Renewal Premium Receipt - NON ULIP

Receipt No : GUT-GUNTUR/I00004175596 Receipt Date : 14-01-2020

Mr. TALLURI RAJA MOHAN . Branch Details: GUNTUR
SBI LIFE INSURANCE CO LTD
1ST FLOOR, D NO. 4-4-66, CHENNAIH AVENUE
ABOVE URBAN BANK,CHANDRAMOULI NAGAR, KORETE PADU MAIN ROAD
GUNTUR
ANDHRA PRADESH
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. TALLURI RAJA MOHAN .
Assignee : N.A.

Policy Details
UIN: 111N055V03 Policy Number: 35866975608
Plan: SBIL - Shubh Nivesh - RP Date of Commencement: 12-01-2017
Premium Frequency: Annual Channel: Bancassurance
Policy Term: 10 Distributor Name: Mr. ALOK RANJAN PADHI
Premium Payment Term: 10 Channel Code: 990073452
Sum Assured: 85000.00 Payment Type: Renewal

Premium Details
Base Amount(Rs.) CGST(Rs.) SGST/UGST(Rs.) IGST(Rs.) Total Amount(Rs.)
Premium(Rs.) 9503.00 106.91 106.91 0.00 9716.82
Late Fees#(Rs.) 0.00
Previous Excess(Rs.) 0.00
Total Amt Payable(Rs.) 9716.82
Amount Received(Rs.) 9717.00
Current 0.18
Excess/Shortage(Rs.)

Received with Thanks Rs.9717.00/- (Nine Thousand Seven Hundred Seventeen Only.) by way of NACH Payment

Next Premium Due Date : 12/01/2021

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 37AAFCS2530P1Z0. 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.)