RENEWAL PREMIUM RECEIPT

Receipt No: Z9961959 Client ID: 58024147 Date: 10/09/2013
Policy No: 14573554 Plan Description: HDFCSL Classic Assure

Koppisetty, Ashok Sahrat
3-128 Itud Lane
Sarada Nagar
Baligattam Narsipatnam
Visahapatnam - 531116
9550820019 /9550297590

Dear Koppisetty, Ashok Sahrat
Life Assured : Koppisetty, Ashok Sahrat

We acknowledge with thanks, receipt of an amount of Rs. ******12,186.00 by Online Payment towards renewal premium. as
regular premium towards your policy
Benefit Opted For Premium Received(Rs) Tax benefit available under the Income Tax Act, 1961
Classic Assure Benefit 12,000.00 Section 80C
Service tax and levies 186

For HDFC Standard Life Insurance Company Limited Renewal Premium Rs. ******12,186.00
Total Amount Received Rs. ******12,186.00
Balance Amount adjusted Rs. ***********0.00
*This is an electronically generated duplicate premium Advance Payment received Rs. ***********0.00
receipt and does not require any signature Premium adjusted for the period to
Next premium due 29/08/2014
Premium payment frequency Annual
Service Tax Registration Number M-IV / ST / IAS - LIFE / 2

Lodha Excelus. Mahalaxmi.M. N . Mumbai . 13th Floor.Any Phone) or 60007777 (Local call . Mumbai- 400011.M. Joshi Marg. Maharashtra.HDFC STANDARD LIFE INSURANCE COMPANY LIMITED Correspondence Address: 11th Floor. Apollo Mills Compound.MTNL/BSNL)/1800-209-7777(Toll Free .400 011. Office: Lodha Excelus. Apollo Mills Compound. Mahalaxmi. Joshi Road. Regd. N.Non BSNL/MTNL) . India Policy Servicing Helpline: 1800-228-228 (Toll free .