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PO Go Digit General Insurance Ltd.

Schedule/Receipt
Digit Two-Wheeler Liability Only Policy
UIN No.: IRDAN158RP0003V01201718

Name MD QUDDUS ANSARI Vehicle Registration No. BR07R7931

Address AT-BAKERGANJ,PO-PS-L Partner Name SABITA MEHTA
SARAI,DBG,BIHAR,0,Darbhanga-846005 1030540

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Partner Code

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Mobile xxxxxxxxx1877 Partner Mobile No. 7903642498 PB

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Email kxxxh@gxxxl.com Partner Email angelsabitamehta@gmail.com

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PAN (POSP) CQMPM3137J

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Aadhar No. For Claims, contact us at 1800-258-5956

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50

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YOUR POLICY DETAILS

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Policy No. D141861679 / 28032024 Policy Issue Date Invoice No. IA129377323
29-Mar-2024 10:58:48

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CG From
Period of Policy Policy Term 1 Year

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To 28-Mar-2025 23:59:59

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PB From -- 28-Mar-2024

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Period of Policy for PA Owner Driver Invoice

-2
To -- Date

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YOUR VEHICLE DETAILS

5-
RTO location Darbhanga,BIHAR Make HERO HONDA Model/Vehicle

2
Variant (Sub- PASSION PRO/CAST SELF

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POS
G01 Engine No. HA10ENEHG51681 Chassis No. MBLHA10A6EHG29341 Type)
64.26

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Body Type Motor Cycle Fuel Type Petrol Year of Regn 2014

-2
Seating

3
2
Capacity Cubic Capacity 97 CC
-0 Year of Mfg. --
24
4.5 FASTag Financier
Odometer
20

Number Details
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ENDORSEMENT
PR
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Invoice Number Invoice Date Net Premium Igst Cgst Sgst Utgst Cess Gross Premium
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IA129377323 2024-03-28 764.00 0.00 68.76 68.76 0.00 0.00 901.52

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FH
PA

CGS
Age LIABILITY PREMIUM (`)
A

FH Basic Third-Party Liability (`) 714.00 PA cover for Owner-Driver (`) --

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N

PA cover for 2 unamed passengers each 0 (`) -- PA cover for Paid Driver 0 (`) --
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POS Legal Liability to Employees (`) Legal Liability to Paid Driver (`) 50.00
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Net Premium (`) 764.00

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ER

CGST @ 9% = (`68.76 ) + SGST/UTGST @ 9% = (`68.76) 137.52

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31

Final Premium (`) 901.52

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BR

Previous Insurer -- Previous Policy No. --

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Previous Policy
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IMT - Endorsements
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xt Expiry Date
Unregistered
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GSTIN/UIN No. State Code 10

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Receipt No. RA156045177 Receipt Date 28-Mar-2024

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Nominee Details
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Other Detials --
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Go Digit General Insurance Ltd, GST Reg No 10AACCO4128Q1ZF , PAN No:- AACCO4128Q, HSN: 997134/General Insurance Services, GSTIN Address
:Darbhanga Business Centre,2nd Floor, Rajeshwari Complex, G M Road, Opp to Radio Station,Darbhanga,Bihar,PIN-846004. Website : www.godigit.com.
Corporate office Address : Atlantis, 95, 4thB Cross Road, Koramangala Industrial Layout, 5thBlock, Bengaluru, Karnataka, PIN – 560095, IRDAI Reg No. 158,
CIN – U66010PN2016PLC167410