pgcr71@gmail.

644640119_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Hyderabad CBO-
LIC OF INDIA,HYDERABAD CBO-22
Transaction No : 15557460
NEAR SAI BABA
Date ( Time ): 20/08/2022 ( 10:22:02 ) HYDERABAD,500060
Email: BO_6042@LICINDIA.COM
Receipt No : PR1555746000012223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 51,220.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Potireddy Ganesh Chandra Reddy(La)

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) (`) (`) (`)
644640119 178 / 83 51,220.00 1 51,220.00 0.00 6042
Potireddy 14/09/2010 YLY 09/22 0.00 0.00 09/23
No 09/22 0.00 51,220.00 36AAACL0582H1ZN
003096042 10,00,000

Page Total (`) 51,220.00 51,220.00 0.00

0.00 0.00
0.00 51,220.00
Grand Total (`) 51,220.00 51,220.00 0.00
0.00 0.00
0.00 51,220.00

GST borne by LIC of India ` 1,152.46

FIFTY ONE THOUSAND TWO HUNDRED TWENTY RUPEES AND ZERO PAISE ONLY

Potireddy Ganesh Chandra Reddy(La)

S/O.P.Jagan Mohan Reddy Lp
Vill Ramakrishnapuram,Chowlapally Po
Via Keshampet, Mahabubnagar Dist

509408 Payment Acknowledgement generated through

Online Portal on 13-Jan-23 Time : 18:36:12.
Mobile: 72******36
Email: pg********71@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!