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Collecting Branch : EPS1 Servicing Branch : LIC of India, New Delhi Br Unit

3rd Floor
Transaction No : 31226522
Jeevan Prakash 25 Kasturba Gandhi
Date ( Time ): 24/12/2020 ( 10:17:11 ) Delhi,110001
Email: [email protected]
Receipt No : PR3122652200012021
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 6,065.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Ashish Singh


towards the following :

Policy No Plan / Term Inst. Premium No Of Inst Total Premium CGST Branch
Name D.O.C. Mode Due From Late Fee SGST/UTGST Next Due
Revival Sum Assured Due To CD Charges Total Amt Reg. No.
Agency Code
(Yes/No) (`) (`) (`)
116499042 165 / 20 6,065.00 1 6,065.00 0.00 117
Ashish Singh 10/01/2012 HLY 01/21 0.00 0.00 07/21
No 01/21 0.00 6,065.00 07AAACL0582H1ZO
46517111 2,50,000

Page Total (`) 6,065.00 6,065.00 0.00


0.00 0.00
0.00 6,065.00
Grand Total (`) 6,065.00 6,065.00 0.00
0.00 0.00
0.00 6,065.00

GST borne by LIC of India ` 136.46


SIX THOUSAND SIXTY FIVE RUPEES AND ZERO PAISE ONLY

Ashish Singh
Consolidated Stamp Duty Paid
E-40, U/G/F, Front Side Jeevan Park
Near Guru Nanak Property Uttam Nagar CSD/113/2020/1936 DTD. 18.09.2020
West Delhi Delhi

110059 Payment Acknowledgement generated through


Online Portal on 24-Dec-20 Time : 10:19:40.
Mobile: 99******78
Email: as********[email protected]

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!

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