Received With Thanks ' 10,188.44 Through Payment Gateway Over The Internet From

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318662465_1

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


NO.12 RAILWAY STATION ROAD
Transaction No : 14989157
PERIA KANCHIPURAM,TAMILNADU
Date ( Time ): 12/08/2021 ( 08:54:39 ) ,631502
Email: [email protected]
Receipt No : PR1498915700012122
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 10,188.44 through Payment Gateway over the Internet from:

Smt./Ms./Shri : M. Mahalakshmi
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) (`) (`) (`)
318662465 914 / 16 9,874.00 1 9,874.00 118.12 734
M. Mahalakshmi 06/07/2020 YLY 07/21 78.20 118.12 07/22
Yes 07/21 0.00 10,188.44 33AAACL0582H1ZT
02122734 1,50,000

Page Total (`) 9,874.00 9,874.00 118.12


78.20 118.12
0.00 10,188.44
Grand Total (`) 9,874.00 9,874.00 118.12
78.20 118.12
0.00 10,188.44

TEN THOUSAND ONE HUNDRED EIGHTY EIGHT RUPEES AND FORTY FOUR PAISE ONLY

M. Mahalakshmi
Consolidated Stamp Duty Paid
No-57/31/14,Krishnan Street
Bharathi Nagar CSD/70/2021/2092 DATED - 24.06.2021
Pillaiyar Palayam Kanchipuram

631501 Payment Acknowledgement generated through


Online Portal on 12-Aug-21 Time : 08:57:03.
Mobile: 94******86
Email: mm********[email protected]
For Payment related queries-Email: [email protected]

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!

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