Date: 22/06/2024

To, Servicing Branch: NAGPUR

Ms SMITA SUNILRAO POKALE Magma HDI General Insurance Company Ltd
Branch Office Address: 2ND FLOOR, AMBAR, 22/B, TILAK NAGAR NAWAB AREA, ,HOUSE NO
D 50 4 VIDYUT VIHAR KTPS ,COLONY KORADI NAGPUR 736, ,NAGPUR -440010 ,MAHARASHTRA , PH: (1800) 2663202
NAGPUR GST Number - 27AAGCM1685C1ZJ
MAHARASHTRA 441111
Mobile:7875786970
Contact Number: 7875786970
Email ID: SMITAPOKALE@GMAIL.COM
GST Number : Unregistered IMD Code : AGD0005984
IMD Name : KALYANI MUKUNDRAO THAWKAR
IMD Aadhar No : Customer ID: 20014398640

Ref: Renewal Premium for PvtCarPackage Policy No. P0024200024/4101/100484

Total Premium Payable (With 45% NCB): 7476 Total Premium Payable (Without NCB): 8148
(In case claim is registered post 22/06/2024)

Dear Ms SMITA SUNILRAO POKALE ,

Thank you for choosing Magma HDI for your insurance needs. It is our privilege to have you as our customer. We wish to remind you that your Motor Policy expires on midnight of 26/07/2024. As our esteemed
customer, it is our endeavor to ensure that you enjoy uninterrupted peace of mind by availing continued insurance cover.

Please arrange to send the premium on or before the expiry date, in order to maintain continuity of cover. The cheque / demand draft should be drawn in favor of 'Magma HDI General Insurance Company Ltd'.

Once again, thank you for choosing Magma HDI and we look forward to being of service to you.

For Magma HDI General Insurance Co. Ltd.

Authorised Signatory

Expiring Policy Coverages Renewal notice coverage

Basic - OD,Basic - TP,LL to Paid Driver IMT 28,Engine Protector,PA Owner Driver,Zero Depreciation,Basic Basic - OD,Basic - TP,Basic Roadside Assistance,Zero Depreciation,Engine Protector,Consumables,LL
Roadside Assistance,Consumables,Add On Cover Bundle,Personal Accident Cover-Unnamed to Paid Driver IMT 28,PA Owner Driver,Personal Accident Cover-Unnamed

To renew your policy:

*visit www.magmahdi.com for Our Branch Locator

Renewal Instruction Form

INSURED MOTOR VEHICLE DETAILS

Make/Model/Type of Body MARUTI MARUTI CELERIO/HATCH Engine No. K10BN2152677 Registration Mark & No MH 40 BJ 0030
Year of Manufacture 2018 Chassis No. MA3ETDE1S00531255 Eligible NCB 45%

INSURED'S DECLARED VALUE

VEHICLE IDV ( ) TRAILER IDV ( ) SIDE CAR IDV ( ) NON-ELECTRICAL ACCESSORIES IDV ( ) ELECTRICAL ACCESSORIES IDV ( ) CNG / LPG Kit ( ) TOTAL IDV ( )
198034 0 0 0 0 0 198034

PREMIUM COMPUTATION
PARTICULARS AMOUNT
A: TOTAL OF OWN DAMAGE PREMIUM CONSIDERING NCB OF 45 % 695.00
B: TOTAL OF THIRD PARTY PREMIUM 2,619.00
NET PREMIUM (INCLUDING ALL DISCOUNT & LOADING) (A+B) 3,314.00
C: PREMIUM PAYABLE INCLUDING CGST , SGST (EXCLUDING MOTOR ADD-ON COVER PREMIUM) 3911

MOTOR ADD-ON COVER APPLICABLE YES

COVERAGE DETAILS ,,Zero Depreciation,Basic Roadside Assistance,Engine Protector,Consumables
D: MOTOR ADD ON COVER PREMIUM PAYABLE INCLUDING CGST , SGST 3,566.00

TOTAL PREMIUM PAYABLE: (C+D) 7,477.00

In case of revision in Motor Third Party (TP) rates, the difference in premium due to the revised rates will be payable by the policyholder.

Hire Purchase/ Lease /Hypothecated with :

Nominee Details of Compulsory PA for Owner-Driver:
Nominee Name Age Relationship
Mr.Vishal Damedhar 44 Husband
*In case of incomplete or no details of Registration/Engine/Chassis No, please provide the RC copy.

Cheque/Demand Draft No.___________________ Dated._________________ Amount of Rs.____________/- Bank / Branch Name :______________________________
Address (If any change):_________________________________________________________________________________________________
Contact Details: Phone No._______________________ Mobile No. :_____________________ Email:___________________________________
GST Number ___________________________________ Aadhaar Number: ________________________ PAN Number: ____________________________
Insured's Signature:____________________________
The total premium mentioned above is inclusive of GST and subject to change due to any revision in the GST rates.

Head Office: UNIT NO. 1B & 2B, 2ND FLOOR, EQUINOX BUSINESS PARK, TOWER 3, LBS MARG, KURLA (WEST), MUMBAI, MAHARASHTRA, 400070.
Registered Office: DEVELOPMENT HOUSE, 24 Park Street , Kolkata -700016.
Toll Free no.: - 1800 266 3202
Email: customercare@magma-hdi.co.in Website: www.magmahdi.com
IRDA Registration no.149
 CIN.U66000WB2009PLC136327
UIN: IRDAN149RP0001V02201213