DEED OF ASSIGNMENT OF POLICY OF LIFE INSURANCE BY WAY OF GIFT WITH RESERVATION
This deed of assignment made the………..day of 20………between .............. of, etc. (assignor), of the one part and .............. of, etc. (assignee), of the other part witnesses that in consideration of natural love and affection between the said .............and .................., the said ...............does hereby and here under transfer and assign as and by way of gift to the said ......................all the benefits of and all moneys now due or shall hereafter become payable under the Policy of Insurance No…………dated…………on the life of the said .............. provided always that in the event of the said .......... predeceasing the said ............. the benefit of and right to receive moneys under the said policy shall to all intents and purposes revert to the said ............ as if this assignment had never been made nor intended. And that the said ................ do hereby covenant with the said ............. that the said policy is still in force and further that the said ................ has not charged nor encumbered the same in any way and furthermore there is no injunction or prohibitory order against him from assigning the same in the manner hereunder effected.
In witness, etc.
Signed, sealed and delivered ................
