Branch: 112 H.NO.

-148,SUBHASH NAGAR
GHOOKNA
RAKESH RAI GALI NO.-2, MEERUT ROAD
Agent : LIC10583112 UP
Leader :M0027112 PIN:201003

10583112 Premium due & Default List for the Month of 04/2020 Page : 1

Sl. Policy Policy Holder Name D.o.C. Plan - M F.U.P. Instlmnt D G S T Total Estm.
No. Number Term od Premium ue Premium Comn
1 129962839 JITENDRA KUMAR 20/05/2019 833-21 Q 11/2019 2922 2 263.00 6107 1461
2 118339006 JITENDRA KUMAR 28/06/2017 815-21 H 12/2019 2941 1 66.00 3007 221
3 109999824 DURGESH RAI 28/01/2018 815-16 H 01/2020 11107 1 250.00 11357 833
4 119994301 MANISHA KUSHWAHA(LA) 28/01/2019 844-11 H 01/2020 3910 1 88.00 3998 293
5 119994418 SIYANAND CHAUHAN 28/01/2019 836-21 H 01/2020 5525 1 124.00 5649 414
6 117274655 TARA DEVI 20/02/2013 165-10 Q 02/2020 1273 1 0.00 1273 64
7 118191105 RAJESH KUMAR 20/02/2017 815-26 Q 02/2020 2227 1 50.00 2277 111
8 118191904 MADAN 28/02/2017 820-20 Q 02/2020 2002 1 45.00 2047 100
9 118191906 VISHNU NARAIN 28/02/2017 827-11 Q 02/2020 1486 1 33.00 1519 56
10 118394463 CHANDERKALA DEVI 28/02/2018 814-12 H 02/2020 4512 1 102.00 4614 338
11 119995188 NISHANT 28/02/2019 833-24 Y 02/2020 11955 1 269.00 12224 897
12 117272742 NAVEEN TYAGI 28/12/2012 149-69 Q 03/2020 1896 1 0.00 1896 95
13 117275491 RAJESH KUMAR 11/03/2013 165-10 Y 03/2020 6005 1 0.00 6005 300
14 117282641 RAJESH KUMAR 16/09/2013 179-16 Q 03/2020 1339 1 0.00 1339 67
15 117287091 HARE RAM DAS 24/12/2013 179-12 Q 03/2020 1562 1 0.00 1562 78
16 117287880 HEMALATA 23/12/2013 165-10 Q 03/2020 766 1 0.00 766 38
17 117892286 NEHA SRIVASTAVA 28/09/2014 827-16 H 03/2020 1795 1 40.00 1835 67
18 117988536 JITENDRA KUMAR 28/09/2015 814-16 H 03/2020 3337 1 75.00 3412 167
19 118037845 DHARMENDRA KUMAR 28/12/2015 814-12 Q 03/2020 2272 1 51.00 2323 114
20 118037846 LAXMI DEVI 28/12/2015 814-12 Q 03/2020 2274 1 51.00 2325 114
21 118394466 ABHISHEK THAKUR 07/03/2018 814-12 H 03/2020 4440 1 100.00 4540 333
22 118395505 BIRJU KUMAR 28/03/2018 820-20 Q 03/2020 1985 1 45.00 2030 149
23 119133059 JIYACHHA DEVI 26/09/2018 827-11 Q 03/2020 1994 1 45.00 2039 110
24 117274658 DEEPAK KUMAR CHAUHAN(LA) 28/01/2013 179-12 Q 04/2020 2790 1 0.00 2790 140
25 117292254 GOPAL SINGH 28/04/2014 820-20 Q 04/2020 2012 1 45.00 2057 101
26 117906994 DUSHYANT SINGH CHAUHAN 15/01/2015 815-16 Q 04/2020 1967 1 44.00 2011 98
27 117986991 HARSH KUMAR TIWARI(LA) 01/04/2015 832-22 H 04/2020 5033 1 113.00 5146 252
28 117988535 AMARESH BAHADUR YADAV 28/10/2015 815-16 H 04/2020 3854 1 87.00 3941 193
29 118144149 SHIV SHANKAR KUMAR 25/10/2016 815-20 H 04/2020 2906 1 65.00 2971 145
30 118189684 ASHA DEVI 28/10/2016 827-13 H 04/2020 2335 1 53.00 2388 88
31 118268494 SOHIT 12/04/2017 827-20 H 04/2020 1829 1 41.00 1870 69
32 118269008 DEEPAK KUMAR 28/04/2017 841-16 Q 04/2020 2252 1 51.00 2303 113
33 118396166 VIPIN AUGUSTIN 12/04/2018 843-16 Y 04/2020 9551 1 215.00 9766 716
34 129962641 POOJA SRIVASTAVA 28/04/2019 814-21 H 04/2020 3710 1 84.00 3794 278
35 129962766 UMED SINGH RAWAT 28/04/2019 814-16 Y 04/2020 16287 1 367.00 16654 1222
36 142799495 KAVITA BANSAL 08/10/2019 815-21 Q 04/2020 1395 1 63.00 1458 349
37 142799496 PRIYANKA THAKUR 08/10/2019 827-16 Q 04/2020 906 1 41.00 947 170
38 142799497 SARVESH KUMAR 08/10/2019 815-21 Q 04/2020 1401 1 63.00 1464 350
39 142799498 SARVESH KUMAR 08/10/2019 815-22 Q 04/2020 1331 1 60.00 1391 333
40 142799663 DHARMENDRA KUMAR 18/10/2019 833-18 Q 04/2020 1691 1 76.00 1767 423
41 142799665 ROSHANI KUSHWAHA 18/10/2019 851-15 H 04/2020 1307 1 0.00 1307 131

Page Totals : Premium : 142082.00 G S T : 3165.00 Commission : 11591.00

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112-10593112 - (06/03/2020 17:01:29)