RENEW THE COMMITMENT TO YOUR DREAMS

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And the commitment towards your dream is fulfilled only when you choose to get it ... you have sufficient funds in your
RENEW THE COMMITMENT TO YOUR DREAMS Policy Number Policyholder Name

0067269618 DALJINDER SINGH

Premium Amount Due

25,000.00

Premium Due Date*

30-03-2019

Product Name

Canara HSBC Oriental Bank of Commerce Life Insurance Smart Goals Plan

Policy Term

15

Premium Payment Term

10

Payment Frequency * Premium amount revised owning to GST implementation effective 01 July 2017

Dear Policyholder, Owning an insurance policy is like securing your dreams. And the commitment towards your dream is fulfilled only when you choose to get it renewed in time. We wish to intimate you that your renewal premium will be due as per the details mentioned above. We request you to make the payment on or before the due date to continue enjoying the policy benefits. If the Premium is not paid within 30 days from the due date indicated the policy will lapse. You can pay your premium using any of the below mentioned options:

NOTE: 1. Please ignore this document if you have already paid your Premium. 2. Please do not hand over cash to the person who comes to collect the Premium. 3. Cheque /DD to be made in the favour of “CANARA HSBC ORIENTAL BANK OF COMMERCE LIFE INSURANCE COMPANY LTD” with Policy No. Please mention your name and contact number on the reverse of the cheque/DD. 4. In case you have opted for Standing Instructions, we suggest that you have sufficient funds in your bank account up to 7 days before and after the Premium due date. 5. Renewal payment receipt shall be dispatched within 7 working days from date of adjustment of Premium in your policy. 6. Premium includes Goods and Services Tax as applicable. 7. You are advised to inform us of any change in material information with respect to health of the life assured, financial disclosures and all such matters that has an impact on the policy, post issuance of policy or last renewal whichever is later. 8. You are advised to keep record of all information provided to the Company. 9. Any person making a payment of insurance premium exceeding 50000/- in a financial year is required to submit his PAN details to the Company. Person who do not hold PAN and has income during the financial year does not exceed the basic exemption limit are required to apply for PAN and submit duly filled Form 60 (revised). 10. For any complaints or grievance with respect to the policy please follow the grievance redressal procedure as provided in your policy terms and conditions and also provided on our website at www.canarahsbclife.com Thank you for your continued patronage

This is a computer generated letter hence requires no signature

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(Customer Copy) Received with thanks Rs.25,000.00 for Policy Number 0067269618 issued by Canara HSBC Oriental Bank of Commerce Life Insurance Company in the Name of MR DALJINDER SINGH

Bank Stamp/ Signature / PA Code Receipt is only valid if properly stamped and signed by the authorized bank staff NAV for Unit linked products would be applicable on later of the due date or date of funds transfer to the Insurance Company’s account

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Holder)

Pay Directly at your nearest OBC Bank Branch Only for Account to Account Transfer

Bank Copy (To be filled by the Account Holder)

MR DALJINDER SINGH authorize the bank to debit the renewal premium due for Rs.25,000.00 from my A/c number

Request you to credit the proceeds to Canara HSBC Oriental Bank of Commerce Life Insurance Company. This premium is being paid for Policy Number 0067269618 issued in the name of MR DALJINDER SINGH Last date of premium payment 30-03-2019

Transfer Slip to be attached with Bank Voucher

______________________________Signature of Account Holder