RENEWAL LIFE INSURANCE PREMIUM RECEIPT

Insured Name Policyowner

: SIVAKUMAR S P : SIVAKUMAR S P

Policy No Receipt Date Agent/Broker Code

: C036015441 : 2011/11/19 : 004002577

Agent/Broker Name : TATA AIG CHENNAI Office Code : CH01

Payment Mode
Monthly

Payment Method
Autopay

Basic Plan Name

Tata AIG Life Life Plus (110N030V01)

Premium due Period

From 2011/11/19 to 2011/12/19

Modal Premium
349.00

Service Tax*
5.00

Amount Due
354.00

Amount Received
354.00

Temporary Receipt No
R2031248

Date
2011/11/19

Amount (INR)
354.00

Excess as on date (if any) : 0.00 Next Premium Due on : 2011/12/19

Upon issuance of this receipt, all previously issued temporary receipts, if any, related to this policy are considered null and void. Any excess premium will be deposited in Future Policy Deposit Fund (FPDF). The amount lying in FPDF shall not bear any interest. Tax benefits on Life Insurance Policies are available u/s 80C, on Pension Policies u/s 80CCC & on Health Policies/Riders u/s 80D. Tax benefits u/s 80D are not available for premium payments in cash. This is a computer-generated receipt and does not require signature.
This receipt is null and void ab initio, if the cheque / any other valid negotiable instrument as per the Negotiable Instruments Act,1881, as receipted by the Company vide this receipt , is reported as dishonoured by the Company bank or any other Financial Institution on which the Negotiable instrument is drawn or is not acceptable to the Company due to any reason deemed fit by the company. *Service tax is payable on life insurance premium as per section 65(105)(zx) of Finance Act, 1994, as amended by Finance Act (No. 2), 2004 at the applicable rates as per circular number F. No. B2/8/2004-TRU (Tax Research Unit), dated 17th September 2004 issued by Government of India, Ministry of Finance and subsequent directions issued by the authorities from time to time.

Tata AIG Life Insurance Company Ltd. (Reg. No. 110)

Tata AIG Life Insurance Company Ltd. (Reg. No. 110) XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

<<Branch Orchard Avenue, Hiranandani Regd./Corporate Office : Delphi-B Wing, 2nd Floor,Address>> <<Branch Tel No>> Business Park, Powai, Mumbai - 400 076 Corporate & Regd. Office: Delphi, B-Wing, 2nd Floor, Orchard Avenue, Hiranandani Business Park, Powai, Mumbai 400076 For more information, call the Tata AIG Toll-free 24-hour Helpline at 1-800-119966 or You can also SMSSERVICE to 58888. You can now get your more information, call our Helpline No's 1-800-11-9966to register your e-mail id with us by writing in to customercare@tata-aig.com For policy information on e-mail. We urge you (toll free BSNL & MTNL only) or at 1-860-266-9966 (local charges apply)
You can now get your policy information on e-mail. We urge you to register your e-mail id with us by writing in to customercare@tata-aig.com

C036015441

S/ROR/Other/478