PremiumReceipt

Dear MR. Navdeep Singh

E2002, Heritage Max, Sector 102,
Gurugram

Haryana 122006

We acknowledge the receipt of payment towards the premium of the following health insurance policy:

Policy Holder's Name Mr. Navdeep Singh Policy Number 30571827827881

Plan Opted for FAMILYFIRST Sum Insured(Rs.) 500, 000
Commencement Date# 22/05/2023 Expiry Date 21/05/2024
Net Premium(Rs.) 51,500.00
Service Tax(Rs.) 7,209.59

Swachh Bharat Cess (Rs.) 258.22

Krishi Kalyan Cess @0.5% 258.22

Loading(Rs .) 0.00

59,226.02
Gross Premium(Rs.)
#
Issuance of policy is subject to clearance of premium paid
Details of persons Insured:

Name of Person Insured Age Ge nder Relationship to policy holder Individual cover(Rs.)
(only in case of Family First)

Mr. Malinder Singh 63 Male Father 250,000

Mrs. Paramjeet Kaur 60 Female Mother 250,000

Upon issuance of this receipt, all previously issued temporary receipts, if any, related to this policy are considered null and void. For the
purpose of deduction under section 80D, the benefit shall be as per the provisions of the Income Tax Act, 1961 and any amendments made
thereafter.
In the event of non-realization of premium, Tax benefits cannot be obtained against this premium receipt

For your eligibility and deductions please refer to provisions of Income Tax Act 1961 as modified and consult your tax consultant.

Service tax Registration number: AAFCM7916HST001

For and on behalf of Max Bupa Health Insurance Co. Ltd.

Location: New Delhi Ashish Mehrotra

Date: 10/05/2023 Managing Director and Chief Executive Officer

AffixStamp

Heartbeat ; UIN no : IRDA/NL-HLT/ MBHI/P-H/V.III/19/16-17