sane rege Eas ewe rou ek Branch Code : €53 LIC of india, Camp Br 053, Ait Complex ‘Transaction No. : 97636683 2408 Gen. Thimmayya Road Camp. Date (Time): 1510372015 (11:42:53) Pune. 411001 ‘mat bo_953¢@icinaia.com HelpDesk: +91-022-1251 RENEWAL PREMIUM RECEIPT Received with thanks Rs, 1,116.00 from pelieyholdor Shri/Smt.Shri Nitin Shankar Dalwale towards the following poiteyi Paley Ne Plan | NSE PFaM(Re) | No OFTnet | Total Premium | Serves Tax | Branch Name Term ‘Mode Duofr | LateFee | Edu. Coss |Next Dus| Agency Gode| _.0.c.__| sum Assured | _Due To Total Amt | 9535¢3040 “103 7116.00 7 TiHT6.00 0.00 355 Daalens 25 ‘aLy sits 0.00 0.00 osits 31300953 | oevosits99 | 100,000.00 | _osits 4,416.00 Page Total (Rs) T1600 TTB.00 oy 0.00 0.00 4,416.00 ‘Grand Total (Rey 76.00 TT6.00 ‘0.00 0.0] ‘00 4,416.00 RUPEES ONE THOUSAND ONE HUNDRED SIXTEEN ONLY Paid by Cash 0.00 Paid by Cheque 1,116.00 ‘Cheque No-20304 Cheque Dato 190972015 ‘Shy Nitin Shankar Dawale Consolidated Stamp Duty Paid ‘ch, 109, Ravivar Poth, Pun 411002, For Life Insurance Corporation of india, Mobie: 919870735490 ‘Me-Shamsunder Harkishan Sarda(3 1200953) Ema ritedalvale@sty.com This receipt is subject to realisation of cheque amount. Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi Promium Point 159; Rasta Peth. Gr. Floot, Venkateshwara Apt Shiralseth Chowk, Pune - 471011. To: 26128464 Time : 8.00 am to 8.30 pm Mobile 9422004892 / 9423067002 / 8421041202 Email; styamsunderhsarda@ yahoo.co.in