241985432_1

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

LIC OF INDIA,DEORIA BRANCH
Transaction No : 1920935
RAGHAV NAGAR.,DEORIA
Date ( Time ): 17/04/2021 ( 19:11:00 ) ,0
Email: BO_282@LICINDIA.COM
Receipt No : PR0192093500012122
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 766.13 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Gyanendra Kumar Pandey

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) (`) (`) (`)
241985432 91 / 16 759.00 1 759.00 0.54 282
Gyanendra 09/09/2009 QLY 03/21 6.05 0.54 06/21
Yes 03/21 0.00 766.13 09AAACL0582HFZ6
05720212 45,000.00

Page Total (`) 759.00 759.00 0.54

6.05 0.54
0.00 766.13
Grand Total (`) 759.00 759.00 0.54
6.05 0.54
0.00 766.13

GST borne by LIC of India ` 17.08

SEVEN HUNDRED SIXTY SIX RUPEES AND THIRTEEN PAISE ONLY

Gyanendra Kumar Pandey

Vill Pandey Pur Po.Kushahri
Distt.Deoria U.P.

274001 Payment Acknowledgement generated through

Online Portal on 17-Apr-21 Time : 19:12:37.
Mobile: 82******51
Email: gk********82@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!