Premium Receipt

Receipt No.: 374121168JUN2201 | Receipt Date: 16-JUN-2022

Personal Details
Policy Number: 374121168 Email ID: dpkshiv012@gmail.com
Policyholder Name: Mr. Deepak Sharma PAN Number: BYPPD1581H
Address: C/O BHARAT BHUSHAN SHARMA,NEAR PETROL PUMP NEHRAN Customer GSTIN: Not Available
PUKHAR,DIYAL,KANGRA Current Residential State: Himachal Pradesh
SUITES 12 ISHWAR INDUSTRIAL
Kangra- 177104
Himachal Pradesh
Mobile Number: 9805219882
Policy Details
Plan Name: Max Life Smart Secure Plus Plan Policy Commencement Date: 11-JUN-2021
Life Insured: Mr. Deepak Sharma Policy Term: 50 Years Premium Payment Term: 30 Years
Premium Payment Frequency: Annual Date of Maturity: 11-JUN-2071 Modal Premium (incl. GST): ` 12,210.52
Late Payment Fee (incl GST): ` 0.00 Premium Received (incl. GST): ` 12,210.52
GST Details Connect for more details
Coverage Taxable SGST/UTGST CGST IGST Name
Type Value (`) Rate Amount (`) Rate Amount (`) Rate Amount (`) Axis Bank Ltd Hamirpur
Base 10,347.89 9% 931.31 9% 931.31 NA 0.00
Rider 0.00 9% 0.00 9% 0.00 NA 0.00
Late Payment 0.00 9% 0.00 9% 0.00 NA 0.00 Contact Number
Total GST Value: ` 1,862.62 18601205577
GSTIN: 02AACCM3201E1ZF GST Regd. State: Himachal Pradesh SAC CODE: 997132

Mudrank: Paid by e-Stamps Certificate no. 948/Issue Date: 4/04/2022/ Vide Treasury (E-CHALLAN) GRN NO.88821464

Total Sum Assured of base

plan and term rider (if any)

11-JUN-2022 to
` 60,00,000.00 ` 12,210.52 10-JUN-2023 11-JUN-2023
*Important Note:
1.For payment mode other than in cash, this receipt is conditional upon the credit in our account. Payment of premium amount does not constitute commencement of risk. The risk commencement starts
after acceptance of risk by us.
2.Amount received would be adjusted against the due premium as per terms and conditions of the policy.
3.Premiums may be eligible for tax benefits under section 80C/80CCC/80D/37(1) of the income Tax Act 1961. Kindly consult your tax advisor for more information. Tax benefits are liable to change
due to changes in legislation or government notification.
4.GST shall comprise CGST, SGST / UTGST or IGST (whichever is applicable) including cesses and levies, if any. All applicable taxes, cesses and levies, as per prevailing laws, shall be borne by you. For
GST purposes, this premium receipt is Tax invoice. Assessable Value in GST for Endowment First Year is 25%, Renewal Year is 12.5%, Single Premium Annuity is 10%, Term and Health is 100%.

Authorised Signatory
PRM21V6.0 09012022 PRODUCT UIN: 104N118V01
E.&O.E 2022-06-16.03.35.14.280981