Harish Chand

Delhi LIC Agent

577, GH-9, PASCHIM VIHAR
NEW DELHI- 110087
INDIA, 9811896425, 9212201725
www.delhiLICagent.com

Due Date Wise

Premiums Due Statement

Date : 09/07/2011
Premiums Due between 01/08/2011 and 31/08/2011
Due
Date

Ag Group
Policy No Cd Code

Page 1 of 1

Policy Holder

Com.
Date
mm/yy

M
Pl/Tm/Pt d

Brn

FUP
Date

Premium
Amount

Pay
Before

01/08/11

333229802

Harish

Harish

02/11

165/25/25 Q

11W

01/08/11

7656.00

01/09/11

08/08/11

333227600

Harish

Harish

02/11

75/20/20 Q

11W

08/08/11

6525.00

08/09/11

09/08/11

333229695

Harish

Harish

03/11

165/25/25 M

11W

09/07/11

255.00

24/08/11

09/08/11

333229696

Harish

Harish

03/11

165/25/25 M

11W

09/07/11

255.00

24/08/11

09/08/11

333229697

Harish

Harish

03/11

165/25/25 M

11W

09/07/11

408.00

24/08/11

09/08/11

333229699

Harish

Harish

03/11

165/25/25 M

11W

09/07/11

408.00

24/08/11

12/08/11

332971212

Harish

Harish

04/10

165/25/25 M

11W

12/07/11

510.00

27/08/11

13/08/11

332977838

Harish

Harish

08/10

165/20/20 Q

11W

13/08/11

6125.00

13/09/11

13/08/11

332977843

Harish

Harish

08/10

149/69/69 M

11W

13/06/11

1363.00

28/08/11

14/08/11

333235908

Harish

Harish

06/11

165/25/25 M

11W

14/07/11

1021.00

29/08/11

15/08/11

332979769

Harish

Harish

09/10

165/21/21 M

11W

15/06/11

1021.00

30/08/11

17/08/11

333228208

Harish

Harish

02/11

165/35/35 M

11W

17/07/11

5104.00

01/09/11

18/08/11

332973422

Harish

Harish

05/10

165/25/25 Q

11W

18/02/11

1531.00

18/09/11

18/08/11

333233251

Harish

Harish

04/11

165/25/25 M

11W

18/05/11

1021.00

02/09/11

18/08/11

333233252

Harish

Harish

04/11

165/25/25 M

11W

18/05/11

1021.00

02/09/11

20/08/11

332979878

Harish

Harish

09/10

165/21/21 M

11W

20/04/11

1021.00

04/09/11

20/08/11

332979881

Harish

Harish

09/10

165/21/21 M

11W

20/04/11

1021.00

04/09/11

22/08/11

332976767

Harish

Harish

07/10

165/25/25 M

11W

22/05/11

1021.00

06/09/11

23/08/11

333223986

Harish

Harish

12/10

165/21/21 M

11W

23/06/11

1021.00

07/09/11

24/08/11

333228629

Harish

Harish

02/11

75/20/20 H

11W

24/08/11

6509.00

24/09/11

24/08/11

333234833

Harish

Harish

05/11

165/25/25 M

11W

24/06/11

510.00

08/09/11

25/08/11

333234956

Harish

Harish

05/11

165/35/35 M

11W

25/06/11

1021.00

09/09/11

26/08/11

332975032

Harish

Harish

06/10

165/25/25 M

11W

26/07/11

2552.00

10/09/11

28/08/11

332978700

Harish

Harish

08/10

165/25/25 Y

11W

28/08/11

6005.00

28/09/11

28/08/11

333232536

Harish

Harish

03/11

165/21/21 M

11W

28/07/11

255.00

12/09/11

28/08/11

333232537

Harish

Harish

03/11

165/22/22 M

11W

28/07/11

255.00

12/09/11

28/08/11

333232539

Harish

Harish

03/11

165/23/23 M

11W

28/07/11

255.00

12/09/11

28/08/11

333232540

Harish

Harish

03/11

165/24/24 M

11W

28/07/11

255.00

12/09/11

28/08/11

333236961

Harish

Harish

06/11

165/21/21 M

11W

28/07/11

2042.00

12/09/11

31/08/11

332979062

Harish

Harish

08/10

191/15/15 Q

11W

31/08/11

5000.00

30/09/11

Grand Total :

m : Policies with SSS Mode

M : Policies with Monthly Mode

Y : Policies with ECS Mode

Insure And Be Secure

62967.00

S : Cheque dishonoured/ Debit fail

Tax
Benef.