Original for Recipient/Duplicate for supplier

Indrasen Dewangan
AAMI House, Near Twinkle Kids School
Friends Nagar, Mowa, Raipur

Raipur - 492007
Chhattisgarh

Date of Invoice & Invoice Number 04/09/2021 & 21AL000010286631

Name of Supplier Aegon Life Insurance Company Ltd
GSTIN Number of Supplier 27AAGCA3203J1ZY
Place of Supply (Name of State) Chhattisgarh
State code CG
Location of Supplier MH
Amount of GST Subject to Reverse Charge NA
SAC 997132
Name of the Policy Holder Indrasen Dewangan
Product Name Aegon Life iTerm Insurance Plan
138N016V06
Policy Number 519020651706
Branch Name Head Office
Date of commencement 04/03/2019
Date of Payment 04/09/2021
Next Premium Due Date 04/10/2021
Frequency Mode Monthly
Payment Mode EBPP
 Product Name Net SGST@ CGST@ IGST@ UTGST@ Total
Premium 0% 0% 18% 0% Premium
Aegon Life iTerm 1101.0 0.0 0.0 198.0 0.0 1299.0
3 Plan
AEGON Life AD 157.0 0.0 0.0 28.0 0.0 185.0
Rider V03
Total 1258.0 0.0 0.0 226.0 0.0 1484.0
Total Premium Aegon Life iTerm 3 Plan Total Premium Rs.(in Aegon Life
Rs. (in words) figures) iTerm 3
Plan

AEGON Life AD Rider V03 AEGON

Life AD
Rider V03

Total Total

The revenue stamp of Re.1 (Re.One only) is paid via certificate no.
CSD/193/2020/3055 Dated 21/12/2020

Regards,
Customer Service Team
Aegon Life Insurance Company Limited

Note:
- Premium paid under this policy is eligible for tax benefit under section 80C/80CCC/ 80D as applicable under Income Tax
Act 1961. Tax laws are subject to amendments from time to time. Please consult your tax advisor for implications. You can
use this receipt as proof for claiming tax benefits.
- IRDAI Company Registration No: 138
- In case paid via Cheque/Demand Draft,this receipt is subject to realization.
- Goods & Services Tax, at applicable rates.
- Tax benefit is subject to provisions of Income Tax Act.

1800 209 90 90 (Toll free,

Registered Office: Aegon Life Tel: +91 226118 0100,
Insurance Company Limited. A - Fax: +91 2261180200/300,
201, 2nd Floor, Leela Business Corporate Identity No:
Park, Andheri-Kurla Road, U66010MH2007PLC169110.
Andheri (E), Mumbai - 400059. IRDAI Company Registration
Number: 138
9 am to 7 pm, Mon to Sat)
MENU to 9221 - 010101
customer.care@aegonlife
.com
www.aegonlife.com

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