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    Policy Receipt

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    jyotsna jha
    This receipt is from Star Health and Allied Insurance Co. Ltd acknowledging receipt of Rs. 16,638 from customer Jyotsna Jha towards an online insurance policy premium payment. The payment was made via credit card on July 13, 2020 at the company's Indira Nagar II branch office in Bangalore. The receipt serves as evidence of payment received by the company and risk coverage will commence once the proposal is examined and accepted.

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    Policy Receipt

    Uploaded by

    jyotsna jha
    42 views1 page
    This receipt is from Star Health and Allied Insurance Co. Ltd acknowledging receipt of Rs. 16,638 from customer Jyotsna Jha towards an online insurance policy premium payment. The payment was made via credit card on July 13, 2020 at the company's Indira Nagar II branch office in Bangalore. The receipt serves as evidence of payment received by the company and risk coverage will commence once the proposal is examined and accepted.

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    This receipt is from Star Health and Allied Insurance Co. Ltd acknowledging receipt of Rs. 16,638 from customer Jyotsna Jha towards an online insurance policy premium payment. The payment was made via credit card on July 13, 2020 at the company's Indira Nagar II branch office in Bangalore. The receipt serves as evidence of payment received by the company and risk coverage will commence once the proposal is examined and accepted.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    42 views1 page

    Policy Receipt

    Uploaded by

    jyotsna jha
    This receipt is from Star Health and Allied Insurance Co. Ltd acknowledging receipt of Rs. 16,638 from customer Jyotsna Jha towards an online insurance policy premium payment. The payment was made via credit card on July 13, 2020 at the company's Indira Nagar II branch office in Bangalore. The receipt serves as evidence of payment received by the company and risk coverage will commence once the proposal is examined and accepted.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Branch Office - Indira Nagar II No.

    57,III rd & IV Floor, Double Road , Indiranagar Bangalore - 560038 , , BANGALORE , 560038

    Advance Premium Receipt


    Customer Code : AA0013197731

    Received from : JYOTSNA JHA


    Customer Address : 407, SUNDHER RESIDENCY, 12TH CROSS, Collection No : 11-01/1519002857

    GM PALYA, Collection Date : 13/07/2020


    Office Code : 141137 - Branch Office -Indira Nagar II

    Supplier GSTIN : 29AAJCS4517L1ZU

    Customer GSTIN : - Place of Supply : - State Code: -

    Amount Collected : Rs. 16638 /- Inclusive of tax :

    Amount in words : Indian Rupees Sixteen Thousand Six Hundred Thirty-Eight Only

    Towards the Following : PREMIUM RECEIPT ONLINE POLICY

    S. No. Proposal Ref. No Fulfiller Code Intermediary Code Amount Collected Mode of Pay Bank Name CHQ/CC/DD No CHQ/DD/BC Dt

    1 R/141137/01/2021/015050 SH31045 BA0000309138 16638 CC DINR 10691919771 13/07/2020

    For Star Health and Allied Insurance Co. Ltd

    Note : Receipt Subject to realization of Cheque / DD


    This is only an evidence of receipt of money by the company
    Risk will commence once the proposal is examined and accepted Authorised Signatory

    IRDA Regn. No 129 Corporate Identity Number U66010TN2005PLC056649 Email id : [email protected]

    Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800 Toll Free Fax No:1800-425-5522 Toll Free No:1800-425-2255 / 1800-102-4477,CIN
    :U66010TN2005PLC056649 Email :[email protected] Website :www.starhealth.in IRDAI Regn.no: 129

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