SSS Membership Subscription

Member Name

Birth Date

Sex

Upload Photo

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Address

State

City

Pincode

Phone: Clinic/Hosp.

Mobile No

Email ID

Suffering from any Major illness

IRIA Membership Number

IRIA Membership Document

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Qualifications

Proposed By

Name

IRIA Life Membership Folio No

Address

Mobile No

Email ID

Attach Proof

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Attach Proof (scanned copy of any of the following IDs: PAN Card, Driving Licence, Voter ID Card, Aadhar, Passport, ID Card issued by IRIA HQ)

Nomination Form

Details of 1st Nominee

Name of the Nominee

Relationship with Member

Address of the Nominee

Upload Photo Id Proof

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Nominee is Minor

Yes

Name of the person who represents the minor

His/Her address

Minor Date of Birth

Details of 2nd Nominee(Applicable In the Event of death 1st nominee,Name to be provided at time of application)

Name of the Nominee

Relationship with Member

Address of the Nominee

Upload Photo Id Proof

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Nominee is Minor

Yes

Name of the person who represents the minor

His/Her address

Minor Date of Birth

I do hereby declare that, I am in sound state of my health and free any condition likely to cause my death in a short span of couple years.Above information including nomination details are true and given in sound state of my mind.I have with held no information what so ever regarding the application and I agree to pay the amount as per schedule of fees of the Scheme

I agree to pay the amount demanded from office of the scheme from time to time, as per constitution of the scheme and I further agree to abide by the rules and regulations laid down in the constitution of Social Security Scheme of IRIA & amendments made in it from time to time

Non payment of demanded amount after speculated date will lead to termination of membership as per bye laws of scheme.

RULE OF ELIGIBILITY TO BECOME MEMBER OF IRIA - SSS

Any Life Member of IRIA upto age of 60 years residing in India is eligible to become a member of this Scheme.

RULE FOR BENEFIT:

The Scheme is purely designed on brotherhood/sisterhood basis & we try to help the family members of IRIA on event of death of member. Death Benefit of the Scheme is liable only after completion of one year of membership of IRIA-SSS. However, nominee of member be entitled for such benefits if death of member occurs in accident even within one year of joining the scheme.

Life Membership of IRIA is compulsory.
Form must accompany Certified xerox copy of (1) Birth Certificate, (2) P.G. Degree/Diploma Certificate, and (3) Two passport size photographs.

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