STATEMENT OF COMMISSION

Commission generated as on 26 Oct 2019

Name : Leela Dhar, Singh Advisor Code : 00743897

Address : 10 Gali No21 Manager Code : 00294634

0
Bank A/c No. : XXXXX 1346
..
Bank Name : HDFC Bank,NEW DELHI NEW FRIENDS
Delhi
COLONY
Pincode : 110044 License No : ICI00743897 Expiry date : 11 Jul 2024

PAN No : AUWPS3434L

If any of the details above are incorrect or have changed, please inform us immediately through any of our service centres.

Customers having ICICI Bank accounts can now pay their first premium deposit and renewal premium using their
mobile phones. Simply dial *525*11# to pay. To know more, SMS MPAY to 56767.

Summary of Commissions

Sr.No Particulars Amount

A New business commission 350.00

B Renewal commission 0.00

C GST (B*GST Rate) 0.00
D Group commission 0.00
E Adjustment where GST is applicable 0.00
F Rewards 0.00
G Adjustment where GST is not applicable 0.00
H Total commission & rewards for TDS (A + B + D + E + F + G) 350.00
I TDS -19.00
J Professional Tax 0.00
K Adjustment where GST & TDS is not applicable 0.00
L Final net commission & rewards (H-C+I+J+K) 331.00

Sr.No GST borne by the Company Amount

M GST on New Business (A*GST Rate) 63.00

N GST on Group Business (D*GST Rate) 0.00
O Adjustment where GST Applicable (E*GST Rate) 0.00
P GST on Rewards (F*GST Rate) 0.00

Total 63.00

Sum of New Business Commission and Productivity Linked Commission(Total: Rs 350.00 )

Comm Policy Policy No Policy Holder Name Prod Product Freq Term Premium Commission Transaction Details
Accural Issuance code Name Amount Amount
date Date

21/10/19 21/06/19 41829782 . BABY PRIYANKA UA8 ICICI Pru Smart Life 12 20N 5000.00 350.00 New Business Commission

Please provide your a/c mandate at the nearest ICICI Prudential branch to get commission on weekly basis.
Please note that the Company has duly paid GST under reverse charge on the above commission in accordance with the law.
ICICI Prudential Insurance Company Limited.
Communication Address: Unit No. 1A & 2A, Raheja Tipco Plaza, Rani Sati Marg, Malad(East), Mumbai-400097
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Registered Office: ICICI Prulife Towers,1089, Appasaheb Marathe Marg,Prabhadevi,Mumbai-400 025