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rajanikant.

span
dey@gmail.co

893324406_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Mumbai B O
LIC OF INDIA, BRANCH OFFICE - 890
Transaction No : 11680925
HEMU CLASSIC BUILDING, GR & I
Date ( Time ): 16/07/2022 ( 00:32:47 ) MALAD(WEST), MUMBAI.,400064
Email: BO_890@LICINDIA.COM
Receipt No : PR1168092500012223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 5,156.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : R K Pandey
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) (`) (`) (`)
893324406 149 / 79 5,156.00 1 5,156.00 0.00 890
Rajani Kant 28/06/2007 HLY 06/22 0.00 0.00 12/22
No 06/22 0.00 5,156.00 27AAACL0582H1ZM
00911890 2,00,000

Page Total (`) 5,156.00 5,156.00 0.00


0.00 0.00
0.00 5,156.00
Grand Total (`) 5,156.00 5,156.00 0.00
0.00 0.00
0.00 5,156.00

GST borne by LIC of India ` 116.02


FIVE THOUSAND ONE HUNDRED FIFTY SIX RUPEES AND ZERO PAISE ONLY

R K Pandey
Consolidated Stamp Duty Paid
B/813, Bldg.No.2,Khot Dongri,
Opp Laxmi Narayan Temple,Off Rs Marg LOA NO/CSD/390/2022 Dtd - 28.06.2022 valid from 05.07.2022 to
Malad East , Mumbai

400097 Payment Acknowledgement generated through


Online Portal on 16-Jul-22 Time : 00:34:57.
Mobile: 99******44
Email: ra********ey@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!

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