Collecting Branch : EPS1

E-mail : bo_eps1@licindia.com
Phone : +91-022-1251
Transaction No. : PR0274376800011415

Servicing Branch : 12J

LIC of India, Ballabhgarh Branch Office
State Bank Complex
G T Road.
Ballabgarh Haryana
Ballabhgarh

Date ( Time ): 24/06/2014 ( 14:36:58 )

RENEWAL PREMIUM ACKNOWLEDGEMENT

Received with thanks Rs. 24610.00 through Payment Gateway over the Internet from:
Smt./Ms./Shri : Mohit Aggarwal
Towards the following
Policy No
Name
Agency Code
126569371

Plan
Term
D.O.C.
178
Aggarwal M
72
0027612J
24/06/2013
Page Total (Rs)

Grand Total (Rs)

Inst. Prem(Rs)
Mode
Sum Assured
24,610.00
YLY
5,00,000.00
24,610.00

No Of Inst
Due Fr
Due To
1
06/14
06/14

Total Premium
Late Fee
24,610.00
0.00
24,610.00
0.00

24,610.00

24,610.00
0.00

Service Tax
Edu Cess
Total Amt
0.00
0.00
24,610.00
0.00
0.00
24,610.00
0.00
0.00
24,610.00

Branch
Next Due
12J
06/15

RUPEES TWENTY-FOUR THOUSAND SIX HUNDRED TEN ONLY

Mohit Aggarwal
S/O Sh Bankey Aggarwal
Hno-17, Sector-10
Faridabad
121006

Payment Acknowledgement generated through Online

Portal on 24-Jul-2015 Time : 18:52:10.

This receipt is electronically generated.

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi

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