kherudkargane

sh@gmail.com

990517376_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Hadapsar Branch
LIC OF INDIA,HADAPSAR BR 95M
Transaction No : 201017
1ST FLOOR, AMAR ARCADE, PUNE-
Date ( Time ): 02/04/2022 ( 12:46:45 ) HADASPAR,PUNE,411028
Email: BO_95M@LICINDIA.COM
Receipt No : PR0020101700012223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 2,837.44 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Ganesh Shankar Kherudkar

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) (`) (`) (`)
990517376 815 / 21 2,775.00 1 2,775.00 31.22 95M
Ganesh Shankar 28/03/2015 HLY 03/22 0.00 31.22 09/22
No 03/22 0.00 2,837.44 27AAACL0582H1ZM
1077895M 1,00,000

Page Total (`) 2,775.00 2,775.00 31.22

0.00 31.22
0.00 2,837.44
Grand Total (`) 2,775.00 2,775.00 31.22
0.00 31.22
0.00 2,837.44

TWO THOUSAND EIGHT HUNDRED THIRTY SEVEN RUPEES AND FORTY FOUR PAISE ONLY

Ganesh Shankar Kherudkar

Sr No- 13, Satavwadi,
Raskar Chal, Siddhi Vinayak Col.
Hadapsar Pune

411028 Payment Acknowledgement generated through

Online Portal on 02-Apr-22 Time : 12:48:34.
Mobile: 91******50
Email: kh********sh@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!