BRANCH OFFICE : AHMEDABAD CBO-11 ( 854 )

DEVELPMENT OFFICER FIRST YEAR PREMIUM INCOME STATEMENT FOR THE MONTH OF 06/2019
DEV.OFFICER CODE : 1138083 NAME : DHARMENDRA M. PATEL DATE : 04/07/2019 PAGE : 1
POL-NO DT-OF-COLL DOC PLAN GROSS.PRM SHORT NAME
AGCD CBRN DUE PPT MODE FPSCHPREM FYSCHPREM

906604037 29-06-2019 2/2019 815 4522.00 MAHERIYA

00648854 CBK1 5/2019 15 QLY 0.00 4522.00

906604121 06-06-2019 2/2019 834 1175.00 PARMAR

00648854 854 5/2019 19 QLY 0.00 1175.00

906604536 19-06-2019 3/2019 815 1446.00 PARMAR

00648854 CBK1 6/2019 21 QLY 0.00 1446.00

906605578 17-06-2019 5/2019 836 2805.00 MAKWANA

00648854 854 5/2019 16 QLY 2805.00 0.00

906605579 17-06-2019 5/2019 843 1117.00 VANIYA

00648854 854 5/2019 20 QLY 1117.00 0.00

906605580 17-06-2019 5/2019 844 946.00 SHAKYA

00648854 854 5/2019 20 QLY 946.00 0.00

TOTAL FOR AGENT : 00648854 PREMIUM : 12011.00 FP Sch.Prem : 4868.00 FY Sch.Prem : 7143.00

906601845 03-06-2019 11/2018 815 1494.00 PARMAR

01495854 CBK1 5/2019 20 QLY 0.00 1494.00

TOTAL FOR AGENT : 01495854 PREMIUM : 1494.00 FP Sch.Prem : 0.00 FY Sch.Prem : 1494.00

906603469 28-06-2019 3/2019 836 2630.00 RABARI

01706854 CBK1 6/2019 16 QLY 0.00 2630.00

906603560 21-06-2019 3/2019 836 2365.00 PATEL

01706854 854 6/2019 16 QLY 0.00 2365.00

906603561 14-06-2019 3/2019 836 2395.00 RATHOD

01706854 854 6/2019 16 QLY 0.00 2395.00

TOTAL FOR AGENT : 01706854 PREMIUM : 7390.00 FP Sch.Prem : 0.00 FY Sch.Prem : 7390.00

906600476 13-06-2019 8/2018 815 385.00 MANGROLIYA

01709854 B083 6/2019 25 MLY 0.00 385.00

906600477 13-06-2019 8/2018 836 1185.00 MANGROLIYA

01709854 B083 6/2019 16 MLY 0.00 1185.00

906604295 10-06-2019 3/2019 815 991.00 PATEL

01709854 854 6/2019 28 QLY 0.00 991.00

906604422 10-06-2019 3/2019 815 394.00 KAILA

01709854 854 6/2019 27 MLY 0.00 394.00

906604422 10-06-2019 3/2019 815 394.00 KAILA

01709854 854 5/2019 27 MLY 0.00 394.00

906604510 10-06-2019 3/2019 815 411.00 KAILA

01709854 854 6/2019 26 MLY 0.00 411.00

906604510 10-06-2019 3/2019 815 411.00 KAILA

01709854 854 5/2019 26 MLY 0.00 411.00

TOTAL FOR AGENT : 01709854 PREMIUM : 4171.00 FP Sch.Prem : 0.00 FY Sch.Prem : 4171.00

906601023 13-06-2019 9/2018 832 1004.00 LOHAR

01784854 B083 6/2019 23 MLY 0.00 1004.00

TOTAL FOR AGENT : 01784854 PREMIUM : 1004.00 FP Sch.Prem : 0.00 FY Sch.Prem : 1004.00

906600603 18-06-2019 8/2018 833 1873.00 VERMA

01913854 B083 6/2019 22 MLY 0.00 1873.00
 BRANCH OFFICE : AHMEDABAD CBO-11 ( 854 )
DEVELPMENT OFFICER FIRST YEAR PREMIUM INCOME STATEMENT FOR THE MONTH OF 06/2019
DEV.OFFICER CODE : 1138083 NAME : DHARMENDRA M. PATEL DATE : 04/07/2019 PAGE : 2
POL-NO DT-OF-COLL DOC PLAN GROSS.PRM SHORT NAME
AGCD CBRN DUE PPT MODE FPSCHPREM FYSCHPREM

906601873 06-06-2019 11/2018 833 2195.00 PATEL

01913854 854 6/2019 22 MLY 0.00 2195.00

906601873 06-06-2019 11/2018 833 2195.00 PATEL

01913854 854 5/2019 22 MLY 0.00 2195.00

906601979 24-06-2019 11/2018 833 12514.00 PATEL

01913854 854 5/2019 22 HLY 0.00 12514.00

906603293 13-06-2019 3/2019 833 2670.00 CHAUDHARI

01913854 B083 6/2019 22 MLY 0.00 2670.00

906603294 13-06-2019 3/2019 833 1837.00 THAKOR

01913854 B083 6/2019 22 MLY 0.00 1837.00

906604732 25-06-2019 2/2019 836 13450.00 PATEL

01913854 CBK1 5/2019 16 QLY 0.00 13450.00

906605550 13-06-2019 6/2019 836 2287.00 PITHADIA

01913854 854 6/2019 16 QLY 2287.00 0.00

906605573 15-06-2019 4/2019 833 29859.00 BARIYA

01913854 854 4/2019 20 HLY 29859.00 0.00

906605598 21-06-2019 6/2019 905 2152.00 PATEL

01913854 854 6/2019 30 HLY 2152.00 0.00

TOTAL FOR AGENT : 01913854 PREMIUM : 71032.00 FP Sch.Prem : 34298.00 FY Sch.Prem : 36734.00

906600188 25-06-2019 7/2018 845 1367.00 PRAJAPATI

01943854 B083 6/2019 15 MLY 0.00 1367.00

906602594 06-06-2019 1/2019 834 1124.00 PRAJAPATI

01943854 854 6/2019 16 MLY 0.00 1124.00

906602594 06-06-2019 1/2019 834 1124.00 PRAJAPATI

01943854 854 5/2019 16 MLY 0.00 1124.00

906602594 06-06-2019 1/2019 834 1124.00 PRAJAPATI

01943854 854 3/2019 16 MLY 0.00 1124.00

906602594 06-06-2019 1/2019 834 1124.00 PRAJAPATI

01943854 854 4/2019 16 MLY 0.00 1124.00

906605546 13-06-2019 6/2019 815 2101.00 RAVAT

01943854 854 6/2019 16 QLY 2101.00 0.00

906605566 15-06-2019 6/2019 815 1370.00 VARLEKAR

01943854 854 7/2019 21 MLY 0.00 1370.00

906605566 15-06-2019 6/2019 815 1370.00 VARLEKAR

01943854 854 6/2019 21 MLY 1370.00 0.00

906605567 15-06-2019 6/2019 815 1160.00 VARLEKAR

01943854 854 7/2019 21 MLY 0.00 1160.00

906605567 15-06-2019 6/2019 815 1160.00 VARLEKAR

01943854 854 6/2019 21 MLY 1160.00 0.00

TOTAL FOR AGENT : 01943854 PREMIUM : 13024.00 FP Sch.Prem : 4631.00 FY Sch.Prem : 8393.00

906603004 26-06-2019 2/2019 815 1485.00 PATEL

01979854 CBK1 5/2019 21 QLY 0.00 1485.00
 BRANCH OFFICE : AHMEDABAD CBO-11 ( 854 )
DEVELPMENT OFFICER FIRST YEAR PREMIUM INCOME STATEMENT FOR THE MONTH OF 06/2019
DEV.OFFICER CODE : 1138083 NAME : DHARMENDRA M. PATEL DATE : 04/07/2019 PAGE : 3
POL-NO DT-OF-COLL DOC PLAN GROSS.PRM SHORT NAME
AGCD CBRN DUE PPT MODE FPSCHPREM FYSCHPREM

TOTAL FOR AGENT : 01979854 PREMIUM : 1485.00 FP Sch.Prem : 0.00 FY Sch.Prem : 1485.00

906602122 28-06-2019 11/2018 815 2803.00 KHANT

02029854 854 5/2019 25 QLY 0.00 2803.00

906602248 28-06-2019 11/2018 815 2716.00 KHANT

02029854 854 5/2019 25 QLY 0.00 2716.00

TOTAL FOR AGENT : 02029854 PREMIUM : 5519.00 FP Sch.Prem : 0.00 FY Sch.Prem : 5519.00

906604470 17-06-2019 3/2019 814 1436.00 SUTHAR

02069854 CBK1 6/2019 18 QLY 0.00 1436.00

TOTAL FOR AGENT : 02069854 PREMIUM : 1436.00 FP Sch.Prem : 0.00 FY Sch.Prem : 1436.00

906605512 06-06-2019 6/2019 836 11118.00 PATEL

02082854 854 6/2019 15 YLY 11118.00 0.00

906605684 28-06-2019 6/2019 850 500000.00 PATEL

02082854 854 6/2019 1 SGL 25000.00 0.00

TOTAL FOR AGENT : 02082854 PREMIUM : 511118.00 FP Sch.Prem : 36118.00 FY Sch.Prem : 0.00

906601333 05-06-2019 10/2018 815 953.00 THAKOR

02193854 CBK1 6/2019 20 MLY 0.00 953.00

906601333 05-06-2019 10/2018 815 953.00 THAKOR

02193854 CBK1 5/2019 20 MLY 0.00 953.00

906601334 05-06-2019 10/2018 836 788.00 THAKOR

02193854 CBK1 6/2019 16 MLY 0.00 788.00

906601334 05-06-2019 10/2018 836 788.00 THAKOR

02193854 CBK1 5/2019 16 MLY 0.00 788.00

906602156 25-06-2019 12/2018 815 1149.00 KANZARIYA

02193854 B083 6/2019 25 MLY 0.00 1149.00

906602157 25-06-2019 12/2018 832 702.00 KANZARIYA

02193854 B083 6/2019 25 MLY 0.00 702.00

906602158 25-06-2019 12/2018 832 815.00 KANZARIYA

02193854 B083 6/2019 22 MLY 0.00 815.00

906603003 28-06-2019 2/2019 820 1287.00 RAVAL

02193854 CBK1 6/2019 15 MLY 0.00 1287.00

906603781 02-06-2019 3/2019 821 988.00 THAKOR

02193854 CBK1 6/2019 20 MLY 0.00 988.00

906603882 30-06-2019 3/2019 821 1487.00 GOHIL

02193854 CBK1 6/2019 20 MLY 0.00 1487.00

906604146 28-06-2019 3/2019 820 1286.00 RAVAL

02193854 CBK1 6/2019 15 MLY 0.00 1286.00

906604296 28-06-2019 3/2019 815 2785.00 TIWARI

02193854 CBK1 6/2019 21 QLY 0.00 2785.00

906604737 13-06-2019 3/2019 821 994.00 THAKOR

02193854 CBK1 6/2019 20 MLY 0.00 994.00

906605115 18-06-2019 4/2019 815 807.00 RATHORE

02193854 B083 6/2019 25 MLY 0.00 807.00

906605527 12-06-2019 6/2019 815 1390.00 KATHERIYA

02193854 854 6/2019 15 MLY 1390.00 0.00
 BRANCH OFFICE : AHMEDABAD CBO-11 ( 854 )
DEVELPMENT OFFICER FIRST YEAR PREMIUM INCOME STATEMENT FOR THE MONTH OF 06/2019
DEV.OFFICER CODE : 1138083 NAME : DHARMENDRA M. PATEL DATE : 04/07/2019 PAGE : 4
POL-NO DT-OF-COLL DOC PLAN GROSS.PRM SHORT NAME
AGCD CBRN DUE PPT MODE FPSCHPREM FYSCHPREM

906605527 12-06-2019 6/2019 815 1390.00 KATHERIYA

02193854 854 7/2019 15 MLY 0.00 1390.00

906605533 12-06-2019 6/2019 815 477.00 KATHERIYA

02193854 854 7/2019 21 MLY 0.00 477.00

906605533 12-06-2019 6/2019 815 477.00 KATHERIYA

02193854 854 6/2019 21 MLY 477.00 0.00

906605602 21-06-2019 6/2019 821 1539.00 GOSWAMI

02193854 854 6/2019 20 MLY 1539.00 0.00

906605602 21-06-2019 6/2019 821 1539.00 GOSWAMI

02193854 854 7/2019 20 MLY 0.00 1539.00

TOTAL FOR AGENT : 02193854 PREMIUM : 22594.00 FP Sch.Prem : 3406.00 FY Sch.Prem : 19188.00

906600562 13-06-2019 8/2018 836 1592.00 MISTRI

02198854 B083 6/2019 16 MLY 0.00 1592.00

906600563 13-06-2019 8/2018 834 438.00 MISTRI

02198854 B083 6/2019 17 MLY 0.00 438.00

906601532 25-06-2019 10/2018 834 438.00 PRAJAPATI

02198854 B083 6/2019 17 MLY 0.00 438.00

906601670 18-06-2019 11/2018 836 821.00 PRAJAPATI

02198854 B083 6/2019 16 MLY 0.00 821.00

906602009 13-06-2019 12/2018 836 8205.00 AKHTAR

02198854 CBK1 6/2019 15 QLY 0.00 8205.00

906602030 27-06-2019 12/2018 836 2956.00 PATEL

02198854 CBK1 6/2019 16 QLY 0.00 2956.00

906602346 12-06-2019 12/2018 815 1536.00 SHAH

02198854 CBK1 6/2019 21 QLY 0.00 1536.00

906602443 27-06-2019 1/2019 815 553.00 PANCHAL

02198854 CBK1 6/2019 21 MLY 0.00 553.00

906602444 27-06-2019 1/2019 815 568.00 PANCHAL

02198854 CBK1 6/2019 21 MLY 0.00 568.00

906603537 18-06-2019 3/2019 814 292.00 ZALA

02198854 B083 6/2019 35 MLY 0.00 292.00

906603596 20-06-2019 3/2019 844 1039.00 THAKAR

02198854 854 5/2019 20 MLY 0.00 1039.00

906603596 20-06-2019 3/2019 844 1039.00 THAKAR

02198854 854 6/2019 20 MLY 0.00 1039.00

906604321 26-06-2019 3/2019 845 2992.00 PATEL

02198854 CBK1 6/2019 25 QLY 0.00 2992.00

906605507 04-06-2019 6/2019 834 1427.00 HANSRAJANI

02198854 854 7/2019 20 MLY 0.00 1427.00

906605507 04-06-2019 6/2019 834 1427.00 HANSRAJANI

02198854 854 6/2019 20 MLY 1427.00 0.00
 BRANCH OFFICE : AHMEDABAD CBO-11 ( 854 )
DEVELPMENT OFFICER FIRST YEAR PREMIUM INCOME STATEMENT FOR THE MONTH OF 06/2019
DEV.OFFICER CODE : 1138083 NAME : DHARMENDRA M. PATEL DATE : 04/07/2019 PAGE : 5
POL-NO DT-OF-COLL DOC PLAN GROSS.PRM SHORT NAME
AGCD CBRN DUE PPT MODE FPSCHPREM FYSCHPREM

TOTAL FOR AGENT : 02198854 PREMIUM : 25323.00 FP Sch.Prem : 1427.00 FY Sch.Prem : 23896.00

906602926 18-06-2019 2/2019 815 539.00 JETHWA

02219854 B083 6/2019 20 MLY 0.00 539.00

TOTAL FOR AGENT : 02219854 PREMIUM : 539.00 FP Sch.Prem : 0.00 FY Sch.Prem : 539.00

906601087 18-06-2019 9/2018 836 1397.00 CHAUDHARY

02246854 B083 6/2019 15 MLY 0.00 1397.00

TOTAL FOR AGENT : 02246854 PREMIUM : 1397.00 FP Sch.Prem : 0.00 FY Sch.Prem : 1397.00

839484877 18-06-2019 12/2017 815 1430.00 DIXIT

02256854 854 9/2018 21 QLY 0.00 1430.00

906601137 18-06-2019 9/2018 833 2036.00 PATEL

02256854 B083 6/2019 22 MLY 0.00 2036.00

906601214 18-06-2019 9/2018 815 4600.00 PATEL

02256854 B083 6/2019 21 MLY 0.00 4600.00

TOTAL FOR AGENT : 02256854 PREMIUM : 8066.00 FP Sch.Prem : 0.00 FY Sch.Prem : 8066.00

906601084 18-06-2019 9/2018 836 791.00 PRAJAPATI

02313854 B083 6/2019 16 MLY 0.00 791.00

TOTAL FOR AGENT : 02313854 PREMIUM : 791.00 FP Sch.Prem : 0.00 FY Sch.Prem : 791.00

TOTAL FOR DEV.OFFICER : 1138083 PREMIUM : 688394.00 FP Sch.Prem : 84748.00 FY Sch.Prem : 128646.00
 BRANCH OFFICE : AHMEDABAD CBO-11 ( 854 )
DEVELPMENT OFFICER FIRST YEAR PREMIUM INCOME STATEMENT FOR THE MONTH OF 06/2019
ABSTRACT

DEV.OFFICER CODE : 1138083 NAME : DHARMENDRA M. PATEL DATE : 04/07/2019 PAGE : 6

Rate Code Number Total Premium % of Credit Scheduled Premium
1 77 179274.00 100 179274.00
2 0 0 60 0
3 0 0 30 0
4 1 500000.00 5 25000.00
5 0 0 10 0
6 0 0 40 0
7 0 0 50 0
8 0 0 3.5 0
9 7 9120.00 **.** 9120.00
10 0 0 15 0
11 0 0 12 0
12 0 0 4 0
Total 85 688394.00 213394.00

F P Scheduled Premium 84748.00

F Y Premium Scheduled Premium 128646.00
Total Scheduled Premium 213394.00