TATA

AIG
INSURANCE

WITM YOu ALWAYs

Name : MR SUNIL P V
Address: #32/1 11TH CROSS 13TH MAIN, NR LYT VIRAT Date: 25/06/2022
NAGAR, BOMMANAHALLI, 13TH MAIN, NRLYT VIRAT
Your Policy Details :
NAGAR, BOMMANAHALLI,
BANGALORE - 560068 Policy Number :0177967663 00 00
BANGALORE Policy Period: From 26/06/2022 To Midnight Of 25/09/2022
KARNATAKA Premium Paid: 4150.0
INDIA

Dear MRSUNIL PV,

Welcome to Tata AIG General Insurance Company Limited's family & we thank you for choosing our policy for your motor vehicle insurance.

We are enclosing Policy schedule cum certificate of insurance of your vehicle. You are requested to visit our website www.tataaig.com for policy
wording.

Your policy has been issued based on the information and declaration provided by you. No Claim Bonus (NCB) if shown on your policy schedule
has been allowed as you had not reported any claim in the previous policy.

Kindly go through the enclosed information/declaration provided by you and in case your policy shows No Claim Bonus, for which you are not
entitled as explained above or any other error/discrepancy then we request you to get in touch with us within 15 days of receipt of the policy for
correction otherwise all particulars will be deemed to be correct.

You may also reach us at our 24*7 helpline 1800 266 7780 for providing any information or in case you desire to have a printed copy of policy
wording.

We assure you of our best services at all times. Happy driving!

Sincerely,
For Tata AIG General Insurance Company Limited

Authorized Signatory

Claims Registration
SMS 'CLAIMS' to 5616181 or
CALL US WRITE TO US e-mail:general.claims@tataaig.com
Tata AlG Genera Insuance Company Limted
24X7 Tol Free A-501, 5th Floor, Builcing No. 4,
Call us on 1-800-266-7780
Infinity Park, Dindoshi, Malad (E).
Mumbai, India - 400 O97.

Park, Ganpatrao Kadam Marg, OfT Senapali Bapat Marg. Lower Parel. Mumbai -400 013.
TATA AIG General insurance Company Ltd. Regd. Ofice: I5th Floor, Tower A, Peninsula Business
PAN: AABCTSI8, UIN No.: IRDANI08RP0077V02OieIo
IRDA Registration No. I08, CIN No : U851 1OMH2000PLC128425,
Helpline I800-266-7780 E-mai Customersupport@ talaaig.com
Website:www.lataaig.com 24X7 Toll frec
 TATA
AIG
INSURANCI
WITN YOU ALWAYS

1. Name (Registered Owner of the Motor Vehicle)* :MR SUNIL PV

# 32/1 11TH CROSS 13TH MAIN, NRLYT VIRAT NAGAR, BOMMANAHALLI, 13TH MAIN, N R LYT
VIRAT NAGAR, BOMMANAHALLI,
BANGALORE - 560068
2. Address for Communication*:
BANGALORE
KARNATAKA
INDIA

3. Vehicle Details: Please refer policy schedule cum certificate.

Make: Model : Variant :
Engine No: Chassis No : Registration Authority (RTO) :
4. Vehicle Purchased is :Roll Over 5. Vehicle Type :indigenous
6. Fuel Type :Diesel
7. Insured's Declared Value - Please refer policy schedule cum certificate.
8. Previous Insurance Particular_*:

Policy Number* : Date of Expiry* : 25/06/2022

141522123380012920 Type of Cover : PackageComprehensive

Name of the Insurer*: RELIANCE GENERAL INSURANCE CO.LTD.

Accident in the previous policy NCB in previous policy : 0% NCB claimed :NO
period: NO
9. Period of Insurance Desired
from*:26/06/2022
to midnight of 25/09/2022

10. Financier's Details:Please refer policy schedule cum certificate.

Hypothecation Loan Account Number : Partner Branch:
11. Extra Benefits opted
Un-Named Persons Personal Accident Cover for seating capacity, including driver: CSI N/A
Wider Legal Liability to Paid Driver (As per Workmen's Compensation Act, Fatal Accident Act & Common Law) :YES

Personal Accident Cover for Owner Driver: CSI 1500000

Name of the Nominee &
Age:Ahkila K & 28
Relationship :Spouse

Name of Appointee (if Nominee is

Minor): Relationship to the Nominee
12. Restriction of Cover/Discounts/Concessions/Extended Covers
Name of Automobile: Membership no :
Third Party Property Damage Cover restricted to 6,000/ only :NO
Is Voluntary Deductible opted: No Amount of Deductible opted: N/A
Vehicle is fitted with Anti Theft Device approved by ARAI :No
13. Add on covers - Please refer policy schedule cum certificate.

14. Bank Details (Required for Refund /Claims)

Name of the Account Holder: MR SUNIL P V
Name of Bank & Branch: N/A.N/A Account Number: N/A IFSC Code of Bank:N/A

15.Declaration for No Claim Bonus (1f NCBConfirmation is not submitted but NCB claimed)
VWe declare that the rate of NCB claimed by melus is correct and that NOCLAIM has arisen in the expiring Policy Period (Copy of Policy
enclosed). We further undertake that if thisdecaration is foundincoect all benefits under the Policy in respect of Section-1 of the Policy will
stand forfeited.

16. Ihereby give my consent to receive one page insurance

pol1cy.
17. AML Guidelines:

1. Uwe hereby confirm that all premiums have heen/willbe naid fom bonafide sources and no premiums have ben'will be paid out of procceds
of crime related to any of the offence listed in Prevention of Money Laundering Act, 2002.