I declare that:

1. I am the legal owner of this policy and competent to negotiate in respect of the policy
2. The above account number is my personal account number and payment into the account provided will discharge Metropolitan Life
Insurance Ghana from further liability in respect of the benefits claimed.
3. To the best of my knowledge and belief, policy has not been ceded or pledged by antenuptial contracts or otherwise.
4. The foregoing information in this application is true and correct, and the payment of the above mentioned claim indicates the receipt of the
amount due me.