PremiumReceipt PR0941870700012324

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gjsivakumar@

306101038_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Kumbakonam Br
LIC OF INDIA,KUMBAKONAM BR
Transaction No : 9418707
JEEVAN JYOTHI,NO 16 DR BESANT
Date ( Time ): 30/06/2023 ( 15:35:18 ) KUMBAKONAM,612001
Email: [email protected]
Receipt No : PR0941870700012324
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 879.90 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Sivakumar N
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) (`) (`) (`)
306101038 934 / 22 842.00 1 842.00 18.95 742
S Krithik Sai La 27/03/2023 MLY 06/23 0.00 18.95 07/23
No 06/23 0.00 879.90 33AAACL0582H1ZT
03832742 2,00,000

Page Total (`) 842.00 842.00 18.95


0.00 18.95
0.00 879.90
Grand Total (`) 842.00 842.00 18.95
0.00 18.95
0.00 879.90

EIGHT HUNDRED SEVENTY NINE RUPEES AND NINETY PAISE ONLY

Sivakumar N
S/O Sri N.Sivakumar P
1/330,Vellalar Street,Kabisthalam
Thanjavur

614203 Payment Acknowledgement generated through


Online Portal on 02-Jul-23 Time : 16:48:38.
Mobile: 99******11
Email: gj********[email protected]
For Payment related queries-Email: [email protected]

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!


gjsivakumar@

306101038_2
Collecting Branch : EPS1 Servicing Branch : LIC of India, Kumbakonam Br
LIC OF INDIA,KUMBAKONAM BR
Transaction No : 6020935
JEEVAN JYOTHI,NO 16 DR BESANT
Date ( Time ): 29/05/2023 ( 14:24:21 ) KUMBAKONAM,612001
Email: [email protected]
Receipt No : PR0602093500012324
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 879.90 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Sivakumar N
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) (`) (`) (`)
306101038 934 / 22 842.00 1 842.00 18.95 742
S Krithik Sai La 27/03/2023 MLY 05/23 0.00 18.95 06/23
No 05/23 0.00 879.90 33AAACL0582H1ZT
03832742 2,00,000

Page Total (`) 842.00 842.00 18.95


0.00 18.95
0.00 879.90
Grand Total (`) 842.00 842.00 18.95
0.00 18.95
0.00 879.90

EIGHT HUNDRED SEVENTY NINE RUPEES AND NINETY PAISE ONLY

Sivakumar N
S/O Sri N.Sivakumar P
1/330,Vellalar Street,Kabisthalam
Thanjavur

614203 Payment Acknowledgement generated through


Online Portal on 02-Jul-23 Time : 16:48:38.
Mobile: 99******11
Email: gj********[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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