LIFE INSURANCE CORPORATION OF INDIA

Policy no. and date Table and Terms Sum Assured Due Date and mode Instaltment premium
of comencement Rs of pament payable Rs
901259110 90-15 300000 01ST 10266
1/3/2001 15 HLY

MRS.MOUSUMI W Date of Maturity--01-03-2016

SHRI.ASIM SARKAR. Date of Last Pament--01-0902015
1/9/2015
78,APARTMENT HOUSE, Date of Barth--06-04-1963
HYDERTABAD ESTATE ,NEPEAN SEA ROAD , Age/Admission-38YES(S)
MUMBAI
Pincode:- 400036
Marriage Endowmewnt/Educational ANNUITY Plan with profit with Accident benefit
The proposer or his assignee or nominees have an option in liue of sum assured 10-hjalf yearly inswtalments at such rates as m
Surving on Date of Maturity-sum assured + vest.bonus

Date when premium payably MAR --SEP EVERY YEAR

Form no j/0069718.

BRANCE /923. DATE PREMIUM

BRANCE /923. 1/3/2001 Rs.10266
BRANCE /923. 00/9/01 Rs.10266
BRANCE /923. 30/3/02 Rs.10266
BRANCE /923. 24/9/02 Rs.10266
BRANCE /923. 9/4/2003 Rs.10266
 Prosal no and
date
6422
16-03-2001

alments at such rates as may be prevalent at the date of maturity.