LIFE
INSURANCENOMINATION FORM

Employee Declaration

I hereby direct that the amount payable to me from the Confiz Group Life Insurance Policy, at the time of my death (Nature or Accidental) shall be distributed among the person(s) mentioned below in the manner shown against their names:

01NOMINEE ONE

Full Name ( as per CNIC )
Zara Azhar
Address
gondlanwala road first floor model town gujranwala
CNIC
3410152416442
Relationship with the Member
Wife
Percentage of Accumulation to be Paid
50

02NOMINEE TWO

Full Name ( as per CNIC )
muhammad babar
Address
street haji ibraheem bagri sialkot road khokherki gujranwala
CNIC
3410124311011
Relationship with the Member
father
Percentage of Accumulation to be Paid
50
Witness 1 | Full Name
CNIC
Witness 1 Signautre
Signature
Witness 2 | Full Name
CNIC
Witness 2 Signautre
Signature

Yours Faithfully,

Employee's Name
Employee ID
2485
Employee Signautre
Employee Signature
HR Authorized Signautre
HR Authorized Signature