Tax Invoice

Mr Nayan kumar Satapathy

FLAT NO F M/15
NETAJI SUBHASH ENCLAVE
NEAR CENTRAL SCHOOL
Bhubaneswar 751017
Orissa
Contact no: 9432011733,9163405389
Your renewal premium receipt for Future Generali Assured Income Plan, policy Date : 10/03/2023
no.01499189
Receipt No.: 16738019 Policy Status: In Force
Dear Mr Nayan kumar Satapathy ,
Thank you for choosing Future Generali as your preferred life insurer. As a valued member of the Future Generali customer family, your continued
patronage is important to us.
Please find below the details of premiums which we have received.
Policy no. Plan name Date of Sum Assured Modal Premium Next Premium
commencement due date
01499189 Future Generali Assured 25th February 2019 6,200,000.00 200,000.00 25/02/2024
Income Plan

Particulars of Premium Received Premium ₹.

Premium Received 204,500.00
Goods and Services Tax 4,500.00
Total Amount Adjusted 204,500.00
Balance amount in excess (if any) 0.00

Taxable Value 25,000.00

CGST @9% 2,250.00
SGST/ UTGST @9% 2,250.00
IGST @18% 0.00

Following is the details of your FGLI branch :

State Name Orissa
State Code 21
FGLIC GSTIN 21AABCF0190Q1ZO
FG Address (Principal place of the business in the state) 1ST FLOOR, KALINGA COMPLEX, PLOT NO-B, UNIT I, RAJPATH
BHUBANESWAR-751009

Note:
· In case you have chosen ECS as premium payment mode, then you have the facility to withdraw ECS option within a period of 15 days prior to due date at no
charge
· The TDS u/s 194DA of Income Tax Act, 1961 is applicable if any amount paid/withdrawn under the policy, if the policy at time of payment falls within the
purview of section 194DA. Hence please visit the nearest branch to update your PAN details, to avoid higher rate of tax i.e. 20% u/s 206AA. If you wish to avail
benefit u/s 197A(1) , 197A(1A) & 197A(1C) of Income Tax Act, 1961 then please submit Form 15G & Form 15H
· Cheque/Autopay payments are subject to realisation and amount received in Company's account
· Premium payment(s) exclusive of Goods and Services Tax to Future Generali India Life Insurance Company Limited are eligible for tax benefit(s) u/s
80C/80CCC(1)/80D as applicable subject to satisfaction of the conditions specified under Income Tax Act, 1961
· Stamp Duty of Rs. 1/- is paid as provided under Article 53(A) of Indian Stamp Act, 1899 and included in Consolidated Stamp Duty Paid to the Government of
Maharashtra Treasury vide Order of Addl. Controller Of Stamps, Mumbai at General Stamp Office, Fort, Mumbai - 400001., vide this Order
No.(LOA/CSD/583/2023/Validity Period Dt.26/01/2023 To Dt.31/12/2025/337123 Date : 24/01/2023) applicable only if the receipt amount is equal to or greater
than Rs 5000
· The rate of the Goods and Services Tax is charged as per prevailing rate. Tax laws are subject to amendments from time to time.
· HSN/SAC- 997132 Life Insurance Services (excluding Reinsurance Services)
"We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the aggregate turnover notified under
sub-rule (4) of rule 48 of the Central Goods and Services Tax Rules, 2017, we are not required to prepare an invoice in terms of the provisions of the said
sub-rule.”