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LIFE INSURANCE PREMIUM CERTIFICATE

( Financial Year 2014-2015)

PAWAN ASHOK MAKHIJA

H 4/18 JAN KALYAN

BANGUR NAGAR

GOREGAON WEST

MUMBAI

ZIP: 400090

PHONE: 2256776000

This is to certify the following details:

Policy Number

Insured Name

Face Amount(`/Units)

U016675542

PAWAN ASHOK MAKHIJA

Basic Plan

Tata AIA Life InvestAssure Flexi (110L055V01)

750,000.00

Policyowner Name

Mode of Premium

PAWAN ASHOK MAKHIJA

MONTHLY

Amount (`)

20,825.00

0.00

0.00

20,825.00

0.00

20,825.00

Tax Sections #

80 C of Income Tax Act, 1961 *

80 CCC of Income Tax Act, 1961**

80D of Income Tax Act, 1961 ***

Total Premium

Service Tax

Total amount paid during the Financial Year2014-2015 :

Total amount of Top up premium paid during the Financial Year 2014-2015 :

* Includes Life Plans, Riders and Immediate Annuity products.

** Includes Pension Plans. Tax benefit is not available for premium payment through automatic loans from Cash Value of the policy if

any, as per the policy provisions.

*** Includes Health Plans & Health Riders. Tax benefit is not available for premium payment in cash or through automatic loans

from Cash Value of the policy if any, as per the policy provisions.

Date: 10 November,2014

This is a computer generated statement and does not require signature.

Service tax is applicable as per governing laws and the same shall be borne by the policyholder. Tata AIA Life Insurance Company Limited reserves the right to recover from the policyholder,

any levies and duties (including service tax), as imposed by the government from time to time.

Service tax Registration Number: AABCT3784CST001

Category of Service: Life Insurance Service and / or Management of investment under ULIP Services

# Income Tax benefits would be available as per the prevailing income tax laws, subject to fulfillment of conditions stipulated therein. Tata AIA Life Insurance Company Ltd. does not assume

responsibility on tax implication mentioned anywhere in this document. Please consult your own tax consultant to know the tax benefits available to you.

Tata AIA Life Insurance Company Ltd. (IRDA Regn. No. 110)(CIN - U66010MH2000PLC128403)

Regd. & Corporate office: 14th Floor, Tower A, Peninsula Business Park, Senapati Bapat Marg, Lower Parel, Mumbai-400 013 .

Please feel free to contact us at our Customer Service on our helpline number 18002679966 (toll free) or 18602669966

(local charges apply) or write to us at [email protected] or SMS SERVICE to 58888 or visit our website:- www.tataaia.com


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