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M Muthukumarasamy is declaring a name difference related to his application for a life insurance policy with ICICI Prudential. He states that his name is consistent on his Aadhar card but differs on his PAN card, where it is listed as M Muthukumaraswamy. He affirms that the details provided are true to the best of his knowledge.

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M Muthukumarasamy is declaring a name difference related to his application for a life insurance policy with ICICI Prudential. He states that his name is consistent on his Aadhar card but differs on his PAN card, where it is listed as M Muthukumaraswamy. He affirms that the details provided are true to the best of his knowledge.

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மிக்கேல் தீபன்
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From:

M Muthukumarasamy

30A, Kular Theru, Alwarthirunagari,

Thoothukudi,

Tamilnadu – 628 612

8675014880

To:

Branch In charge,

Icici Prudential Life insurance Company

Tirunelveli – 627 007

Sub : Name Difference Declaration

Respected sir:

I reside in the above given address and I have applied for Life time
classic policy in your company with application number OS27479635. On
my application my name is given as M Muthukumarasamy and as per my
aadhar my name is same as M Muthukumarasamy and I declare that on
my pan card my name is M Muthukumaraswamy and on my Bank proof
itself its same as aadhar that is Muthukumarasamy M

I hereby declare that the above given details are true as per my
knowledge.

Date : 24/02/2025

Place Tirunelveli

Regards

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