THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
COLLECTION RECEIPT CUM ADJUSTMENT VOUCHER
Issuing Office : BANGALORE DO I (670100)
Address : CITY DIVISIONAL OFFICE : I, NO. 40, LAXMI COMPLEX, K R ROAD,
OPP:VANIVILAS HOSPITAL
BANGALORE,560002
BANGALORE
Insured Pan Number :
Phone : 08026703898
Email : nia.670100@newindia.co.in
Fax : 08026703898
Collection Number : 67010081240000086584
Collection Date : 21/12/2024
Business Source Code : BR00001128
PAN No of Payer :
Received with thanks from MANIESH D B.
The amount received/Adjusted is towards -
Policy No. A/C Description Amount` A/C Code Sub A/C Code
67010031240200085392 Bank-670100 4030.00 9100.670100 BA00026906-670100-9100
Total = ` 4030.00
Your Payment/Adjustment Details are as under -
Mode Amount ` Cheque Cheque Date Drawee Bank Drawee Branch Reference No. Scroll/BG/A
No. PD Balance
ECS 4030.00 VF24122 N.A. null null 6701002410862058 N.A.
113
4554119
920
6327
Total = ` 4030.00
Utilization details of the Collected Amount :
Premium GST Stamp Duty Excess Amount
3416.00 614.00 0.00 0
Sl no. Agency Code Agency Name Department Code
1 NA PHONEPE INSURANCE BROKING SERVICES PRIVATE 31
LIMITED
For The New India Assurance Company Limited
Revenue Stamp
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Date of Issue: 21/12/2024
(Ms. MANJULA
VISHAL)
[Off. B O INCHARGE]
Cashier's Initial Authorized Signatory
Note -
1.Please note the Policy Number, Collection Number and date in all future correspondence. .
2.NIA shall not be liable for any claim arising out of sales made during the period between the due date and date of payment of the
installment
Signature Not if the premium paid has been exhausted by turnover declarations/if there is insufficient premium balance.
Verified
Digitally signed
by DHIRAJ
KUMAR
Date: 2024.12.21
13:52:30 IST
Policy No. : 67010031240200085392Document generated by PHONEPE at 21/12/2024 13:52:09 Hours.
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
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THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)
We hereby declare that though our aggregate turnover in any preceding financial year from
2017-18 onwards is more than the aggregate turnover notified under sub-rule (4) of rule 48,
we are not required to prepare an invoice in terms of the provisions of the said sub-rule.
Tax Invoice No : 67010024P0088538
IRDA Registration Number: 190
NIA PAN NUMBER: AAACN4165C
Policy No. : 67010031240200085392Document generated by PHONEPE at 21/12/2024 13:52:09 Hours.
Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
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