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    Circi: Insurance

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    applerajiv
    This document is a receipt for a life insurance premium payment made by Mr. Rajiv Subramani to Max Life Insurance. It provides details of the policy such as the policy number, plan details, premium amount paid, duration of coverage, agent and insured person details. The premium receipt acknowledges receipt of the premium payment for the period from 12-Dec-2022 to 11-Jan-2023.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Circi: Insurance

    Uploaded by

    applerajiv
    72 views1 page
    This document is a receipt for a life insurance premium payment made by Mr. Rajiv Subramani to Max Life Insurance. It provides details of the policy such as the policy number, plan details, premium amount paid, duration of coverage, agent and insured person details. The premium receipt acknowledges receipt of the premium payment for the period from 12-Dec-2022 to 11-Jan-2023.

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    This document is a receipt for a life insurance premium payment made by Mr. Rajiv Subramani to Max Life Insurance. It provides details of the policy such as the policy number, plan details, premium amount paid, duration of coverage, agent and insured person details. The premium receipt acknowledges receipt of the premium payment for the period from 12-Dec-2022 to 11-Jan-2023.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    72 views1 page

    Circi: Insurance

    Uploaded by

    applerajiv
    This document is a receipt for a life insurance premium payment made by Mr. Rajiv Subramani to Max Life Insurance. It provides details of the policy such as the policy number, plan details, premium amount paid, duration of coverage, agent and insured person details. The premium receipt acknowledges receipt of the premium payment for the period from 12-Dec-2022 to 11-Jan-2023.

    Copyright:

    © All Rights Reserved
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    MAX

    INSURANCE Date: 13-Dec-2022 CIRCI


    Receipt No.: 196453718 DEC202201

    Life Insurance Premium Receipt


    Duration For Which the Premium is Received: 12-DEC-2022 to 11-JAN-2023

    Personal Details

    Policy Number: 196453718 Current residential state: TamilNadu

    Policyholder Name: Mr. Rajiv Subramani Mobile No. 7010369032

    Commuinication Address: NO:47 KaliLer Street Landline no. Please inform us for regular updates
    MGR Nagar Life Insured Name: MR_ N.Subramani
    Chennai
    PAN Number: DPEPS7414N
    Tamil Nadu
    Pin - 600078

    Email ID: [email protected]

    Policy Details
    Plan Name: Max Life Online Term Plan PlusMax Life Waiver Of Premium Plus Rider CO - 104N092V02

    Policy Term 15 Years Premium Payment Frequency Monthly

    Date of Commencement 12-DEC-2022 Date of Maturity 12-DEC-2033

    Last Premium Due Date I2-DEC-2022 Next Due Date 12-JAN-2023

    Reinstatement Interest (incl. GST) Rs. 0.00 Model Premium (incl. GST) £ 4,167.66

    Total Premium Received (incl. GST)* Rs.4,167.66 Total Sum Assured of base plan and term Rs. 1,00.00,000.00
    rider(if any)
    Agent's Name Coverfox Insurance Brokin Agent's Contact No.
    18002005522

    GST Details

    Coverage Type SAC Code


    GST (INR) GSM 27AACCIVI3201E1Z3
    Base 997132
    Rs.94.83 GST Regd. State TamilNadu
    Rider 997132

    Reinstatement Interest Affix


    RsD.00 Reg
    Total revenue
    :Z.s205.11
    stamp

    Important Note:
    *For payment mode other than in cash, this receipt is con ditional upon the credit in our account. Payment of premium amount does not constitute commencement of risk. The risk
    commencement stain after acceptance of risk by us. "Amormt received would be adjusted against the due premiumas per terms mot condthous of the policy. "Premium paid would be eligible
    for deduction as per the provision of Income TaxAct, 1961. Kindly consult your tax advisor for more infomiatien. Tax benefits are liable to change due to changes in legislation or am-
    error:rem notification "Applicable Taxes, Gess. and Levies, as per prevailing laws, shall be home by you "For GST proposes:this premium receipt is Tax InvomeAssmsable
    'Shim m GST for Endowment Frost Year is 2594,_ Renew-al Year is 115"k Single PrermemAnmuty is 139/k, Term and Health is 100%, In case of mut lurked product GST Is applicable
    on charges.

    „L
    ,(6);
    Authorised signatory

    PRTY120

    Illto important: DO NOT believe calls, SMS, emails offering discounts. Pay only to HSBC Bank A/c no. <1165your policy no.> IFSC - HSBC0110002

    41110Vebsite Dedicated Email Connect Helpl ine Facol:


    1111. wmnrcmaxl leinsurance.com goldcirele 1800 200 4003 lerfacel ccorn/rna)dife
    @rnaxliteinsurance.com
    F 0124-4159397, GIN: U74899P62000PLG0451326
    Regd. Office: 419, Bhai Mohan Singh Nagar, Ratmajra, Tahsil Balachaur, District Nawarshahr, Punjab -144 533
    Max Life Insurance Co. Ltd. Plot No. 90A, Sector 18, Gurugram, 122015, Haryana. IRDAI Registration No. 104

    LA Max Financial Services and `MS Joint Venture

    F 0124-4159397, GIN, U74899P62000PLC045625


    Regd. Office: 419, Bhai Mohan Singh Nagar, Ralmatra, Tahsil Balechaur, District Nawarshahr, Punjab -144 533
    Max Life Insurance Co Ltd Plot Na 90A. Sector 18, Ourugram, 122015, Haryana_ IRDAI Registration No. 104

    6A Max Financial Services and•MS Joint Venture


    T

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