Mr. Anandachary

Acknowledgement Receipt Date: 08/11/09 Proposal No: 127744A Name of the customer: Mr. Anandachary Payment mode:

Cash / Cheque / DD / PO

Payment details: Cash / Cheque Cheque/DD/PO No ___________ dated __________________ (Favouring ‘Bharti AXA Life Insurance Company Limited’)

Rs _____5156.82____

For and on Behalf of Bharti AXA Life Insurance Company Limited ______________________________ Authorized Signatory

 

  

Income tax benefits are as per Income Tax Act, 1961 and are subject to conditions mentioned therein and amendments made thereto from time to time If the payment has been made other than in cash, this receipt is conditional upon realization of the same by the company This is only an acknowledgement and premium receipt shall be issued by Bharti AXA Life Insurance Company Ltd Benefits under this policy shall be effective from the date of acceptance of risk subject to clearance of payment Insurance is the subject matter of the solicitation

Bharti AXA Life Insurance Company Limited Reg. N. 130, Registered Office: Unit No. 601 & 602, 6th floor, Raheja Titanium, Off Western Express Highway, Goregaon (East),Mumbai - 400 063. www.bharti-axalife.com Call centre: 022 40394444