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Renewal Premium Receipt: Collecting Branch: E-Mail: Phone: Transaction No.: Date (Time) : Servicing Branch
Renewal Premium Receipt: Collecting Branch: E-Mail: Phone: Transaction No.: Date (Time) : Servicing Branch
Received with thanks Rs. 5448.00 through Payment Gateway over the Internet from:
Policy No Plan Inst. Prem(Rs) No Of Inst Total Premium Service Tax Branch
Name Term Mode Due Fr Late Fee Edu Cess Next Due
Agency Code D.O.C. Sum Assured Due To Total Amt
120758828 93 5,448.00 1 5,448.00 0.00 114
Arora A 25 YLY 04/14 0.00 0.00 04/15
64829111 28/04/1998 1,00,000.00 04/14 5,448.00
Page Total (Rs) 5,448.00 5,448.00 0.00
0.00 0.00
5,448.00
Grand Total (Rs) 5,448.00 5,448.00 0.00
0.00 0.00
5,448.00