PREMIUM COLLECTION RECEIPT AGAINST LAPSED POLICY
Servicing Branch:
GSTIN No:
PERSONAL DETAILS
Name of Proposer : M PRADEEP KUMAR Invoice/Receipt No : WC0059533127
Contact No : XXXXXX7100 Invoice/Receipt Date : 20/08/2025
Policy No : 54136321 Date of Printing : 20/08/2025
Communication Address :
GST State Code of Customer :
Place of Supply :
Please update your latest email address and contact number to help us to keep you informed of key updates on your life insurance policy.
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POLICY DETAILS PREMIUM DETAILS
Policy No.: 54136321 A. Previous Renewal Date: 05/07/2025
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Plan Name: Nishchit samrudhi Income Limited B. Suspense Amount: 0.88
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Premium Amount: 489234.55 (incl of rider and GST) C. Amount Received: 491580.00
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Policy Term: 28 D. New Balance (B+C): 491580.88
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Premium Payment Term: 7 E. Installment Amount: 489234.55
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Final Installment Due Date: 05/07/2028 F. No. of Installment (D/F): 1
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G. Next Renewal Date: 05/07/2026
H. Pending Inst. Amount: 489234.55
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ADVISOR DETAILS
I. Interest Amount: 4561.91
Advisor Code: 21253501
J. Total Inst. Amount: 489234.55
Advisor Name: SYAM MOHAN
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SGST/UTGST Amount: 5383.0
Advisor Contact No.: 9645922983 / 9645922983
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CGST Amount: 5383.0
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CESS Amount: 0.00
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HSN Code (Life insurance services): 9971
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PAYMENT DETAILS
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Payment Type Receipt No. Cheque/DD No. Cheque/DD Date Bank Name Amount
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CHEQUE WC0059533127 364880 20/08/2025 FEDERAL BANK 491580.00
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Amount Received : 491580.00
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Amount (in words) : Rupees Four Lakh Ninety One Thousand Five Hundred and Eighty Only
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CONSOLIDATED REVENUE STAMP DUTY OF RE.1/-PAID VIDE NOTIFICATION NO: Mudrank CSD/306/2021/1265/2021 : DATED 30.03.2021
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Seal & Signature
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[Authorised Signatory]
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TERMS & CONDITIONS
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1. This receipt is issued subject to the clearance of the cheque if payment is made by cheque. Insurance protection shall only be provided effective from the date of acceptance of
the risk.
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2. Payments to Reliance Nippon Life Insurance Company Limited formerly known as Reliance Life Insurance Company Limited are eligible for tax benefit us 80C/80CCC[1]/80D as
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applicable.
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For more details about payment options please visit www.reliancenipponlife.com.
As per recent IRDAI notification,you also have an option to apply to receive claim/maturity/any other sum under your policy through electronic transfer.
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Your nearest branch for premium payment is:
RNLIC ADDRESS SBI BANK ADDRESS AXIS BANK ADDRESS
RNLIC-4TH FLOOR, NEW SBI BANK,CHENNAKKARA BLDG,ALTHARA, AXIS BANK,BUILDING
BHARATH HEIGHTS, VELLAYAMBALAM,SASTHAMANGALAM,THIRUVANTH,KERALA,THIRUVANANTHAPURAM,695010 NO.TC.7/3530(1),JEROSY, SREEKARYAM
THYCAUD, TRIVANDRUM, ULLOOR
THIRUVANATHAPURAM ROAD,THIRUVANANTHAPURAM 695011
DISTRICT, KERALA-695014 KERALA
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