PREMIUM PAYMENT ACKNOWLEDGEMENT

Policy Transaction Transaction Amount Policy Owner Name Plan Name

Number Number Date Received
(in )

C202565152 14279957839 19-11-2021 5167.00 MONDAL TAPAS KUMAR TATA AIA LIFE ASSURE 21
18:08:31 YEARS MONEY SAVER

Please note :

• This document can be used as a proof for claiming deduction while filing tax returns in accordance
to prevailing provisions of tax laws.

• The above amount will be credited to your policy on the due date; subject to credit. Premium receipt will be
sent on your registered email ID in 2 working days thereafter.

• For ULIP policies, if the premium is received before 3:00 PM, NAV of the same business day will be
applied, else next business day's NAV will be applied.

• Applicable govt taxes, surcharge, cess including GST would be charged in accordance to applicable laws
and the Company will have the right to recover the same from policyholder.

• Please refer policy document for detailed terms and conditions.

This is a system generated acknowledgement, hence does not require any signature.

Tata AIA Life Insurance Company Limited (IRDAI Regn. No.110) CIN: U66010MH2000PLC128403. Registered & Corporate Office: 14th
Floor, Tower A, Peninsula Business Park, Senapati Bapat Marg, Lower Parel, Mumbai - 400013. Trade logo displayed above belongs to Tata
Sons Ltd and AIA Group Ltd. and is used by Tata AIA Life Insurance Company Ltd under a license. For any information including cancellation,
claims and complaints, please contact our Insurance Advisor / Intermediary or visit Tata AIA Life’s nearest branch office or call 1-860-266-9966
(local charges apply) or write to us at customercare@tataaia.com. Visit us at: www.tataaia.com or SMS 'SERVICE' to 5676799.

IRDAI 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.