Payment Acknowledgement

Ref. No.: HOMX42309TG822 | Date: 16-DEC-2023

Dear Mr. Nongmaithem Bikram,

Greetings from Max Life Insurance!

Thank you for choosing us as your Life Insurance Partner. Congratulations on financially securing the future for you and your family!

This is to acknowledge that we have received the payment towards your Max Life Insurance Policy.

Policy Details
Plan Name: Max Life Smart Wealth Advantage Guarantee Plan
Policy No.: 119081081 Payment Received: ` 102249.99
Transaction Date: 16-DEC-2023 Method of Payment: Direct Debit

We request you to continue making timely renewal payments and keep enjoying the benefits of your policy. We value your association with us and assure you the best
of our services always.

Warm Regards,
Max Life Insurance Company Limited

Important Information:
1.Premium paid will be eligible for tax benefits (under section 80C/ 80CCC/ 80D/ 37(1) of income tax act 1961, as per applicability) subject to levies under prevailing tax laws. Your policy may be
entitled to certain tax benefits or subject to deductions. We request you to please consult with your tax consultant for more information.
2.This is payment acknowledgement and does not require revenue stamp.
3.If the payment has been made other than cash, this acknowledgement is conditional upon the credit in Company's account post clearance of instrument/facility including electronic mode.
4.Monies received would be adjusted against the due premium as per the policy contract. In case policy status is lapsed, the risk coverage is subject to the reinstatement of the policy as per
terms and conditions of the plan opted.
5.In case the premium for Unit Linked Insurance policies is received before 3:00 PM on a business day, Net Asset Value (NAV) of the same day will be applicable; in case premium is received after
3:00 PM or on non-business day, the NAV of the next business day will be applied.
6.All applicable taxes, cesses or any other taxes, charges, levies as per prevailing laws, shall be borne by you.
7.I/We hereby declare that though our turnover is more than the turnover notified under sub-rule (4) of rule 48, we are not required to prepare an invoice in terms of the said sub-rule.

This acknowledgement is electronically generated and does not require signature.

DSM01 V1.3 19012023