akashdas.

1916
25@gmail.com

543734883_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Dhanbad Br Office
LIC OF INDIA,DHANBAD BR OFFICE
Transaction No : 37768630
B P AGARWAL BLDG,JHARIA
Date ( Time ): 27/02/2023 ( 19:54:20 ) DIST-DHANBAD,826001
Email: BO_557@LICINDIA.COM
Receipt No : PR3776863000012223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 1,796.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Rajesh Kumar Das

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) (`) (`) (`)
543734883 150 / 18 1,796.00 1 1,796.00 0.00 557
Rajesh Kumar 11/08/2005 QLY 02/23 0.00 0.00 05/23
No 02/23 0.00 1,796.00 20AAACL0582H1Z0
02402557 3,00,000

Page Total (`) 1,796.00 1,796.00 0.00

0.00 0.00
0.00 1,796.00
Grand Total (`) 1,796.00 1,796.00 0.00
0.00 0.00
0.00 1,796.00

GST borne by LIC of India ` 40.42

ONE THOUSAND SEVEN HUNDRED NINETY SIX RUPEES AND ZERO PAISE ONLY

Rajesh Kumar Das

Central Bank Of India
Po-Dhansar
Dhanbad

828106 Payment Acknowledgement generated through

Online Portal on 27-Feb-23 Time : 19:58:54.
Mobile: 94******15
Email: ak********25@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!