Acknowledgment No: 1579590

Deposit Receipt
Policy Number: 502-7066983 26-Aug-2021

Receipting Date:

Dear

This is to acknowledge receipt of premium towards Policy Number 502-7066983 for an amount of Rs 26980.00, Vide Cheque Number 000080,
dated 23/08/2021 drawn towards BHARTI AXA LIFE INSURANCE COMPANY LIMITED

Payment Details Deposit INR 26980.00

Premium Received For MODE CHANGE _________________

INR 26980.00

FOR AND ON BEHALF OF

BHARTI AXA LIFE INSURANCE COMPANY LIMITED

Next Due Date:

RENEWAL STAMP PAID VIA MUDRANK MAINTAINED AT CENTRAL OFFICE

____________________________________________________________________________________________________________________

1. Tax Benifits can be availed under section 80C/80D and Section 10(10D) of Income Tax Act, 1961 and are subject to conditions mentioned there
in and amendments made there to from line to line

2. Service Tax and Cess shall be applicable as per prevalling tax laws

3. If the payment has been made other than in cash, this receipt is conditional upon realiziation of the same by the company

4. Life Cover shall be effective from the date of acceptance of risk

5. ALL ULIP requests received upto 3 P.M. would be considered from the same day NAV, and post 3 P.M. for the next working day

6. Insurance is the subject matter of soliciation

7. If you have paid your premium in advance, your premium receipt can be viewed after one working day of your premium due date.

8. In customer portal, premium paid will get reflected next day of premium settlement .

9. Deposit paid for reinstatement of policy may vary on account of underwritting of the policy during reinstatement.

10. Mode change of the policy will be effective only from Policy Anniversary Date.

Bharti AXA Life Insurance Company Limited

(Regd. No. 130), Regd. Address: Unit No. 1904, 19th Floor, Parinee Crescenzo, 'G' Block, Bandra Kurla Complex, BKC Road, Behind
MCA Ground, Bandra East, Mumbai -400051, Maharashtra.Service Unit address: Bharti AXA Life Insurance Company Limited, Spectrum
tower, 3rd Floor, Malad link road, Malad (west), Mumbai 400064. Maharashtra.

Website:www.bharti-axalife.com. Call Us on 18001024444 or SMS "Service" to 56677 and we will be in touch within 24 hours

You can also write to us at : service@bharti-axalife.com

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