Premium Receipt

Policy Number From Due Date To Due Date No. of Dues

0088470515 20/05/2019 20/05/2019 1

Plan Name Due Premium Total Premium Premium Paid Date & Time

Canara HSBC Oriental Bank of Commerce Life 655.47 773.46 23/05/2019 16:00:38

Service Tax + Cess Late Fee Total Amount Paid Next Due Date

0.00 0.00 773.46 20/06/2019

GST on Total Regular Premium Goods and Services Tax +

353.97 117.99

Reference Number: 227404563

Dear MR. JAYANANDA V,
This is to acknowledge the receipt of renewal premium for the above mentioned policy number.

Should you need any further assistance, please contact us on the numbers/email id provided below.

Note: - In case of discrepancy, you are requested to contact us / Specified Person immediately.
1. Please check the correctness of the policy number, premium amount and due date on this Acknowledgement.
2. In case of any excess premium, interest if any will be as per the applicable laws.
3. Premium paid on life insurance policy with the Company would be eligible for the applicable tax benefits as per Income Tax Act, 1961. Tax
benefits are subject to change in tax laws.
4. In case of linked Insurance products, allocation of NAV shall be as per the applicable IRDAI regulations as amended time to time. For further
details, please refer to sales brochure or your policy document containing T & C.
5. For any other details regarding your policy, please refer to your policy document.
6. In case of reinstatement of the lapsed policy the risk commencement date shall be from the date on which the policy is reinstated and
appropriate communication sent to the policyholder in this regard.
7. Top-up premiums should not exceed 25% of the regular premiums paid under the policy.
8. Company does not accept the premium amount in cash. Any cash payment done by the customer shall render this receipt as void and the
Company shall have no liability regarding the same.
For any assistance -
Call: 1800-103-0003/1800-180-0003 (BSNL/MTNL) SMS: 9779030003 E-mail: customerservice@canarahsbclife.in

Canara HSBC Oriental Bank of Commerce Life Insurance Company Limited (IRDAI Regn. No.136)
Corporate Office: 2nd Floor, Orchid Business Park, Sector-48, Sohna Road, Gurugram 122018, Haryana, India.
Corporate Identification No.: U66010DL2007PLC248825

This is a computer generated receipt and does not require a signature