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Branch: 95E AT.PO.

CHANAI
KULTHE SHANKAR SHIVAJI TQ. AMBAJOGAI
Agent : LIC0569695E
Leader :0098261 PIN:431517

0569695E Premium due & Default List for the Month of 02/2020 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 917630005 SOMNATH BHAGWANRAO SATHE 14/08/2019 836-25 M 10/2019 821 5 185.00 4290 1026
2 912882624 BALIRAM MAHADEV LONDHE 28/05/2019 836-21 H 11/2019 6060 1 273.00 6333 1515
3 917630004 KRANTI DINESHRAO KADAM 14/08/2019 844-20 Q 11/2019 697 2 63.00 1457 349
4 912880283 RANI ANKUSH SHEP 27/03/2019 836-21 Q 12/2019 2797 1 126.00 2923 699
5 912113502 SUREKHA GOVINDRAO BHISE 11/01/2019 833-25 H 01/2020 13331 1 300.00 13631 1000
6 912883588 SANJIVANI DIPAK MORE 26/07/2019 833-21 Q 01/2020 1405 1 63.00 1468 351
7 917629812 ANJALI BHAGWANRAO KULKARNI 05/08/2019 836-21 Q 02/2020 3378 1 152.00 3530 845
8 917630006 JWALAPRASAD SHIVAJI KULTHE 14/08/2019 843-16 H 02/2020 1866 1 84.00 1950 467
9 917658807 DHANANJAY BALASAHEB KADAM 28/11/2019 843-20 Q 02/2020 700 1 32.00 732 175
10 917658808 VISHAL HANUMANT KADAM 28/11/2019 843-20 Q 02/2020 700 1 32.00 732 175
11 917658809 SANKET DNYANOBA INGLE 28/11/2019 843-20 Q 02/2020 697 1 31.00 728 174
12 917658811 AVINASH ANANT PUJARI 28/11/2019 843-20 Q 02/2020 699 1 32.00 731 175
13 917658812 UMESH OMKAR HAIGALE 28/11/2019 843-20 Q 02/2020 700 1 32.00 732 175
14 917658813 MAHADEV VASANTRAO KADAM 28/11/2019 843-20 Q 02/2020 699 1 32.00 731 175
15 917658814 KIRAN BRAHMACHARI INGLE 28/11/2019 843-20 Q 02/2020 699 1 32.00 731 175
16 917658876 SAROJA RAJABHAU PAWAR 28/11/2019 844-20 Q 02/2020 699 1 32.00 731 175
17 917658877 DHARMRAJ SUBHASH UBALE 28/11/2019 843-20 Q 02/2020 703 1 32.00 735 176
18 917658878 SAMEER SHASHIKANT BHASKARE 28/11/2019 814-19 Q 02/2020 1401 1 63.00 1464 350
19 917658879 PUYUSH RAHUL AMBEKAR 28/11/2019 843-20 Q 02/2020 697 1 31.00 728 174
20 917658880 ROHIT RAJENDRA GODAM 28/11/2019 843-20 Q 02/2020 700 1 32.00 732 175
21 917658881 PRASHANT GANPATRAO KADAM 28/11/2019 843-20 Q 02/2020 699 1 32.00 731 175
22 917658953 SHOBHA DHANANJAY KADAM 28/11/2019 844-20 Q 02/2020 699 1 32.00 731 175

Page Totals : Premium : 40847.00 G S T : 1723.00 Commission : 8876.00


Grand Totals : Premium : 40847.00 G S T : 1723.00 Commission : 8876.00

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95E-0569895E - (04/02/2020 16:22:58)

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