Collecting Branch : EPS1 Servicing Branch : LIC of India, Hajipur Branch

P B No 1
Transaction No : 25850759
Soni Alankar Complex.,Gudri Bazar
Date ( Time ): 05/02/2020 ( 23:10:08 ) Hajipur,0
bo_eps1@licindia.com
Receipt No : PR2585075900011920
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 10,979.60 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Kumod Kumar

towards the following :

Policy No Plan Inst. Premium No Of Inst Total Premium CGST Branch

Name Term Mode Due From Late Fee SGST/UTGST Next Due
Agency Code D.O.C. Sum Assured Due To CD Charges Total Amt Reg. No.
(`) (`) (`)
595780426 815 10,738.00 1 10,738.00 120.80 545
Kumod Kumar 25 HLY 02/20 0.00 120.80 08/20
02491545 28/08/2015 02/20 0.00 10,979.60 10AAACL0582H2Z0
5,00,000

Page Total (`) 10,738.00 10,738.00 120.80

0.00 120.80
0.00 10,979.60
Grand Total (`) 10,738.00 10,738.00 120.80
0.00 120.80
0.00 10,979.60

TEN THOUSAND NINE HUNDRED SEVENTY NINE RUPEES AND SIXTY PAISE ONLY

Kumod Kumar
Consolidated Stamp Duty Paid
S/O Sri Shashi Bhushan Singh
At-Manua,Po-Ismalpur CSD/328/2019/646/19 DTD.15/02/2019
Ps-Hajipur Sadar Dt-Vaishali

844102 Payment Acknowledgement generated through

Online Portal on 05-Feb-20 Time : 23:12:56.
Mobile: 8877879098
Email: kumod.ihm@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!