The Oriental Insurance Company Ltd.

DO TUTICORIN NO 6-A, FIRST FLOOR , AVM BUILDING ,NORTH COTTON ROAD , , TUTICORIN , 628001
GST NO : 33AAACT0627R3Z4
RECEIPT

Office Code & Name : 480200 - DO TUTICORIN Bank Code : 9100(C-PORTAL-01)

Collection No. : 51-01/1032303399 Posted Doc No. : 1032303396
Collection Date : 29/10/2019 14:20 Posted Doc Dt.. : 29/10/2019
Received with thanks From Sh./Smt./ M/s. : MR.K.RAJAGOPAL
The Sum of : Indian Rupees One Thousand Seven Hundred Twenty-Two Only

Towards the following : Premium collections

Sl Dept. Policy No. Policy End/Ren/Dec/ Dev. Off. Code Source Amount C/D GL SL Code Pay Bank Bank Instrument Instr. Dt./CC
No. Code Status Claim No. Code Collected Code Mode Name Branch No. Exp. Dt.

1 31 2020/4786 New NA0000001718 1,722.00 C 5083 AA0000000001 CC ICICI ***********00 08/11/2019

Policy 91
Total 1,722.00

Vehicle Make : SUZUKI ACCESS UZ 125 FOR THE ORIENTAL INSURANCE COMPANY LTD
Regn. Number : TN-69-BD-9388
GST : Rs. 262

GST NO Of Insured : 33BAKPR8583C1ZE

Policy Type / Zone : PACKAGE POLICY --- ZONE B

This Receipt is Electronically Generated

CIN: U66010DL1947GOI007158 IRDA Regn. No. 556 - All the amounts mentioned in this report are in Indian Rupees