Policy Purchase

I do hereby declare that the foregoing statements and answer have been given by me after fully understanding the questions and the same are true and complete in every particular and that I have not withheld any information and I do hereby agree and declare that these statements and this declaration shall be basis of the contract of assurance between me and the 'Life Insurance Corporation Of Bangladesh LTD' and that if any untrue averment be contained therein the said contract shall be void with as per provisions of IDRA Act.