The Manager,
__________ (Name of Insurance Company),
__________ (Insurance Company Address)

Date: __/__/____ (Date)

Subject: Request for surrender value of policy number ________ (policy number).

Dear Sir/Madam,

With due respect, I, _________ (Your Name) do hold an insurance policy from your insurance company ______________ (type of insurance) bearing policy number __________ (Policy Number). The same is due for maturity on _______(Policy Maturity Date).

I am writing this letter to request you to kindly provide me with the surrender value of the above-mentioned policy. The reason for requesting the surrender value is ________ (mention reason – personal records/surrender/any other).

I am enclosing _________ (mention required documents) along with the application.

Thanking you in advance,


__________ (Your Name)
__________ (Policy Number)
__________ (Contact Number)

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