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✦ AMFI Registered Mutual Fund Distributor — ARN-50844 | ✦ Insurance Claim Assistance|✦ Loan Assistance · Home Visits Delhi NCR | ✦ IRDA Certified Insurance Advisor | ✦ LIC & GIC Agent · CLIA · Chairman’s Club

LIC Forms Download

LIC Forms Download (PDF)

Download LIC of India service forms in one place: claims, revival, nomination, assignment, loan, NEFT/ECS mandate, health insurance, pension and group scheme forms. Jump to a section below, or read our LIC claim guide. Looking for other forms? See all forms in one place.

Note: Forms are published by LIC of India and can be revised from time to time. Please check LIC’s official website for the latest version before submitting. Insurance is the subject matter of solicitation. Claim approval is at the sole discretion of the insurer.

LIC Death Claim forms

Form No. 3783Claim Form A – Claimant’s Statement (Death Claim)

To be filled by the nominee/legal heir to claim policy money after the death of the life assured. Submit with death certificate and original policy bond.

⬇ Download PDF (2.2 MB)
Form No. 3783AClaim Form 3783(A) – Death Claim (policy in force 3+ years)

Simplified death claim form that may be used when the policy has run for 3 years or more from the date of risk.

⬇ Download PDF (1.2 MB)

LIC Maturity Claim forms

Form No. 3825Discharge Form for Maturity Claim

Discharge receipt to be submitted with the original policy at least one month before the maturity date so payment is received on time.

⬇ Download PDF (313 KB)

LIC Survival Benefit forms

Form No. 5180Survival Benefit Claim Form

For claiming periodic survival benefit (money-back instalments) payable during the policy term.

⬇ Download PDF (2.4 MB)

LIC Alteration forms

LIC FormRequest for Change in Policy Terms

Request form for alterations in policy terms such as plan, term, sum assured or premium mode, subject to LIC rules.

⬇ Download PDF (83 KB)

LIC Revival forms

Form No. 680Revival of Lapsed Policy – Form 680 (Declaration of Good Health)

Declaration of good health required for reviving a lapsed policy.

⬇ Download PDF (360 KB)
Form No. 700Revival of Lapsed Policy – Form 700

Revival form for lapsed policies, as required by LIC depending on the lapse period and sum assured.

⬇ Download PDF (3.3 MB)
Form No. 720Revival of Lapsed Policy – Form 720

Revival form for lapsed policies, as required by LIC depending on the case.

⬇ Download PDF (2.5 MB)

LIC ECS Mandate forms

LIC FormECS Direct Debit Mandate Form

Authorise automatic payment of LIC premium directly from your bank account through ECS.

⬇ Download PDF (109 KB)

LIC Nomination forms

Form No. 3750Notice of Change of Nomination

To change the nominee registered under your policy.

⬇ Download PDF (119 KB)
Form No. 3751Notice of Cancellation of Nomination

To cancel an existing nomination under the policy.

⬇ Download PDF (116 KB)
Form No. 3265Form of Nomination for Minor Nominee

Nomination where the nominee is a minor (appointee details required).

⬇ Download PDF (113 KB)
Form No. 3264Form of Nomination

Standard form to register a nominee under the policy.

⬇ Download PDF (113 KB)
Form No. 3237Form of Nomination under Jeevan Sathi

Nomination form for Jeevan Sathi (joint life, husband-wife) policies.

⬇ Download PDF (114 KB)
Form No. 3237(A)Form of Nomination under Joint Life Policy

Nomination form for joint life policies.

⬇ Download PDF (116 KB)
Form No. 3738Form of Appointment of Appointee

To appoint an appointee who will receive the claim on behalf of a minor nominee.

⬇ Download PDF (113 KB)
Form No. 3741Form of Appointment of Fresh Appointee

To appoint a new appointee in place of the existing one.

⬇ Download PDF (114 KB)
Form No. 3740Form for Revocation of Appointment of Appointee

To revoke (cancel) the appointment of an appointee.

⬇ Download PDF (114 KB)

LIC Assignment forms

Form No. 3838Conditional Assignment to Wife/Close Relative – Whole Life Policy

Conditional assignment of a whole life policy in favour of wife or a close relative.

⬇ Download PDF (75 KB)
Form No. 3837Conditional Assignment to Wife/Close Relative – Endowment Policy

Conditional assignment of an endowment or double endowment policy in favour of wife or a close relative.

⬇ Download PDF (131 KB)

LIC Loan forms

Form No. 5196 / 5205 / 5200 / 3516 / 5198 / 3599Policy Loan Forms (combined set)

Combined set of forms for applying for a loan against your LIC policy.

⬇ Download PDF (97 KB)

LIC Salary Saving Scheme forms

Form No. Annexure-VBipartite Agreement – Salary Saving Scheme (SSS)

Agreement between employer and LIC for premium deduction from salary under SSS.

⬇ Download PDF (34 KB)
Form No. Annexure-I(B)Addendum for Conversion to SSS Mode

Addendum to convert an existing policy to Salary Saving Scheme premium mode.

⬇ Download PDF (40 KB)
Form No. Annexure-I(A)Addendum to Proposal for Insurance under SSS

Addendum to the proposal form for a new policy under Salary Saving Scheme.

⬇ Download PDF (28 KB)

LIC Pension / Annuity (IPP) forms

LIC FormIPP – NEFT Mandate Form

Bank details mandate for receiving pension/annuity directly into your bank account via NEFT.

⬇ Download PDF (57 KB)
LIC FormCertificate of Existence

Life certificate to be submitted by annuitants for continued receipt of pension/annuity.

⬇ Download PDF (58 KB)
LIC FormIPP – Letter of Indemnity

Letter of indemnity form for individual pension plan (IPP) cases.

⬇ Download PDF (59 KB)

LIC NEFT Mandate forms

LIC FormNEFT Mandate Form

Register bank account details so that claim/maturity/survival benefit payments are credited directly via NEFT.

⬇ Download PDF (1.3 MB)

LIC Health Insurance forms

LIC FormHealth Insurance Claim Form

Main claim form for LIC health insurance plans.

⬇ Download PDF (140 KB)
LIC FormHealth Claim Intimation Form

To intimate LIC about a health insurance claim (hospitalisation/surgery).

⬇ Download PDF (142 KB)
LIC FormDTB Claim Form (Daily Treatment Benefit)

Claim form for Daily Treatment Benefit / hospital cash under LIC health plans.

⬇ Download PDF (35 KB)
LIC FormDTB Discharge Form

Discharge form for Daily Treatment Benefit claims.

⬇ Download PDF (68 KB)
LIC FormHospital Treatment Form

To be filled by the treating hospital/doctor with treatment details.

⬇ Download PDF (714 KB)
LIC FormAnnexure – List of Documents (Health Claim)

Checklist of documents required for a health insurance claim.

⬇ Download PDF (90 KB)
LIC FormNEFT Mandate Format (Health Claims)

Bank details form for receiving health claim payment via NEFT.

⬇ Download PDF (95 KB)

LIC Duplicate Policy forms

LIC FormQuestionnaire for Duplicate Policy

Questionnaire to be filled when the original policy bond is lost or damaged.

⬇ Download PDF (1.0 MB)
Form No. 3756Form No. 3756 – Indemnity for Duplicate Policy

Indemnity bond required along with the questionnaire for issue of a duplicate policy.

⬇ Download PDF (2.1 MB)

LIC FATCA / CRS forms

LIC FormFATCA & CRS Self-Certification (Individuals)

Self-declaration of tax residency status required under FATCA/CRS regulations.

⬇ Download PDF (455 KB)

LIC Group Scheme Claims forms

LIC FormGLES Claim Form

Claim form under Group Leave Encashment Scheme.

⬇ Download PDF (573 KB)
LIC FormGratuity Claim Form

Claim form under LIC Group Gratuity Scheme.

⬇ Download PDF (579 KB)
LIC FormGSLI Claim Form

Claim form under Group Savings Linked Insurance scheme.

⬇ Download PDF (577 KB)
LIC FormGSLI Discharge Form

Discharge form for GSLI claims.

⬇ Download PDF (476 KB)
Form No. Annexure-IIEmployer-Employee Group Claim Forms

Claim forms for employer-employee group insurance schemes.

⬇ Download PDF (292 KB)
Form No. Annexure-IIIGI in lieu of EDLI Claim Forms

Claim forms for Group Insurance in lieu of EDLI.

⬇ Download PDF (476 KB)
Form No. Annexure-IVNon Employer-Employee Group Claim Forms

Claim forms for non employer-employee group schemes.

⬇ Download PDF (823 KB)
Form No. Annexure-VIIGroup Claims – Annexure VII

Additional claim annexure for P&GS group schemes.

⬇ Download PDF (320 KB)

LIC Annuity forms

LIC FormAnnuity Claim Forms

Forms for claiming annuity/pension under LIC pension and group annuity schemes.

⬇ Download PDF (1.1 MB)

LIC Reference forms

LIC FormTurn Around Time (TAT) – Pension & Group Schemes

LIC’s service timelines for pension and group scheme requests.

⬇ Download PDF (209 KB)
LIC FormPre-Contract Integrity Pact

LIC integrity pact document (for vendors/contracts).

⬇ Download PDF (7.1 MB)

How to fill and submit LIC forms

  1. Identify the form you need from the sections above.
  2. Download it from this page and print it.
  3. Fill it in block letters, sign where indicated and attach the documents the form asks for (policy bond, ID proof, death certificate or bank details as applicable).
  4. Submit it at your LIC branch as per LIC’s process, or contact us and we will help you with the documents and follow-up.

Frequently asked questions

Where can I download LIC of India forms? ▼
You can download the LIC forms listed on this page as PDFs, grouped by purpose: claims, revival, nomination, assignment, loan, mandates, health insurance, pension and more. For the latest version, also check LIC of India’s official website before you submit.
Which LIC form do I need for a death claim? ▼
A death claim usually needs the claimant’s statement (Claim Form A) along with documents such as the death certificate and the original policy bond. The exact set of documents depends on the case, so check the description under each form and LIC’s guidance.
How do I change the nominee on my LIC policy? ▼
Use the nomination forms listed in the Nomination section of this page, fill them in, sign, and submit them to your LIC branch as per LIC’s process.
Can you help me with LIC forms or a claim? ▼
Yes. Binod Kumar Shukla is an LIC of India agent (CLIA, Chairman’s Club member) in Delhi NCR and helps policyholders and nominees with form filling, documents and follow-up. Call 9911581705 or message on WhatsApp.

Need help with an LIC form or claim? Binod Kumar Shukla, LIC of India agent and insurance advisor, Delhi NCR.

Call 9911581705Book a consultation
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