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Premium Payment Receipt

Customer Copy

Dear Mr./Ms. JITIN TOTEJA

The following transaction has been completed successfully.

Request Type : Premium Payment

Policy Number : 0000000544452

Customer ID : 6908301

No of Premiums : 3

Premium : 2835.00

Premium Paid From : 01/08/2023

Premium Paid Till : 31/10/2023

CGST : 32.0

SGST/UTGST 32.0

Total GST : 64.00

GST Number : 07AAAGH0019M2ZK

Rebate : 0.00

Default : 28.00

Excess Amount : 0.00

Total Paid Amount * : 2927.00

Transaction Number : OR0016861361

Receipt Number : 583616484

Receipt Date and Time : 30/10/2023 10:23:22

*Excluding Payment Gateway Transaction charges

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