PREMIUM PAID CERTIFICATE FOR THE YEAR 2023-2024

This is to certify that as per our records the following payments have been received by us to effect or keep "In Force" Health
Protection Plus held by
Mrs. Ruqaya Posh

Life Assured's Name:

Policy No’s: Plan Name: Health Protection Plus

Benefits/Rider Sum Assured Coverage Premium Premium Due UIN

Amt
Health Protection Plus 0.00 SEC 80 D 30000.00 0.00 291N232V21
0

Policy Total 30000.00

Amt in 0.00
Suspense
Total Premium 30000.00

Premium Paid to avail Income Tax Benefits Under:

SEC 80 D 30000.00

Total 30000.00

Please note the mortality charges under the base plan as well as riders (if any) would be recovered every month as per the
Terms and Conditions of the Policy.

The above mortality charges are the actual charges recovered till date. The recovery of such charges would be subject to
change on monthly basis.

This is a computer generated statement and does not require any signature.

ICICI Prudential Life Insurance Company Limited.

Communication Address:Vinod Silk Mills Compound,Chakravarthy Ashok Road, Ashok Nagar,Kandivali(E), Mumbai-400 101
Registered Office:ICICI Prulife Towers,1089, Appasaheb Marathe Marg,Prabhadevi,Mumbai-400 025
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