mahendra0974

144076840_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Bahadurgarh
LIC OF INDIA,BAHADURGARH
Transaction No : 9824228
NEAR BUS STAND NAJATGARH
Date ( Time ): 29/06/2022 ( 16:39:37 ) HARYANA,124507
Email: BO_16J@LICINDIA.COM
Receipt No : PR0982422800012223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 14,404.98 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Mahendra Prasad Yadav

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) (`) (`) (`)
144076840 915 / 35 14,088.00 1 14,088.00 158.49 16J
Mahendra 28/06/2020 YLY 06/22 0.00 158.49 06/23
No 06/22 0.00 14,404.98 06AAACL0582H1ZQ
1085416J 4,00,000

Page Total (`) 14,088.00 14,088.00 158.49

0.00 158.49
0.00 14,404.98
Grand Total (`) 14,088.00 14,088.00 158.49
0.00 158.49
0.00 14,404.98

FOURTEEN THOUSAND FOUR HUNDRED FOUR RUPEES AND NINETY EIGHT PAISE ONLY

Mahendra Prasad Yadav

Consolidated Stamp Duty Paid
S/O Lt. Sh. Sharda Prasad Yadav
Parmi Patti, Pandri Mustarka, LOA/CSD/280/2022 DTD- 24.02.2022 VALID FROM 14.03.2022 TO
Distt Pratapgarh, U.P.

230135 Payment Acknowledgement generated through

Online Portal on 29-Jun-22 Time : 16:44:14.
Mobile: 73******01
Email: ma********74@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!