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Branch : Andheri East, Unit No.15, OPTIONS PRIMO, Plot No.X-21, Cross Road No.21, MIDC,Andheri(Esat),Mumbai - 400093 MUMBAI Maharashtra INDIA 400093

Name: BAJAJ ALLIANZ LIFE INSURANCE COMPANY LIMITED Branch IFSC Code : ESMF0001148
Address: GORUND FLOOR 2 6 FLOOR BAJAJ ALLIANZ Account Number : 20180000024486
HOUSE AIRPORT ROAD YERAWADA Branch of Ownership : Andheri East
YERAWADA 411006 Branch MICR Code : 400760002
MAHARASHTRA INDIA Date Opened : 10/12/2018
Signatories: MR. SHAM YASHWANT TANAWADE (AUTH.SIGN.) Activation Date : 20/12/2018
MR. ANAND GANDHI (AUTH.SIGN.) Currency Code : INR
MR. RAJAT KAPOOR (AUTH.SIGN.) Account Status : Active

Statement of Account
From:01/01/2024 To:10/01/2024
Date Effective Cheque Number Description Withdrawal Deposit Amt. Balance
Date Amt.
01/01/2024 01/01/2024 WITHDRAWAL,ACH Debit-BAJAJ ALLIANZ LIFE I- 1,00,00,000.00 11,67,666.76
ESAF0000000000022815-INV01012024_5-9006470721
01/01/2024 01/01/2024 WITHDRAWAL,ACH Debit-BAJAJ ALLIANZ LIFE I- 11,00,000.00 67,666.76
ESAF0000000000022815-INV01012024_6-9006470722
01/01/2024 DEPOSIT,RETAIL LOAN INSURANCE DECEMBER 9,63,758.00 10,31,424.76
302023 COUNT108
01/01/2024 DEPOSIT,Bajaj 30 December 2023PREMIUM AMOUNT 55,20,767.40 65,52,192.16
IGL Count6576GL220 MFIG Count1318VJL2JEEVADH
01/01/2024 01/01/2024 FEE CHG,WTHDRL FEES/SMS/1/2024/Dec 10.09 65,52,182.07
02/01/2024 02/01/2024 WITHDRAWAL,ACH Debit-BAJAJ ALLIANZ LIFE I- 64,00,000.00 1,52,182.07
ESAF0000000000022815-INV02012024_6-9047784930
02/01/2024 DEPOSIT,Bajaj 01 January 2024PREMIUM AMOUNT 21,98,763.40 23,50,945.47
IGL Count3058GL191 MFIG Count156VJL11JEEVADHA
03/01/2024 DEPOSIT,Bajaj 02 January 2024PREMIUM AMOUNT 28,51,618.20 52,02,563.67
IGL Count3952GL184 MFIG Count346VJL10JEEVADHA
03/01/2024 DEPOSIT,RETAIL LOAN INSURANCE JANUARY 1,75,599.00 53,78,162.67
012023 COUNT10
04/01/2024 04/01/2024 WITHDRAWAL,ACH Debit-BAJAJ ALLIANZ LIFE I- 52,00,000.00 1,78,162.67
ESAF0000000000022815-INV04012024_6-9149598967
04/01/2024 DEPOSIT,Bajaj 03 January 2024PREMIUM AMOUNT 29,11,499.60 30,89,662.27
IGL Count4086GL181 MFIG Count208VJL4JEEVADHAR
04/01/2024 DEPOSIT,RETAIL LOAN INSURANCE JANUARY 1,87,013.00 32,76,675.27
02032023 COUNT22
05/01/2024 05/01/2024 WITHDRAWAL,ACH Debit-BAJAJ ALLIANZ LIFE I- 31,00,000.00 1,76,675.27
ESAF0000000000022815-INV05012024_5-9201652872
05/01/2024 DEPOSIT,Bajaj 04 January 2024PREMIUM AMOUNT 28,57,313.12 30,33,988.39
IGL Count4018GL164 MFIG Count194VJL8JEEVADHAR
05/01/2024 DEPOSIT,RETAIL LOAN INSURANCE JANUARY 96,418.00 31,30,406.39
042023 COUNT14
06/01/2024 DEPOSIT,RETAIL LOAN INSURANCE JANUARY 2,01,152.00 33,31,558.39
052023 COUNT19
06/01/2024 DEPOSIT,Bajaj 05 January 2024PREMIUM AMOUNT 33,95,439.80 67,26,998.19
IGL Count4604GL125 MFIG Count478VJL5JEEVADHAR
06/01/2024 DEPOSIT,VVY LOAN INSURANCE 25122023 TO 28,696.00 67,55,694.19
31122023COUNT50
08/01/2024 08/01/2024 WITHDRAWAL,ACH Debit-BAJAJ ALLIANZ LIFE I- 66,00,000.00 1,55,694.19
ESAF0000000000022815-INV08012024_5-9301950508
08/01/2024 DEPOSIT,Bajaj 06 January 2024PREMIUM AMOUNT 53,85,552.16 55,41,246.35
IGL Count6760GL352 MFIG Count450VJL16JEEVADHA
08/01/2024 DEPOSIT,RETAIL LOAN INSURANCE JANUARY 3,00,259.00 58,41,505.35
062023 COUNT30
09/01/2024 09/01/2024 WITHDRAWAL,ACH Debit-BAJAJ ALLIANZ LIFE I- 57,00,000.00 1,41,505.35
ESAF0000000000022815-INV09012024_6-9346348654
09/01/2024 DEPOSIT,RETAIL LOAN INSURANCE JANUARY 1,96,218.00 3,37,723.35
082023 COUNT11
09/01/2024 DEPOSIT,Bajaj 08 January 2024PREMIUM AMOUNT 23,97,363.40 27,35,086.75
IGL Count3290GL176 MFIG
Count160VJL5JEEVADHARBajaj 08 Jan
10/01/2024 10/01/2024 WITHDRAWAL,ACH Debit-BAJAJ ALLIANZ LIFE I- 26,00,000.00 1,35,086.75
ESAF0000000000022815-INV10012024_5-9404948606
10/01/2024 DEPOSIT,RETAIL LOAN INSURANCE JANUARY 2,32,654.00 3,67,740.75
092023 COUNT22
10/01/2024 DEPOSIT,Bajaj 09 January 2024PREMIUM AMOUNT 20,41,914.20 24,09,654.95
IGL Count3078GL169 MFIG Count82VJL6JEEVADHARA

Statement Summary:-
Opening Balance Dr Count Cr Count Debits Credits Closing Balance
1,11,67,666.76 9 18 4,07,00,010.09 3,19,41,998.28 24,09,654.95

Unless the constituent notifies the Bank of any discrepancy in this statement within 15 days from the date of statement, it will be construed that this transaction(s) in the statement are
correct.This is a computer generated statement requires no signature.
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Branch : Andheri East, Unit No.15, OPTIONS PRIMO, Plot No.X-21, Cross Road No.21, MIDC,Andheri(Esat),Mumbai - 400093 MUMBAI Maharashtra INDIA 400093

Name: BAJAJ ALLIANZ LIFE INSURANCE COMPANY LIMITED Branch IFSC Code : ESMF0001148
Address: GORUND FLOOR 2 6 FLOOR BAJAJ ALLIANZ Account Number : 20180000024486
HOUSE AIRPORT ROAD YERAWADA Branch of Ownership : Andheri East
YERAWADA 411006 Branch MICR Code : 400760002
MAHARASHTRA INDIA Date Opened : 10/12/2018
Signatories: MR. SHAM YASHWANT TANAWADE (AUTH.SIGN.) Activation Date : 20/12/2018
MR. ANAND GANDHI (AUTH.SIGN.) Currency Code : INR
MR. RAJAT KAPOOR (AUTH.SIGN.) Account Status : Active

Statement of Account
From:01/01/2024 To:10/01/2024

Unless the constituent notifies the Bank of any discrepancy in this statement within 15 days from the date of statement, it will be construed that this transaction(s) in the statement are
correct.This is a computer generated statement requires no signature.