Collecting Center : A001 Branch Code : 38E

LIC of India, Bhilai Br II

Transaction No. : 94681163 LIC OF INDIA,BHILAI BR II
BRANCH OFFICE II
Date ( Time ): 10/02/2022 ( 16:34:58 ) BHILAI M P, 490011
email: BO_38E@LICINDIA.COM
Call Center No: 022-68276827

RENEWAL PREMIUM RECEIPT

Received with thanks Rs. 9,156.00 from policyholder Shri/Smt.Sashi Bhushan Singh
towards the following policy/ies

Policy No Plan Inst. Prem(Rs) No Of Inst Total Premium CGST Branch | Agency
Name Term Mode Due Fr Late Fee SGST*/UTGST Code
Revival D.O.C. Sum Assured Due To CD Chgs + Total Amt Next Due
(Yes/No) Xcharge Reg. No.
368093055 833 8,955.00 1 8,955.00 100.74 38E |0240838E
Singh Sb 15 YLY 01/22 0.00 100.74 01/23
No 28/01/2020 1,00,000.00 01/22 0.00 + 0.00 9,156.48 22AAACL0582H2ZV
Page Total (Rs) 8,955.00 8,955.00 100.74
0.00 100.74
0.00 9,156.48
Grand Total (Rs) 8,955.00 8,955.00 100.74
0.00 100.74
0.00 9,156.48

RUPEES NINE THOUSAND ONE HUNDRED FIFTY-SIX ONLY

Paid by Cash/Card/Sr :9,156.48
Paid by Cheque :0.00
Cheque No/ChequeDate : 0/

Sashi Bhushan Singh Consolidated Stamp Duty Paid

House Nop- 92 Ward-15 CSD/70/2021/2092 DATED - 24.06.2021
Ghasidas Nagar
Bhilai Dist Durg Cg
490026. For Life Insurance Corporation of India,
Mobile: Ram Lakhan Soni(0240838E)

*SGST also includes cess amount of Rs. 0.00.

GST and Cess borne by LIC of India is Rs 0.00

Har Pal Aapke Sath!!