Request for Closure of PMJJBY
Formal request to discontinue the PMJJBY life cover and stop the annual auto-debit from a savings account.
PMJJBY closure letter workspace
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A4 · print readyPradhan Mantri Jeevan Jyoti Bima Yojana
Request for Closure of PMJJBY
Date: 02/09/2026
To,
The Branch Manager
BANK NAME
Branch
Subject: Request for Closure of PMJJBY
Respected Sir / Madam,
I, Applicant Name, am an account holder of your branch and an enrolled subscriber under the Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY). I request you to kindly close my PMJJBY enrolment linked to the savings account mentioned below and stop the annual auto-debit of the premium with effect from the date of this application.
I request you to kindly acknowledge this application and complete the closure formalities at the earliest. Please inform me once the enrolment has been discontinued in the bank's records.
| Full Name | Applicant Name |
|---|---|
| Father's / Husband's Name | — |
| Mobile Number | — |
| Aadhaar Number | — |
| Address | — |
| Bank Name | — |
|---|---|
| Branch Name | — |
| Branch Address | — |
| Account Number | — |
| IFSC Code | — |
| Scheme | Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY) |
|---|---|
| Request Type | Closure of PMJJBY |
| Reason for Closure | Voluntary Closure |
| Date of Request | 02/09/2026 |
Declaration
I hereby declare that the particulars furnished above are true and correct to the best of my knowledge and belief. I understand that the insurance cover under this scheme will cease from the date of closure and that no claim shall be admissible thereafter.
Thanking you,
Yours faithfully,
—
How to use
- 1Fill in the subscriber, bank and branch details in the form on the left.
- 2Choose the reason for closing the PMJJBY enrolment.
- 3Check the live preview on the right — it updates as you type.
- 4Press Download PDF for an A4 file, or Print to print it directly.
- 5Get the printed letter signed by the customer and submit it at the branch.
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Disclaimer
R.K Technical Support is not a bank, insurer or government body and is not affiliated with any of them. This template is provided as a drafting convenience only. Banks may prescribe their own closure form or additional documents, so please confirm the current requirement with the branch before submission.