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PREMIUM PAID CERTIFICATE FOR THE YEAR 2018 - 2019 Policy Holder Birth Day
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DATE OF ISSUE: 28/02/2019 List
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AgentsDiscussion This is to certify that the following premium have been received under the following
Discussion Forum life insurance policy held by Sandeep  Sharma Premium Paid Statement
For All Policies
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Name Sandeep  Sharma Claims Enquiry
Policy Number 165398220
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Plan 815 ( New Jeevan Anand )
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Policy Term 20
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Premium Paying Term 20
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Commencement Date 10/06/2014
Circulars Instalment Premium 2,822.00
Agent Circulars Mode Of Premium Payment MLY
Reference Code 17289170
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AgentBusinessReports
View Business Reports Due Number Of Premium Amount Received Collecting
Due To Status
From Instalments Received Date Branch
04/2018 04/2018 1 2,822.00 18/04/2018 B033 Normal
05/2018 05/2018 1 2,822.00 18/05/2018 B033 Normal
06/2018 06/2018 1 2,822.00 19/06/2018 B033 Normal
07/2018 07/2018 1 2,822.00 20/07/2018 B033 Normal
08/2018 08/2018 1 2,822.00 18/08/2018 B033 Normal
09/2018 09/2018 1 2,822.00 17/09/2018 B033 Normal
10/2018 10/2018 1 2,822.00 25/10/2018 B033 Normal
11/2018 11/2018 1 2,822.00 16/11/2018 B033 Normal
12/2018 12/2018 1 2,822.00 24/12/2018 B033 Normal
01/2019 01/2019 1 2,822.00 17/01/2019 B033 Normal
02/2019 02/2019 1 2,822.00 16/02/2019 B033 Normal

Total amount received towards premium for the policy number 165398220 is Rs.
31,042.00 for the financial year 2018 - 2019

This certificate is electronically generated

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