Version:1.

3_(24/08/09)

Tamil Nadu 600015 ..

ct_bigboss@yahoo.co.in
Tamil Nadu 600015Chennai
24 Oct 2009
RENEWAL PREMIUM RECEIPT Saidapet, Chenna
Annasalai Little Mount

Life Assured: Mr. Chidhambaram T.R

Proposer: Mr. Chidhambaram T.R
No-26 First Floor Start early and retire comfortably.
Annasalai Little Mount Secure your life post retirement. Presenting
Saidapet, Chennai LifeStage Pension Advantage from ICICI Prudential.
Chennai For more information, SMS 'NUMBER' to 57827.
Tamil Nadu
600015 Date of Receipt Policy Status UIN *
Tel.No. :- - In Force
24/10/2009 105L083V01
Cheque Number Cheque Date Receipt Number Name of Bank
44221030
Policy Number Plan Name
10121100 LifeStage Assure
Due Date
Benefits Amount
From To
06/10/2009 06/10/2010 Lifestage Assure 30000.00

Total 30000.00

Tax benefit would be available as follows: Life Insurance Policy u/s 80C, *Interest on late payment will be charged
pension Policy u/s 80CCC, Health Policy/ rider (if any) u/s 80D. @ 0.00 p.a. compounded half-yearly
Tax benefits are as per the Income Tax Act, 1961, and are subject to any
amendments made thereto from time to time. Service Tax and Education Your next due date is : 06/10/2010
Cess extra as applicable. Servce Tax Details: Category of Service: Life
Insurance Service. Registration NO: MIV/ST/IAS-LIFE/1; Balance in Deposit 0.00
PAN BASED STC NO:AAACI7351PST001

Mudrank No.: CONSOLIDATED REVENUE STAMP DUTY PAID : NOTIFICATION NO - MUDRANK 0715/20716/CR-322/M1-26/08/2009
* UIN - Unique Identification No. Specified by IRDA.
If the payment has been made other than in cash, this receipt is conditional upon the credit in company's account post clearance of
the instrument/facility including electronic modes. This is a computer generated advice and does not require any signature.

Going Green - Committed to saving paper for a greener future: Effective Aug '09, customers on monthly premium paying
frequency will receive their printed receipts on a quarterly basis. The monthly receipts will be emailed to the registered email id
and will also be available on www.iciciprulife.com

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