Life Insurance Corporation of India

PCMC,Network Operating Center

1st Floor,Jeevan Seva Annexe
S.V. Road,SantaCruz(W)
Mumbai - 400 054

PREMIUM PAID STATEMENT FOR THE YEAR 2023-2024

DATE OF ISSUE :28/06/2024

The following premium has been received for life insurance policies of Akash Singh

Premium/ Service
Number of Tax / GST
Instalments Additional Received
Policy Number Date Of Due From Amount Coll. Br.
and Premium Date
Policy Holder's Name Commence. Due To Received * Serv. Br.
Payment Amount
mode (`) (`)
269152599 28/11/2023 2 283
28/11/2023 3,760.00 169.00 27/12/2023
Kanti 28/12/2023 Mly 283

269152599 28/01/2024 1 CBK3

28/11/2023 1,880.00 84.60 31/12/2023
Kanti 28/01/2024 Mly 283

269152599 28/02/2024 1 CBK3

28/11/2023 1,880.00 84.60 22/02/2024
Kanti 28/02/2024 Mly 283

269152599 28/03/2024 1 CBK3

28/11/2023 1,880.00 84.60 28/03/2024
Kanti 28/03/2024 Mly 283

All the above payments are subject to cheque realisation, wherever applicable.

Total amount received towards premium for the policies listed above is ` 9,400.00 for the financial year 2023-
2024.

Total amount received towards Service Tax / GST for the policies listed above is ` 422.8 for the financial year
2023-2024.

* Please note GST is applicable from 1st July, 2017.

This document is electronically generated. In case of any queries, please send SMS as follows -- type "LICHELP
<policy no>" and send it to 9222492224. Our Customerzone Official will get in touch with you shortly.