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Collecting Center : A001

Branch Code : 69A


LIC of India,
City Branch Office No-2
Ratna Arcade Dwarka Nagar.
Vishakhapatnam Ii, 530016
email: bo_69A@licindia.com
HelpDesk: +91-022-1251

Transaction No. : 37011889


Date ( Time ): 23/07/2014 ( 06:42:16 )

RENEWAL PREMIUM RECEIPT


Received with thanks Rs. 3,244.00 from policyholder Shri/Smt.Marella Narasimhabhargava
towards the following policy/ies
Policy No
Name
Agency Code
695638747
Narasimhabhargava
M

0108269A
695638735
Narasimha Bhargava
M

Plan
Term
D.O.C.
89
20
25/01/2011

Inst. Prem(Rs)
Mode
Sum Assured
1,678.00
HLY
50,000.00

No Of Inst
Due Fr
Due To
1
07/14
07/14

Total Premium
Late Fee

91
18
25/01/2011

1,566.00
HLY
50,000.00

1
07/14
07/14

1,566.00
0.00

0108269A
Page Total (Rs)

Grand Total (Rs)

1,678.00
0.00

3,244.00

3,244.00
0.00

3,244.00

3,244.00
0.00

Service Tax
Edu. Cess
Total Amt
0.00
0.00
1,678.00

Branch
Next Due

0.00
0.00
1,566.00

69A
01/15

69A
01/15

0.00
0.00
3,244.00
0.00
0.00
3,244.00

RUPEES THREE THOUSAND TWO HUNDRED FORTY-FOUR ONLY


Paid by Cash :3,244.00
Paid by Cheque :0.00
Cheque No :0
Cheque Date :
Marella Narasimhabhargava
Flat..203,B-Block,
Jeevan Visakha Aptartments,
Mmtc Colony,Visakhapatnam,
530023.
Mobile: 918110942770
Email: mn.bhargava@yahoo.in

Consolidated Stamp Duty Paid

For Life Insurance Corporation of India,


V.Ratnakar(00676803)

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi

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