Memorandum Of Transfer - Mlc Page 2
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42. New owner(s) details (transferee(s))
If the policy is being transferred to more than one person, please provide details for each person. If ownership of the policy is to continue
under any of the Current Owners, then those persons must also be specified as New Owners on this form. Please note when
transferring a policy to more than one person, the policy will be held in joint tenancy.
Please note: All communications (including renewal and lapse notices) will be sent to the person shown on the Memorandum of
Transfer form as Transferee 1 unless an alternative instruction in provided in Section 3 of this form.
It is their responsibility to send copies of any communications to other Policy owners or any other person who may have an interest in
this policy.
New Owner 1 (Transferee 1)
New Owner 2 (Transferee 2) (if applicable)
Title
Name
Address
Postcode
Postcode
Postal address
(if different to above)
Postcode
Postcode
Phone number(s)
Home
Home
Business
Business
Occupation
Date of birth
(DD/MM/YYYY)
Signature of New Owner
Date
Date
(DD/MM/YY)
(DD/MM/YY)
(Transferee)
✗
✗
Full name of Witness
(Person must be over the age of
18 and not a party to this transfer)
Signature of Witness
Date
Date
(DD/MM/YY)
(DD/MM/YY)
✗
✗
New Owner 3 (Transferee 3) (if applicable)
New Owner 4 (Transferee 4) (if applicable)
Title
Name
Address
Postcode
Postcode
Postal address
(if different to above)
Postcode
Postcode
Phone number(s)
Home
Home
Business
Business
Occupation
Date of birth
(DD/MM/YYYY)
Signature of New Owner
Date
Date
(DD/MM/YY)
(DD/MM/YY)
(Transferee)
✗
✗
Full name of Witness
(Person must be over the age of
18 and not a party to this transfer)
Signature of Witness
Date
Date
(DD/MM/YY)
(DD/MM/YY)
✗
✗
Memorandum of transfer
Page 2 of 4
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