Collecting Branch : EPS1 Servicing Branch : LIC of India, Gaya Branch

Swarajpuri Road.
Transaction No : 30201017
Raja Niwas
Date ( Time ): 15/12/2020 ( 16:54:50 ) Gaya,823001
Email: bo_eps1@licindia.com
Receipt No : PR3020101700022021
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 6,209.64 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Abhimanyu Kumar Singh

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) (`) (`) (`)
828988410 821 / 25 6,073.00 1 6,073.00 68.32 51M
Suman Kumari 28/12/2018 YLY 12/20 0.00 68.32 12/21
No 12/20 0.00 6,209.64 10AAACL0582H2Z0
0198451M 1,00,000

Page Total (`) 6,073.00 6,073.00 68.32

0.00 68.32
0.00 6,209.64
Grand Total (`) 6,073.00 6,073.00 68.32
0.00 68.32
0.00 6,209.64

SIX THOUSAND TWO HUNDRED NINE RUPEES AND SIXTY FOUR PAISE ONLY

Abhimanyu Kumar Singh

S/O.Rajendra Singh
Vill/Po-Parsabad
Dt-Kodarma Jharkhand

825318 Payment Acknowledgement generated through

Online Portal on 15-Dec-20 Time : 16:59:54.
Mobile: 89******89
Email: ab********85@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!

 Collecting Branch : EPS1 Servicing Branch : LIC of India, Gaya Branch
Swarajpuri Road.
Transaction No : 30201017
Raja Niwas
Date ( Time ): 15/12/2020 ( 16:54:50 ) Gaya,823001
Email: bo_eps1@licindia.com
Receipt No : PR3020101700022021
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 6,234.97 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Abhimanyu Kumar Singh

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) (`) (`) (`)
517598241 165 / 15 6,065.00 1 6,065.00 12.96 51M
Abhimanyu 21/09/2011 HLY 09/20 144.05 12.96 03/21
Yes 09/20 0.00 6,234.97 10AAACL0582H2Z0
0198451M 2,50,000

Page Total (`) 6,065.00 6,065.00 12.96

144.05 12.96
0.00 6,234.97
Grand Total (`) 6,065.00 6,065.00 12.96
144.05 12.96
0.00 6,234.97

GST borne by LIC of India ` 136.46

SIX THOUSAND TWO HUNDRED THIRTY FOUR RUPEES AND NINETY SEVEN PAISE ONLY

Abhimanyu Kumar Singh

S/O.Rajendra Singh
Vill/Po-Parsabad
Dt-Kodarma Jharkhand

825318 Payment Acknowledgement generated through

Online Portal on 15-Dec-20 Time : 16:59:54.
Mobile: 89******89
Email: ab********85@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!