Ref.

No…………………………… Date: 02nd November 2022

TO WHOM SOEVER IT MAY CONCERN

This is to certified that Sh. Darshan Singh S/o Swaran Singh resident of Vill:
Mansurpur Badala, PO: Salala, Distt. Jalandhar, Punjab.

The above said member is policy holder of our organization i.e Royal
Sundaram General Insurance in respect of his vehicle Registration Number
PB08 CA 1728, Make BOLERO ZLX 2WT, Engine Number GPCA344125
and Chassis Number MA1XX2GPAK2A6451241, Vehicle Class LMV.

The Policy Number is being issued to the said policy holder as follows:
Policy Number Valid upto
0176014554421465 24 October 2014
th

0176014554445685 24th October 2016

0176014554441265 24th October 2018
0176014554477459 24th October 2020
0176014554436541 24th October 2022

Apart from that, we hereby certify that the said member had not availed any
claim under this insurance policy.

This certificate is being issued to him on his request.

Thanking you,
For Royal Sundaram General Insurance Limited

Authorized Signatory

# 37/2B, Singasandra, Near Kaveri School, Hosur Main Road, Bangalore 560068.
Mob :9632177070, Web : www.royalsundaram.in E-mail: avinash.bcom@gmail.com