Plot No 3 and 4,Padmavathi Tower, 3rd Floor,Survey,No
145,Near JNTU opp.More Mega Store, S.P.Ngr and Sai Ngr, N.H.9 Ranga Reddy Dist,Hydernagar,Kukatpally Hyderabad Telangana-500085 Phone: 040-4011642728 Telefax:
Collection Receipt
Customer Code : 907892 Collection No : 131115/RV/2025/0182323389
Received From : AMARNATH RAJU TAMMINENI Collection Date : 20-Dec-2024 Customer Address : Plot No 58 II phase, J P N Office Code : 131115 - Branch Office - Nagar, Miyapur, Hyderabad Plot Kukadapally No 58 II phase, J.P.N.Nagar, GSTIN : 36AAJCS4517L1ZZ Miyapur HYDERABAD Place of Supply : Telangana Shaikpet Telangana 500050 Customer mobile : 789XXXXX54 Type of proposal : Renewal number Customer GSTIN : NO State Code : 36 Amount Collected : Rs. 41,904/- Amount in words : INDIAN RUPEES Forty One thousand nine hundred four only Towards the Following : Amount Receipted towards Premium Sr. Proposal Fulfiller Intermediary Amount Mode of Bank CHQ/CC/DD CHQ/DD/BC No Ref. No Code Code Collected payment Name No Dt. (Rs) 1 61256676646 SH7332 SMD 41,904/- PAYTM 241220123628 20-Dec-2024 2 441342
For Star Health and Allied Insurance Co. Ltd.
Authorised Signatory
Note : Receipt Subjected to realization of Cheque/DD
This is only an evidence of receipt of money by the company. Risk will commence once the proposal is examined and accepted. “Available modes of payments of Premium: Cash, Cheque, DD, Net Banking, RTGS/NEFT, Credit Card, Debit Card, UPI, Payment Gateway(PAYTM, PAYU, AIRPAY, BBPS, CSC, UBONA).” ''CONSOLIDATED STAMP DUTY FOR REVENUE STAMPS PAID VIDE ORDER NO. NO GSO5/8326/R/2023 FROM DT 02.08.2023''
OID.2.5.4.17=560097, OID.2.5.4.20=6790b30666b75b5b38bb63bf7adee63ad3d22e5d7442f0f2901f2e91fd09c393, OID.2.5.4.65=3d419b0bb1a244e29097659c201722ac, O=PERSONAL, C=IN. Date :Wed Jan 01 22:28:58 IST 2025 Page 1 of 1 IRDAI Regn.No.129 Corporate Identity Number L66010TN2005PLC056649 Email ID: info@starhealth.in
