Lic Policy Recipt 11-04-20 PDF

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Collecting Branch : EPS1 Servicing Branch : LIC of India,

Palasa B O
Transaction No : 1221890
Palasa Kasibugga.,Dt Srikakulam A P
Date ( Time ): 11/04/2020 ( 08:45:08 ) Palasa-Kasibugga,532222
[email protected]
Receipt No : PR0122189000012021
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 12,570.98 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Tamada Mani


towards the following :

Policy No Plan Inst. Premium No Of Inst Total Premium CGST Branch


Name Term Mode Due From Late Fee SGST/UTGST Next Due
Agency Code D.O.C. Sum Assured Due To CD Charges Total Amt Reg. No.
(`) (`) (`)
696589917 165 12,010.00 1 12,010.00 42.79 69C
Tamada Mani 10 YLY 11/19 475.40 42.79 11/20
0261369C 28/11/2011 11/19 0.00 12,570.98 37AAACL0582H2ZK
2,50,000

Page Total (`) 12,010.00 12,010.00 42.79


475.40 42.79
0.00 12,570.98
Grand Total (`) 12,010.00 12,010.00 42.79
475.40 42.79
0.00 12,570.98

GST borne by LIC of India ` 270.22


TWELVE THOUSAND FIVE HUNDRED SEVENTY RUPEES AND NINETY EIGHT PAISE ONLY

Tamada Mani
Consolidated Stamp Duty Paid
W/O T Nageswara Rao
Bathupuram Vil/Po CSD/323/2020/802/2020 DTD.20/02/2020
Akkupalli Via Sklm Dt

532219 Payment Acknowledgement generated through


Online Portal on 11-Apr-20 Time : 08:47:56.
Mobile: 9492186945
Email: [email protected]

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!

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