sharmaakshay

237@gmail.co

We observe

Collecting Branch : EPS1 Servicing Branch : LIC of India, Chandigarh II

LIC OF INDIA,CHANDIGARH II
Transaction No : 30718021
BRANCH OFFICE UNIT NO
Date ( Time ): 02/01/2023 ( 09:37:19 ) SECTOR 17/B
Email: BO_180@LICINDIA.COM
Receipt No : PR3071802100012223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 2,422.42 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Akshay
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) (`) (`) (`)
165102951 165 / 35 2,400.00 1 2,400.00 1.71 180
Akshay 28/08/2011 QLY 11/22 19.00 1.71 02/23
Yes 11/22 0.00 2,422.42 04AAACL0582H1ZU
01281180 2,00,000

Page Total (`) 2,400.00 2,400.00 1.71

19.00 1.71
0.00 2,422.42
Grand Total (`) 2,400.00 2,400.00 1.71
19.00 1.71
0.00 2,422.42

GST borne by LIC of India ` 54.00

TWO THOUSAND FOUR HUNDRED TWENTY TWO RUPEES AND FORTY TWO PAISE ONLY

Akshay
H.No 1650,
Sector 52,
Chandigarh

160017 Payment Acknowledgement generated through

Online Portal on 02-Jan-23 Time : 09:39:26.
Mobile: 98******16
Email: sh********37@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!