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Premium Payment Acknowledgment

Dear Malwinder Singh,

We thank you for giving us an opportunity to serve you on the Web Platform.

This is with reference to the

Online Premium Payment

submitted for

Policy Number 11904861 under

Transaction ID: 3699168 , on 09-Jan-2012

Please note that as per your instruction the transaction of online premium payment is

SUCCESS

Net Premium Paid Mode of Payment Card/Bank Name

Transaction Details 10000.0 Debit Card ICICI Bank Ltd(Visa Card)

In case the transaction status is a success, kindly allow us one working day to generate the Premium Receipt. The same can be downloaded from E-Statements > Premium Receipt section on the next working day.

In case of any further clarification or assistance required in this regards, kindly write back to us at lifeline@iciciprulife.com

Note:
This is NOT A PREMIUM RECEIPT but only a proof of the payment made by Proposer. The premium receipt shall be generated by ICICI Prudential Life Insurance Co. Ltd., subject to applying renewal premium such a premium receipt may be used for claiming tax benefits. This acknowledgment is conditional upon credit in company's account post clearance of the facility. Proposer shall be solely responsible for correctness of the information provided to ICICI Prudential Life Insurance Co. Ltd. for use of the facilities. ICICI Prudential Life Insurance Co. Ltd. does not accept any liability for consequence arising from incorrect information provided by the Proposer. This is a computer generated slip and does not require any signature. For further clarifications please contact our customer service touch points. the details for which are available at http://www.iciciprulife.com/public/Others/Call-us.htm

Thanks and Regards,

ICICI Prudential Life Insurance

ICICI Prudential Life Insurance Company Limited. Communication Address:Vinod Silk Mills Compound,Chakravarthy Ashok Road, Ashok Nagar,Kandivali(E), Mumbai-400 101 Registered Office:ICICI Prulife Towers,1089, Appasaheb Marathe Marg,Prabhadevi,Mumbai-400 025 Page 1