Branch: 53E AT PO MUKHTIYARPUR

MD SHAUKAT ALI VIA DALSINGSARAI

0138253E Premium due & Default List for the Month of 10/2019 Page : 1

Sl. Policy Policy Holder Name D.o.C. Plan - M F.U.P. Instlmnt D G S T Total Estm.
No. Number Term od Premium ue Premium Comn
1 529115184 MD KURBAN 28/05/2011 075-20 H 05/2019 3228 1 0.00 3228 194
2 529607767 SHIV CHANDRA KUMAR MAHTO 28/05/2013 075-20 H 05/2019 3214 1 0.00 3214 193
3 529461598 MD RAHMAT 28/12/2011 179-20 H 06/2019 3513 1 0.00 3513 176
4 529587725 MD. MOKHTAR 28/12/2012 179-16 H 06/2019 3906 1 0.00 3906 195
5 529588881 RANJIT MAHTO 28/12/2012 075-20 H 06/2019 3290 1 0.00 3290 197
6 529854720 SHAFINA KHATOON 28/12/2013 014-20 H 06/2019 2971 1 0.00 2971 149
7 534891762 MANTU MAHTO 21/03/2005 075-20 Q 06/2019 844 2 0.00 1688 101
8 535989920 SUSHILA DEVI 06/06/2007 179-20 H 06/2019 1210 1 0.00 1210 61
9 537384676 MD MOSTAKIM 28/12/2008 075-20 H 06/2019 1707 1 0.00 1707 102
10 537384678 SANJIBAN KUMAR RAM 28/12/2008 179-20 H 06/2019 1109 1 0.00 1109 55
11 529476209 RAJ KUMAR MAHTO 28/07/2012 075-20 H 07/2019 1707 1 0.00 1707 102
12 535445395 MD. MUSTAFA 19/07/2006 075-20 H 07/2019 1686 1 0.00 1686 101
13 535445608 MD ISLAM 24/07/2006 014-15 H 07/2019 1936 1 0.00 1936 97
14 535976215 SULENDRA MAHTO 28/01/2007 179-20 H 07/2019 1103 1 0.00 1103 55
15 537375143 MD. ASGAR 28/07/2008 075-20 H 07/2019 1669 1 0.00 1669 100
16 537399521 URMILA DEVI 17/07/2009 179-20 H 07/2019 1097 1 0.00 1097 55
17 535446667 MAHBUB ALAM 17/08/2006 075-20 H 08/2019 1696 1 0.00 1696 102
18 535976192 SHANTI DEVI 03/02/2007 179-20 H 08/2019 1191 1 0.00 1191 60
19 537387628 MD KALAM 14/02/2009 075-20 H 08/2019 1674 1 0.00 1674 100
20 537388389 ENOOL MIYAN 26/02/2009 075-20 H 08/2019 1797 1 0.00 1797 108
21 529122856 MD RAHEES 28/09/2011 075-20 H 09/2019 1666 1 0.00 1666 100
22 529122857 DASHRATH PASWAN 28/09/2011 075-20 H 09/2019 1684 1 0.00 1684 101
23 529124216 SUNIL KUMAR SAH 28/09/2011 179-20 H 09/2019 1147 1 0.00 1147 57
24 529480085 JAHANGEER ALAM 28/09/2012 075-20 Y 09/2019 12497 1 0.00 12497 750
25 535979755 MANTU MAHTO 20/03/2007 179-20 H 09/2019 1174 1 0.00 1174 59
26 535980178 NARESH KUMAR KAUSHIK 22/03/2007 179-20 H 09/2019 1072 1 0.00 1072 54
27 535980428 UDAY KANT JHA 24/03/2007 179-20 H 09/2019 1248 1 0.00 1248 62
28 535985451 VEENA DEVI 28/03/2007 179-20 H 09/2019 1366 1 0.00 1366 68
29 535985473 NOORJAHAN BEGAM 28/03/2007 179-20 H 09/2019 1191 1 0.00 1191 60
30 537365987 NOOR MOHAMMAD 20/03/2008 014-15 H 09/2019 2030 1 0.00 2030 102
31 537368520 RAM LAKHAN SINGH 28/03/2008 075-20 H 09/2019 1637 1 0.00 1637 98
32 537369315 RAMCHANDRA SAHNI 28/03/2008 075-20 H 09/2019 1672 1 0.00 1672 100
33 537391145 PAPPU MAHTO 26/03/2009 075-20 H 09/2019 1680 1 0.00 1680 101
34 537394089 RAM UCHIT MAHTO 28/03/2009 075-20 H 09/2019 1832 1 0.00 1832 110
35 537394090 PINKI DEVI 28/03/2009 075-20 H 09/2019 1715 1 0.00 1715 103
36 847390779 DHANRAJ MAHTO 28/09/2017 814-12 Y 09/2019 18087 1 407.00 18494 1357
37 528735769 SURESH SAH 28/10/2014 814-17 Y 10/2019 8539 1 192.00 8731 427
38 528776806 INDU KUMARI 28/04/2015 820-20 H 10/2019 4013 1 90.00 4103 201
39 528984587 DIPU RAJAK 28/04/2016 820-20 H 10/2019 4836 1 109.00 4945 242
40 529124675 JITENDRA KUMAR 28/10/2011 179-20 H 10/2019 1072 1 0.00 1072 54
41 529124676 JITENDRA KUMAR PANDIT 28/10/2011 179-20 H 10/2019 1055 1 0.00 1055 53
42 529126423 RAM SAGAR MAHTO 28/10/2011 075-20 H 10/2019 3614 1 0.00 3614 217

Page Totals : Premium : 115375.00 G S T : 798.00 Commission : 6779.00

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53E-0138253E - (09/10/2019 17:38:25)
0138253E Premium due & Default List for the Month of 10/2019 Page : 2

Sl. Policy Policy Holder Name D.o.C. Plan - M F.U.P. Instlmnt D G S T Total Estm.
No. Number Term od Premium ue Premium Comn
43 529126424 MD IMTIYAJ 28/10/2011 075-20 Y 10/2019 6693 1 0.00 6693 402
44 529482095 BASANTI DEVI 27/10/2012 075-20 Y 10/2019 7134 1 0.00 7134 428
45 529483063 SITA DEVI 28/10/2012 075-20 Y 10/2019 6557 1 0.00 6557 393
46 529484157 AKALU RAJAK 28/10/2012 179-16 Y 10/2019 3341 1 0.00 3341 167
47 529599855 PINKI DEVI 28/04/2013 075-20 H 10/2019 6487 1 0.00 6487 389
48 529604960 RAKESH KUMAR 28/04/2013 075-20 H 10/2019 3151 1 0.00 3151 189
RADHESHYAM KUMAR URF RADHESHYAM PR
49 529604961 28/04/2013 075-20 H 10/2019 3149 1 0.00 3149 189
50 535443017 MD ILIYAS 28/04/2006 014-15 H 10/2019 2060 1 0.00 2060 103
51 537355409 INDU DEVI 04/10/2007 179-20 H 10/2019 1158 1 0.00 1158 58
52 538249674 ARVIND RAJAK 28/01/2010 075-20 Q 10/2019 884 1 0.00 884 53
53 538257634 ASHFAQ ALAM 15/04/2010 075-20 H 10/2019 3380 1 0.00 3380 203
54 538257770 MD. AWWAS 19/04/2010 075-20 H 10/2019 1974 1 0.00 1974 118
55 538258392 JAMILA KHATOON 28/04/2010 075-20 H 10/2019 1881 1 0.00 1881 113
56 817120787 VIJAY PASWAN 28/10/2017 820-20 H 10/2019 4065 1 92.00 4157 305
57 828598193 NAND KUMAR RAM 28/10/2018 815-20 H 10/2019 6203 1 140.00 6343 465
58 831455422 SAPNA KUMARI 28/10/2018 820-20 Y 10/2019 9918 1 223.00 10141 744
59 831455423 ASHOK MAHTO 28/10/2018 820-20 Y 10/2019 8286 1 186.00 8472 621
60 831455424 PRAMOD MAHTO 28/10/2018 820-20 Y 10/2019 8190 1 184.00 8374 614
61 847042537 MD. IMRAN ANSARI 28/10/2016 820-20 H 10/2019 4938 1 111.00 5049 247
62 847342468 AFSANA KHATOON 28/04/2017 841-24 H 10/2019 5909 1 133.00 6042 443
63 847343458 SHIV KUMAR RAY 28/04/2017 820-20 H 10/2019 9033 1 203.00 9236 677
64 847345043 MD KAMARUL 28/04/2017 820-20 H 10/2019 3998 1 90.00 4088 300

Page Totals : Premium : 108389.00 G S T : 1362.00 Commission : 7221.00

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53E-0139853E - (09/10/2019 17:38:25)