An affidavit is a sworn written statement used as evidence in legal matters. This sample affidavit demonstrates how to properly declare a lost insurance policy document before a notary public in Bangladesh. Always consult with legal professionals when preparing such documents.
AFFIDAVIT
I, FARHANA AKTER, Wife of MD. Rahim Sheikh, Mother’s Name: Sufia Begum of Permanent Address: Vill: Nayanpur, P.O. Durgapur, P.S. Kotwali, Dist: Comilla, Bangladesh, by nationality Bangladeshi, do hereby Solemnly affirm and declare as follows:
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That since the policy of Insurance BD No. AL-2023-8765 issued by Global Life Insurance Company on my life was effected, I have not in any way dealt with such policy or done anything which would create any encumbrance or charge thereon.
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That I have lost my above-mentioned policy document.
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That despite making diligent searches at all possible places, I am unable to locate the said policy document.
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That no duplicate copy of this policy has been issued to any third party to my knowledge.
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That I am the sole beneficiary entitled to all benefits under the said policy, free from any liens or encumbrances.
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That I undertake to immediately surrender the original policy document to Global Life Insurance Company if found after this declaration.
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That I shall indemnify the insurance company against any claims arising from my loss of this document.
That the statements made above are true to the best of my knowledge & belief.
______________________
Deponent
(Farhana Akter)
NID: 1995XXXXXXXXXX
Contact: 01XXXXXXXX
The deponent is known to me, identified by me, and has signed in my presence.
______________________
Advocate/Notary Public
(Name: Md. Asif Rahman)
Enrollment No: DH-1254/2010
Dhaka Bar Association
Advice:
Always verify policy details with your insurance provider before submitting the affidavit. Keep multiple copies of the notarized affidavit for future reference. Report the loss to your insurance company immediately after notarization. Consider publishing a newspaper advertisement if required by your insurer.
Note: This is only a sample; it is advisable to proceed with the guidance of a lawyer or experienced persons.
Courtesy: Team Shovonio
Image: Internet
