{"id":2332,"title":"Form of Appointment of Fresh Appointee (Form No. 3741)","purpose":"service","insurer":{"slug":"lic","name":"Life Insurance Corporation of India"},"source_pdf":"https://licindia.in/documents/d/guest/3741e-1","sha256":"3671c2ff9e7cbd58af80916b2fbf4e944a99110eb0d46746134754ae1f38a2c2","pages":2,"collected":"2026-10-20","instructions":{"about":"This form is used by the life assured (policyholder) to appoint a fresh appointee to receive policy monies on behalf of a nominee who is a minor. The appointee consents to the appointment by signing the form.","notes":["An appointment of fresh appointee can only be made by the life assured on his own life after revoking the original appointment.","The form must be copied on the back of the policy along with the witness certificate if the life assured's signature is not in English.","The life assured must sign the endorsement in presence of a witness; if illiterate, thumb impression before authorized officers is required.","The appointee must sign in presence of a witness who attests the signature.","The appointment is not effective until communicated to and registered by the Corporation.","Send the policy with the endorsement to the servicing office for registration."],"title":"Form of Appointment of Fresh Appointee (Form No. 3741)","submit":{"to":"Servicing Office of the Corporation where the Policy is being serviced","how":"send the policy bearing the endorsement for registration","address":""},"purpose":"service","sections":[{"title":"Appointment Details","fields":[{"help":"Write your relationship to the appointee","type":"text","label":"I, hereby appoint my ( relationship )","options":[],"required":null,"pdf_field":""},{"help":"Write the full name of the appointee","type":"text","label":"Shri/Smt.","options":[],"required":null,"pdf_field":""},{"help":"Write the full address of the appointee","type":"text","label":"whose address is :","options":[],"required":null,"pdf_field":""},{"help":"Enter the date of the previous appointee endorsement","type":"date","label":"in lieu of the previous appointee named in the endorsement hereon dated","options":[],"required":null,"pdf_field":""},{"help":"Write the place where the form is signed","type":"text","label":"Dated at","options":[],"required":null,"pdf_field":""},{"help":"Write the date of signing (day, month, year)","type":"date","label":"this day of","options":[],"required":null,"pdf_field":""},{"help":"Signature of the witness","type":"signature","label":"Witness Signature","options":[],"required":null,"pdf_field":""},{"help":"Signature of the policyholder (life assured)","type":"signature","label":"Signature of Life Assured","options":[],"required":null,"pdf_field":""}],"filled_by":"life assured (policyholder)"},{"title":"Consent of Appointee","fields":[{"help":"Place where the appointee signs","type":"text","label":"Dated at","options":[],"required":null,"pdf_field":""},{"help":"Date of signing (day, month, year)","type":"date","label":"the day of","options":[],"required":null,"pdf_field":""},{"help":"Signature of the witness to appointee's consent","type":"signature","label":"Witness Signature","options":[],"required":null,"pdf_field":""},{"help":"Signature of the appointee consenting to the appointment","type":"signature","label":"Signature of the Appointee","options":[],"required":null,"pdf_field":""}],"filled_by":"appointee"}],"deadlines":[],"applies_to":"","attachments":[],"declarations":["The contents of the Appointment of fresh Appointee have been explained to the Assured in vernacular and he affixed his signature/thumb impression after understanding the same.","The appointee consents to the appointment by signing the form."],"dropped_labels":6},"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/2332-form-of-appointment-of-fresh-appointee-form-no-3741"}