Branch: 95E AT.

CHANAI
KADAM SHRIKANT GANPATRAO TQ. AMBAJOGAI
Agent : LIC0572495E
Leader :0098261 PIN:431517

0572495E Premium due & Default List for the Month of 10/2019 Page : 1

Sl. Policy Policy Holder Name D.o.C. Plan - M F.U.P. Instlmnt D G S T Total Estm.
No. Number Term od Premium ue Premium Comn
1 912878906 VANITA DNYANOBA SURNAR 28/02/2019 814-21 H 08/2019 2577 1 116.00 2693 644
2 912882584 RAM NAVNATH SHINDE 28/05/2019 836-21 Q 08/2019 3491 1 157.00 3648 873
3 912882706 VISHAL VINOD GAURKAR 07/06/2019 833-21 M 08/2019 1615 3 218.00 5063 1211
4 912879864 ANUPAM BHARATRAO CHOUDHARI 20/03/2019 833-22 Q 09/2019 2502 1 113.00 2615 626
CHANDRASHEKHAR SUDHAKARRAO KULTHE
5 912880291 25/03/2019 833-21 H 09/2019 8847 1 398.00 9245 2212
6 912882831 SIDHARTH MADHUKAR KASABE 15/06/2019 836-21 Q 09/2019 2815 1 127.00 2942 704
7 917630464 JALINDAR BALASAHEB KADAM 01/04/2019 814-17 H 10/2019 4994 1 225.00 5219 1249

Page Totals : Premium : 26841.00 G S T : 1354.00 Commission : 7519.00

Grand Totals : Premium : 26841.00 G S T : 1354.00 Commission : 7519.00

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95E-0572595E - (05/10/2019 16:26:52)