Collecting Center : A001 Branch Code : 686

LIC of India, Vijayawada Br Office-I,

Transaction No. : 33100745 LIC OF INDIA,VIJAYAWADA BR OFFICE-I,
JEEVAN KRISHNA BUILDING
Date ( Time ): 01/07/2024 ( 14:28:56 ) GOVERNORPET VIJAYAWADA, 520002
email: BO_686@LICINDIA.COM
Call Center No: 022-68276827

RENEWAL PREMIUM RECEIPT

Received with thanks Rs. 40,540.00 from policyholder Shri/Smt.Lingambhotla V S R Phaneendra Sarma
towards the following policy/ies

Policy No Plan Inst. Prem(Rs) No Of Inst Total Premium CGST Branch | Agency
Name Term Mode Due Fr Late Fee SGST*/UTGST Code
Revival D.O.C. Sum Assured Due To CD Chgs + Total Amt Next Due
(Yes/No) Xcharge Reg. No.
678731993 845 39,648.00 1 39,648.00 446.04 686 |02927686
L V S R P Sarma 66 HLY 07/24 0.00 446.04 01/25
No 27/01/2020 10,00,000.00 07/24 0.00 + 0.00 40,540.08 37AAACL0582H2ZK
Page Total (Rs) 39,648.00 39,648.00 446.04
0.00 446.04
0.00 40,540.08
Grand Total (Rs) 39,648.00 39,648.00 446.04
0.00 446.04
0.00 40,540.08

RUPEES FORTY THOUSAND FIVE HUNDRED FORTY ONLY

Paid by Cash/Card/QR/SR :40,540.08
Paid by Cheque :0.00
Cheque No/ChequeDate : 0/

Lingambhotla V S R Phaneendra Sarma Consolidated Stamp Duty Paid

11-48-6, Lingambhotla Vari St, Consolidated Stamp Duty paid vide order no.
Opp Old Sivalayam, LOA/ENF-1/CSD/16/2024-25/2288 dated 10.05.2024,
Vijayawada valid from 10.05.2024 to 31.03.2025
520001.
Mobile:
For Life Insurance Corporation of India,
Bommisetty Nagendra Vara Prasad
Babuji(03459686)

*SGST also includes cess amount of Rs. 0.00.

GST and Cess borne by LIC of India is Rs 0.00

Check the authenticity of the receipt using following url: https://services.licindia.in/validatereceipt

Har Pal Aapke Sath!!