Renewal Receipt

Bajaj Allianz Life Insurance Company Limited
Renewal Premium Receipt
Receipt No:0786844807 Collected By:

Date:31/10/2019 Time:02:15:49 PM Collected At:
Policy No/Membership No:0185633655 Mode of Premium payment:DCOL
Policy Holder:MR RAMESH SAW Life Assured/Member:MR RAMESH SAW
AT- DHAMDHAMIA
B-TYPE RAMESH HOTEL~
PO - NAWADIH, PS - KHALARI
RANCHI JHARKHAND
829208
Product Name and UIN: CASHGAIN-116N016V01 Pan /Form 60: VALIDATED

DOC.: 25/09/2010 DOM: 25/09/2025
Policy Term: 15 Premium Paying Term: 15
Premium Amount: 15384 Sum Assured: 150000
Premium Frequency: YLY No. of Installment Due: 0
Deposit B/F: 0.0 Receivable B/F: 0.0
Deposit C/F: 0.24 Receivable C/F: 0.0
OS Interest: 0.0 Premium Due Date: 25/09/2019
Gross Amount: 15881.0 GST: 369.22
Agent Code:1000985364 Agent Name:SHILPA SONI
Received with thanks from: MR RAMESH SAW Payment of Rs 15881.0 (In figures),Amount of Rs Rupees Fifteen Thousand Eight Hundred Eighty
One And Paise Zero Only- (In Words) via ONLINE towards payment of Renewal Premium.
This is System Generated Receipt hence requires no signature. Mudrank No.:CSD/29/2019/2554/19Date:07-JUN-19
BEWARE OF SPURIOUS PHONE CALLS AND FICTITIOUS/FRAUDULENT OFFERS - IRDAI clarifies to public that -
1. IRDAI or its officials do not involve in activities like sale of any kind of insurance or financial products nor invest premiums.
2. IRDAI does not announce any bonus. Public receiving such phone calls are requested to lodge a police complaint along with details of phone call, number.
Disclaimer:1. Amount held in deposit will not attract any interest. 2. Receipt is subject to 1 Bajaj Allianz Life Insurance Company Limited. IRDAI Reg. No. 116,
realization of negotiable instrument / Bankers instruction. 3. For Eligibility under Income Tax 2 Regd. Address: G.E. Plaza, Airport Road, Yerawada, Pune - 411006.
Act 1961, please refer to relevant provisions of Income Tax Act and rules. 4. Goods and 3 Corporate Identity Number (CIN) - BALIC: U66010PN2001PLC015959
Service Tax and
Relevant Cess are charged at the rates applicable from time to time. 5. In ULIP, all renewals 4 The Logo of Bajaj Allianz Life Insurance Co. Ltd. is provided on the basis of license given by
BajajFinserv Ltd. to use its Bajaj Logo and Allianz SE to use its Allianz logo,
received for any unit transaction till the cut-off time of a day shall be processed at the unit 5 In case of Unit-linked insurance policies (ULIPs), the investment risk in the investment
price of the same day. The renewals received after the cut-off time of a day shall be portfolio is borne by the policyholder.
processed at the unit price of the next business day. Currently the cut-off time is 3.00pm for 6 Policyholder has the option to receive the claims/maturity payments/other sum due to
applicability of unit price for a particular day. Please refer to policy terms for further details. him/her from the Company through electronic mode. If you wish to receive the payment
6. In the event you note any error in the acknowledgment, you are required to immediately through electronic mode, kindly furnish your Bank Account details (Account No., Name &
bring it to the notice of the Company. 7. Advance premium for life insurance can be paid in Address of the Bank and IFSC No.) along with a copy of cancelled cheque at the Office of the
full anytime during the same financial year of the due date of premium. For premium due Company. Please ensure to keep your bank particulars updated in case of any subsequent
change.
due dates in next financial year, advance premium can be paid in this financial year up to 3 7 Policy holder has an option to pay his / her renewal premium through online modes (using
months in advance from the due date of premium. creditcard / debit card / Net Banking) or policy holder can make payment through ECS / ADI.
For more details, please contact our toll free numbers.
For any Policy servicing related issues kindly approach the nearest branch office of Bajaj 8 E-mail: [email protected] | Visit: www.bajajallianz.com | Toll free number:1800
Allianz Life Insurance Company. 209 7272, 1800 103 7272, 1800 233 7272 | Insurance is the subject matter of solicitation

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Bajaj Allianz Life Insurance Company Limited

Renewal Premium Receipt

Receipt No:0786844807 Collected By:

Product Name and UIN: CASHGAIN-116N016V01 Pan /Form 60: VALIDATED

Agent Code:1000985364 Agent Name:SHILPA SONI

This is System Generated Receipt hence requires no signature. Mudrank No.:CSD/29/2019/2554/19Date:07-JUN-19

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