FATCA Disclaimer

I / We confirm that above details provided by me / us are correct and to the best of my knowledge. I / We also confirm that I / We will report any change in my/our tax status in future to IndiaFirst Life Insurance within 30 days of such change. I acknowledge that towards compliance with tax information sharing laws, such as FATCA/CRS, IndiaFirst Life Insurance may be required to seek additional personal, tax and beneficial owner information and certain certifications and documentation from the account holder. Such information may be sought either at the time of Policy issuance or any time subsequently./ hereby give consent to IndiaFirst Life Insurance to share with any regulatory body my information such as contact details, tax identification number / social security number, account balances / activities or any transactions undertaken with IndiaFirst Life Insurance. IndiaFirst Life Insurance may deduct from the moneys payable to me such amount as may be required to comply with any instruction issued by a Government/ Statutory/ Regulatory authority, including, but not limited to, instructions by Indian Authorities to comply with a foreign law, such as FATCA/CRS. I also authorise IndiaFirst Life Insurance to terminate the Policy in the event that appropriate documentation of Insured / Policyholder as may be required by IndiaFirst Life Insurance for the compliance as aforesaid is not timely provided to IndiaFirst Life Insurance.