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Premium Paid Certificate

Payee: Mr. Shridhant Pati

House No B302 Bren Champion Square :


St No. 91, 92, Sarjapur - Marathahalli Rd, Date: 19-Oct-2022
Carmelaram, Ambedkar Nagar,
Chikkabellandur,
Bengaluru, Karnataka 560035

Nominee:
Himanshu Shekhar Age: 61 years
Menaka Pati Age: 56 years

Ref: Policy No. 39165848

Coverage Face Amount Modal Premium Coverage Status


Parental Policy 1000000 49625 Premium paying (One-Time)

This is to certify that the following amounts have been received towards premium for the above
policy for the period 19-Oct-2022 to 18-Oct-2023.

Effective Date of Deposit Premium (Rs)


19-Oct-22 49625

This letter is based on our understanding of current tax laws prevailing in India. These laws are
subject to change and any such change could have a retrospective effect. This letter should not be
construed as tax, legal or investment opinion forums. For specific suitability, you are requested to
consult your tax advisor.

THIS IS A COMPUTER GENERATED STATEMENT AND DOES NOT REQUIRE A SIGNATURE

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