Renewal Premium Receipt - ULIP

Receipt No : I00002778223 Receipt Date : 18-11-2019

Mr. PAWAN SUDHEENDRA KULKARNI Branch Details: BANGALORE 2
SBI LIFE INSURANCE CO LTD
Plot No. 96/04, 3rd Floor,
Chandrasales, South End Road, Basavangudi,
BANGALORE
KARNATAKA
Please note that your servicing branch has shifted. The new address of your servicing branch is given above.
You may approach either your servicing branch or any of our other branches for all your servicing needs and premium payment.
Life Assured : Mr. PAWAN SUDHEENDRA KULKARNI
Assignee : N.A.

Policy Details
UIN: 111L094V01 Sum Assured: 0
Policy Number: 1H340512002 Channel: Bancassurance
Plan: SBIL - Retire Smart Distributor Name: Mr. NARASIMHAREDDY BOGALA
Date of Commencement: 16-11-2017 Channel Code: 990829206
Premium Frequency: Annual Total Premium: 400,000.00
Policy Term: 10 Premium Paying Term: 5

Received with Thanks Rs.400000.00/- (Four Lakh Only.) by way of SBI EPAY Online Payment

Total Premium Allocated(Rs.) 400,000.00

Less:- Allocation Charges(Rs.) 16000.00
Less:- GST on Charges(Rs.) 2880
CGST: 1,440.00 SGST/UGST: 1,440.00 IGST: 0.00
Net Invested Amount(Rs.) 381,120.00

Next Premium Due Date : 16/11/2020

UNIT ALLOCATION STATEMENT

Opening Balance Amount Invested Closing Balance
Fund Name SFIN NO NAV Units Fund % Units Fund Units Fund Value
Value Value
SBI Life Equity Pension ULIF027300513PEEQIT2FND11 19.9863 7496.44 149826.1 16.82 3207.42 64104.46 10703.86 213930.56
Fund II 1

SBI Life Bond Pension ULIF028300513PENBON2FND1 16.4746 40053.22 659860.7 79.02 18280.56 301164.9 58333.78 961025.69
Fund II 11 8 1
SBI Life Money Market ULIF029300513PEMNYM2FND 15.0274 2307.6 34677.23 4.16 1054.79 15850.75 3362.4 50528.13
Pension Fund II 111
Total 844364.1 100 381120.1 1225484.38
1 2

Authorized Signatory

Notes:
- #-Late fees is inclusive of GST if applicable.
- The validity of this receipt is subject to realization of cheque. The amount held in policy deposit does not earn any interest.
- In case of outstation cheques,allocation amount will be done on the date of adjustment of premiums or the realizatin of cheque whichver is later.
- GST Registration Number 29AAFCS2530P1ZX. SAC Code of Life Insurance Service 991732
- As per GOI Notification, GST has been levied on your insurance policy @18% on premium or charges.(or as applicable) w.e.f. 01.07.2017 in the case of endowment
policy, the taxable value is 25% of the premium. Please refer SBI Life website for deails.
- In case of revival of the policy, the risk cover under the base policy and the rider covers, if any, will recommence from the date of revival. Any contingencies which may
have happened while the policy was lapsed will NOT be covered even if the claim is made or intimated after the policy has been revived.
- Consolidated Stamp duty paid vide Mudrank receipt no CSD/100/2019/3617/19 dated 26th Jul 2019

SBI Life Insurance Company Limited

IRDAI Regn No. 111. CIN: L99999MH2000PLC129113.
Central processing Centre: 7th Level(D Wing) & 8th Level, Seawoods Grand Central, Tower 2 Plot No R-1, Sector 40, Seawoods, Nerul Node, Navi Mumbai-400706
Dist. Thane, Maharashtra, Website - www.sbilife.co.in & Email at info@sbilife.co.in
Toll free no. : 1800 267 9090 (Customer Service Timings: 9:00 a.m. to 9:00 p.m.)