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    Receipt Doc

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    unknown10111969

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    © All Rights Reserved
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    Receipt Doc

    Uploaded by

    unknown10111969
    9 views1 page

    Original Title

    79156203_RECEIPT_DOC

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    Copyright:

    © All Rights Reserved
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    9 views1 page

    Receipt Doc

    Uploaded by

    unknown10111969

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Tele Sales -Noida No:209-210,LakshmiDeep Building, , DIST Centre ,LakshmiNagar, , Delhi-110092 , Noida , 110092

    Collection Receipt
    Customer Code : AA0004545424

    Received from : Mr.SUMIT NANDI


    Customer Address : C - 1006 , SECTOR - B , MAHANAGAR LUCKNOW UTTAR Collection No : 11-01/1355018706
    PRADESH - 226006
    . Collection Date : 15/01/2021

    . Office Code : 700004 - Tele Sales-Noida


    Supplier GSTIN : 09AAJCS4517L1ZW

    Customer GSTIN : 09ABGPN0658JIZD Place of Supply : Uttar Pradesh State Code: 9

    Amount Collected : Rs. 21859 /- Inclusive of tax :

    Amount in words : Indian Rupees Twenty-One Thousand Eight Hundred Fifty-Nine 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/700004/01/2021/037980 SO700004 OD700004 21859 CC WALLET 210115711074 15/01/2021


    816463

    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

    CN=R Margabandhu,

    R Margabandhu
    SERIALNUMBER=00f82dcf76fdf6537e3331f8479ef45e7b4f3861b15
    475488cdf3b2c3c26c3c9, ST=TAMIL NADU, OID.2.5.4.17=600034,
    OID.2.5.4.20=513b7b33f2ce960f23148ea208744690e09638750806
    ca65f89e15179f5fe50a, OU=UNDERWRITING - Chief Risk Officer,
    O=STAR HEALTH AND ALLIED INSURANCE COMPANY, C=IN.
    Date :Fri Jan 15 15:38:00 IST 2021

    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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