Premium Receipt
Dear Mr. Ajinkya Bagade
H-9, Flat no.135, Ashtavinayak
Nagar, Sahakar Nagar
No.2,Parvati,
Pune, Maharashtra - 411009
We acknowledge the receipt of payment towards the premium of the following health insurance policy:
Policy Holder's Name Mr. Ajiknya Bagade Policy Number 30209660201200
Plan Opted for Family First Silver 50 lacs Sum Insured (Rs) 50,00,000
Commencement Date 03/04/2021 Expiry date 02/04/2022
Net Premium (Rs.) 45,897.00
Service Tax (Rs.) 5,108.00
Education Cess (Rs.) 110.00
Secondary & Higher Education Cess (Rs.) 56.00
Gross Premium (Rs.) 51,171.00
*Stamp Duty
*Insurance policy is subject to clearance of premium paid
Details at persons Insured:
Name of person Insured Age Gender Relationship to policy holder Individual Cover(Rs.)
(Only in case of family
first)
Mr. Hemant Bagade 64 M Father 25,00,000
Mrs. Suvarna Bagade 60 F Mother 25,00,000
Upon issuance of this receipt, all previously issued temporary receipts, if any, related to this
policy are considered null and void. For the purpose of deduction under section 80D, the benefit
shall be as per the provisions of the Income Tax Ad, 1961 and any amendments made thereafter. In
the event of non-realization of premium, Tax benefits cannel be obtained against this premium
receipt.
For your eligibility and deductions please refer to provisions of Income Tax Act 1961 as
modified and consult your tax consultant.
Service tax Registration number. AAFCM791611ST001
For & On behalf of Max Bupa Health Insurance Co. Ltd.
Location : Pune
Date:
17/04/2021 Ashish
Mehrotra Managing Director & Chief
Executive Officer
