{"id":2326,"title":"FORM OF NOMINATION (for Minor Nominee) (Form No. 3265)","purpose":"service","insurer":{"slug":"lic","name":"Life Insurance Corporation of India"},"source_pdf":"https://licindia.in/documents/d/guest/fno-3265-e-1","sha256":"273538efa6b766183c2af65bdb1a1c36a71bfd75cc1b5a66ad31d27e28820559","pages":2,"collected":"2026-10-20","instructions":{"about":"This form is used by the life assured to nominate a minor as the nominee for the policy proceeds and to appoint an appointee to receive the money on behalf of the minor nominee in case of the life assured's death.","notes":["An appointment of Appointee can be made only by the holder of a Policy on his own life, i.e. only by the Life Assured.","After filling the form, the Life Assured should copy it on the back of the Policy along with the witness certificate if the signature is not in English.","If the Life Assured is not conversant with English, signature must be before an English-knowing witness; if illiterate, thumb impression must be before an authorized official with witness certificate.","Use the exact format and ensure all signatures and witness details are properly filled."],"title":"FORM OF NOMINATION (for Minor Nominee) (Form No. 3265)","submit":{"to":"","how":"","address":""},"purpose":"service","sections":[{"title":"Nomination Details","fields":[{"help":"Enter the full name of the Life Assured","type":"text","label":"I,","options":[],"required":null,"pdf_field":""},{"help":"Enter the policy number or details","type":"text","label":"the Life Assured under the within Policy","options":[],"required":null,"pdf_field":""},{"help":"Specify the relationship of the nominee to the Life Assured","type":"text","label":"hereby nominate, my (relationship)","options":[],"required":null,"pdf_field":""},{"help":"Enter the name of the minor nominee","type":"text","label":"named","options":[],"required":null,"pdf_field":""},{"help":"Enter the age of the minor nominee in years","type":"number","label":"aged","options":[],"required":null,"pdf_field":""},{"help":"Enter the address of the minor nominee","type":"text","label":"and whose address is","options":[],"required":null,"pdf_field":""},{"help":"Enter the name of the appointee","type":"text","label":"I hereby appoint","options":[],"required":null,"pdf_field":""},{"help":"Enter the age of the appointee in years","type":"number","label":"aged","options":[],"required":null,"pdf_field":""},{"help":"Enter the address of the appointee","type":"text","label":"and whose address is","options":[],"required":null,"pdf_field":""},{"help":"Enter the place where the form is signed","type":"text","label":"Signed at","options":[],"required":null,"pdf_field":""},{"help":"Enter the day of signing","type":"number","label":"this","options":[],"required":null,"pdf_field":""},{"help":"Enter the month of signing","type":"text","label":"day of","options":[],"required":null,"pdf_field":""},{"help":"Enter the year of signing","type":"number","label":"20","options":[],"required":null,"pdf_field":""}],"filled_by":"life assured"},{"title":"Witness Details for Life Assured","fields":[{"help":"Signature of the witness","type":"signature","label":"Witness Signature","options":[],"required":null,"pdf_field":""},{"help":"Signature of the Life Assured","type":"signature","label":"Signature of Life Assured","options":[],"required":null,"pdf_field":""},{"help":"Full name of the witness","type":"text","label":"Full Name","options":[],"required":null,"pdf_field":""},{"help":"Occupation of the witness","type":"text","label":"Occupation","options":[],"required":null,"pdf_field":""},{"help":"Address of the witness","type":"text","label":"Address","options":[],"required":null,"pdf_field":""}],"filled_by":"witness"},{"title":"Consent of Appointee","fields":[{"help":"Enter the name of the appointee","type":"text","label":"I, the above named (Appointee) do hereby endorse my consent to my appointment as aforesaid.","options":[],"required":null,"pdf_field":""},{"help":"Place where the consent is signed","type":"text","label":"Dated at","options":[],"required":null,"pdf_field":""},{"help":"Day of signing","type":"number","label":"the","options":[],"required":null,"pdf_field":""},{"help":"Month of signing","type":"text","label":"day of","options":[],"required":null,"pdf_field":""},{"help":"Year of signing","type":"number","label":"20","options":[],"required":null,"pdf_field":""},{"help":"Signature of the witness to the appointee's consent","type":"signature","label":"Witness Signature","options":[],"required":null,"pdf_field":""},{"help":"Full name of the witness","type":"text","label":"Full Name","options":[],"required":null,"pdf_field":""},{"help":"Occupation of the witness","type":"text","label":"Occupation","options":[],"required":null,"pdf_field":""},{"help":"Address of the witness","type":"text","label":"Address","options":[],"required":null,"pdf_field":""},{"help":"Signature of the appointee","type":"signature","label":"Signature of the Appointee","options":[],"required":null,"pdf_field":""}],"filled_by":"appointee"}],"deadlines":[],"applies_to":"","attachments":[],"declarations":["The witness certifies that the contents of the Appointment of Appointee have been explained to the Life Assured in vernacular and that the Life Assured signed or affixed thumb impression after understanding.","The appointee consents to the appointment by signing the form."],"dropped_labels":0},"pdf_fields":null,"fillable_pdf":false,"send_to":[{"purpose":"customer-care","channel":"phone","value":"+91-22-68276827","label":"Customer Care Phone Number","level":null,"hours":"24*7","applies_to":"all","source_url":"https://licindia.in/web/guest/grievances","quote":"Corporation \r\n   of India.\nNavigation\nSkip to Content\nMenu Display\nVoice Search\nSearch\nSkip to main content\n8976862090\n+91-22-68276827\nBranch Locator\nLanguage Selector\nenglish\nहिन्दी [beta]\nमराठी\nA+\nA\nA-\nA\nA\nAbout Us\nHistory\nObjectives Of LIC\nMission/Vis","fetched_at":"2026-10-20"},{"purpose":"customer-care","channel":"phone","value":"8976862090","label":"Customer Care Phone Number","level":null,"hours":"24*7","applies_to":"all","source_url":"https://licindia.in/web/guest/grievances","quote":"e Insurance Corporation \r\n   of India.\nNavigation\nSkip to Content\nMenu Display\nVoice Search\nSearch\nSkip to main content\n8976862090\n+91-22-68276827\nBranch Locator\nLanguage Selector\nenglish\nहिन्दी [beta]\nमराठी\nA+\nA\nA-\nA\nA\nAbout Us\nHistory\nObjectives Of","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"address","value":"'Yogakshema' , Jeevan Bima Marg, P.O. Box No19953, Mumbai – 400 021.","label":"Corporate Office Address","level":null,"hours":null,"applies_to":"all","source_url":"https://licindia.in/web/guest/grievances","quote":"any grievances, email at\nco_complaints[at]licindia[dot]com\nCorporate Office\n: Life Insurance Corporation of India \r\n\t\t\t\t'Yogakshema' , Jeevan Bima Marg, P.O. Box No19953, \r\n\t\t\t\tMumbai – 400 021. IRDAI Reg No- 512\nFor any query regarding this website, please contact the Web Information Manager\nSmt. Himali As","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"email","value":"co_healthsc@licindia.com","label":"Senior Citizens Health Grievance Email","level":null,"hours":null,"applies_to":"health","source_url":"https://licindia.in/documents/20121/124155/Sample_Policy_Document_LIC-s-Arogya-Rakshak.pdf/ed974eaa-4330-7732-6a85-43cfd7980a67?t=1669266625981","quote":"District Court Judge is member of each of the Claims Dispute Redressal Committees. For Senior Citizens:\nEmail address: co_healthsc@licindia.com Health Toll free Number: 18004259876\nOf IRDAI:\nIn case the customer is not satisfied with the response or do not receiv","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"phone","value":"+91-22-68276827","label":"LIC Call Center","level":null,"hours":"24*7","applies_to":"all","source_url":"https://licindia.in/phone-help-line","quote":"Corporation \r\n   of India.\nNavigation\nSkip to Content\nMenu Display\nVoice Search\nSearch\nSkip to main content\n8976862090\n+91-22-68276827\nBranch Locator\nLanguage Selector\nenglish\nहिन्दी [beta]\nमराठी\nA+\nA\nA-\nA\nA\nAbout Us\nHistory\nObjectives Of LIC\nMission/Vis","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"phone","value":"8976862090","label":"LIC Call Center","level":null,"hours":"24*7","applies_to":"all","source_url":"https://licindia.in/phone-help-line","quote":"e Insurance Corporation \r\n   of India.\nNavigation\nSkip to Content\nMenu Display\nVoice Search\nSearch\nSkip to main content\n8976862090\n+91-22-68276827\nBranch Locator\nLanguage Selector\nenglish\nहिन्दी [beta]\nमराठी\nA+\nA\nA-\nA\nA\nAbout Us\nHistory\nObjectives Of","fetched_at":"2026-10-20"},{"purpose":"grievance","channel":"sms","value":"SMS LICHELP <pol.no.> to 9222492224","label":"Grievance Redressal SMS","level":null,"hours":null,"applies_to":"all","source_url":"https://licindia.in/phone-help-line","quote":"Branch / Division / Zonal / Corporate Level.\n(For details click on the `Grievances' tab on the homepage).\nSMS LICHELP :\nSMS LICHELP <pol.no.> to 9222492224.\nDetails of Health Insurance TPA along with Toll Free Numbers\n(Content: English | Format: PDF | View/Download |Size: 44","fetched_at":"2026-10-20"}],"how_to_use":"Ask the user for each field in order, in plain words; never invent an answer. Labels are as printed. If fillable_pdf is true, pdf_fields gives the PDF's own field names so the file can be filled directly. The printed form decides if anything differs.","url":"https://indiainsurances.com/forms/lic/2326-form-of-nomination-for-minor-nominee-form-no-3265"}