Premium Receipt

RENEWAL PREMIUM RECEIPT

Receipt No: Z9961959

Client ID: 58024147

Date: 10/09/2013

Policy No: 14573554

Plan Description: HDFCSL Classic Assure

Koppisetty, Ashok Sahrat 3-128 Itud Lane Sarada Nagar Baligattam Narsipatnam Visahapatnam - 531116 9550820019 /9550297590 Dear Koppisetty, Ashok Sahrat Life Assured : Koppisetty, Ashok Sahrat

We acknowledge with thanks, receipt of an amount of Rs. ******12,186.00 by Online Payment towards renewal premium. as regular premium towards your policy Benefit Opted For

Premium Received(Rs)

Tax benefit available under the Income Tax Act, 1961

Classic Assure Benefit

12,000.00

Section 80C

Service tax and levies

186

For HDFC Standard Life Insurance Company Limited

*This is an electronically generated duplicate premium receipt and does not require any signature

Renewal Premium Rs. ******12,186.00 Total Amount Received Rs. ******12,186.00 Balance Amount adjusted Rs. ***********0.00 Advance Payment received Rs. ***********0.00 Premium adjusted for the period to Next premium due 29/08/2014 Premium payment frequency Annual Service Tax Registration Number M-IV / ST / IAS - LIFE / 2

HDFC STANDARD LIFE INSURANCE COMPANY LIMITED Correspondence Address: 11th Floor, Lodha Excelus, Apollo Mills Compound, N .M. Joshi Road, Mahalaxmi, Mumbai400011. Regd. Office: Lodha Excelus, 13th Floor, Apollo Mills Compound, N.M. Joshi Marg, Mahalaxmi, Mumbai - 400 011. Maharashtra, India Policy Servicing Helpline: 1800-228-228 (Toll free - MTNL/BSNL)/1800-209-7777(Toll Free - Any Phone) or 60007777 (Local call - Non BSNL/MTNL)