amitk6655@g

528973197_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Madhepura
LIC OF INDIA,MADHEPURA BRANCH
Transaction No : 37991763
MAIN ROAD GENERAL HIGH
Date ( Time ): 28/02/2023 ( 20:57:58 ) 852113,0
Email: BO_53A@LICINDIA.COM
Receipt No : PR3799176300012223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 27,273.14 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Amit Kumar

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) (`) (`) (`)
528973197 820 / 20 26,673.00 1 26,673.00 300.07 53A
Amit Kumar 28/01/2016 HLY 01/23 0.00 300.07 07/23
No 01/23 0.00 27,273.14 10AAACL0582H2Z0
018600541 7,05,000

Page Total (`) 26,673.00 26,673.00 300.07

0.00 300.07
0.00 27,273.14
Grand Total (`) 26,673.00 26,673.00 300.07
0.00 300.07
0.00 27,273.14

TWENTY SEVEN THOUSAND TWO HUNDRED SEVENTY THREE RUPEES AND FOURTEEN PAISE
ONLY

Amit Kumar
Consolidated Stamp Duty Paid
S/O-Shivanand Yadav
Progect Girl H/School LOA/CSD/526/4822 DTD- 14.11.2022 valid from 16.12.2022 to
At-Po-Singheshwar Dt-Madhepura

852128 Payment Acknowledgement generated through

Online Portal on 28-Feb-23 Time : 20:59:47.
Mobile: 79******70
Email: am********55@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!