L$TAR Nesh

ne &Carteg surace
T Nealth INance Speciet Star Health and Allied Insurance Company
Limited

Tax Certificate

To

Customer Name ENJAMURI VENUGOPALA SWAMY

Address H.No: 35-2-392/2,

DWARAKA SAI COLONY PHASE 1,ROAD No. 5, GOPALPUR, HANAMKONDA
506001
505467

D of Income Tax Act 1961 and any amendments

Subject: Premium Certificate for the purpose of deduction under Section 80
made thereafter.

Dear Customer,
Insurance Coverage under "Health Insurance Policy"
This is to certify that the company has received the premium for Health
with the following details.
Mrs. BALASANISATYAMMA
Mrs. ENJAMURI RAMAKKA P/131400/01/2022/010066
P/131400/01/2023/011854
Policy Holder's Name : Policy No. :
Sr Citizen Red Carpet Total Premium : 50480
Policy Name: Insurance Plan
Policy End Date : 09/09/2023
09/09/2024
Policy Start Date: 10/09/2023
10/09/2022
Servicing Branch
Customer GSTIN : GSTIN : 36AAJCS4517L1ZZ

Customer Code :
Premium Terms : Non-Installment
AA0007704236
Servicing Branch #11-25-30, JAKOTIA COMPLX, M.G
Servicing Branch 131400- Area Ofice. Address :
Code &Name: ROAD,
Warangal POCHAMMA MAIDAN, WARANGAL -
Area Office - Warangal 506002.

IGST CGST SGST

Total Premium
Receipt Date Basic Premium % Rs.
% Rs. % Rs.

9 3850 3850 50480

10-SEP-22
10-SEP-2023 42780

The Product is eligible for deduction us 80D of the Income Tax Act 1961 and any amendments made there to.

Amount
Financial Year

Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road, Nungambakkam,Chennai - 600034,Phone: 044 -28302700 / 28288800 Toll Free Fax No. 1800-425-5522 Toll
Free No1800-425-2255/ 1800-102.4477, CIN US8010TN2005PLCO56649 Email :support@starthealth.in Website www.starheath in IRDAI Regn.no: 129
EHALNUBER-0082tES3T1331 84 7el4se Tb4r861b1s4
RMargabandhu OD25420$13/e004
OSTARHEAL HAND AL 1ED NSRANE COM
Dale SaL Feb 04 124 ST 21
 2023-2024 50480
25960

Note:-
1) This certificate must be surrendered to the Insurance Company of insurance of fresh Certificate in case of Cancellation of the
Policy or any alternation in the Insurance affecting the Premium.
2) This Certificate is reflecting the Premium(s) Receipts cleared at the time of generating this certificate.
3) The Liability of any changes in the Premium Receipt's clearing status post generating the certificate shall be upon the
policy holder.

Date : 10/09/2023
25/01/2024 For and On behalf of

Place : WARANGAL Star Health and Allied Insurance Company Ltd

IRDA Regn. No 129

Corporate Identity Number L66010TN2005PLC056649

Email ID : info@starhealth.in Authorised signatory.

Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800 Toll Free Fax No: 1800-425-5522 Toll
Free No:1800-425-2255 / 1800-102-4477,CIN : L66010TN2005PLC056649 Email :support@starthealth.in Website :www.starhealth.in IRDAI Regn.no: 129