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80D Certificate

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Tax Certificate

To
Customer Name : RINTU DAS
Address A36, 3rd floor Lake View Park,Bonhooghly,
: Bonhooghly,
Kolkata
700108

Subject: Premium Certificate for the purpose of deduction under Section 80 D of Income Tax Act 1961 and any amendments
made thereafter.

Dear Customer,
This is to certify that the company has received the premium for Health Insurance Coverage under "Health Insurance Policy"
with the following details.

RINTU DAS
Policy Holder's Name : P/700020/01/2024/009012
Policy No. :

Policy Name : Star Health Assure Insurance Total Premium : 29297


Policy
Policy End Date :
Policy Start Date : 28/03/2024 27/03/2025
Servicing Branch
Customer GSTIN : GSTIN :
- 09AAJCS4517L1ZW

Customer Code : Premium Terms :


Installment
AA0031258195
Servicing Branch
Servicing Branch Space No. 553A & 553B,
700020 - Lucknow - TS Address :
Code & Name : 2"D Floor, Lekhraj Market-3 Indira Nagar,
Lucknow - TS
Faizabad Road,, Lucknow-226016

IGST CGST SGST


Receipt Date Basic Premium Total Premium
% Rs. % Rs. % Rs.

28-MAR-24 6207 18 1117 0 0 0 0 7324

The Product is eligible for deduction us 80D of the Income Tax Act 1961 and any amendments made there to.

Financial Year Amount

Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800 Toll Free Fax No: 1800-425-5522 Toll
Free No:1800-425-2255 / 1800-102-4477,CIN : L66010TN2005PLC056649 Email :support@starthealth.in Website :www.starhealth.in IRDAI Regn.no: 129
CN=NAGARAJAN RANGANATHAN,

NAGARAJAN SERIALNUMBER=571a5eb638953f23a816eb6b4ba547263f54f12c3e
b01eeffe482ca5cef2a530, ST=KARNATAKA, OID.2.5.4.17=560097,
OID.2.5.4.20=6790b30666b75b5b38bb63bf7adee63ad3d22e5d7442f
0f2901f2e91fd09c393,
RANGANATHAN OID.2.5.4.65=a239b1f28cc54836b0a11b2d664227a3,
O=PERSONAL, C=IN. Date :Mon Jun 10 14:41:57 IST 2024
2023-2024 7324

Note:-
1) This certificate must be surrendered to the Insurance Company of insurance of fresh Certificate in case of Cancellation of the
Policy or any alternation in the Insurance affecting the Premium.
2) This Certificate is reflecting the Premium(s) Receipts cleared at the time of generating this certificate.
3) The Liability of any changes in the Premium Receipt's clearing status post generating the certificate shall be upon the
policy holder.

Date : 10/06/2024 For and On behalf of

Place : Lucknow Star Health and Allied Insurance Company Ltd

IRDA Regn. No 129


Corporate Identity Number L66010TN2005PLC056649

Email ID : info@starhealth.in Authorised signatory.

Regd.&Corporate Office:1,New Tank Street,Valluvar Kottam High Road,Nungambakkam,Chennai - 600034,Phone : 044 -28302700 / 28288800 Toll Free Fax No: 1800-425-5522 Toll
Free No:1800-425-2255 / 1800-102-4477,CIN : L66010TN2005PLC056649 Email :support@starthealth.in Website :www.starhealth.in IRDAI Regn.no: 129

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