GROUP PERSONAL ACCIDENT POLICY FOR OPTIONAL TRAVEL INSURANCE

FOR E-TICKET PASSENGERS OF IRCTC

Endorsement

Certificate Number: AG56051336990714

Name of the Insured: Suvarna Ajaykris

Trip: From: 30-AUG-18 To: 31-AUG-18

Originating Station : KSR BENGALURU

Destination Station : SOLAPUR JN

PNR Number: 4348529878

Notwithstanding anything stated herein to the contrary,it is hereby declared and agreed that the details of Nominee of the
Insured in respect of the above mentioned PNR number should read as below:

NOMINEE DETAILS

Name Age Relationship to the Insured Mobile No

Ajay Krishnan 38 Father 9846554213

Subject otherwise to the terms,conditions and exclusions of the Policy Number AG00056051000100

Please quote the Certificate Number in all your correspondence.

IN WITNESS WHEREOF, this Endorsement has been signed on 27-AUG-18

Service Tax No.AABCR106GST001 PAN Number : AABCR 7106G

For Royal Sundaram General Insurance Co.Limited

Duly Authorised Signatory

Group Personal Accident Policy for Optional Travel Insurance for E-ticket Passengers of IRCTC
UIN:IRDAI/HLT/RSGI/P-H(G)/V.I/44/2016-17
IRDAI Registration Number:102
 GROUP PERSONAL ACCIDENT POLICY FOR OPTIONAL TRAVEL INSURANCE
FOR E-TICKET PASSENGERS OF IRCTC

Endorsement

Certificate Number: AG56051336990713

Name of the Insured: Akshay Ajaykrish

Trip: From: 30-AUG-18 To: 31-AUG-18

Originating Station : KSR BENGALURU

Destination Station : SOLAPUR JN

PNR Number: 4348529878

Notwithstanding anything stated herein to the contrary,it is hereby declared and agreed that the details of Nominee of the
Insured in respect of the above mentioned PNR number should read as below:

NOMINEE DETAILS

Name Age Relationship to the Insured Mobile No

Ajay Krishnan 38 Father 9846554213

Subject otherwise to the terms,conditions and exclusions of the Policy Number AG00056051000100

Please quote the Certificate Number in all your correspondence.

IN WITNESS WHEREOF, this Endorsement has been signed on 27-AUG-18

Service Tax No.AABCR106GST001 PAN Number : AABCR 7106G

For Royal Sundaram General Insurance Co.Limited

Duly Authorised Signatory

Group Personal Accident Policy for Optional Travel Insurance for E-ticket Passengers of IRCTC
UIN:IRDAI/HLT/RSGI/P-H(G)/V.I/44/2016-17
IRDAI Registration Number:102