Collecting Center : A001 Branch Code : 11M

LIC of India, Delhi Branch Unit 11M

Transaction No. : 11431784 Zulfae Bangal
G.T.Road Shahdara
Date ( Time ): 07/04/2019 ( 10:57:08 ) New Delhi, 110092
email: bo_11M@licindia.com
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks Rs. 30,936.00 from policyholder Shri/Smt.Shiv Singh Manral
towards the following policy/ies

Policy No Plan Inst. Prem(Rs) No Of Inst Total Premium CGST Branch

Name Term Mode Due Fr Late Fee SGST/UTGST Next Due
Agency D.O.C. Sum Assured Due To CD Chgs Total Amt Reg. No.
Code
124913803 179 30,936.00 1 30,936.00 0.00 11M
Shiv Ssm 16 YLY 03/19 0.00 0.00 03/20
55355111 07/03/2009 4,00,000.00 03/19 0.00 30,936.00 07AAACL0582H1ZO
Page Total (Rs) 30,936.00 30,936.00 0.00
0.00 0.00
0.00 30,936.00
Grand Total (Rs) 30,936.00 30,936.00 0.00
0.00 0.00
0.00 30,936.00

RUPEES THIRTY THOUSAND NINE HUNDRED THIRTY-SIX ONLY

Paid by Cash/Card :30,936.00
Paid by Cheque :0.00
Cheque No :0
Cheque Date :

Shiv Singh Manral Consolidated Stamp Duty Paid

A-305 Swarn Ganga Apptts. CSD/328/2019/646/19 DTD.15/02/2019
Sec-Vith Vasundhara
Ghaziabad U.P.
201012. For Life Insurance Corporation of India,
Mobile: 919810163040 Sh.Hari Shanker Tiwari(55355111)
Email:

**GST borne by LIC of India is Rs 696.06

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