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United lndia lnsurance Company Limited


24. Whites Road "Chennai - 600 014 ,Website : http://www.uiic.co.in
1 020302001 61081 21 402 pavmenilD: i 1603020010827465
Voucher No.: 1

2611212016 Transaction 2611212016


Money Voucher Date: )afe:
Receipt O3O2OO DO 2 KOLKATA
lssuino Office Code. Name and Address:
38 B, HIMALAYA HOUSEJAWAHARLAL NEHRU ROAD, CHOWRINGHEETOOOTl

) olicy/E ndt/C la in Main Acct


lntermediaryi Bank Name and Cheque No and Account Description
ll Nr
Tr.Cd. (eil Numbe
Customer/ Date Narration
Sub Acct Amount
Employee
Drawee Branch RS P:
Name
PUNJAB 9111120000
113189 COLLECTIONS CHEQUES ON
1 2301598522 NATIONAL BANK
23t12t2016 HAND 0 i2011 ()(

T02 24PGS NORTH


Paoe Total: 1201r
leceived with thanks from:
AYEETA BISWAS PAUL Grand Total: 12a11

Rs. Twelve thousand eleven rupees only


p
,f, c{*,^./o,
Siqnature of
Narration:
'owards premium
I iervice Tax Registration
RAJ25062 YEETA BISWAS Number(UllC) :
26t1212016 tAUL,2824, -
2'.07'.29 PM 2011.00,
!SURANCE
,REMIUM AAACU5552CSTOO1 Approved By I Cheque Signed

http://gccore.uiic,irVConfigurator/accounts/Acc_Voucher_Report.aspx?VoucherNumber:... 2611212016
.Lccounts Reports Page 1 of I

United lndia lnsurance Company Limited


24, Whites Road,Chennai - 600 014 ,Website : http://www.uiic.co.in
020302001 61 081 21468
Voucher No.:
1
PavmFnf rD. 111603020010827522t

2611212016 Transaction 26112/2016


Money Voucher Date: .)afc:
Receipt
O3O2OO DO 2 KOLKATA
lssuing Office Code, Name and Address:
38 B, HIMALAYA HOUSEJAWAHARLAL NEHRU ROAD, CHOWRINGHEETOOOTl

f
^li^v/tr I\,4ain Acct
ntermediary, Cheque No. and Account Description
Sl. N( Tr.Cd. (eat Numbe
Customer/
Bank Name and
Date Narration Sub Acct Amount
Drawee Branch
Employee Name Rs Pr

1301 9985221 COLLECTIONS CASH ON 9111110000


1 0 52 0(
T02 HAND 0

leceived with thanks from: Paqe Total: s2 o(

AYEETA BISWAS PAUL Grand Total: s2 o(

Rs. Fifty-two rupees only ,, -f f tf


Revenue Stamp
.ff.C ",- y'..
I b-, "
Siqnature! of Recipient
Narration:
Towards premium Service Tax R.eg istration I

RAJ25062 AYEETA BISWAS


26t12t2016 PAUL, 2824,52.00, Number(UllC):
2:09:23 PM INSURANCE
PREMIUM
AAACU5552CSTOO1 Approved Bv' Cheque Siqned By

http:llgccore.uiic.irVConfigurator/accounts/Acc Voucher Report.aspx?VoucherNumber:... 261f212016


@
UNITED INDIA INSURANCE COMPANY LIMITED

RENEWAL NOTICE

To, From,

MRS AYEETA BTSWAS PAUL ( 2301998522r ) Issuing Office : O3O20O


soDEpLillt RoAD, BADAMTALA. SHRIpUR, p.O. MADHYAMGRAM 38 B, HIMALAYA HOUSE
JAWAHARLAL NEHRU ROAD, CHOWRINGHEE
NORTH]'WENTY FOUR PARGANAS-7OO13O KOLKATA, KOLKJ\TA, WEST BENGAL
WEST EENGAL KOLKATA-7OOO7I
Mobile:9748444975 WEST BENGAL
Telephone:(O331 2226
Dear SirT'Madam,

Re : Renewal of Individual Famil; Medicare policy No:03020o2815p11o7g3Do5

This is to remind you that your insurance policy mentioned below is expiring on og/L212o16. please
above actdress within the details of changes, if rny, we will advise you the correct premium payable contact us at an early date at the
continuit'/ of your insurance. by you well in advance to maintain

Policy Expiring on : O9/L2/2OL6

RANJAN OATT / AGIOO62869


Developri.lent Officer Name / :ode PURNENDU SAHA / 36389

Name Age Sex Relation Sum Insured No Claim Discount/Loading


AYE:ETA BISWAS PAUL 34 Female Self 500000
AISHIK PAUL 34 Male S pouse 50000G
ASMITA PAUL
L.II].NA 3 Female Daug hter 50000c,

I Current Renewal No. of Claims


T1o,49o,oo
Service Tax(rn.rudins sw..hh Bbr.t c6r or - T1o,49o,oo Registered :0
{1,521.00 T1,573.00
itamp Duty T1. oo
lotal Premium Pavatrle {tz.otr.oo T12,063.00

Authorised Signatory

To,

United India Insurance Company Limited MRS AYEETA BISWAS PAUL ( 23019985221
Issuing Office : O3O2OO )
SODEPUR ROAD, BADAMTALA, SHRIPUR, P.O. MADHYAMGRAM
38 B, I.IIMALAYA HOUSE
JAWAHARLAL NEHRU ROtrD, CHOWRINGHEE NORTH TWENTY FOUR PARGANAS-7OO13O
KOLKATA, KOLKATA, WEST BENGAL WEST BENGAL
KOLKATA-7OOO71 Mobile:9748444975
WEST BENGAL
Tr

Dear Sir/Madam,

Ref : Renewal of My Individual Fanri!y Medicare policy No.03o2oo2815p11o783oo5

with referr:nce to your renewal notice(s) please renew the policy o3o2oo2g15p1to7g3oi)5
herewith my cheque/DD/cash for T 12,0t,3.OO for further period of one year. I enclose
towards r-en"*ai premium,

Date :

Place :
Payment due on : 09/,12/2016
Pay by: 09/12/2016

Signature of Insured