233846973_1

Collecting Branch : EPS1 Servicing Branch : LIC of India, Kanpur District Br

LIC OF INDIA,KANPUR DISTRICT BR
Transaction No : 4663946
SHIVOY TOWER, M G MARG,P B
Date ( Time ): 10/05/2021 ( 22:09:38 ) KANPUR,208001
Email: BO_231@LICINDIA.COM
Receipt No : PR0466394600012122
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 9,454.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Gorver 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) (`) (`) (`)
233846973 107 / 20 9,454.00 1 9,454.00 0.00 231
Nitin Grover 28/04/2007 YLY 04/21 0.00 0.00 04/21
No 04/21 0.00 9,454.00 09AAACL0582HFZ6
08694231 1,05,000

Page Total (`) 9,454.00 9,454.00 0.00

0.00 0.00
0.00 9,454.00
Grand Total (`) 9,454.00 9,454.00 0.00
0.00 0.00
0.00 9,454.00

GST borne by LIC of India ` 212.72

NINE THOUSAND FOUR HUNDRED FIFTY FOUR RUPEES AND ZERO PAISE ONLY

Gorver N
Consolidated Stamp Duty Paid
124/442
Block No-11,Govind Nagar CSD/113/2020/1936 DTD. 18.09.2020
Kanpur

208006 Payment Acknowledgement generated through

Online Portal on 10-May-21 Time : 22:11:28.
Mobile: 98******31
Email: ni********09@gmail.com
For Payment related queries-Email: bo_eps1@licindia.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!