Notice of bank’s interest in fire insurance policy, with acceptance

To

the (insurance company).?

Policy No.____________

On (premises).

_____________ Bank

_____________ Branch.

(Date.)

In name of ___________________ (insured).?Please note that the property covered by the above-mentioned policy has been charged to this bank. We shall be glad to hear if you will accept this notification of our interest in the policy instead of endorsing it in our favour.

We shall also be glad to know if in the event of the renewal premium on the policy not being paid at the expiration of the days of grace you will at once give us notice of such non-payment and extend the days of grace for a further period of seven days in order that we may have an opportunity of communicating with the policy-holder or if we desire to do so of paying the renewal premium ourselves.

To

___________ Bank

(Signature on behalf of bank)

We accept this notice of your interest in the above-mentioned policy in lieu of and as equivalent to endorsing such interest upon the policy and we undertake to notify you on the expiration of the days of grace of any renewal premium of the policy not having been received by us at the time of such notification and to extend the days of grace for a further period of seven days but on omission on our part to give such notification shall have the effect of extending the liability under the abovementioned policy beyond that period or render us liable for any claim for negligence or otherwise for omitting to give such notice.

Dated

________________

(Signature on behalf of insurance company)