Self-Certification Form for Individuals
This file contains the Self-Certification Form for individuals as required by the Life Insurance Corporation of India. It is mandatory for policyholders to fill out this form accurately for tax compliance under FATCA/CRS. Ensure all details are provided to avoid delays in processing.
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How do I fill this out?
To fill out the Self-Certification Form, start by carefully reading each section. Ensure all mandatory fields are completed accurately. Once you have filled in all the required information, review your answers before submission.

How to fill out the Self-Certification Form for Individuals?
1
Read the instructions carefully before starting.
2
Fill in all mandatory fields marked with an asterisk.
3
Provide accurate tax residency details.
4
Sign and date the form where required.
5
Submit the completed form as instructed.
Who needs the Self-Certification Form for Individuals?
1
Policyholders of LIC need this form to verify their tax residency status.
2
Joint Policyholders must provide this certification to fulfill tax obligations.
3
Beneficiaries need to complete this to ensure rightful claims under the policy.
4
Assignees require it to authorize changes made to the policy.
5
Re-assignees must submit this for tax compliance after re-assignment.
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What are the instructions for submitting this form?
To submit the Self-Certification Form, you may email it to the designated LIC email address available on their website. Alternatively, you can fax the completed form to the provided fax number. For those preferring physical mail, send the form to your nearest LIC office address as outlined in the LIC documentation.
What are the important dates for this form in 2024 and 2025?
Please check the LIC website for important 2024 and 2025 deadlines related to the filing of this Self-Certification Form. Timely submission is crucial to adhere to FATCA/CRS compliance. Be mindful of any changes in regulations that may affect your submission timeline.

What is the purpose of this form?
The purpose of the Self-Certification Form is to collect accurate information regarding the tax residency status of individuals associated with LIC policies. This information is crucial for compliance with international tax regulations such as FATCA/CRS. By completing this form, policyholders ensure that they fulfill their legal obligations related to taxation.

Tell me about this form and its components and fields line-by-line.

- 1. Customer ID: A unique identification number for the policyholder.
- 2. Name: Full name of the individual filling out the form.
- 3. Tax Residency: Indicates the individual's residence for tax purposes.
- 4. Identification Type: Type of identification document being presented.
- 5. Occupation: Details about the individual's current occupation.
- 6. Address: Current residential or business address.
- 7. Signature: Section for the individual to sign and date the form.
What happens if I fail to submit this form?
Failure to submit this form may lead to compliance issues, affecting the policy's validity or claims. It is essential to ensure that the form is completed and submitted accurately and on time to avoid penalties. Incomplete or incorrect information can result in further verification requests from LIC.
- Policy Validity: Not submitting the form can jeopardize the policy validity.
- Claim Processing: Claims may be delayed if this form is not submitted.
- Additional Queries: LIC may reach out for further details, complicating the process.
How do I know when to use this form?

- 1. Applying for a New Policy: Required to establish tax residency at the time of application.
- 2. Changing Policy Details: Necessary when personal or tax-related information changes.
- 3. Processing Claims: Needed to process claims accurately and in compliance with tax laws.
Frequently Asked Questions
How do I fill out the Self-Certification Form?
Fill out all mandatory fields, ensure accuracy of the details, and submit as instructed.
What if I make a mistake while filling out the form?
You can easily edit the PDF using PrintFriendly’s editor before submitting.
Where can I find the form?
The Self-Certification Form is available for download on PrintFriendly.
Can I save my work on PrintFriendly?
You can edit and download your PDF, ensuring you have a copy for your records.
Is there a deadline for submitting the form?
Check LIC’s guidelines for specific submission deadlines related to your policy.
Who do I contact if I have questions about the form?
Contact LIC customer support for assistance regarding the Self-Certification Form.
What happens if I don't submit the form?
Failure to submit may result in compliance issues affecting your policy.
Can I submit my form electronically?
Yes, once completed, you can submit the PDF electronically as per LIC’s procedures.
What information do I need to provide?
You will need to provide personal information, tax residency details, and identification numbers.
How do I ensure my information is secure?
PrintFriendly uses secure processing for your editing and downloading needs.
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