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G1210954_ICICIPru_PremiumReceipt_20240111192232

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30-DEC-2023

Amit Bartwal
B 15 2ND FLOOR LEFT SIDE
KHASRA NO60 STREET NO 13

Delhi
DELHI-110074
Mobile No: 8447948708

Amit Bartwal iProtect Smart RP NA G1210954 / 42

SUMMARY OF PAYMENT DETAILS


Premium Balance
Next Premium Balance Deposit
Date of Receipt Policy Number Installment & Payment Mode Premium Due (In
Due on (In `)
Frequency `)
29-12-2023 G1210954 29-01-2024 2189 / MONTHLY Auto Debit 5565 0

DETAILS OF THE POLICY PREMIUM PAID FOR FINANCIAL YEAR 2023 - 2024
Premium Total Premium Eligible for
CGST^ SGST^ IGST^ CESS^
Policy Receipt Product/ Amount** Paid
@9% @9% @18% @1%
Number no. Rider Name In ` (A) In ` Tax
In ` (B) In ` (C) In ` (D) In ` (E)
F=(A)+(B)+(C)+ Benefit*
ICICI Pru (D)+(E)
G1210954 P9506553 iProtect 12985 0 0 2338 0 15323 SEC 80 C
Smart
Total Premium Paid ` 15323

GSTIN number of company for Maharashtra : 27AAACI7351P1Z3


Place of Supply : Delhi
HSN No. - 997132
Address of supplier : ICICI Prulife Towers, 1089, Appasaheb Marathe Marg, Prabhadevi, Maharashtra, Mumbai - 400025

*Tax benefit on premium paid towards Life insurance policy u/s 80C, pension policy u/s 80CCC(1), health policy/ health related riders (if any)
u/s 80D as per the conditions prescribed in the relevant sections of The Income Tax Act, 1961. Tax laws are subject to amendments made
there from time to time. UIN
105N151V06

105N151V07

**Premium amount is inclusive of reinstatement charges paid (If any).


^ Taxes and Cess (if any) is inclusive of tax on reinstatement charges (If any).
Please note:
• Premium paid in advance will be applied to the policy on premium due date.

• Premium due amount is considered from last unpaid premium.

• If the payment has been made other than in cash, this premium paid certificate is conditional upon credit in company's account post
clearance of the instrument/facility including electronic mode.
• For any confirmation / impact analysis customer is advised to refer the matter to his Tax consultant.

• CONSOLIDATED REVENUE STAMP DUTY PAID: NOTIFICATION NO - MUDRANK CSD/79/2023/3028-26/06/2023.


• Goods and Service Tax and cess (if any) will be charged as per applicable rates and prevailing tax laws.

Registered Address: 1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai 400025. Reg No.: 105. CIN No.:L66010MH2000PLC127837. Call us on 1-860-266-7766
(10am-7pm, Monday to Saturday, except national holidays). Overseas customers can call us on +91-80-6938-5555 (Valid for calls made outside India). You can email us
at lifeline@iciciprulife.com or visit us at www.iciciprulife.com. UIN No. 105N151V06,105N151V07 COMP/DOC/Dec/2023/112/4826.
This is a system generated document, doesn’t require signature
• Tax is not payable under reverse charge.
• We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the
aggregate turnover notified under sub-rule (4) of rule 48, we are not required to prepare an invoice in terms of the provisions of the said
sub-rule.
• As per Rule 9(9B) of the Prevention of Money Laundering (Maintenance of Records) Amendment Rules, 2023, you are required to
intimate us if there is any change in your KYC details within a period of 30 days from the date the change was made. Once you intimate
us, we will make the necessary changes in our records. You can update us by writing to lifeline@iciciprulife.com or visiting the nearest
branch.

• For NRI customers: Please save all your proof of premium payments and documents ( bank statement, passbook copy ) in case you are
paying premiums through an NRE account and want to receive future payouts in the same account.

• To access your CKYC number, login to www.iciciprulife.com or download the ICICI Prudential Life app from Google Play/ App Store and
follow these steps: Login with your policy details --> Go to My Profile & check personal details

• View annual report 2022-23, released by Council for Insurance Ombudsmen for details on grievance redressal process. To view the
report, visit: https://cioins.co.in/AnnualReports

Your CKYC no. is 60056773984223

Registered Address: 1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai 400025. Reg No.: 105. CIN No.:L66010MH2000PLC127837. Call us on 1-860-266-7766
(10am-7pm, Monday to Saturday, except national holidays). Overseas customers can call us on +91-80-6938-5555 (Valid for calls made outside India). You can email us
at lifeline@iciciprulife.com or visit us at www.iciciprulife.com. UIN No. 105N151V06,105N151V07 COMP/DOC/Dec/2023/112/4826.
This is a system generated document, doesn’t require signature

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