Premium Receipt
Dear Mr. Mushtaq Satkut
Flat no. 404,S.S Heritage, Sector-20,
Plot No.9, Ulwe, Navi Mumbai
We acknowledge the receipt of payment towards the premium of the following health insurance policy:
Policy Holder's Name Mr. Mushtaq Satkut Policy Number 30209164701210
Plan Opted for Family First Sllver50 lacs Sum Insured (Rs) 50,00,000
Commencement Date 03/04/2024 Expiry date 02/04/2025
Net Premium (Rs.) 50,897.00
Service Tax (Rs.) 5,108.00
Education Cess (Rs.] 110.00
Secondary & Higher Education Cess (Rs.) 56.00
Gross Premium (Rs.) 56,171.00
•stamp Duty
•insurance policy is subject to clearance of premium paid
Details at personsI nsured:
Name of person Insured Age Gender Relationship to policy holder Individual Cover(Rs.)
(Only in case of family first}
Mr. Mushtaq Satkut 65 M
Father 25,00,000
Mrs. Ruksana Satkut 61 F
Mother 25,00,000
Upon issuance of this receipt, all previously issued temporary receipts, if any, related to this
policy are considered null and void. For the purpose of deduction under section 80D,the
benefit shall be as per the provisions of the Income Tax Ad,1961and any amendments made
thereafter. In the event of non-realization of premium.
For your eligibility and deductions please refer to provisions of Income Tax Act 1961as
modified and consult your tax consultant.
Service tax Registration number . AAFCM791611ST001
For & On behalf of Max Bupa Health Insurance Co. Ltd.
Location:Mumba
i
Date:17/04/202 Ashish
4 Mehrotra Managing Director & Chief
Executive Officer
