ICICI PRUDENTIAL LIFE INSURANCE COMPANY LIMITED

EMPLOYEE SETTLEMENT SHEET

Employee No. Name Date of Joining Date of Resignation Date of Separation LWP Recover (Days) BANK ACC/CHQ GRADE 40983 Basic HRA Conveyance Personal Pay CCA Spec. City Allowance Stat. Bonus Other Payments Performance Bonus FSC Bonus UM Bonus UM BDA QSRACE Relocation Allowance Talent Hunt Pinnacle Payout FCP Reimbursements Leave Travel Allowance Medical Car Expenses Telephone Others Leave Encashment @ Basic Rs -645 /30 x 0 days Notice Pay Recovery @ Basic Rs -645 /30 x 4500 days Notice Payment Deductions Provident Fund Prof. Tax Income Tax ESIC Reversal Entry Canteen Recovery Misc Income /Ded Leased (Laptop) Recovery FSC Laptop (Deposit) Recovery NCFM Recovery Other Recovery TOTAL Total Amount Due To Employee / (Recoverable from Employee) 5000587 ASHWINI MISHRA 21-Jul-11 14-Feb-12 15-Mar-12 0 005701564660 I Earnings 6,677 4,006 1,187 9,451 15,457 433 Deductions -

645 -

1,500 -

38,711

801 200 1,140 2,786 35,925