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Draft Tax invoice
- 1. Asia Insurance Corporation No: 32 , Barly _____ Tipe Road Green Path Colombo – 03 RECEIPT RENEWAL (THIS IS NOT A TAX INVOICE) Insured Name & Addess Receipt No : KU00008R64 Mrs. H.M.T Menike Copy : CUSTOMER COPY Herath Stores , koswatta Date : 02/12/2012 Panadaragama Time : 10.45 AM Department : KURUNAGALA POLICY NO : 97KUD666675 Buss. Class : MOTOR ENDORSMENT NO : KU00008154567 Policy Type : HIRING VEHICLE Init Sum Insured : Rs. 1,000,000.00 Effect Date : 05/12/2012 New Sum Insured : Rs. 900,000.00 Period of Cover : 05/04/2012 – 04/04/2013 Risk Refference : 48-2264 Particulars Amount (Rs.) PREMIUM EXCLUDING SRCC / TC 8,717.50 SRCC PREMIUM 1,000.00 POLICY FEE 200.00 Total Excluding Levies 9,717.50 Other Levies 1462.62 Admin Fee 33.31 Total Includin Levies 11,213.43 Received with thanks a sum of srilankan Rupees. Eleven thousend two hundred and thirteen and cents forty three only …………………. ………………… ………………….. ………………………… Prepared By Checked By Authorised by Cashier Signature Subject to realiztion of the cheque