Payment Claims Voucher
| Pcv No | 2026-06-032822 | Settle Date | June 05, 2026 |
| Insured Name | MR. RAJPUT SHIVAM HIRDYANAND | Policy No | PV/PPI/C-259972 |
| Claims No | CL/PV/PPI/11818-01 | ||
| No | Invoice No | Description | Exchange Rate | Amount |
|---|---|---|---|---|
| 1 | Payment For: OWN DAMAGE | USD 120.00 | ||
| Pay To: TAN SOUR | ||||
| Payment Status: Full Payment | ||||
| Cheque No: | ||||
| Total | USD 120.00 | |||
| Amount in Word | USD One Hundred Twenty and Zero Cents Only |
| Reviewed & Appr. PPI | Signature | Name | Date |
|---|---|---|---|
| PREPARED BY | kosal | June 05, 2026 | |
| CHECKED BY AM | KUSORL | June 05, 2026 | |
| VERIFIED BY HOD | SOCHEAN | June 05, 2026 | |
| APPR BY PPI CEO | SALY SOULEVANN | June 05, 2026 |
| Review And Approved By Group : | CHAIRMAN & CEO | CFO |
| Account Code | Account Name | Debit | Credit | |
|---|---|---|---|---|
| 111005 | Claim Paid -Motor.(Othe) | 120.00 | ||
| 660020 | Amount due from/(TO)Reinsuranc | 36.00 | ||
| 115505 | Claim Rec.Cam.Re-Motor-Other | 36.00 | ||
| Claim Rec.Out FAC-Motor-Othe | ||||
| Claim Rec.Q.T Share-Motor-Oth | ||||
| 660215 | FTB-Claims Acc. | 120.00 | ||
| TOTAL | 156.00 | 156.00 | ||
Print By: kosal