CO02, LIC Of India, Central Office - MBAC (Hub)

4th Floor,Jeevan Seva Annexe Bldg,Santa Cruz (W),Mumbai-400054

Tel: 022-26100350/331/338, Email: co_mbac-hub@licindia.com

LIC Branch Code 67R Bank Sol Id 1717

LIC Branch Address

LIC OF INDIA,VUYYUR BR OFFICE

PALADUGU SUBBA RAO & SONS BUILDING

1-241/3,MAIN ROAD.

VUYYUR 521165

BO_67R@LICINDIA.COM

Agency Code 80001884(IDBI Bank Ltd) S.P. Code SP0135243042

Access Id 156214139 CRM Id 128953

Name JANDHYALA NAGA VYSHNAVI

Email ibkl0001717@idbi.co.in Mobile No. 9291803102

Plan-Policy Term 934-23 Premium Paying Term 18

Mode Yearly NACH Indication N

Sum Proposed 200000 PAN Details BUMPJ9582K

PROPOSAL DEPOSIT RECEIPT

Received with thanks Rs. 10489 from

Smt./ Ms./ Shri : JANDHYALA NAGA VYSHNAVI

towards the following :

Transaction No. : 19247 Date (Time) : 09/07/2020 10:59:55

BOC Number : 19247 Proposal Deposit (Rs.) : 10489

Amount in Words : Ten Thousand Four Hundred and Eighty Nine

Receipt of payment made online is issued subject to realisation

ACCEPTANCE OF THIS DEPOSIT DOES NOT MAKE THE CORPORATION LIABLE FOR ACCEPTANCE OF RISK

We may mention that your risk will be covered only after all the above documents and Medical / Special Reports are received and
accepted to the satisfaction of our underwriters. Hence, you are requested to kindly expedite the same.

This receipt is electronically generated.

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi

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