Branch Code: 907 NAJYOTI SOCIETY,

Agent Name : MRS JIGNA NAYAN SANGHAVI 1ST FLOOR, FLAT NO 7,

Agent Code : LIC01464907 L B S MARG, GHATKOPAR EAST, MUMBAI

Premium Due List For The Agent LIC01464907 For 12/2023

S.No PolicyNo Name of Assured D.o.C Pln/Tm Mod FUP Flg InstPrem Due GST TotPrem EstCom

1 908136660 NAYAN LAHERIKANT SANGHVI 23/04/2015 827/20 Qly 07/2023 703.00 2 32.00 1438 52.72
2 903339778 BHARATKUMAR TALAKSHI PUJ 28/07/2008 103/21 Mly 07/2023 499.00 6 0.00 2994 179.64
3 903339779 BHARATKUMAR TALAKSHI PUJ 28/07/2008 103/21 Mly 07/2023 499.00 6 0.00 2994 179.64
4 903346254 LEENA NILESH MEHTA 14/02/2009 165/25 Qly 08/2023 919.00 2 0.00 1838 91.90
5 903566560 VIRATEE AMIT SANGHVI(P) 15/02/2010 184/21 Hly 08/2023 2990.00 1 0.00 2990 149.50
6 903566561 VIRATEE AMIT SANGHVI(P) 15/02/2010 185/21 Hly 08/2023 3052.00 1 0.00 3052 152.60
7 902854857 RUPALI K VETURKAR 10/06/2007 165/30 Qly 09/2023 766.00 2 0.00 1532 76.60
8 903343060 RAVI POONARAM JANGID 15/12/2008 165/30 Qly 09/2023 919.00 2 0.00 1838 91.90
9 902854658 KAMLESH VARDHAMAN MEHTA 21/06/2007 108/25 Qly 09/2023 2056.00 2 0.00 4112 246.72
10 902854660 KAMLESH VARDHAMAN MEHTA 21/06/2007 133/30 Qly 09/2023 621.00 2 0.00 1242 62.10
11 902854661 KAMLESH VARDHAMAN MEHTA 21/06/2007 165/30 Qly 09/2023 766.00 2 0.00 1532 76.60
12 903567928 MEGHA DINESH SARFARE 26/03/2010 165/25 Qly 09/2023 1531.00 2 0.00 3062 153.10
13 903150150 BHARAT L MEHTA 10/10/2007 149/58 Yly 10/2023 44234.00 1 0.00 44234 2211.70
14 903150151 BHARAT L MEHTA 10/10/2007 164/23 Yly 10/2023 13707.00 1 0.00 13707 685.35
15 904038299 SRI BHARAT LEELADHAR MEHTA 15/04/2012 165/21 Hly 10/2023 44289.00 1 0.00 44289 2214.45
16 904038302 SRI BHARAT LEELADHAR MEHTA 15/04/2012 5/34 Hly 10/2023 30170.00 1 0.00 30170 1508.50
17 908481800 ANKIT BHARAT MEHTA 28/10/2018 833/18 Qly 10/2023 12970.00 1 292.00 13262 648.50
18 908481801 ANKIT BHARAT MEHTA 28/10/2018 845/70 Qly 10/2023 20037.00 1 451.00 20488 1001.85
19 928350806 DOLLY TEJASH SHAH 11/11/2021 936/16 Qly 11/2023 ST 19316.00 1 435.00 19751 1448.70
20 903561697 TEJAL KALPESH MEHTA 14/08/2009 165/25 Qly 11/2023 3062.00 1 0.00 3062 153.10
21 933512475 DIPAK MOHANLAL PATADIYA 22/11/2022 855/30 Yly 11/2023 ST 45560.00 1 8201.00 53761 3417.00
22 933512476 DIPAK MOHANLAL PATADIYA 22/11/2022 914/21 Yly 11/2023 ST 29258.00 1 658.00 29916 2194.35
23 903565047 KALPESH PRAVINCHANDRA MEHTA 24/11/2009 165/35 Qly 11/2023 6125.00 1 0.00 6125 306.25
24 903346521 MEENA JAYESHY SHAH 25/02/2009 165/25 Qly 11/2023 1225.00 1 0.00 1225 61.25
25 904032741 RILPA KIRAN PATEL 25/11/2011 165/21 Yly 11/2023 6005.00 1 0.00 6005 300.25
26 908415219 KAUSHIK PRAVINCHANDRA SHAH 07/12/2017 905/30 Yly 12/2023 3170.00 1 571.00 3741 158.50
27 908415220 MOSMIBEN KAUSHIK SHAH 07/12/2017 905/30 Yly 12/2023 3740.00 1 673.00 4413 187.00
28 908350279 HETA ANKIT MEHTA 08/12/2016 836/25 Hly 12/2023 11472.00 1 258.00 11730 573.60
29 908350280 HETA ANKIT MEHTA 08/12/2016 815/16 Hly 12/2023 18348.00 1 413.00 18761 917.40
30 908350281 JUHIKA NISHANT MEHTA 08/12/2016 815/16 Yly 12/2023 35853.00 1 807.00 36660 1792.65
31 908350282 JUHIKA NISHANT MEHTA 08/12/2016 836/25 Yly 12/2023 22614.00 1 509.00 23123 1130.70
32 908350410 NISHANT MAHESH MEHTA 08/12/2016 823/35 Hly 12/2023 2499.00 1 450.00 2949 124.95
33 908350411 NISHANT MAHESH MEHTA 08/12/2016 836/25 Hly 12/2023 22744.00 1 512.00 23256 1137.20
34 908350412 NISHANT MAHESH MEHTA 08/12/2016 815/16 Hly 12/2023 18187.00 1 409.00 18596 909.35
35 908350454 ANKIT BHARAT MEHTA 08/12/2016 823/35 Hly 12/2023 3034.00 1 546.00 3580 151.70
36 908350455 ANKIT BHARAT MEHTA 08/12/2016 815/16 Hly 12/2023 18447.00 1 415.00 18862 922.35
37 908350456 ANKIT BHARAT MEHTA 08/12/2016 836/25 Hly 12/2023 22843.00 1 514.00 23357 1142.15
38 908415498 MAHESH CHUNILAL THACKER 08/12/2017 815/21 Yly 12/2023 54840.00 1 1234.00 56074 2742.00
39 908415499 MAHESH CHUNILAL THACKER 08/12/2017 814/15 Yly 12/2023 34133.00 1 768.00 34901 1706.65
40 908415500 MAHESH CHUNILAL THACKER 08/12/2017 836/16 Yly 12/2023 42068.00 1 947.00 43015 2103.40
41 911613183 RAJESH RAMJIBHAI JETHVA 11/12/2019 845/51 Yly 12/2023 117291.00 1 2639.00 119930 5864.55
42 908415288 UMANG KAMLESH SANGHVI 12/12/2017 814/30 Yly 12/2023 5089.00 1 115.00 5204 254.45
43 908415290 VISHAL MANSUKHLAL SANGHVI 12/12/2017 814/30 Yly 12/2023 5332.00 1 120.00 5452 266.60
44 908415291 DIPALI VISHAL SANGHVI 12/12/2017 814/30 Yly 12/2023 5332.00 1 120.00 5452 266.60
45 908415292 DIPALI VISHAL SANGHVI 12/12/2017 905/30 Yly 12/2023 4220.00 1 760.00 4980 211.00
46 908415293 KAMLESH PREMCHAND SANGHVI 12/12/2017 905/16 Yly 12/2023 17390.00 1 3130.00 20520 869.50
47 907942333 PANKAJ DHANJI CHHEDA 14/01/2015 815/25 Mly 12/2023 5837.00 1 131.00 5968 291.85
48 908415308 UMANG KAMLESHBHAI SANGHVI 14/12/2017 905/30 Yly 12/2023 2465.00 1 444.00 2909 123.25

Page Total Premium : 808052 G S T : 26554 Estimated Comn : 41511.67

( Page No : 1 | 907 | LIC01464907 | 17014992040307 | Due Month 12/2023)
S.No PolicyNo Name of Assured D.o.C Pln/Tm Mod FUP Flg InstPrem Due GST TotPrem EstCom

49 903564108 MILIN NALIN DAFTARY 15/12/2009 165/25 Hly 12/2023 1516.00 1 0.00 1516 75.80
50 907644351 SURYAKUMAR KESHAVLAL MEHTA 15/03/2013 165/21 Qly 12/2023 3675.00 1 0.00 3675 183.75
51 907644353 SURYAKUMAR KESHAVLAL MEHTA 15/03/2013 5/51 Qly 12/2023 1021.00 1 0.00 1021 51.05
52 902854955 DEEPAKHASMITA P SANGHAVI 21/06/2007 89/25 Qly 12/2023 1760.00 1 0.00 1760 88.00
53 916948664 PARV KALPESH MEHTA 22/03/2021 936/25 Qly 12/2023 ST 44300.00 1 997.00 45297 3322.50
54 916945477 JINISHA UMANG SANGHVI 25/12/2019 845/72 Yly 12/2023 49425.00 1 1112.00 50537 2471.25
55 903568438 GOPAL DERKI SINGH 28/03/2010 165/25 Qly 12/2023 1262.00 1 0.00 1262 63.10
56 907935896 ALPA NITIN KHONA 28/12/2013 165/15 Yly 12/2023 6005.00 1 0.00 6005 300.25
57 907935898 ALPA NITIN KHONA 28/12/2013 14/15 Yly 12/2023 6950.00 1 0.00 6950 347.50
58 907936343 JIGNA NAYAN SANGHVI 28/12/2013 165/21 Yly 12/2023 3603.00 1 0.00 3603 180.15
59 907936399 NAYAN LAHERIKANT SANGHVI 28/12/2013 5/44 Yly 12/2023 3870.00 1 0.00 3870 193.50
60 907936912 SONAL SUNIL SHAH 28/12/2013 5/43 Yly 12/2023 39643.00 1 0.00 39643 1982.15
61 907936913 SONAL SUNIL SHAH 28/12/2013 14/20 Yly 12/2023 54816.00 1 0.00 54816 2740.80
62 907936914 SONAL SUNIL SHAH 28/12/2013 190/20 Yly 12/2023 9700.00 1 0.00 9700 485.00
63 907937811 NAYAN LAHERIKANT SANGHVI 28/12/2013 5/44 Yly 12/2023 3870.00 1 0.00 3870 193.50
64 907937812 JIGNA NAYAN SANGHVI 28/12/2013 149/66 Yly 12/2023 11009.00 1 0.00 11009 550.45
65 908228403 JAKIN PRABHASHANKAR GOR 28/03/2016 815/35 Qly 12/2023 7600.00 1 171.00 7771 380.00
66 908228404 JAKIN PRABHASHANKAR GOR 28/03/2016 815/35 Qly 12/2023 7600.00 1 171.00 7771 380.00

Page Total Premium : 260076 G S T : 2451 Estimated Comn : 13988.75

Grand Total Premium : 1068128 G S T : 29005 Estimated Comn : 55500.42

FY - First year Prem. ST-> 2nd,3rd Year Prem. LP : Last Premium. MT : Matures after this due.

( Page No : 2 | 907 | LIC01470907 | 17014992040307 | Due : 12-2023 )