Max Term Insurance - Tejkumar

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i� INSURANCE

Recei t No.: 323075358AUG2512


Premium Receipt
I· .
Recei t Date: 25-AUG-2023

Policy Number: 326585358 Email ID: [email protected]


Policyholder Name: Mr.Kokkanti Tejkumar PAN Number: HFCPK3837K
Address: 3-146-11-3A1, PRASANTH NAGAR, Customer GSTIN: Not Available
Madanapalli-517325 Current Residential State: Andhra Pradesh
Andhra Pradesh India

Mobile Number: 8099527595


Policy Details
Plan Name: Max Life Online Term Plan Plus Policy Term: 50 Years Policy Commencement Date: 30-AUG-2019
Life Insured: Mr. Kokkanti Tejkumar Date of Maturity: 30-AUG-2069 Premium Payment Term: 31 Years
Premium Payment Frequency: Annual Premium Received (incl. GST): f 14,278.00 Modal Premium (incl. GST): f 14,278.00
Late Payment Fee (incl GST): f 0.00
GST Details Connect for more details
Coverage Taxable SGST/UTGST CGST IGST Name
Type Value(f) Rate Amount(f) Rate Amount(f) Rate Amount(f) Yes Bank Ltd.
Base 12,100.00 NA 0.00 NA 0.00 18% 2,178.00
Rider 0.00 NA 0.00 NA 0.00 18% 0.00
Late Payment 0.00 NA 0.00 NA 0.00 18% 0.00 Contact Number
Total GST Value: f 2,178.00 18601205577
GSTIN: 27AACCM3201E1Z3 GST Regd. State: Maharashtra SAC CODE: 997132

0
Mudrank: Paid bye-Stamps Certificate no. 01/lssue Date: 03/04/2023/ Vide Treasury(E-CHALLAN) GRN NO.100904462

Total Sum Assured of base


plan and term nder (if any)

!§'�%
Premium Received
(in cl GST)* A_
L____sJ
Duration for which
the premium 1s received

30-AUG-2023to
Next Premium Due Date
0
t 1,00,00,ooo.oo t 14,278.00 29-AUG-2024 30-AUG-2024
*Important Note:
I.For payment mode other than in cash, this receipt is conditional upon the credit in our account. Payment of premium amount does not constitute commencement of risk. The risk commencement starts
after acceptance of risk by us.
2.Amount received would be adjusted against the due premium as per terms and conditions of the policy.
3.Premiums may be eligible for tax benefits under section 80C/80CCC/80D/37(1) of the income Tax Act 1961. Kindly consult your tax advisor for more information. Tax benefits are liable to change
due to changes in legislation or government notification.
4.GST shall comprise CGST, SGST / UTGST or IGST (whichever is applicable) including cesses and levies, if any. All applicable taxes, cesses and levies, as per prevailing laws, shall be borne by you. For
GST purposes, this premium receipt is Tax invoice. Assessable Value in GST for Endowment First Year is 25%, Renewal Year is 12.5%, Single Premium Annuity is 10%, Term and Health is 100%.
5.1/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.

Authorised Signatory
PRM21V6.l 19012023 PRODUCT UIN: 104N092V03
E.&O.E 2023-08-30.03.35.14.280981

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� Call us at 1860 120 5577 Followus f � (Q} D

Important: DO NOT believe in calls, SMS, E-mail offering discounts. For NEFT Payments, please transfer only to "HSBC Bank A/C No. 1165 <Followed by 9 digit Policy No.> IFSCode: HSBC0110002". Max Ute does
not collect Premium in any other account. Max Life Insurance Co. Ltd: Plot No. 90C, Sector 18, Udyog Vihar, Gurugram, Haryana - 122 015. Regd. Office: 419, Bhai Mohan Singh Nagar, Aailmajra, Tehsil Balachaur, District Nawanshahr,
Punjab - 144 533. Fax: 0124-4159397. CIN:U74899PB2000PLC045626 I Customer Helpline Number: 1860 120 55n IRDAI Registration No. 104

BEWARE OF SPURIOUS/ FRAUD PHONE CALLS!• IADAI is not involved in activities like selling insurance policies, announcing bonus or investment of premiums• Public receiving such phone calls are requested
to lodge a police complaint.

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