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Activa Insurance

United India Insurance Company Limited issued a receipt to Sunil Natvarlal Shah for Rs. 1,211 for the payment of final premium, CGST, and SGST towards policy number 0662813120P100404334 for a two-wheeler. The payment was made via payment gateway using instrument number SUR28700167818 drawn on CIT Bank on 11/04/2020. The receipt is valid subject to realization of the payment.

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yash shah
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134 views1 page

Activa Insurance

United India Insurance Company Limited issued a receipt to Sunil Natvarlal Shah for Rs. 1,211 for the payment of final premium, CGST, and SGST towards policy number 0662813120P100404334 for a two-wheeler. The payment was made via payment gateway using instrument number SUR28700167818 drawn on CIT Bank on 11/04/2020. The receipt is valid subject to realization of the payment.

Uploaded by

yash shah
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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UNITED INDIA INSURANCE COMPANY LIMITED


 
RECEIPT
Issuing Office 066281 / MO SHAPAR Receipt
10106628120100216147
code/Address : 110, BHOOMI COMPLEX, N.H. 8-BNEAR Number :
BANK OF INDIA, SHAPAR JUNCTION360024 Collection
11/04/2020
Date :

Received with thanks from SUNIL NATVARLAL SHAH (Customer ID : 23081855479, Customer
GST/UIN No :Not Available) a sum of Rs. 1211.00( One thousand two hundred eleven rupees
only) as per detail given hereunder:
SL Endt/Ren/Clm/Decln Total
Policy Number Policy Type Particulars
No No Amount
Final
1 0662813120P100404334 TwoWheeler 0 1,027.00
Premium
2 0662813120P100404334 TwoWheeler 0 CGST 92.00
3 0662813120P100404334 TwoWheeler 0 SGST 92.00
Total (Rounded Off) : 1,211.00
Stamp Duty : 0.00
Bank Charges : 0.00
Total Amount : 1,211.00

Instrument Details
SL Mode of Instrument Instrument Bank Branch Tagged
Payment ID
No Payment Number Date Name Name Amount
PAYMENT
1 120000100100136575 SUR28700167818 11/04/2020 CIT   1,211.00
GATEWAY
Particulars :  
GSTIN (UIIC) :   24AAACU5552C3ZN for UNITED INDIA INSURANCE COMPANY LIMITED

Cashier Initial AUTHORISED SIGNATORY


Note:
1. Receipt valid subject to realisation of cheque
2. Please quote policy no., collection no., and date in all correspondences.

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