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Collecting Branch : EPS1

E-mail : bo_eps1@licindia.com
Phone : +91-022-1251

Servicing Branch : 667


LIC of India, Kovilpatti Br Office
Jeevan Jyothi
Post Box No.31
952/5 Sattur Main Road Kovilpatti
Kovilpatti
628501

Transaction No. : PR1451199200011516


Date ( Time ): 19/02/2016 ( 14:25:17 )

RENEWAL PREMIUM RECEIPT


Received with thanks Rs. 532.00 through Payment Gateway over the Internet from:
Smt./Ms./Shri : D Murugeswari
Towards the following
Policy No
Name
Agency Code
322842961

Plan
Term
D.O.C.
179
Murugeswari D
20
01360667
14/12/2007
Page Total (Rs)

Grand Total (Rs)

Inst. Prem(Rs)
Mode
Sum Assured
532.00
QLY
50,000.00
532.00

532.00

No Of Inst
Due Fr
Due To
1
03/16
03/16

Total Premium
Late Fee
532.00
0.00
532.00
0.00
532.00
0.00

Service Tax
Edu Cess
Total Amt
0.00
0.00
532.00
0.00
0.00
532.00
0.00
0.00
532.00

Branch
Next Due
667
06/16

RUPEES FIVE HUNDRED THIRTY-TWO ONLY


D Murugeswari
D/O K Dharmaraj
236 Ii Street
Valluvar Nagar,Kovilpatti
628501
This receipt is electronically generated.

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi


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