LIC Surrender Form No 3510/5074 PDF

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LIC Surrender Form No 3510/5074

This is an Application Form 5704/3510 for the LIC policyholder who wants to surrender his/her life insurance policy or make a partial withdrawal from the policy fund and this form can be download from the link given below free of cost.

Documents Required for LIC Surrender Form

  • Surrender Policy 
    • Original policy documents
    • Canceled cheque with the policyholder’s name on it
    • In case the canceled cheque does not have a pre-printed name, account number, or a new account is mentioned on the cheque, then the passbook copy/bank statement having the pre-printed name and the account number is required
    • ID proof (PAN Card, Aadhaar Card, Passport, Driving License, Voters ID)
    • Policy surrender or cancellation form
    • Latest contact details
    • NRE bank statement reflecting any premiums paid from the NRE account
  • Partial Withdrawal
    • Original policy documents
    • Copy of CI or YPD submitted for the withdrawal request (carry original documents for verification in the branch)
    • Canceled cheque of the insured’s name
    • In case the canceled cheque does not have a pre-printed name and account number or a new account is mentioned on the cheque, then passbook copy/bank statement having the pre-printed name and the account number is required
    • ID proof (PAN Card, Aadhaar Card, Passport, Driving License, Voters ID)
    • Pay-out form
    • Latest contact details
    • NRE bank statement reflecting any premiums paid from the NRE account

Contact Details

The following options can be used to connect with LIC of India:

Call: 022 6827 6827 / 18004259876 for Health Insurance policies

SMS: LICHELP <pol.no.> to 9222492224 or SMS LICHELP <pol.no.> to 56767877

Mailing Address:
Corporate Office,
Yogakshema Building,
Jeevan Bima Marg,
P.O. Box No – 19953,
Mumbai – 400 021

You can download the LIC Surrender Form No 3510/5074 in PDF format online from the link given below.

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