Recpt 676038326 5703137

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Servicing Branch : 67K

JAGGAYYAPET
LIC OF INDIA,JAGGAYYAPET BR OFFICE
HOTEL INDU COMPLEX,MAIN ROAD
Collecting Branch : PCMC JAGGAYYAPET.
Call Center (24X7) : 022 6827 6827 ANDHRA PRADESH
Transaction no. : 5703137 PIN:521175 Phone:
Date : 28/12/2022 Email: bo_67K@licindia.com

RENEWAL PREMIUM ACKNOWLEDGEMENT

through EBPP (Bill-


Received with thanks Rs. 6005.00 pay)
from Smt/Shri/Ms BIBI
towards the following
Policy Number 676038326 Premium Due From 11/2022
Instalment Premium 6005.00 Premium Due Upto 11/2022
Premium Mode Yearly No. of Instalments 1
Plan, Term & PPT 165/16/16 Premium 6005.00
Date of Commence. 28/11/2012 Late Fee 0.00
Sum Assured 125000 CGST/SGST/UTGST 0.00
Next Premium Due on 28/11/2023
GST Borne By LIC 135.12 Total 6005.00

SHAIK BIBI
W/O SK.BASHA A/S MAHABOOB BASHA,
2-38/1,RAMACHANDRAPURAM (VIL),B.C.C
NUTTAKKI (PO), MANGALAGIRI
PIN Code: 522663

This receipt is electronically generated


Mudrank: LOA/CSD/526/4822/14.1

Kindly register your mobile no. for receiving your policy related information.
For SMS helpline, type LICHELP <policy-no> and send to 92224 92224

Har Pal Aapke Saath

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