpatrao Kadam Marg, Lower Parel, Mumbai 400013)
          A200                 Branch: 05                                                             Insured Copy                   Page 1 of 1

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Gpe 627971308652346242

  • 1. Tata AIG General Insurance Company Ltd. ENDORSEMENT Endorsement No: 1 Effective Date: 15/06/2011 Expiry Date: 19/05/2012 Attached to and forming part of Policy No. 0151291774 00 A200 It is hereby declared and agreed that the Policy stands amended from 14:54 hours 15/06/2011 for: The correct name of the insured is KIRAN and not as mentioned therein. This has resulted in changes to the Policy with no change in Premium. Subject to the Endorsements No(s) & Memorandum: A200, All other terms and conditions of the Policy remain unaltered. For Tata AIG General Insurance Company Ltd. Atri Chakraborty National Head - Operations & Systems Name : KIRAN . Address: No. 36 , Ft No 1 , 2nd Floor, Sri Durga Complex, Katarguppe Main Road ,3 Stg, Bangalore. BANGALORE, 560085 KARNATAKA Tata AIG General Insurance Co. Ltd. Policy Holder Services, P. O. Box No. 9407, Chakala MIDC- Post Office, Mumbai 400093. TOLLFREE HELP LINE: 1 800 119966 (Regd Office: Peninsula Corporate Park, Nicholas Piramal Tower, 9th Floor, Ganpatrao Kadam Marg, Lower Parel, Mumbai 400013) A200 Branch: 05 Insured Copy Page 1 of 1