Policy Deposit Receipt

Name of the Life assured :

MR Pushpranjan Saroj

Receipt No :

33241731

Policy Owner :

MR Pushpranjan
Saroj

Date of Receipt :

05-Feb-2015

Address :

Food Corporation Of India,Near Jagadhri

Bus Stand,Jagadhri,Haryana,,135003

Contact Details :

,9896590743

Client ID :

55757726

Policy No:

02656202

We acknowledge with thanks, receipt of Rs. 15010 via Net banking towards renewal of your policy.

Policy Term:

15

Premium Paying Term :

Plan Component

Premium

Kotak Capital Multiplier Plan

Service Tax

14782

15

Payment Frequency :
Revival Charge
(Late Fee)

Education Cess

222

248.73
Total

Annual

Total Premium Paid

15259.73
15010

Next Due Date : 30-Dec-2015 *

Payment Mode

Net banking

Cheque No./Transaction ID. :

Bank Name

State Bank of India

Mudrank No: EMSHU-2014/2574/CN391/M1 Dated 14-08-2014

This is a computer generated

receipt and does not require
manual signature.

Notes:
1. Service Tax, Education Cess and Higher Secondary Education Cess on Service Tax, is levied at the applicable Tax rates in accordance with the
prevailing Tax Laws, from time to time. Premium are eligible for deduction under Income Tax act 1961,as per the prevailing tax laws.
2. For cheque payments the receipt is subject to clearance and for electronic mode of payment upon the credit in companys account.
3. Service Tax Registration Number : AAACO3983BST002