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Collecting Branch : EPS1 Servicing Branch : LIC of India, Dindigul Branch

Post Box No-5


Transaction No : 20089614
45 New Agraharam.,Dindigul (Tn)
Date ( Time ): 09/12/2019 ( 20:25:15 ) Dindigul,624001
bo_eps1@licindia.com
Receipt No : PR2008961400011920
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 6,125.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : S Reena
towards the following :

Policy No Plan Inst. Premium No Of Inst Total Premium CGST Branch


Name Term Mode Due From Late Fee SGST/UTGST Next Due
Agency Code D.O.C. Sum Assured Due To CD Charges Total Amt Reg. No.
(`) (`) (`)
746569200 165 6,125.00 1 6,125.00 0.00 749
S Reena 15 QLY 11/19 0.00 0.0 02/20
03936749 10/02/2011 11/19 0.00 6,125.00 33AAACL0582H1ZT
5,00,000

Page Total (`) 6,125.00 6,125.00 0.00


0.00 0.00
0.00 6,125.00
Grand Total (`) 6,125.00 6,125.00 0.00
0.00 0.00
0.00 6,125.00

GST borne by LIC of India ` 137.82


SIX THOUSAND ONE HUNDRED TWENTY FIVE RUPEES AND ZERO PAISE ONLY

S Reena
D/O.V.Selvanayagam
5/939,Chandru Nagar,Siluvathur Road
Balakrishnapuram Post,Dindigul

624005 Payment Acknowledgement generated through


Online Portal on 14-Jan-20 Time : 14:20:19.
Mobile: 8870221300
Email: reenashyamala14@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!