sumanbeniwal

07@gmail.com

147706848_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Bahadurgarh
LIC OF INDIA,BAHADURGARH
Transaction No : 31239800
NEAR BUS STAND NAJATGARH
Date ( Time ): 05/01/2023 ( 08:42:31 ) HARYANA,124507
Email: BO_16J@LICINDIA.COM
Receipt No : PR3123980000012223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 49,647.48 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Sunan Devi

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) (`) (`) (`)
147706848 936 / 25 48,555.00 1 48,555.00 546.24 16J
Sunan Devi 06/12/2021 YLY 12/22 0.00 546.24 12/23
No 12/22 0.00 49,647.48 06AAACL0582H1ZQ
1139616J 10,00,000

Page Total (`) 48,555.00 48,555.00 546.24

0.00 546.24
0.00 49,647.48
Grand Total (`) 48,555.00 48,555.00 546.24
0.00 546.24
0.00 49,647.48

FORTY NINE THOUSAND SIX HUNDRED FORTY SEVEN RUPEES AND FORTY EIGHT PAISE ONLY

Sunan Devi
W/O Sh. Ajay Kumar
Vill-Godhri,Po-Achhej,Teh-Beri
Dt-Jhajjar, Haryana

124106 Payment Acknowledgement generated through

Online Portal on 05-Jan-23 Time : 08:44:23.
Mobile: 96******00
Email: su********07@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!