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State Bank of India

The Rankrr fu 1.very Indian
SBILife

InsuranceCompany: SBI Life Insurance Company Limited (sBILIFE')

Collecting Bank State Bank of India ("Bank")

Branch Code: 40263

Policy I Form No.: 1KNE286626

1KNE286627
Acknowledgement No.: 258531982 SBILF40263202230430771313

Date& Time: 31-10-2022 13:33:19

Name ofthe Policyholder VENKATESH
SANJAY R S

PAYMENT ACKNOWLEDGEMENT SLIP

Received with thanks towards the below mentioned Policy the below mentioned premium amount

Policy Form
1KNE286626
1KNE286627
Number

Total Amount Paid 200000.0

Name of the
VENKATESH
SANJAY R S
Policyholder
Premium Type Initial

PaymentMode Transfer

Please Note

1. This is computer generated acknowledgement slip and does not require any signature.

Maximum amount that can be accepted in cash by any office of State Bank of India towards premium payment is Rs
2.
49,999/-
3 This acknowledgement is subject to realization if paid through cheques
Neither SBILIFE nor the Bank shall accept any liability for the lapsation of the policy or any other loss of any nature
4
whatsoever in the event that the premiums have been paid beyond due dates

s Service tax and relevant cess are charged at the rates applicable from time to tume and have been included in the premum
.
amount.

This acknowiedgement slip is issued by Bank (acting as a collecting Bank) for the premiums due to SBILIFE The sameshal
not be construed as premium paid receipt which will be issued separately by SBILIFE. The insurance cover amount payabie
and other benefits under the policy shall be governed by the terms and conditions of the policy issued by the insurance
company and on the basis of the premium paid receipt issued by SBI Life.

7. For queries the customer can contact SBI Life Insurance Company Limited

Toll Free number: 1800 22 9090 Email info@sbilife.co.in Website: www.sbilife co.in

Reglstered and Corporate Office:

SBI Life Insurance Co Ltd. "Natraj", M V Road & Western Express Highway Junction, Andheri (East). Mumbai 400069

httns://csngrtal.sbi.co.in/SBILife/Enquiry/PrintPreview?referenceNumber=SBILF402... 04-11-202