Agent (0208917J) Policies Statement

Calculation Date: 01/05/2023

Dated: Tuesday, 09 May 2023

SN Pol Holder DOB Pol No AgCd CommDt P/T/PP Sum Mode FUP Premium

1 KAYAAN GULIA LA 09-05-2019 148342591 0208917J 15/04/21 934/24/19 5,00,000 H 15/04/23 12,288
Mobile : Address: S/O SH AJAY SINGH P 778,VPO-KISHANGARH CHANDIGARH UT 160101 Policy Status: In Force Nominee:

2 MANJEET KAUR 07-04-1974 146481122 0208917J 28/10/20 920/20/15 1,00,000 H 28/04/23 4,546
Mobile : Address: W/O SH KULDEEP SINGH H NO-35,WARD NO-14,INDRA BASTI PEHOWA,DT-KURUKSHETRA HARYANA 136128 Policy
Status: In Force Nominee: RAVINDER SINGH

3 ROHAN KANGER 15-08-1992 145394943 0208917J 03/06/20 936/25/16 5,00,000 M 03/05/23 1,976
Mobile : Address: S/O SH ACHHBAL VILL KHANODA PO TEEK TEH DT KAITHAL 136027 Policy Status: In Force Nominee: KAVITA DEVI

4 RINKU 07-03-1995 134682130 0208917J 07/07/19 833/21/18 5,00,000 M 07/05/23 2,317

Mobile : Address: S/O SH SULTAN SINGH VILL-KHANODA, PO-TEEK TEH DT-KAITHAL, HRY 136027 Policy Status: In Force Nominee:
NANHI DEVI

5 PRABHMAN SINGH 31-10-2013 102287570 0208917J 15/03/18 834/21/16 2,00,000 M 15/05/23 1,028
LA
Mobile : Address: S/O SH PANKAJ P VILL-DAHA, PO-MADHUBAN TEH DT-KARNAL, HR 132037 Policy Status: In Force Nominee:

6 MINAKSHI DEVI 09-04-1986 102287571 0208917J 15/03/18 836/21/15 2,00,000 M 15/05/23 961
Mobile : Address: W/O SH PANKAJ VILL-DAHA, PO-MADHUBAN TEH DT-KARNAL, HR 132037 Policy Status: In Force Nominee: SH
PANKAJ

7 SHAM PAL 09-10-1984 125266868 0208917J 15/10/18 833/21/18 5,00,000 M 15/05/23 2,459
Mobile : Address: S/O SH SURINDER PAL 467, WARD NO -17 GURU NANAK COLONY PEHOWA DT KKR 136128 Policy Status: In Force
Nominee: SAKSHI

8 HARDEEP KAUR 21-02-1988 158822822 0208917J 15/11/22 936/21/15 2,00,000 M 15/05/23 990
Mobile : Address: W/O SH DHARMINDER SINGH VILL-TALHERI,PO-MALIKPUR TEH-PEHOWA,DT-KURUKSHETRA HRY 136128 Policy
Status: In Force Nominee: DHARMINDER SINGH

9 ANITA 03-12-1982 102287717 0208917J 20/03/18 836/21/15 2,00,000 M 20/05/23 968

Mobile : Address: W/O VIVEK VILL-AMLOHA, PO-SILI KALAN TEH-JAGADHARI, DT-YAMUNANAGAR 135133 Policy Status: In Force
Nominee: SH VIVEK
SN Pol Holder DOB Pol No AgCd CommDt P/T/PP Sum Mode FUP Premium

10 MANGA RAM 01-01-1978 156546484 0208917J 25/05/22 936/21/15 2,00,000 Y 25/05/23 11,950
Mobile : Address: S/O SH KISHNA NEAR ANIMAL HOSPITAL,TEEK DT-KAITHAL HRY 136027 Policy Status: In Force Nominee: SURESHO
DEVI

11 RAJINDER KUMAR 06-07-1960 119308594 0208917J 28/05/18 830/12/9 3,50,000 M 28/05/23 3,472
Mobile : Address: S/O SH RAM SINGH VILL.DAHA,PO -MADHUBAN, TEH DISTT KARNAL 132037 Policy Status: In Force Nominee:
SHAKUNTLA DEVI

12 PARAMJEET KAUR 01-01-1980 125266869 0208917J 28/11/18 820/20/15 5,00,000 H 28/05/23 20,380
Mobile : Address: W/O SH BHAG SINGH VPO THANA,TEH PEHOWA, DISTT KKR 136128 Policy Status: In Force Nominee: BHAG SINGH

13 HARSHIT SETHI 19-12-1997 125269934 0208917J 28/05/19 833/21/18 2,00,000 Y 28/05/23 11,025
Mobile : Address: S/O SH VIJAY KUMAR 412, W.NO-5, GALI NO-2,NAND COLONY-2 PEHOWA, DT KURUKSHETRA 136128 Policy Status: In
Force Nominee: SUMAN

14 HARVINDER KAUR 10-12-1990 134681566 0208917J 28/05/19 836/16/10 12,00,000 Y 28/05/23 1,02,567
Mobile : Address: W/O SAHJAD SINGH NEAR GURUDWARA VPO BAKAL, TEH PUNDRI DT KAITHAL 136043 Policy Status: In Force
Nominee: SAHJAD SINGH

15 AMANPREET 25-03-1991 134681734 0208917J 28/05/19 833/21/18 5,00,000 H 28/05/23 13,957

SINGH
Mobile : Address: S/O SH JAGJIT SINGH VILL-JAGATPURA, PO-HARIGARH BHORAKH TEH-PEHOWA, DT-KURUKSHETRA, HR 136128
Policy Status: In Force Nominee: DALJIT KAUR

16 HARJINDER SINGH 03-07-1988 134682729 0208917J 28/05/19 820/20/15 1,50,000 H 28/05/23 6,113
Mobile : Address: S/O SH BALBIR SINGH VPO THASKA MIRANJI TEH ISMAILABAD DT KKR 136129 Policy Status: In Force Nominee:
DAWINDER KAUR

17 RAJ KUMAR 16-06-1982 146481959 0208917J 28/11/20 936/21/15 2,00,000 H 28/05/23 5,822
Mobile : Address: S/O SH RAMESHWAR DASS 210/162,WARD NO-7,NAND COLONY NO-1 PEHOWA,DT-KURUKSHETRA HARYANA 136128
Policy Status: In Force Nominee: RAJNI

18 RAJNI 15-01-1983 146481960 0208917J 28/11/20 936/21/15 2,00,000 H 28/05/23 5,822

Mobile : Address: W/O SH RAJ KUMAR 210/162,WARD NO-7,NAND COLONY NO-1 PEHOWA,DT-KURUKSHETRA HARYANA 136128 Policy
Status: In Force Nominee: RAJ KUMAR

19 SUMAN RANI 02-04-1981 149062366 0208917J 28/05/21 945/60/60 7,50,000 H 28/05/23 30,558
Mobile : Address: W/O SH SUKHDEV SINGH VILL-SANDHOLA,PO-SANDHOLI DT-KURUKSHETRA HARYANA 136128 Policy Status: In Force
Nominee: SUKHDEV SINGH

20 PARVEEN KUMAR 08-09-1984 144930914 0208917J 28/12/19 836/25/16 5,00,000 H 28/06/23 12,008
Mobile : Address: S/O SH DHRAM PAL 684 WARD NO-05, NAND COLONY NO-2 PEHOWA KURUKSHETRA 136128 Policy Status: In Force
Nominee: SEEMA RANI
SN Pol Holder DOB Pol No AgCd CommDt P/T/PP Sum Mode FUP Premium

21 ANIL KUMAR 02-08-1985 148341977 0208917J 28/03/21 943/20/20 75,000 Q 28/06/23 729
Mobile : Address: S/O SH ISHWAR CHAND 181,W.NO-15,NR SHIV MODEL SCHOOL,PRANCHI ROAD,MODEL TOWN,PEHOWA,KKR HRY
136128 Policy Status: In Force Nominee: NEELAM DEVI

22 NEELAM DEVI 15-04-1986 148341978 0208917J 28/03/21 944/20/20 75,000 Q 28/06/23 724
Mobile : Address: W/O SH ANIL KUMAR 181,W.NO-15,NR SHIV MODEL SCHOOL,PRANCHI ROAD,MODEL TOWN,PEHOWA,KKR HRY 136128
Policy Status: In Force Nominee: ANIL KUMAR