Bajaj Allianz Life insurance Company Limited

Date : 17-May-2023

Reference ID: 0762244218

Online Transaction Slip

Thank you for choosing and investing with us for your insurance needs.

We are in receipt of your application bearing application number 43574209 submitted online for availing Policy.

Receipt No Application No Name Amount Paid Premium Mode Pay Date

1814-00033870 43574209 Anish Sharma 60,000 Annual 17-May-2023

1. Please note that this is an electronically issued transaction slip and does not require signature. A premium receipt shall
beissued and sent to you along with your policy document in case of issuance of policy. Issuance of this transaction slip does
not mean acceptance of your application and is subject to under writing by the company.
2. Insurance cover shall commence only from the date of acceptance of risk based on Proposal submitted and
otherrequirements called for by the company.
3. Amount held in deposit will not attract any interest
4. In case of Unit-linked insurance policies (ULIPs), the investment risk in the investment portfolio is borne by the policyholder.
5. Please refer to the product brochure for further details on terms and conditions.
6. In the event you note any error in this transaction slip, you are required to immediately bring it to the notice of the Company.
7. You may also approach the nearest branch of Bajaj Allianz Life Insurance Company for any issues.

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Office Address: BAJAJ ALLIANZ HOUSE, Airport Road, Yerawada, Pune - 411006., IRDAI Reg No.: 116, Visit :
www.bajajallianzlife.com, BALIC CIN : U66010PN2001PLC015959, Mail us : customercare@bajajallianz.co.in, Call on : 1800-
209-5858 , Fax No: 02066026789, Insurance is the subject matter of solicitation. The Logo of Bajaj Allianz Life Insurance Co. Ltd.
is provided on the basis of license given by Bajaj Finserv Ltd. to use its Bajaj Logo and Allianz SE to use its Allianz logo.