PrmPayRcpt PR0077035000011617

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Collecting Branch : EPS1 Servicing Branch : 25H

E-mail : bo_eps1@licindia.com LIC of India, Ghaziabad Branch II 25H


Phone : +91-022-1251 408/2,Model Town,
G.T.Road,
Transaction No. : PR0077035000011617 Ghaziabad (UP)
Ghaziabad
Date ( Time ): 18/01/2023 ( 17:10:29 ) UP 201001

RENEWAL PREMIUM RECEIPT

Received with thanks Rs. 24,590.00through Payment Gateway over the Internet from:

Smt./Ms./Shri : Ajay Chaudhary

Towards the following

Policy No Plan Inst. Prem(Rs) No Of Inst Total Premium Service Tax Branch
Name Term Mode Due Fr Late Fee Edu Cess Next Due
Agency Code D.O.C. Sum Assured Due To Total Amt
257055498 165 24,590.00 1 24,209.70 0.00 25H
Chaudhary A 21 YLY 02/16 380.30 0.00 02/17
0285325H 13/02/2013 5,00,000.00 02/16 24,590.00
Page Total (Rs) 24,590.00 24,209.70 0.00
380.30 0.00
24,590.00
Grand Total (Rs) 24,590.00 24,209.70 0.00
380.30 0.00
24,590.00

RUPEES TWENTY-FOUR THOUSAND FIVE HUNDRED NINETY ONLY

Ajay Chaudhary A.Mu.Sh.2015/2194/CR 695/M-1 Dated 18/01/2023


H.No-21 Choudhary Enclave
Free Hold Sanjay Nagar
Ghaziabad U.P.
201002

This receipt is electronically generated.

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi


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