Branch Code: 89G ROOM NO.

4, SHANTI

Agent Name : SHRI JANARDAN P GUPTA NIKETAN CHAWL,MAHATMA

Agent Code : LIC0132189G PHULE NGR, SAKINAKA

Premium Due List For The Agent LIC0132189G For 01/2022

S.No PolicyNo Name of Assured D.o.C Pln/Tm Mod FUP Flg InstPrem Due GST TotPrem EstCom

1 894404149 AKHIL ANANDSINGH RAWAT 11/11/2010 165/15 Mly 06/2021 4083.00 8 0.00 32664 1633.20
2 894021040 SAMEER JAMIL KHAN 14/03/2009 178/65 Mly 06/2021 854.00 8 0.00 6832 341.60
3 894404257 RINKLE A RAWAT 15/11/2010 165/15 Mly 06/2021 4083.00 8 0.00 32664 1633.20
4 894756764 AJAYKUMAR SHRINATH SINGH 03/08/2012 165/20 Hly 08/2021 6065.00 1 0.00 6065 303.25
5 893308527 FAIZ MOHAMMAD SHAIKH 19/02/2008 179/20 Qly 08/2021 951.00 2 0.00 1902 95.10
6 894746464 HARINDRA F GUPTA 20/10/2011 165/25 Mly 08/2021 255.00 6 0.00 1530 76.50
7 894753812 SAIPRASAD AKEN(LA) 25/04/2012 165/25 Mly 08/2021 1000.00 6 0.00 6000 300.00
8 894753922 SAMIR JAMIL KHAN 27/04/2012 165/20 Mly 08/2021 3062.00 6 0.00 18372 918.60
9 894409348 LALITA NARAYAN AKEN 28/03/2011 165/15 Mly 08/2021 1021.00 6 0.00 6126 306.30
10 895176289 SAMIR JAMIL KHAN 15/04/2013 165/25 Mly 10/2021 510.00 4 0.00 2040 102.00
11 893305472 KHAN SABITALI SABIRALI 23/10/2007 179/16 Qly 10/2021 798.00 2 0.00 1596 79.80
12 893305473 KHAN ARSHAD.MOHD ZAFAR.MOHD. 23/10/2007 179/16 Qly 10/2021 741.00 2 0.00 1482 74.10
13 893022592 GUPTA PRAMILA HARINDRA 27/10/2005 14/20 Qly 10/2021 671.00 2 0.00 1342 67.10
14 919519361 BRIJBALA SINGH 07/01/2021 914/20 Mly 11/2021 FY 2394.00 3 323.00 7505 1376.55
15 896026367 VANDANA SANJAY SINGH 17/10/2016 836/21 Mly 11/2021 942.00 3 64.00 2890 141.30
16 893296102 KHAN SIDRA 28/02/2007 102/15 Qly 11/2021 MT 849.00 1 0.00 849 42.45
17 894404734 WASIMJAHAN KHAN 28/11/2010 165/15 Mly 11/2021 817.00 3 0.00 2451 122.55
18 915158925 SANJAY SINGH 28/11/2019 814/25 Mly 11/2021 ST 352.00 3 24.00 1080 79.20
19 893291406 ISMAIL MIYAN MUNIRMIYAN 12/09/2006 75/20 Qly 12/2021 836.00 1 0.00 836 50.16
20 894025961 POONAM GUPTA 18/08/2009 179/20 Mly 12/2021 658.00 2 0.00 1316 65.80
21 894747327 RAVI HIRAVAN GUPTA 18/11/2011 165/20 Mly 12/2021 510.00 2 0.00 1020 51.00
22 894754376 ASHA DEY 18/05/2012 165/16 Mly 12/2021 3318.00 2 0.00 6636 331.80
23 894406552 ARVIND SHANKAR SOLANKI 19/01/2011 165/15 Mly 12/2021 1531.00 2 0.00 3062 153.10
24 894756143 NIZAMUDDIN HAMIDULLA MANSOORI 21/07/2012 165/20 Mly 12/2021 2042.00 2 0.00 4084 204.20
25 893293886 SMT. KHAN KHUSHBUNNISA SABJI ALI, 22/12/2006 179/16 Qly 12/2021 741.00 1 0.00 741 37.05
26 894034318 LALITA NARAYAN AKEN 22/03/2010 165/15 Mly 12/2021 500.00 2 0.00 1000 50.00
27 894756150 SAVARI ANTONYCAROLIN NADAR 23/07/2012 165/25 Mly 12/2021 500.00 2 0.00 1000 50.00
28 896025292 SAMIRA MEHBOOB SAYYED 23/08/2016 836/21 Mly 12/2021 932.00 2 42.00 1906 93.20
29 893735907 RESHMA ZIUDDIN SIDDIQUI 24/10/2008 165/15 Mly 12/2021 255.00 2 0.00 510 25.50
30 893308715 NARAYAN NARSAYYA AKEN 26/02/2008 179/16 Mly 12/2021 315.00 2 0.00 630 31.50
31 894024625 SHAHMOHAMMAD SHAIKH 26/06/2009 165/15 Qly 12/2021 1531.00 1 0.00 1531 76.55
32 894753819 SANDEEP KUMAR GUPTA 26/04/2012 165/20 Mly 12/2021 2042.00 2 0.00 4084 204.20
33 917984614 RAJKUMAR FOOLCHAND GUPTA 26/10/2020 933/17 Mly 12/2021 ST 622.00 2 28.00 1272 93.30
34 893293942 SRI KHAN SHAHIDALI SABIR ALI, 27/12/2006 179/16 Qly 12/2021 791.00 1 0.00 791 39.55
35 894750968 HARINDER F GUPTA 27/02/2012 165/25 Mly 12/2021 500.00 2 0.00 1000 50.00
36 894760199 SAMROZ SHERU KHAN 27/11/2012 165/16 Mly 12/2021 500.00 2 0.00 1000 50.00
37 895173639 SUBODH RAM GIRI 27/02/2013 165/20 Mly 12/2021 2042.00 2 0.00 4084 204.20
38 893294151 KASIM ALI KHAN 28/12/2006 102/20 Qly 12/2021 614.00 1 0.00 614 30.70
39 893294152 MOHD. HASSAN KHAN 28/12/2006 102/16 Qly 12/2021 791.00 1 0.00 791 39.55
40 893294158 MOHD. HUSSAIN KHAN 28/12/2006 102/16 Qly 12/2021 791.00 1 0.00 791 39.55
41 893306294 MUKESH GUPTA 28/11/2007 179/20 Mly 12/2021 310.00 2 0.00 620 31.00
42 893732488 DILAWER ALI SHAIKH 28/06/2008 165/15 Mly 12/2021 1021.00 2 0.00 2042 102.10
43 893736960 NARAYAN NARSAYYA AKEN 28/11/2008 165/15 Mly 12/2021 408.00 2 0.00 816 40.80
44 893739761 ASHA DEY 28/01/2009 178/63 Mly 12/2021 437.00 2 0.00 874 43.70
45 894395870 LAXMAN MARUTI BEDKODE 28/03/2010 165/15 Mly 12/2021 306.00 2 0.00 612 30.60
46 894396190 NARAYAN NARSAIYA AKEN 28/03/2010 165/15 Mly 12/2021 500.00 2 0.00 1000 50.00
47 894409274 NARAYAN NARSAYYA AKEN 28/03/2011 165/15 Mly 12/2021 2042.00 2 0.00 4084 204.20
48 894409630 VIJAY BIRJU YADAV 28/03/2011 165/15 Mly 12/2021 1021.00 2 0.00 2042 102.10

Page Total Premium : 184179 G S T : 481 Estimated Comn : 10268.21

( Page No : 1 | 89G | LIC0132189G | 16408813100901 | Due Month 01/2022)
S.No PolicyNo Name of Assured D.o.C Pln/Tm Mod FUP Flg InstPrem Due GST TotPrem EstCom

49 894747659 ZEENAT SIKANDER SHAIKH 28/11/2011 165/15 Mly 12/2021 1500.00 2 0.00 3000 150.00
50 894750976 RAJKUMAR F GUPTA 28/02/2012 165/25 Mly 12/2021 500.00 2 0.00 1000 50.00
51 894752892 VINEETA S SAROJ 28/03/2012 165/20 Mly 12/2021 510.00 2 0.00 1020 51.00
52 894752894 LALLANPRASAD GUPTA 28/03/2012 165/16 Mly 12/2021 2042.00 2 0.00 4084 204.20
53 894752900 SHIVPRAKASH K SAROJ 28/03/2012 165/20 Mly 12/2021 1021.00 2 0.00 2042 102.10
54 894754644 SABITALI SABIRALI KHAN 28/05/2012 165/16 Mly 12/2021 3981.00 2 0.00 7962 398.10
55 894755421 MANOJ KUMAR GUPTA 28/06/2012 165/25 Mly 12/2021 306.00 2 0.00 612 30.60
56 895175183 MAMTA MAHENDRA GUPTA 28/03/2013 165/20 Mly 12/2021 1021.00 2 0.00 2042 102.10
57 895175966 ANJALI K SINGH 28/03/2013 165/25 Mly 12/2021 1021.00 2 0.00 2042 102.10
58 895190198 ZEENAT SIKANDER SHAIKH 28/03/2014 814/15 Mly 12/2021 1740.00 2 78.00 3558 174.00
59 895646127 POOJA GUPTA 28/03/2015 827/20 Mly 12/2021 562.00 2 25.00 1149 42.14
60 895646128 MAMTA MAHENDRA GUPTA 28/03/2015 827/20 Mly 12/2021 584.00 2 26.00 1194 43.80
61 895966232 NIZAMUDDIN HAMIDULLAH MANSOORI 28/12/2015 827/16 Mly 12/2021 805.00 2 36.00 1646 60.36
62 896027089 RAVI BHANUDAS KAMBLE 28/11/2016 820/20 Mly 12/2021 664.00 2 30.00 1358 66.40
63 896027091 HARESH SOMNATH MANGALE 28/11/2016 821/25 Mly 12/2021 990.00 2 45.00 2025 99.00
64 915158923 MANOJ KUMAR DAYARAM GUPTA 28/11/2019 814/21 Mly 12/2021 ST 415.00 2 19.00 849 62.26
65 915159026 VINOD DAYARAM GUPTA 28/11/2019 814/25 Mly 12/2021 ST 354.00 2 16.00 724 53.10
66 915159213 ARTIKENIGO J NADAR 28/11/2019 814/25 Mly 12/2021 ST 356.00 2 16.00 728 53.40
67 893733591 RADHESHYAM BARMADIN DHOBI 04/08/2008 165/15 Mly 01/2022 267.00 1 0.00 267 13.35
68 893732644 AKTHARUNNISA R SHAIKH 07/07/2008 165/15 Mly 01/2022 510.00 1 0.00 510 25.50
69 894754128 SUNITA SURESH CHAVAN 07/05/2012 165/16 Mly 01/2022 510.00 1 0.00 510 25.50
70 895173966 GANESH OMIKHATIK PARDESHI 07/03/2013 165/20 Mly 01/2022 510.00 1 0.00 510 25.50
71 893733714 DILAWERALI HAIDERALI SHAIKH 08/08/2008 165/15 Mly 01/2022 510.00 1 0.00 510 25.50
72 915158246 VIJAY YADAV 08/11/2019 843/20 Mly 01/2022 ST 487.00 1 11.00 498 36.53
73 915158247 VIJAY YADAV 08/11/2019 814/21 Mly 01/2022 ST 429.00 1 10.00 439 32.18
74 919519982 ARCHANA CHANDRASHEKHAR SINGH 08/02/2021 921/25 Mly 01/2022 FY 2473.00 1 111.00 2584 494.60
75 893732692 IMTIAZ AHMED NASIRALI 09/07/2008 165/15 Mly 01/2022 250.00 1 0.00 250 12.50
76 894406163 BALRAM RAMDEO YADAV 10/01/2011 165/15 Mly 01/2022 510.00 1 0.00 510 25.50
77 895645256 VIJAY BIRJU YADAV 10/03/2015 827/15 Mly 01/2022 859.00 1 19.00 878 32.21
78 895645257 SAROJANI VIJAY YADAV 10/03/2015 827/15 Mly 01/2022 854.00 1 19.00 873 32.02
79 895641309 GIRISH SOLANKI 12/09/2014 820/20 Mly 01/2022 662.00 1 15.00 677 33.10
80 893732806 SALMAN AHMED(LA) 14/07/2008 165/15 Mly 01/2022 250.00 1 0.00 250 12.50
81 894745377 SANJAY C SINGH 14/09/2011 165/35 Mly 01/2022 3062.00 1 0.00 3062 153.10
82 896026318 VIJAY YADAV 14/10/2016 836/21 Qly 01/2022 6950.00 1 156.00 7106 347.50
83 896026319 VIJAY YADAV 14/10/2016 814/20 Qly 01/2022 5130.00 1 115.00 5245 256.50
84 893294665 BEG AZHARULLAH 15/01/2007 179/20 Yly 01/2022 3503.00 1 0.00 3503 175.15
85 893732886 BADRUNNISSA IMTIAZ ALI 15/07/2008 165/15 Mly 01/2022 255.00 1 0.00 255 12.75
86 893732895 PARVEZ AHMED(LA), 15/07/2008 165/15 Mly 01/2022 250.00 1 0.00 250 12.50
87 894031479 SHAHMOHAMMAD SHAIKH 15/01/2010 165/15 Qly 01/2022 750.00 1 0.00 750 37.50
88 894408833 MOHDAYUB MOHDFAROOQUE SAIFEE 15/03/2011 165/25 Mly 01/2022 1500.00 1 0.00 1500 75.00
89 894751725 RAMBARAN YADAV 15/03/2012 165/20 Mly 01/2022 510.00 1 0.00 510 25.50
90 894751731 SAQIB ABUTALIB KHAN 15/03/2012 165/20 Mly 01/2022 500.00 1 0.00 500 25.00
91 895176281 SAIPRASAD NARAYAN AKEN 15/04/2013 165/35 Mly 01/2022 500.00 1 0.00 500 25.00
92 895176285 ARTIK ENIGO-J NADAR 15/04/2013 165/25 Mly 01/2022 510.00 1 0.00 510 25.50
93 917982144 LALMAN BALIRAM YADAV 16/01/2020 836/21 Yly 01/2022 ST 16486.00 1 371.00 16857 1236.45
94 917982172 ANIL JANDHAN YADAV 17/01/2020 836/21 Yly 01/2022 ST 16633.00 1 374.00 17007 1247.48
95 919518210 SARITA BABLU.NIRMAL KANOJIA 17/11/2020 914/20 Mly 01/2022 ST 435.00 1 10.00 445 32.63
96 896128621 LOURDU SASIKALA NADAR 18/07/2017 836/25 Mly 01/2022 794.00 1 18.00 812 39.70
97 896129282 LOURDU SASIKALA NADAR 18/07/2017 836/25 Mly 01/2022 794.00 1 18.00 812 39.70
98 896128701 PAULIN.ANITA J.J.BOSCO NADAR 21/07/2017 836/25 Mly 01/2022 1190.00 1 27.00 1217 59.50
99 893022593 BEENA RAJKUMAR GUPTA 27/10/2005 14/20 Qly 01/2022 664.00 1 0.00 664 33.20
100 894750979 PRADEEP DEEPCHAND GUPTA 28/02/2012 165/25 Mly 01/2022 2042.00 1 0.00 2042 102.10
101 896028660 MAHENDRA PARASNATH GUPTA 28/01/2017 836/25 Hly 01/2022 7999.00 1 180.00 8179 399.95

Page Total Premium : 118027 G S T : 1745 Estimated Comn : 7032.86

( Page No : 2 | 89G | LIC0132189G | 16408813100901 | Due Month 01/2022)
S.No PolicyNo Name of Assured D.o.C Pln/Tm Mod FUP Flg InstPrem Due GST TotPrem EstCom

102 896028661 MAHENDRA PARASNATH GUPTA 28/01/2017 827/20 Hly 01/2022 3939.00 1 89.00 4028 147.71
103 896028716 MAMTA MAHENDRA GUPTA 28/01/2017 814/18 Hly 01/2022 2946.00 1 66.00 3012 147.30

Page Total Premium : 7040 G S T : 155 Estimated Comn : 295.01

Grand Total Premium : 309246 G S T : 2381 Estimated Comn : 17596.08

FY - First year Prem. ST-> 2nd,3rd Year Prem. LP : Last Premium. MT : Matures after this due.

( Page No : 3 | 89G | LIC0134389G | 16408813100901 | Due : 1-2022 )