Branch: 400 B-64,GANGANAGAR

BRIHASPATI SARKAR PO-MUKUNDAPUR

Agent : LIC12836400 PS-PURBA JADAVPUR
Leader :1774402 PIN:700099

12836400 Premium due & Default List for the Month of 06/2021 Page : 1

Sl. Policy Policy Holder Name D.o.C. Plan - M F.U.P. Instlmnt D G S T Total Estm.
No. Number Term od Premium ue Premium Comn
1 137023232 SUSMITA HALDER 04/01/2017 841-24 M 01/2021 985 6 133.00 6043 296
2 402958501 ALIPRIYA DEY 28/01/2019 832-19 H 01/2021 3776 1 85.00 3861 283
3 405807116 CHANDAN MONDAL 28/08/2019 843-17 M 01/2021 388 6 52.00 2380 175
4 405807117 CHANDAN MONDAL 28/08/2019 843-16 M 01/2021 420 6 57.00 2577 189
5 407682643 SUBAL DAS 28/01/2020 814-12 H 01/2021 30953 1 696.00 31649 2321
6 408424630 CHANDAN MONDAL 28/10/2020 914-20 M 01/2021 440 6 119.00 2759 660
7 408424633 SUMI DEY 28/10/2020 914-17 M 01/2021 530 6 143.00 3323 795
8 401129052 TAPAN HOWLADER 14/02/2018 836-21 Y 02/2021 22080 1 497.00 22577 1104
9 400839344 SOMNATH SAHA 23/08/2017 841-20 Q 02/2021 1916 2 86.00 3918 192
10 400842917 SAYANI BHANDARI(LA) 25/11/2017 832-20 Q 02/2021 1921 2 87.00 3929 192
11 400839631 SK MAIDUL ISLAM 26/08/2017 841-24 Q 02/2021 1921 2 87.00 3929 192
12 405811308 ARIJIT MAJUMDER 27/11/2019 832-18 Q 02/2021 1662 2 75.00 3399 249
13 408418756 RATAN NANDY 28/02/2020 943-18 Q 02/2021 1085 2 49.00 2219 163
14 137076828 ANKITA SAHA (L/A) 04/03/2017 834-20 Y 03/2021 7307 1 164.00 7471 365
15 408424532 PRASANTA MAJUMDAR 13/11/2020 914-20 M 03/2021 966 4 174.00 4038 966
16 400843712 SAPTAJIT BARUI(LA) 15/12/2017 832-25 Q 03/2021 1618 2 73.00 3309 162
17 402345223 SAMIT SARKAR 20/08/2018 845-73 M 03/2021 2049 4 184.00 8380 615
18 137078289 SUSAMOY SAHA 25/03/2017 814-20 Y 03/2021 5947 1 134.00 6081 297
19 402954060 SAMIT SARKAR 28/09/2018 814-16 M 03/2021 561 4 51.00 2295 168
20 402954061 SAMIT SARKAR 28/09/2018 814-15 M 03/2021 603 4 54.00 2466 181
21 405811300 BHASKAR PATRA 28/09/2019 845-59 Q 03/2021 4087 2 184.00 8358 613
22 408422352 SAMRIDDHI MONDAL 28/08/2020 934-25 M 03/2021 962 4 173.00 4021 962
23 408422353 SAMRIDDHI MONDAL 28/08/2020 934-25 M 03/2021 962 4 173.00 4021 962
24 408426660 BISWAJIT MONDAL 28/12/2020 943-16 Q 03/2021 945 2 85.00 1975 473
25 408426667 SURAJIT HALDER 28/12/2020 914-17 M 03/2021 970 4 175.00 4055 970
26 408426668 ASTAMI HALDER 28/12/2020 914-18 M 03/2021 886 4 160.00 3704 886
27 408427327 RUDRANIL HALDER (L/A) 28/12/2020 932-24 M 03/2021 409 4 74.00 1710 409
28 408427328 INDRANIL HALDER(L/A) 28/12/2020 932-15 M 03/2021 697 4 126.00 2914 697
29 839892855 SHUBHA DAS(L/A) 28/09/2016 821-25 Q 03/2021 1492 2 67.00 3051 149
30 405804682 JAYSMITA SAHA(L/A) 10/07/2019 834-25 Q 04/2021 4549 1 102.00 4651 341
31 405808994 BIJAYA MONDAL 21/10/2019 814-18 H 04/2021 2946 1 66.00 3012 221
32 405808995 BIJAYA MONDAL 21/10/2019 815-18 H 04/2021 3453 1 78.00 3531 259
33 408428598 SOMA SAMADDAR 22/01/2021 944-18 M 04/2021 278 3 38.00 872 209
34 420768724 PINKI MAJUMDER 22/02/2021 921-25 M 04/2021 591 3 80.00 1853 355
35 420769164 JHARNA MAJUMDER 22/02/2021 944-15 M 04/2021 387 3 52.00 1213 290
36 405807115 CHANDAN MONDAL 28/08/2019 814-17 M 04/2021 526 3 36.00 1614 118
37 408428388 MADHURI ROY 28/01/2021 944-16 Q 04/2021 1383 1 62.00 1445 346
38 408428389 RAJENDRA ROY 28/01/2021 943-16 Q 04/2021 1488 1 67.00 1555 372
39 137528621 SMRITI ADHIKARI 07/08/2017 814-17 Q 05/2021 1765 1 40.00 1805 88
40 137528622 PARTHA SIKDER 07/08/2017 836-21 Q 05/2021 2932 1 66.00 2998 147
41 402955380 SHAYAAN KABIRAJ 07/11/2018 832-23 M 05/2021 997 2 45.00 2039 150
42 402341157 SUJAY SAHA 11/05/2018 836-25 H 05/2021 5043 1 114.00 5157 252

Page Totals : Premium : 124876.00 G S T : 5063.00 Commission : 18834.00

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12836400 Premium due & Default List for the Month of 06/2021 Page : 2

Sl. Policy Policy Holder Name D.o.C. Plan - M F.U.P. Instlmnt D G S T Total Estm.
No. Number Term od Premium ue Premium Comn
43 404921395 BAPI KARGUPTA 13/02/2019 820-20 Q 05/2021 3497 1 79.00 3576 262
44 405805976 AJOY DAS 13/08/2019 843-17 Q 05/2021 1174 1 26.00 1200 88
45 405805977 AYAN DAS 13/08/2019 843-17 Q 05/2021 1135 1 26.00 1161 85
46 405805978 ANJANA DAS 13/08/2019 844-17 Q 05/2021 928 1 21.00 949 70
47 404921455 UMA KARGUPTA 14/02/2019 814-15 Q 05/2021 3805 1 86.00 3891 285
48 404921456 DEBDUT KARGUPTA 14/02/2019 814-20 Q 05/2021 2522 1 57.00 2579 189
49 405811302 PINKI MAJUMDER 15/11/2019 814-16 M 05/2021 560 2 25.00 1145 84
50 405811303 PINKI MAJUMDER 15/11/2019 814-17 M 05/2021 523 2 24.00 1070 78
51 402341104 ASHOK GHOSH 21/05/2018 814-19 Q 05/2021 1466 1 33.00 1499 73
52 407680182 PRIYANKA DEB 22/12/2019 844-17 M 05/2021 290 2 13.00 593 44
53 408422351 SAMPRITI CHATTERJEE 22/08/2020 934-25 Q 05/2021 2219 1 100.00 2319 555
54 408425122 SETU KABIRAJ 22/11/2020 944-11 M 05/2021 494 2 45.00 1033 198
55 408428287 DIPU SIKDAR 22/01/2021 943-16 M 05/2021 397 2 36.00 830 199
56 408428289 SONIA MONDAL 22/01/2021 944-16 M 05/2021 375 2 34.00 784 188
57 400839347 MOU GHOSH 23/08/2017 841-24 Q 05/2021 1601 1 36.00 1637 80
58 402340068 SANDIP DEY 23/04/2018 814-16 M 05/2021 618 2 28.00 1264 62
59 402345070 PIYALY PODDAR 23/08/2018 814-19 Q 05/2021 1389 1 31.00 1420 104
60 402345071 PIYALY PODDAR 23/08/2018 814-17 Q 05/2021 1574 1 35.00 1609 118
61 402345072 BAPI PODDAR 23/08/2018 814-16 Q 05/2021 1696 1 38.00 1734 127
62 402345073 BAPI PODDAR 23/08/2018 814-18 Q 05/2021 1491 1 34.00 1525 112
63 402345074 ARADHYA PODDER(LA) 23/08/2018 832-24 Q 05/2021 1206 1 27.00 1233 90
64 402340099 MILI DAS 24/04/2018 844-16 M 05/2021 472 2 21.00 965 47
65 420769160 SURAJ MONDAL 26/02/2021 914-21 Q 05/2021 1210 1 55.00 1265 303
66 401129760 RAJDIP ROY(LA) 27/02/2018 832-23 Q 05/2021 1282 1 29.00 1311 64
67 405811301 POULIMA ADHIKARI MUKHERJEE 27/11/2019 830-21 H 05/2021 24894 1 560.00 25454 1245
68 405811304 JHARNA PURKAIT 27/11/2019 844-16 Q 05/2021 1001 1 23.00 1024 75
69 405811305 JHARNA PURKAIT 27/11/2019 844-17 Q 05/2021 1041 1 23.00 1064 78
70 137076664 TANMOY DHAR 28/02/2017 836-25 Q 05/2021 2367 1 53.00 2420 118
71 400839858 MOUSUMI GHOSH 28/08/2017 841-24 M 05/2021 722 2 33.00 1477 72
72 401132062 SHYAMAL GHOSH 28/03/2018 814-17 M 05/2021 526 2 24.00 1076 53
73 402342814 PRIYANKA DEB 28/06/2018 844-17 M 05/2021 290 2 13.00 593 36
74 402342825 PUSHPENDU DALUI 28/06/2018 814-20 M 05/2021 438 2 20.00 896 55
75 405807143 SUHANI ROY 28/08/2019 832-21 Q 05/2021 1418 1 32.00 1450 106
76 405812154 SAURAV DAS 28/11/2019 814-21 Q 05/2021 2106 1 47.00 2153 158
77 408424628 CHANDAN MONDAL 28/10/2020 914-19 M 05/2021 466 2 42.00 974 233
78 408425126 SHREYA DAS 28/11/2020 932-21 Q 05/2021 1418 1 64.00 1482 355
79 408425130 SHREYA DAS 28/11/2020 934-21 Q 05/2021 1092 1 49.00 1141 273
80 401127926 SUKRITI NAYAK(LA) 05/01/2018 832-19 M 06/2021 732 1 17.00 749 37
81 401127927 PREETIPIUSA NAYAK(LA) 05/01/2018 832-23 M 06/2021 588 1 13.00 601 29
82 401131585 DONA DAS(LA) 06/03/2018 814-17 M 06/2021 614 1 14.00 628 31
83 402954093 RIDHAN DAS-L/A 06/09/2018 834-25 M 06/2021 734 1 17.00 751 55
84 404922741 RATHINDRA NATH BAIRAGI 06/03/2019 814-21 Q 06/2021 4790 1 108.00 4898 359
85 137474917 RANA BISWAS 07/06/2017 843-16 M 06/2021 524 1 12.00 536 26
86 401130339 GORACHAND MONDAL 07/03/2018 836-21 Q 06/2021 3060 1 69.00 3129 153
87 402953121 SUMAN MONDAL 07/09/2018 814-16 M 06/2021 560 1 13.00 573 42
88 405811306 KAUSHIK BANERJEE 07/11/2019 814-15 M 06/2021 2952 1 66.00 3018 221
89 408428597 SUBHANKAR DHAR 07/01/2021 945-68 M 06/2021 4099 1 185.00 4284 1025
90 401131872 GAUTAM GOPE 08/03/2018 845-53 M 06/2021 9981 1 225.00 10206 499
91 405804447 MUNNA KUMAR CHAUDHARY 08/07/2019 814-21 M 06/2021 628 1 14.00 642 47
92 402340686 SUKANTA BASU 10/05/2018 836-16 M 06/2021 2613 1 59.00 2672 131

Page Totals : Premium : 101578.00 G S T : 2734.00 Commission : 9017.00

___________________________________________________________________________________________________
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12836400 Premium due & Default List for the Month of 06/2021 Page : 3

Sl. Policy Policy Holder Name D.o.C. Plan - M F.U.P. Instlmnt D G S T Total Estm.
No. Number Term od Premium ue Premium Comn
93 402343403 RUDRAAN SHAW-L/A 10/07/2018 832-18 M 06/2021 2162 1 49.00 2211 162
94 402343406 PRAMILA SHAW 10/07/2018 814-20 M 06/2021 797 1 18.00 815 60
95 402953182 AMIT DEY 10/09/2018 814-21 Q 06/2021 1489 1 34.00 1523 112
96 405803489 SASWATA SAHA- LA 10/06/2019 834-21 M 06/2021 1475 1 33.00 1508 111
97 405804686 PIYALI ACHARYA 10/07/2019 844-15 M 06/2021 1325 1 30.00 1355 99
98 405804687 PIYALI ACHARYA 10/07/2019 814-15 M 06/2021 607 1 14.00 621 46
99 405804688 LAKHAN HALDER 10/07/2019 833-18 M 06/2021 582 1 13.00 595 44
100 405804689 LAKHAN HALDER 10/07/2019 843-16 M 06/2021 428 1 10.00 438 32
101 405804691 BABLU BANERJEE 10/07/2019 814-16 M 06/2021 757 1 17.00 774 57
102 137527468 KINJAN SANTARA(LA) 11/07/2017 834-21 M 06/2021 7006 1 158.00 7164 350
103 137527477 SOMA SANTARA DAS 11/07/2017 836-21 M 06/2021 3892 1 88.00 3980 195
104 400842466 SUBHRA DATTA 11/11/2017 836-25 M 06/2021 792 1 18.00 810 40
105 402343168 BIPLAB SHEKHAR KABIRAJ 11/07/2018 814-15 M 06/2021 642 1 15.00 657 48
106 404922740 KAKALI SARKAR 11/03/2019 844-15 Q 06/2021 1556 1 35.00 1591 117
107 137526138 PRATIP MONDAL 12/06/2017 843-20 Y 06/2021 4747 1 107.00 4854 237
108 137526139 AYUSHMAN MAITI(LA) 12/06/2017 832-18 Q 06/2021 3282 1 74.00 3356 164
109 137526140 SUBOJITE SARKAR 12/06/2017 834-22 M 06/2021 584 1 13.00 597 29
110 402341927 SUMI DEY 12/06/2018 814-15 M 06/2021 727 1 16.00 743 36
111 402341930 MONISHA DAS (L/A) 12/06/2018 814-16 Q 06/2021 4310 1 97.00 4407 216
112 401130602 SWAPNA MONDAL 13/03/2018 844-16 M 06/2021 313 1 7.00 320 16
113 401130603 ASIM MANDAL 13/03/2018 843-16 M 06/2021 317 1 7.00 324 16
114 405807578 SHAKUNTALA PURKAIT 13/09/2019 844-16 M 06/2021 507 1 11.00 518 38
115 405807579 SHAKUNTALA PURKAIT 13/09/2019 844-15 M 06/2021 496 1 11.00 507 37
116 408424531 KAKALI SHIL 13/11/2020 945-62 M 06/2021 2215 1 100.00 2315 554
117 400841942 SRABANI MONDAL 14/10/2017 836-21 M 06/2021 973 1 22.00 995 49
118 401131586 NIRAPADA MALLICK 14/03/2018 814-17 M 06/2021 1030 1 23.00 1053 52
119 402344781 ROHIT MONDAL(LA) 14/08/2018 814-17 M 06/2021 514 1 12.00 526 39
120 402344782 MANORAMA MONDAL 14/08/2018 814-16 M 06/2021 567 1 13.00 580 43
121 400843707 ABHIK GOPE(LA) 15/12/2017 836-21 H 06/2021 9390 1 211.00 9601 470
122 400843711 RABIN HALDER 15/12/2017 836-21 Q 06/2021 2902 1 65.00 2967 145
123 402345443 NEPAL NAHA 15/08/2018 848-20 M 06/2021 6171 1 139.00 6310 463
124 402957826 RATNA ADHIKARY 15/01/2019 844-17 M 06/2021 386 1 9.00 395 29
125 405802892 TAPAN DAS 15/05/2019 833-18 M 06/2021 568 1 13.00 581 43
126 405802893 PRATHAM DAS 15/05/2019 814-21 M 06/2021 996 1 22.00 1018 75
127 405806752 SOMNATH PURKAIT 15/08/2019 843-17 M 06/2021 427 1 10.00 437 32
128 405806784 JYOTIRMOY MAITY 15/08/2019 814-17 M 06/2021 604 1 14.00 618 45
129 405806785 JYOTIRMOY MAITY 15/08/2019 843-17 M 06/2021 425 1 10.00 435 32
130 405806789 SOMRIDDHI PURKAIT 15/08/2019 832-25 M 06/2021 727 1 16.00 743 55
131 405807010 AMRITA ROY BASAK 15/08/2019 844-17 M 06/2021 385 1 9.00 394 29
132 405807011 AMRITA ROY BASAK 15/08/2019 844-16 M 06/2021 313 1 7.00 320 23
133 405808512 SHUBHAMAY PODDAR 15/09/2019 815-16 M 06/2021 686 1 15.00 701 51
134 405808513 MOUSUMI PODDAR 15/09/2019 815-16 M 06/2021 660 1 15.00 675 50
135 405808516 RANJAN GOSWAMI 15/09/2019 843-18 M 06/2021 360 1 8.00 368 27
136 405808517 RANJAN GOSWAMI 15/09/2019 815-18 M 06/2021 571 1 13.00 584 43
137 405808518 RANJAN GOSWAMI 15/09/2019 815-19 M 06/2021 538 1 12.00 550 40
138 407684612 SUBHENDU KANDAR 15/02/2020 914-16 M 06/2021 1534 1 35.00 1569 115
139 408419997 SUBHANKAR DHAR 15/06/2020 914-25 M 06/2021 402 1 9.00 411 30
140 408420112 RIMI SARKAR 15/06/2020 914-25 M 06/2021 344 1 8.00 352 26
141 408426088 PRODYOT KUMAR DAS 15/12/2020 915-20 M 06/2021 1861 1 84.00 1945 465
142 408428385 RISHIKA BANERJEE- LA 15/01/2021 914-15 M 06/2021 650 1 29.00 679 163

Page Totals : Premium : 74992.00 G S T : 1798.00 Commission : 5450.00

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12836400 Premium due & Default List for the Month of 06/2021 Page : 4

Sl. Policy Policy Holder Name D.o.C. Plan - M F.U.P. Instlmnt D G S T Total Estm.
No. Number Term od Premium ue Premium Comn
143 420768525 BHAGIRATH MANDAL 15/02/2021 914-21 M 06/2021 809 1 36.00 845 202
144 420768603 SAYAN SAHA 15/02/2021 932-19 M 06/2021 583 1 26.00 609 146
145 420768605 SUMAN DAS 15/02/2021 914-18 M 06/2021 543 1 24.00 567 136
146 420769158 KOUSIK GHOSH 15/02/2021 936-25 M 06/2021 1186 1 53.00 1239 297
147 839892271 TAPATI SAHA 15/09/2016 820-20 M 06/2021 701 1 16.00 717 35
148 839925893 DIPANJAN ROY 15/11/2016 841-24 M 06/2021 517 1 12.00 529 26
149 839926946 DIPA MAJUMDAR 15/12/2016 836-21 M 06/2021 985 1 22.00 1007 49
150 839926947 RAJIB NANDY 15/12/2016 834-24 Q 06/2021 3005 1 68.00 3073 150
151 839926949 SAGNIK PAUL 15/12/2016 834-21 M 06/2021 768 1 17.00 785 38
152 839925109 SUBHRAJIT ROY 17/10/2016 821-25 M 06/2021 1491 1 34.00 1525 75
153 408426852 AVIJIT CHATTERJEE 18/12/2020 914-12 Q 06/2021 19130 1 861.00 19991 3826
154 400843802 KALU HALDER 19/12/2017 836-21 M 06/2021 1090 1 25.00 1115 55
155 401130977 ANAMIKA CHATTERJEE 19/03/2018 814-17 M 06/2021 551 1 12.00 563 28
156 401130978 KAJAL SARKAR 19/03/2018 844-17 M 06/2021 390 1 9.00 399 20
157 401130979 BABUL SARKAR 19/03/2018 843-17 M 06/2021 391 1 9.00 400 20
158 137025020 MOHIT GHARAMI 20/02/2017 834-25 M 06/2021 1650 1 37.00 1687 83
159 400841047 RAMA DAS 20/09/2017 836-21 M 06/2021 2982 1 67.00 3049 149
160 401131056 AVIJIT CHATTERJEE 20/03/2018 814-17 M 06/2021 588 1 13.00 601 29
161 404923538 SK NURUL ISLAM 20/03/2019 814-16 Q 06/2021 6082 1 137.00 6219 456
162 405807939 KABITA GHOSH 20/09/2019 844-16 Q 06/2021 970 1 22.00 992 73
163 405807940 SUNIPA DAS MONDAL 20/09/2019 844-16 Q 06/2021 1011 1 23.00 1034 76
164 405807941 FALGUNI DAS 20/09/2019 815-17 Q 06/2021 1737 1 39.00 1776 130
165 405807942 FALGUNI DAS 20/09/2019 844-17 Q 06/2021 864 1 19.00 883 65
166 405807943 FALGUNI DAS 20/09/2019 815-16 Q 06/2021 1859 1 42.00 1901 139
167 405807944 FALGUNI DAS 20/09/2019 815-15 Q 06/2021 1995 1 45.00 2040 150
168 405807945 PRABIR DAS 20/09/2019 815-17 Q 06/2021 1842 1 42.00 1884 138
169 405807946 PRABIR DAS 20/09/2019 815-16 Q 06/2021 1967 1 44.00 2011 148
170 405807947 SANJAY DAS 20/09/2019 815-16 Q 06/2021 2006 1 45.00 2051 150
171 405807948 SOMA SAMADDAR 20/09/2019 844-17 M 06/2021 297 1 7.00 304 22
172 405807949 PANNA DAS 20/09/2019 844-16 Q 06/2021 981 1 22.00 1003 74
173 405807950 TAPAN DAS 20/09/2019 843-16 Q 06/2021 1057 1 24.00 1081 79
174 420768602 SNEHASISH CHOUDHURY 20/02/2021 914-13 M 06/2021 725 1 33.00 758 145
175 405808985 SUBHANKAR DHAR 21/10/2019 814-21 M 06/2021 626 1 14.00 640 47
176 405808988 SUBHANKAR DHAR 21/10/2019 815-21 M 06/2021 723 1 16.00 739 54
177 839925997 ANAMIKA CHATTERJEE 21/11/2016 821-25 M 06/2021 1387 1 31.00 1418 69
178 402342267 BRIHASPATI SARKAR 22/06/2018 905-20 Y 06/2021 3000 1 540.00 3540 150
179 404921866 BRIHASPATI SARKAR 22/02/2019 815-16 M 06/2021 1629 1 37.00 1666 122
180 404921870 MANOJIT SARKAR 22/02/2019 815-16 M 06/2021 1473 1 33.00 1506 110
181 405803322 DEBASREE BISWAS 22/05/2019 814-16 M 06/2021 619 1 14.00 633 46
182 405804028 PRIYA KARMAKAR 22/06/2019 832-20 Q 06/2021 1478 1 33.00 1511 111
183 405804029 PRIYA KARMAKAR 22/06/2019 834-20 Q 06/2021 1540 1 35.00 1575 116
184 405804030 BISWARUP KARMAKAR 22/06/2019 833-18 Q 06/2021 3330 1 75.00 3405 250
185 405804031 BISWARUP KARMAKAR 22/06/2019 821-25 Q 06/2021 2398 1 54.00 2452 180
186 405805359 MOUMITA DATTA 22/07/2019 836-25 M 06/2021 788 1 18.00 806 59
187 405807014 MANORAMA MONDAL 22/08/2019 844-16 M 06/2021 488 1 11.00 499 37
188 405807015 ROHIT MONDAL 22/08/2019 843-16 M 06/2021 474 1 11.00 485 36
189 405807140 SANGITA ADHIKARY 22/08/2019 844-16 M 06/2021 484 1 11.00 495 36
190 405807152 NIRAPADA MALLICK 22/08/2019 843-16 M 06/2021 469 1 11.00 480 35
191 405807161 BISWAJIT DEB 22/08/2019 843-16 M 06/2021 314 1 7.00 321 24
192 405807163 SHREYA SHIL 22/08/2019 844-10 M 06/2021 558 1 13.00 571 42

Page Totals : Premium : 82531.00 G S T : 2849.00 Commission : 8733.00

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12836400 Premium due & Default List for the Month of 06/2021 Page : 5

Sl. Policy Policy Holder Name D.o.C. Plan - M F.U.P. Instlmnt D G S T Total Estm.
No. Number Term od Premium ue Premium Comn
193 407679924 SUKUMAR SAHA 22/12/2019 843-16 M 06/2021 435 1 10.00 445 33
194 407680175 BISWARUP KARMAKAR 22/12/2019 843-16 Q 06/2021 951 1 21.00 972 71
195 407680273 SAHADEV SANTARA 22/12/2019 843-17 M 06/2021 322 1 7.00 329 24
196 407680281 NIRAPADA MALLICK 22/12/2019 843-20 M 06/2021 244 1 6.00 250 18
197 407680283 RIMPA GOSWAMI 22/12/2019 832-25 M 06/2021 462 1 10.00 472 35
198 407680284 RIMPA GOSWAMI 22/12/2019 832-25 M 06/2021 385 1 9.00 394 29
199 408420577 PRATIMA SAPUI 22/06/2020 914-21 M 06/2021 1230 1 28.00 1258 92
200 408426083 ARCHANA BAIDYA 22/12/2020 944-15 H 06/2021 6053 1 272.00 6325 1513
201 408426086 BIPLAB SHEKHAR KABIRAJ 22/12/2020 943-15 M 06/2021 378 1 17.00 395 95
202 408426087 RAJU MONDAL 22/12/2020 943-15 M 06/2021 351 1 16.00 367 88
203 408426089 RATHINDRA NATH BAIRAGI 22/12/2020 943-19 M 06/2021 336 1 15.00 351 84
204 408426090 BIDHAN CHANDRA ROY 22/12/2020 943-15 Q 06/2021 1581 1 71.00 1652 395
205 408426091 MANA NASKAR 22/12/2020 944-15 M 06/2021 486 1 22.00 508 122
206 408426661 SUKUMAR SAHA 22/12/2020 943-15 M 06/2021 355 1 16.00 371 89
207 408426666 SRABANI MONDAL 22/12/2020 944-15 M 06/2021 358 1 16.00 374 90
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230 400839626 SAMPRIKTA DAS(LA) 26/08/2017 832-23 M 06/2021 624 1 14.00 638 31
231 400839632 SUMI DEY 26/08/2017 841-24 M 06/2021 531 1 12.00 543 27
232 839892677 MAYA HALDER 26/09/2016 827-16 Q 06/2021 1435 1 32.00 1467 54
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Page Totals : Premium : 55775.00 G S T : 1670.00 Commission : 8883.00

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Sl. Policy Policy Holder Name D.o.C. Plan - M F.U.P. Instlmnt D G S T Total Estm.
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246 137076657 CHANDRA MANDAL GHOSH 28/02/2017 836-25 M 06/2021 821 1 19.00 840 41
247 137076660 SIKHA SARDAR 28/02/2017 841-24 M 06/2021 552 1 12.00 564 28
248 137076661 NIRAPADA MALLICK 28/02/2017 836-25 M 06/2021 1420 1 32.00 1452 71
249 137526661 TULI MONDAL SIKDER 28/06/2017 836-21 Q 06/2021 2800 1 63.00 2863 140
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254 400840482 BISWARUP KARMAKAR 28/08/2017 841-24 M 06/2021 531 1 12.00 543 27
255 400840484 AYANIKA KUNDU(LA) 28/08/2017 832-19 M 06/2021 636 1 14.00 650 32
256 402339461 NISHA KHARWAR 28/03/2018 814-17 M 06/2021 656 1 15.00 671 33
257 402342641 JAYANTA MITRA 28/06/2018 843-18 Q 06/2021 1624 1 37.00 1661 81
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262 402342804 ISHAK HAWLADAR(LA) 28/06/2018 832-24 Y 06/2021 4950 1 111.00 5061 248
263 402342806 RAMA KABIRAJ 28/06/2018 844-17 M 06/2021 290 1 7.00 297 15
264 402342822 DEBA KABIRAJ 28/06/2018 843-17 M 06/2021 291 1 7.00 298 15
265 402344075 SRABANI MONDAL 28/07/2018 814-20 M 06/2021 461 1 10.00 471 35
266 402344077 SANDIP KUMAR MONDAL 28/07/2018 843-17 M 06/2021 322 1 7.00 329 24
267 402344078 AYANIKA KUNDU(LA) 28/07/2018 832-18 M 06/2021 576 1 13.00 589 43
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269 402344083 SOMA SAMADDAR 28/07/2018 844-16 M 06/2021 319 1 7.00 326 24
270 402344085 SOMA SAMADDAR 28/07/2018 844-17 M 06/2021 296 1 7.00 303 22
271 402344087 KINJAN SANTARA(L/A) 28/07/2018 832-20 M 06/2021 530 1 12.00 542 40
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273 402344089 SAHADEV SANTARA 28/07/2018 843-16 M 06/2021 341 1 8.00 349 26
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275 402344091 SAHADEV SANTARA 28/07/2018 843-18 M 06/2021 299 1 7.00 306 22
276 402344092 SOMA SANTARA DAS 28/07/2018 844-16 M 06/2021 420 1 10.00 430 32
277 402344094 SOMA SANTARA DAS 28/07/2018 844-17 M 06/2021 291 1 7.00 298 22
278 402344095 SOMA SANTARA DAS 28/07/2018 844-18 M 06/2021 270 1 6.00 276 20
279 402344176 MOUSUMI KUNDU 28/07/2018 844-17 M 06/2021 298 1 7.00 305 22
280 402954062 SUMI DEY 28/09/2018 814-15 M 06/2021 725 1 16.00 741 54
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292 402954095 MOUSUMI DAS 28/09/2018 827-19 M 06/2021 339 1 8.00 347 19

Page Totals : Premium : 57414.00 G S T : 1295.00 Commission : 3376.00

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Sl. Policy Policy Holder Name D.o.C. Plan - M F.U.P. Instlmnt D G S T Total Estm.
No. Number Term od Premium ue Premium Comn
293 402954097 MOUSUMI DAS 28/09/2018 827-18 M 06/2021 382 1 9.00 391 21
294 402954105 SOUMI DAS 28/09/2018 834-25 M 06/2021 734 1 17.00 751 55
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297 402957328 ADRIJA MISTRY(LA) 28/12/2018 832-22 Q 06/2021 1443 1 33.00 1476 108
298 402957330 MOUSUMI KUNDU 28/12/2018 814-18 M 06/2021 1955 1 44.00 1999 147
299 402957333 MAYUKH SARKAR 28/12/2018 843-16 Q 06/2021 1251 1 28.00 1279 94
300 404924815 AMAR KUMAR BAIDYA 28/03/2019 814-20 Q 06/2021 1434 1 32.00 1466 108
301 405807142 PRAMILA SHAW 28/08/2019 844-16 M 06/2021 317 1 7.00 324 24
302 405807162 SUMI DEY 28/08/2019 844-16 M 06/2021 485 1 11.00 496 36
303 405808508 SUROJIT MAJUMDER 28/09/2019 815-30 Q 06/2021 964 1 22.00 986 72
304 405808514 RANJAN GOSWAMI 28/09/2019 815-16 Q 06/2021 1946 1 44.00 1990 146
305 407680277 DEBOJYOTI SAHA 28/12/2019 814-16 Q 06/2021 1650 1 37.00 1687 124
306 407680278 DEBOJYOTI SAHA 28/12/2019 820-20 Q 06/2021 1941 1 44.00 1985 146
307 407680279 DEBOJYOTI SAHA 28/12/2019 821-25 Q 06/2021 1489 1 34.00 1523 112
308 407680280 SHYAMALI SAHA 28/12/2019 844-17 Q 06/2021 918 1 21.00 939 69
309 408420576 SHIKHA BAPARI 28/06/2020 944-17 Q 06/2021 3776 1 85.00 3861 283
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311 408420824 RINKI CHAKRABORTY 28/06/2020 914-16 Q 06/2021 3282 1 74.00 3356 246
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313 408423383 BOSHITA MITRA 28/09/2020 932-15 Q 06/2021 10495 1 472.00 10967 2624
314 408423385 KAKALI KUNDU DAS 28/09/2020 914-18 Q 06/2021 3819 1 172.00 3991 955
315 408426656 SOMA SARKAR 28/12/2020 944-15 Q 06/2021 1313 1 59.00 1372 328
316 408426659 SAMAR KARAN 28/12/2020 943-16 Q 06/2021 1365 1 61.00 1426 341
317 408426663 KAJAL BARAL 28/12/2020 914-16 Q 06/2021 1712 1 77.00 1789 428
318 408426664 KAJAL KARAN 28/12/2020 944-16 Q 06/2021 1030 1 46.00 1076 258
319 408426665 ARPITA DHAR 28/12/2020 944-15 Q 06/2021 1029 1 46.00 1075 257
320 408427244 KARTICK HIRA 28/12/2020 914-16 Q 06/2021 2097 1 94.00 2191 524
321 408427245 RUMPA DAS 28/12/2020 914-16 Q 06/2021 1712 1 77.00 1789 428
322 408427247 SURAJIT DAS 28/12/2020 914-16 Q 06/2021 3347 1 151.00 3498 837
323 408427759 SUBATA BALA 28/12/2020 944-15 Q 06/2021 4549 1 205.00 4754 1137
324 420769159 CHANDANA MITRA 28/01/2021 944-12 M 06/2021 486 1 22.00 508 97
325 420769168 SOUVIK MITRA 28/01/2021 943-12 M 06/2021 531 1 24.00 555 106
326 420769935 SHYAMALI SAHA 28/02/2021 944-17 M 06/2021 308 1 14.00 322 77
327 839892858 DEBA KABIRAJ 28/09/2016 827-16 M 06/2021 303 1 7.00 310 11
328 839892954 KAUSHALYA NAIYA 28/09/2016 820-20 M 06/2021 997 1 22.00 1019 50

Page Totals : Premium : 67492.00 G S T : 2280.00 Commission : 10865.00

Grand Totals : Premium : 564658.00 G S T : 17689.00 Commission : 65158.00

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