Revival details under Policy

Policy Number : 803257858

Plan Number : 174
Premiums not paid since : 28/03/2016
No of Instalments due : 3
Instalment Premium : ` 3,564.00
Total Premium Amount : ` 10,692.00
Late Payment Charges : ` 1,259.85
Total Revival Amount : ` 11,951.85
Revival Quotation valid till : 11/07/2018
Premium Mode : Yearly

This document is electronically generated and no signature is required.In case of any

discrepancies/queries about revival, please send SMS as follows -- type "LICHELP <policy
no>" and send it to 9222492224. Our Customerzone Official will get in touch with you shortly.
* Please note that the revival quotation does not include the applicable GST amount. GST rate
as per rules prevailing will be applicable at the time of payment.