Customer Name Card Account No

MR GOGULOTH JYOTHI 4375 XXXX XXXX 1002

30 2 491 MITTURAMANA COLONY
MADIKONDA
ROAD NO 3
NEAR MITTU GUTTA TEMPLE
WARANGAL 506003

Statement Period

01/04/2020 TO 31/03/2021

TRANSACTION DETAILS
Card Number : 0000 XXXX XXXX 2587
International
Date Ref. Number Transaction Details Currency
amount
Amount(in `)
07-APR-20 Fee levied for cash payment 0.00 100.00

08-APR-20 IGST-CI@18% 0.00 18.00

13-MAY-20 IGST-CI@18% 0.00 90.00

13-MAY-20 Late Payment Fee 0.00 500.00

18-MAY-20 Fee levied for cash payment 0.00 100.00

19-MAY-20 IGST-CI@18% 0.00 18.00

21-MAY-20 Interest Charges 0.00 268.80

21-MAY-20 IGST-CI@18% 0.00 48.38

TRANSACTION DETAILS
Card Number : 4375 XXXX XXXX 1002
International
Date Ref. Number Transaction Details Currency
amount
Amount(in `)
07-APR-20 M3144126 CASH PYMT. RECD.AT BRANCH 0.00 -8,300.00

14-APR-20 74332740106010555058863 DMART WARANGAL IN 0.00 3,874.75

20-APR-20 74332740112011155885426 NPDCL BILLDESK MUMBAI IN 0.00 127.13

20-APR-20 74332740112011152877145 NPDCL BILLDESK MUMBAI IN 0.00 715.38

18-MAY-20 M3235241 CASH PYMT. RECD.AT BRANCH 0.00 -5,100.00

06-JUN-20 CLICK TO PAY PAYMENT RECEIVED 0.00 -1,862.00

08-JUN-20 100208062020S96113382 NEFT PAYMENT RECEIVED 0.00 -1,900.00

10-JUN-20 74766510162023065188685 TATA SKY LTD MUMBAI IN 0.00 1,000.00

The category of service:Credit & Debit Card,Charge Card or Other payment Card service.
RegistrationNo.Mum/Div -III/ST/CDR/23. PAN based STC No:AAACI1195HST001.
REGISTERED OFFICE IS ICICI BANK LIMITED,"LANDMARK",RACE COURSE CIRCLE, VADODARA 390 007 , INDIA.
This is an authenticated intimation/statement.Customers are requested to immediately notify the Bank of any discrepancy in the statement
 TRANSACTION DETAILS
Card Number : 4375 XXXX XXXX 1002
International
Date Ref. Number Transaction Details Currency
amount
Amount(in `)
19-JUN-20 74332740172017105175963 NPDCL BILLDESK MUMBAI IN 0.00 3,962.56

19-JUN-20 74332740172017189821441 NPDCL BILLDESK MUMBAI IN 0.00 3,572.47

01-JUL-20 74766510183026989330981 6 EMI AMAZON HTTP://WWW.AM IN 0.00 0.00

01-JUL-20 Principal Amount Amortization - <1/6>6 0.00 2,988.45

EMI AMAZON

01-JUL-20 Interest Amount Amortization - <1/6>6 EMI 0.00 222.80

AMAZON

02-JUL-20 IGST-CI@18% 0.00 40.10

08-JUL-20 CLICK TO PAY PAYMENT RECEIVED 0.00 -7,000.00

14-JUL-20 74332740197019672093497 NPDCL BILLDESK MUMBAI IN 0.00 49.44

14-JUL-20 74332740197019682356538 NPDCL BILLDESK MUMBAI IN 0.00 1,153.28

01-AUG-20 Principal Amount Amortization - <2/6>6 0.00 3,030.43

EMI AMAZON

01-AUG-20 Interest Amount Amortization - <2/6>6 EMI 0.00 180.82

AMAZON

02-AUG-20 Interest Amount Amortization - 0.00 67.14

<1/12>FLIPKART PAYMENTS

02-AUG-20 IGST-CI@18% 0.00 32.55

02-AUG-20 74766510215030499063134 FLIPKART PAYMENTS BANGALORE IN 0.00 0.00

02-AUG-20 Principal Amount Amortization - 0.00 433.50

<1/12>FLIPKART PAYMENTS

03-AUG-20 IGST-CI@18% 0.00 12.09

07-AUG-20 CLICK TO PAY PAYMENT RECEIVED 0.00 -4,089.00

11-AUG-20 74585190225026691415781 SECRET STYLES WARANGAL IN 0.00 1,500.00

12-AUG-20 74585190226026701260010 INSTAKART SERVICES PVT WARANGAL IN 0.00 1,798.00

01-SEP-20 Interest Amount Amortization - <3/6>6 EMI 0.00 145.49

AMAZON

01-SEP-20 IGST-CI@18% 0.00 26.19

01-SEP-20 Principal Amount Amortization - <3/6>6 0.00 3,065.76

EMI AMAZON

02-SEP-20 IGST-CI@18% 0.00 10.79

02-SEP-20 Interest Amount Amortization - 0.00 59.93

<2/12>FLIPKART PAYMENTS

02-SEP-20 Principal Amount Amortization - 0.00 440.71

<2/12>FLIPKART PAYMENTS

The category of service:Credit & Debit Card,Charge Card or Other payment Card service.
RegistrationNo.Mum/Div -III/ST/CDR/23. PAN based STC No:AAACI1195HST001.
REGISTERED OFFICE IS ICICI BANK LIMITED,"LANDMARK",RACE COURSE CIRCLE, VADODARA 390 007 , INDIA.
This is an authenticated intimation/statement.Customers are requested to immediately notify the Bank of any discrepancy in the statement
 TRANSACTION DETAILS
Card Number : 4375 XXXX XXXX 1002
International
Date Ref. Number Transaction Details Currency
amount
Amount(in `)
08-SEP-20 CLICK TO PAY PAYMENT RECEIVED 0.00 -7,055.00

16-SEP-20 74332740261026016755997 T MART WARANGAL IN 0.00 925.00

01-OCT-20 Interest Amount Amortization - <4/6>6 EMI 0.00 109.74

AMAZON

01-OCT-20 IGST-CI@18% 0.00 19.75

01-OCT-20 Principal Amount Amortization - <4/6>6 0.00 3,101.51

EMI AMAZON

02-OCT-20 Principal Amount Amortization - 0.00 445.85

<3/12>FLIPKART PAYMENTS

02-OCT-20 IGST-CI@18% 0.00 9.86

02-OCT-20 Interest Amount Amortization - 0.00 54.79

<3/12>FLIPKART PAYMENTS

06-OCT-20 CLICK TO PAY PAYMENT RECEIVED 0.00 -4,674.00

07-OCT-20 74766510281040892437669 AMAZON HTTP://WWW.AM IN 0.00 2,728.00

08-OCT-20 74766510282040951157249 AMAZON HTTP://WWW.AM IN 0.00 1,455.00

08-OCT-20 74931970283000000143553 KENDRIYA VIDYALAYA SANGAT MUMBAI 0.00 1,827.00

IN

08-OCT-20 028219429710 UPI Payment Received 0.00 -1.00

17-OCT-20 74766510291041486778847 AMAZON HTTP://WWW.AM IN 0.00 439.00

18-OCT-20 74766510294041677650158 AMAZON HTTP://WWW.AM IN 0.00 -466.00

01-NOV-20 Principal Amount Amortization - <5/6>6 0.00 3,137.66

EMI AMAZON

01-NOV-20 IGST-CI@18% 0.00 13.25

01-NOV-20 Interest Amount Amortization - <5/6>6 EMI 0.00 73.59

AMAZON

02-NOV-20 IGST-CI@18% 0.00 8.93

02-NOV-20 Principal Amount Amortization - 0.00 451.05

<4/12>FLIPKART PAYMENTS

02-NOV-20 Interest Amount Amortization - 0.00 49.59

<4/12>FLIPKART PAYMENTS

02-NOV-20 PREPAID RECHARGE FACILITY 0.00 599.00

05-NOV-20 031011327993 UPI Payment Received 0.00 -9,723.00

05-NOV-20 031011334096 UPI Payment Received 0.00 -9.00

22-NOV-20 74332740328032737448376 NPDCL BILLDESK MUMBAI IN 0.00 728.49

The category of service:Credit & Debit Card,Charge Card or Other payment Card service.
RegistrationNo.Mum/Div -III/ST/CDR/23. PAN based STC No:AAACI1195HST001.
REGISTERED OFFICE IS ICICI BANK LIMITED,"LANDMARK",RACE COURSE CIRCLE, VADODARA 390 007 , INDIA.
This is an authenticated intimation/statement.Customers are requested to immediately notify the Bank of any discrepancy in the statement
 TRANSACTION DETAILS
Card Number : 4375 XXXX XXXX 1002
International
Date Ref. Number Transaction Details Currency
amount
Amount(in `)
22-NOV-20 74332740328032731965961 NPDCL BILLDESK MUMBAI IN 0.00 78.70

23-NOV-20 74678440329000000088714 UTILITIESCC MUMBAI IN 0.00 598.00

26-NOV-20 74056630332033134623208 Flipkart Payments BANGALORE IN 0.00 509.00

01-DEC-20 IGST-CI@18% 0.00 6.66

01-DEC-20 Principal Amount Amortization - <6/6>6 0.00 3,174.19

EMI AMAZON

01-DEC-20 Interest Amount Amortization - <6/6>6 EMI 0.00 37.00

AMAZON

02-DEC-20 Interest Amount Amortization - 0.00 44.34

<5/12>FLIPKART PAYMENTS

02-DEC-20 IGST-CI@18% 0.00 7.98

02-DEC-20 Principal Amount Amortization - 0.00 456.30

<5/12>FLIPKART PAYMENTS

02-DEC-20 033722056415 UPI Payment Received 0.00 -4,324.00

02-DEC-20 033722059253 UPI Payment Received 0.00 -7.00

08-DEC-20 74163260344029561702707 Paragon Polyme Banglor Banglore IN 0.00 652.00

15-DEC-20 74163260351029736221054 Paragon Polyme Banglor Banglore IN 0.00 789.00

02-JAN-21 Principal Amount Amortization - 0.00 461.62

<6/12>FLIPKART PAYMENTS

02-JAN-21 Interest Amount Amortization - 0.00 39.02

<6/12>FLIPKART PAYMENTS

03-JAN-21 IGST-CI@18% 0.00 7.02

08-JAN-21 CLICK TO PAY PAYMENT RECEIVED 0.00 -7,075.00

16-JAN-21 74332741017101636669335 WAL MART INDIA PRIVATE WARANGAL IN 0.00 774.06

21-JAN-21 74332741022102138330155 G R ENTERPRISES ADILABAD IN 0.00 23,000.00

02-FEB-21 Principal Amount Amortization - 0.00 467.01

<7/12>FLIPKART PAYMENTS

02-FEB-21 IGST-CI@18% 0.00 6.05

02-FEB-21 Interest Amount Amortization - 0.00 33.63

<7/12>FLIPKART PAYMENTS

02-FEB-21 103312065539 UPI Payment Received 0.00 -1,282.00

02-FEB-21 103312242512 UPI Payment Received 0.00 -6.00

02-MAR-21 Interest Amount Amortization - 0.00 28.19

<8/12>FLIPKART PAYMENTS

The category of service:Credit & Debit Card,Charge Card or Other payment Card service.
RegistrationNo.Mum/Div -III/ST/CDR/23. PAN based STC No:AAACI1195HST001.
REGISTERED OFFICE IS ICICI BANK LIMITED,"LANDMARK",RACE COURSE CIRCLE, VADODARA 390 007 , INDIA.
This is an authenticated intimation/statement.Customers are requested to immediately notify the Bank of any discrepancy in the statement
 TRANSACTION DETAILS
Card Number : 4375 XXXX XXXX 1002
International
Date Ref. Number Transaction Details Currency
amount
Amount(in `)
02-MAR-21 IGST-CI@18% 0.00 5.07

02-MAR-21 Principal Amount Amortization - 0.00 472.45

<8/12>FLIPKART PAYMENTS

06-MAR-21 106508431154 UPI Payment Received 0.00 -23,500.00

For ICICI Bank Limited.

Sudipta Roy
Head – Consumer Cards

Important Messages
Safe Banking Tips - Do not transact if you find any suspicious device attached to the ATM. Do not take help
from strangers at an ATM.

ICICI Bank Credit Cards Goods and Services Tax Identification Number (GSTIN) is 27AAACI1195H3ZK

HSN Code for service: 9971 - Financial and related services

Our registered office address : ICICI Bank Tower, Bandra Kurla Complex, MUMBAI, Mumbai Suburban,
Maharashtra - 400051

Making only minimum payment every month can lead to repayment stretching over years with consequent
interest payment on outstanding balance

Please pay your credit card outstanding before the payment due date to avoid penal fees and interest
charges.

For payments made through cheque, we request you to make the payment atleast 3 working days before the
due date incase of an ICICI Bank cheque and 5 working days before the due date for Non-ICICI Bank cheques.

For any clarification or more information, you may contact us through the 'Get in Touch' option at
www.icicibank.com

* Mark-up fee and corresponding GST levied is included in the transaction amount displayed

The category of service:Credit & Debit Card,Charge Card or Other payment Card service.
RegistrationNo.Mum/Div -III/ST/CDR/23. PAN based STC No:AAACI1195HST001.
REGISTERED OFFICE IS ICICI BANK LIMITED,"LANDMARK",RACE COURSE CIRCLE, VADODARA 390 007 , INDIA.
This is an authenticated intimation/statement.Customers are requested to immediately notify the Bank of any discrepancy in the statement