298683578_1

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

LIC OF INDIA,DEORIA BRANCH
Transaction No : 4014059
RAGHAV NAGAR.,DEORIA
Date ( Time ): 06/05/2021 ( 09:46:02 ) ,0
Email: BO_282@LICINDIA.COM
Receipt No : PR0401405900012122
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 27,296.66 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) (`) (`) (`)
298683578 833 / 21 26,696.00 1 26,696.00 300.33 282
Gyanendra 28/05/2015 HLY 05/21 0.00 300.33 11/21
No 05/21 0.00 27,296.66 09AAACL0582HFZ6
07299282 10,00,000

Page Total (`) 26,696.00 26,696.00 300.33

0.00 300.33
0.00 27,296.66
Grand Total (`) 26,696.00 26,696.00 300.33
0.00 300.33
0.00 27,296.66

TWENTY SEVEN THOUSAND TWO HUNDRED NINETY SIX RUPEES AND SIXTY SIX PAISE ONLY

Gyanendra Kumar Pandey

Consolidated Stamp Duty Paid
S/O Uday Bhan Pandey
Vill-Pandeypur, Po-Kushahari CSD/113/2020/1936 DTD. 18.09.2020
Dt-Deoria Uttar Pradesh

274001 Payment Acknowledgement generated through

Online Portal on 06-May-21 Time : 09:47:30.
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!