devmani9911

334012510_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Branch Office 129
LIC OF INDIA, BRANCH OFFICE - 129
Transaction No : 10835096
20-A, FIRST FLOOR, SHIVAJI
Date ( Time ): 27/06/2024 ( 12:51:40 ) NEW DELHI.,110018
Email: BO_129@LICINDIA.COM
Receipt No : PR1083509600012425
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 6,002.08 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Mohammad Firoz

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) (`) (`)
334012510 821 / 25 5,870.00 1 5,870.00 66.04 129
Mohammad 28/05/2014 HLY 05/24 0.00 66.04 11/24
No 05/24 0.00 6,002.08 07AAACL0582H1ZO
50455111 2,00,000

Page Total (`) 5,870.00 5,870.00 66.04

0.00 66.04
0.00 6,002.08
Grand Total (`) 5,870.00 5,870.00 66.04
0.00 66.04
0.00 6,002.08

SIX THOUSAND TWO RUPEES AND EIGHT PAISE ONLY

Mohammad Firoz
Consolidated Stamp Duty Paid
A-1/43 Yadav Nagar Gali No-6
Prem Nagar-Iii,Kirari Suleman Nagar Consolidated Stamp Duty paid vide order no. LOA/ENF-
New Delhi

110086 Payment Acknowledgement generated through

Online Portal on 27-Jun-24 Time : 12:52:57.
Mobile: 99******79
Email: de********11@gmail.com
For Payment related queries-Email: bo_eps1@licindia.com

This receipt is electronically generated and no signature is required.

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