4. Send us your form
Please mail your completed, signed and dated form to us at:
MLC Life Insurance
PO Box 200
North Sydney NSW 2059
If you have any questions, please contact your financial adviser or call us on 1300 428 482 any business day between 8.00 am and
6.00 pm (AEST/AEDT).
OUR USE ONLY
Date of Registration of Transfer by Company
(DD/MM/YYYY)
Signature of Principal Officer of Company or authorised person
✗
This is the annexure to Policy Number
Name
on the life of
Signature of Witness
Date
(DD/MM/YY)
✗
issued by MLC Limited bearing a Memorandum of Transfer
of the said Policy.
Memorandum of transfer
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