Received With Thanks ' 5,546.00 Through Payment Gateway Over The Internet From

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

Jagmohan Bhawan
Transaction No : 30696699
Tulsipur Marg Gandhi Nagar.,Akbarpur
Date ( Time ): 26/03/2020 ( 08:52:01 ) Akbarpur,209101
bo_eps1@licindia.com
Receipt No : PR3069669900011920
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 5,546.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Arvind Kumar


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.
(`) (`) (`)
217796276 149 5,546.00 1 5,546.00 0.00 393
Arvind Kumar 67 HLY 03/20 0.00 0.00 09/20
01636393 28/09/2007 03/20 0.00 5,546.00 09AAACL0582HFZ6
2,00,000

Page Total (`) 5,546.00 5,546.00 0.00


0.00 0.00
0.00 5,546.00
Grand Total (`) 5,546.00 5,546.00 0.00
0.00 0.00
0.00 5,546.00

GST borne by LIC of India ` 124.78


FIVE THOUSAND FIVE HUNDRED FORTY SIX RUPEES AND ZERO PAISE ONLY

Arvind Kumar
Consolidated Stamp Duty Paid
S/O Sri Kalika Prasad Verma
Vi Kartora,Po Kartora Jafarganj CSD/323/2020/802/2020 DTD.20/02/2020
Akbarpur,Ambedkar Nagar

200000 Payment Acknowledgement generated through


Online Portal on 26-Mar-20 Time : 08:52:53.
Mobile: 9434001237
Email: arvind_kumaram@yahoo.co.in

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!

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