Customer Name Card Account No

MR. SHAIKH QUAIYUM B 4477 XXXX XXXX 8009

NATIONAL URDU HIGH SCHOOL,
I-BLOCK,PREMNAGAR,IDD GAH MAIDAN,
JOGESHWARI-EAST
MUMBAI 400060

Statement Period

01/04/2021 TO 31/03/2022

TRANSACTION DETAILS
Card Number : 4375 XXXX XXXX 4007
International
Date Ref. Number Transaction Details Currency
amount
Amount(in `)
19-APR-21 Principal Amount Amortization - <5/9>9 0.00 1,940.46
EMI AMAZON

19-APR-21 CGST-CI@9% 0.00 10.42

19-APR-21 SGST-CI@9% 0.00 10.42

19-APR-21 Interest Amount Amortization - <5/9>9 EMI 0.00 115.78

AMAZON

28-APR-21 CLICK TO PAY PAYMENT RECEIVED 0.00 -10,615.00

30-APR-21 Principal Amount Amortization - <4/12> 0.00 2,630.61

30-APR-21 CGST-CI@9% 0.00 26.03

30-APR-21 SGST-CI@9% 0.00 26.03

30-APR-21 Interest Amount Amortization - <4/12> 0.00 289.24

03-MAY-21 74766511123117695768506 IRCTC E TICKETING HTTPS://PLAY. IN 0.00 1,456.65

05-MAY-21 74766511125117787874715 IRCTC E TICKETING HTTPS://PLAY. IN 0.00 -16.99

05-MAY-21 74766511125117787876959 IRCTC E TICKETING HTTPS://PLAY. IN 0.00 -1,439.66

09-MAY-21 74332741130112952930617 WWW FUTUREPAY CO IN GURGAON IN 0.00 1,370.00

12-MAY-21 74766511132118076677281 PAYTM NOIDA IN 0.00 1,470.23

16-MAY-21 74332741137113661960062 FLIPKART PAYMENTS GURGAON IN 0.00 1,886.00

19-MAY-21 Principal Amount Amortization - <6/9>9 0.00 1,963.08

EMI AMAZON

19-MAY-21 CGST-CI@9% 0.00 8.38

The category of service:Credit & Debit Card,Charge Card or Other payment Card service.
RegistrationNo.Mum/Div -III/ST/CDR/23. PAN based STC No:AAACI1195HST001.
REGISTERED OFFICE IS ICICI BANK LIMITED,"LANDMARK",RACE COURSE CIRCLE, VADODARA 390 007 , INDIA.
This is an authenticated intimation/statement.Customers are requested to immediately notify the Bank of any discrepancy in the statement
 TRANSACTION DETAILS
Card Number : 4375 XXXX XXXX 4007
International
Date Ref. Number Transaction Details Currency
amount
Amount(in `)
19-MAY-21 SGST-CI@9% 0.00 8.38

19-MAY-21 Interest Amount Amortization - <6/9>9 EMI 0.00 93.16

AMAZON

30-MAY-21 Principal Amount Amortization - <5/12> 0.00 2,661.28

30-MAY-21 CGST-CI@9% 0.00 23.27

30-MAY-21 SGST-CI@9% 0.00 23.27

30-MAY-21 Interest Amount Amortization - <5/12> 0.00 258.57

01-JUN-21 74332741153115299444947 WWW FUTUREPAY CO IN GURGAON IN 0.00 2,485.00

02-JUN-21 74332741154115329973906 WWW FUTUREPAY CO IN GURGAON IN 0.00 -19.00

19-JUN-21 Interest Amount Amortization - <7/9>9 EMI 0.00 70.27

AMAZON

19-JUN-21 Principal Amount Amortization - <7/9>9 0.00 1,985.97

EMI AMAZON

19-JUN-21 74766511170124752464864 CRED HTTPS://WWW.C IN 0.00 15,233.00

20-JUN-21 SGST-CI@9% 0.00 6.32

20-JUN-21 CGST-CI@9% 0.00 6.32

30-JUN-21 Principal Amount Amortization - <6/12> 0.00 2,692.30

30-JUN-21 CGST-CI@9% 0.00 20.48

30-JUN-21 SGST-CI@9% 0.00 20.48

30-JUN-21 Interest Amount Amortization - <6/12> 0.00 227.55

19-JUL-21 SGST-CI@9% 0.00 4.24

19-JUL-21 Interest Amount Amortization - <8/9>9 EMI 0.00 47.12

AMAZON

19-JUL-21 Principal Amount Amortization - <8/9>9 0.00 2,009.12

EMI AMAZON

19-JUL-21 CGST-CI@9% 0.00 4.24

30-JUL-21 CGST-CI@9% 0.00 17.65

30-JUL-21 SGST-CI@9% 0.00 17.65

30-JUL-21 Principal Amount Amortization - <7/12> 0.00 2,723.69

30-JUL-21 Interest Amount Amortization - <7/12> 0.00 196.16

18-AUG-21 400718082021S92376882 NEFT PAYMENT RECEIVED 0.00 -15,000.00

The category of service:Credit & Debit Card,Charge Card or Other payment Card service.
RegistrationNo.Mum/Div -III/ST/CDR/23. PAN based STC No:AAACI1195HST001.
REGISTERED OFFICE IS ICICI BANK LIMITED,"LANDMARK",RACE COURSE CIRCLE, VADODARA 390 007 , INDIA.
This is an authenticated intimation/statement.Customers are requested to immediately notify the Bank of any discrepancy in the statement
 TRANSACTION DETAILS
Card Number : 4375 XXXX XXXX 4007
International
Date Ref. Number Transaction Details Currency
amount
Amount(in `)
19-AUG-21 Interest Amount Amortization - <9/9>9 EMI 0.00 23.69
AMAZON

19-AUG-21 SGST-CI@9% 0.00 2.13

19-AUG-21 CGST-CI@9% 0.00 2.13

19-AUG-21 Principal Amount Amortization - <9/9>9 0.00 2,032.45

EMI AMAZON

30-AUG-21 Interest Amount Amortization - <8/12> 0.00 164.41

30-AUG-21 SGST-CI@9% 0.00 14.80

30-AUG-21 CGST-CI@9% 0.00 14.80

30-AUG-21 Principal Amount Amortization - <8/12> 0.00 2,755.44

30-SEP-21 SGST-CI@9% 0.00 11.91

30-SEP-21 Principal Amount Amortization - <9/12> 0.00 2,787.57

30-SEP-21 CGST-CI@9% 0.00 11.91

30-SEP-21 Interest Amount Amortization - <9/12> 0.00 132.28

03-OCT-21 74056631277127637936714 FLIPKART INTERNET PRIVATE BANGALORE 0.00 6,051.00

IN

06-OCT-21 74766511279139380293428 FLIPKART INTERNET PVT LTD 0.00 6,478.00

HTTPS://WWW.F IN

06-OCT-21 74056631280127972658100 FLIPKART INTERNET PRIVATE BANGALORE 0.00 11,908.00

IN

10-OCT-21 74056631284128310037573 Flipkart Internet Pvt BANGALORE IN 0.00 1,241.00

10-OCT-21 74056631284128318379217 FLIPKART INTERNET PRIVATE BANGALORE 0.00 899.00

IN

24-OCT-21 74056631298129726356643 Jio Mart MUMBAI IN 0.00 2,667.90

27-OCT-21 74056631301130053808201 Jio Mart MUMBAI IN 0.00 -486.40

30-OCT-21 Interest Amount Amortization - <10/12> 0.00 99.78

30-OCT-21 Principal Amount Amortization - <10/12> 0.00 2,820.07

31-OCT-21 CGST-CI@9% 0.00 8.98

31-OCT-21 SGST-CI@9% 0.00 8.98

11-NOV-21 SGST-CI@9% 0.00 45.00

11-NOV-21 CGST-CI@9% 0.00 45.00

11-NOV-21 Annual Fees 0.00 500.00

The category of service:Credit & Debit Card,Charge Card or Other payment Card service.
RegistrationNo.Mum/Div -III/ST/CDR/23. PAN based STC No:AAACI1195HST001.
REGISTERED OFFICE IS ICICI BANK LIMITED,"LANDMARK",RACE COURSE CIRCLE, VADODARA 390 007 , INDIA.
This is an authenticated intimation/statement.Customers are requested to immediately notify the Bank of any discrepancy in the statement
 TRANSACTION DETAILS
Card Number : 4375 XXXX XXXX 4007
International
Date Ref. Number Transaction Details Currency
amount
Amount(in `)
18-NOV-21 74766511322145197770984 CRED HTTPS://WWW.C IN 0.00 10,093.00

18-NOV-21 74056631323132237970737 Dreamplug Technologies Pv BANGALORE 0.00 2.00

IN

18-NOV-21 132219107442 UPI Payment Received 0.00 -2.00

18-NOV-21 132219707628 UPI Payment Received 0.00 -57.00

30-NOV-21 CGST-CI@9% 0.00 6.02

30-NOV-21 SGST-CI@9% 0.00 6.02

30-NOV-21 Principal Amount Amortization - <11/12> 0.00 2,852.94

30-NOV-21 Interest Amount Amortization - <11/12> 0.00 66.91

30-DEC-21 Principal Amount Amortization - <12/12> 0.00 2,886.01

30-DEC-21 CGST-CI@9% 0.00 3.03

30-DEC-21 SGST-CI@9% 0.00 3.03

30-DEC-21 Interest Amount Amortization - <12/12> 0.00 33.65

TRANSACTION DETAILS
Card Number : 4477 XXXX XXXX 8009
International
Date Ref. Number Transaction Details Currency
amount
Amount(in `)
26-MAY-21 114613395789 UPI Payment Received 0.00 -4,342.00

26-MAY-21 800926052021S36416466 NEFT PAYMENT RECEIVED 0.00 -1.00

26-MAY-21 800926052021S36444343 NEFT PAYMENT RECEIVED 0.00 -8.00

27-JUN-21 117822704612 UPI Payment Received 0.00 -5,270.00

11-JUL-21 Interest Charges 0.00 996.83

11-JUL-21 SGST-CI@9% 0.00 89.72

11-JUL-21 CGST-CI@9% 0.00 89.72

12-JUL-21 800912072021S88646770 NEFT PAYMENT RECEIVED 0.00 -7.00

28-JUL-21 120977289102 UPI Payment Received 0.00 -12,000.00

28-JUL-21 800928072021S41066179 NEFT PAYMENT RECEIVED 0.00 -9.00

11-AUG-21 Interest Charges 0.00 834.37

11-AUG-21 SGST-CI@9% 0.00 75.09

11-AUG-21 CGST-CI@9% 0.00 75.09

24-AUG-21 800924082021S42915095 NEFT PAYMENT RECEIVED 0.00 -9.00

The category of service:Credit & Debit Card,Charge Card or Other payment Card service.
RegistrationNo.Mum/Div -III/ST/CDR/23. PAN based STC No:AAACI1195HST001.
REGISTERED OFFICE IS ICICI BANK LIMITED,"LANDMARK",RACE COURSE CIRCLE, VADODARA 390 007 , INDIA.
This is an authenticated intimation/statement.Customers are requested to immediately notify the Bank of any discrepancy in the statement
 TRANSACTION DETAILS
Card Number : 4477 XXXX XXXX 8009
International
Date Ref. Number Transaction Details Currency
amount
Amount(in `)
27-AUG-21 123956471272 UPI Payment Received 0.00 -6,010.00

10-SEP-21 800910092021S95133068 NEFT PAYMENT RECEIVED 0.00 -5.00

25-SEP-21 126821360075 UPI Payment Received 0.00 -12.00

26-SEP-21 126960521840 UPI Payment Received 0.00 -4,995.02

25-OCT-21 129875761336 UPI Payment Received 0.00 -10.00

28-OCT-21 130112704570 UPI Payment Received 0.00 -29,508.67

01-NOV-21 130566291213 UPI Payment Received 0.00 -10.00

01-NOV-21 130566293498 UPI Payment Received 0.00 -14.00

01-NOV-21 130566740073 UPI Payment Received 0.00 -8.00

27-NOV-21 133141406922 UPI Payment Received 0.00 -5,667.31

27-NOV-21 133142111843 UPI Payment Received 0.00 -5.00

27-NOV-21 133142131969 UPI Payment Received 0.00 -8.00

18-DEC-21 feelevy204213303684 Reward redemption handling 0.00 25.00

fee-Ord.No.204213303684 dtd 27112

18-DEC-21 feelevy204213156528 Reward redemption handling 0.00 25.00

fee-Ord.No.204213156528 dtd 16112

19-DEC-21 CGST-CI@9% 0.00 2.25

19-DEC-21 CGST-CI@9% 0.00 2.25

19-DEC-21 SGST-CI@9% 0.00 2.25

19-DEC-21 SGST-CI@9% 0.00 2.25

26-DEC-21 136081368249 UPI Payment Received 0.00 -12,954.89

29-DEC-21 SGST-CI@9% 0.00 2.25

29-DEC-21 CGST-CI@9% 0.00 2.25

29-DEC-21 feelevy204213532142 Reward redemption handling 0.00 25.00

fee-Ord.No.204213532142 dtd 14122

31-DEC-21 136560128565 UPI Payment Received 0.00 -8.00

31-DEC-21 136562159988 UPI Payment Received 0.00 -5.00

29-JAN-22 202928301248 UPI Payment Received 0.00 -3,001.22

03-FEB-22 203448485348 UPI Payment Received 0.00 -10.00

The category of service:Credit & Debit Card,Charge Card or Other payment Card service.
RegistrationNo.Mum/Div -III/ST/CDR/23. PAN based STC No:AAACI1195HST001.
REGISTERED OFFICE IS ICICI BANK LIMITED,"LANDMARK",RACE COURSE CIRCLE, VADODARA 390 007 , INDIA.
This is an authenticated intimation/statement.Customers are requested to immediately notify the Bank of any discrepancy in the statement
For ICICI Bank Limited.

Sudipta Roy
Head – Consumer Cards

Important Messages
Safe Banking Tips - Do not transact if you find any suspicious device attached to the ATM. Do not take help
from strangers at an ATM.

ICICI Bank Credit Cards Goods and Services Tax Identification Number (GSTIN) is 27AAACI1195H3ZK

HSN Code for service: 9971 - Financial and related services

Our registered office address : ICICI Bank Tower, Bandra Kurla Complex, MUMBAI, Mumbai Suburban,
Maharashtra - 400051

Making only minimum payment every month can lead to repayment stretching over years with consequent
interest payment on outstanding balance

Please pay your credit card outstanding before the payment due date to avoid penal fees and interest
charges.

For payments made through cheque, we request you to make the payment atleast 3 working days before the
due date incase of an ICICI Bank cheque and 5 working days before the due date for Non-ICICI Bank cheques.

For any clarification or more information, you may contact us through the 'Get in Touch' option at
www.icicibank.com

* Mark-up fee and corresponding GST levied is included in the transaction amount displayed

The category of service:Credit & Debit Card,Charge Card or Other payment Card service.
RegistrationNo.Mum/Div -III/ST/CDR/23. PAN based STC No:AAACI1195HST001.
REGISTERED OFFICE IS ICICI BANK LIMITED,"LANDMARK",RACE COURSE CIRCLE, VADODARA 390 007 , INDIA.
This is an authenticated intimation/statement.Customers are requested to immediately notify the Bank of any discrepancy in the statement