Received With Thanks ' 7,890.00 Through Payment Gateway Over The Internet From

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Collecting Branch : EPS1 Servicing Branch : LIC of India, Sadulpur Branch

Qureshi Bazar
Transaction No : 19944253
Taranagar Road.,Sadulpur [Rajasthan]
Date ( Time ): 11/09/2020 ( 20:08:53 ) Sadulpur,331023
bo_eps1@licindia.com
Receipt No : PR1994425300012021
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 7,890.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Smt.Pawan Kaur


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
Revival D.O.C. Sum Assured Due To CD Charges Total Amt Reg. No.
(Yes/No) (`) (`) (`)
501030972 128 7,890.00 1 7,890.00 0.00 50D
Smt.Pawan Kaur 20 YLY 09/20 0.00 0.00 09/21
No 01/09/2001 09/20 0.00 7,890.00 08AAACL0582H2ZL
1,00,000

Page Total (`) 7,890.00 7,890.00 0.00


0.00 0.00
0.00 7,890.00
Grand Total (`) 7,890.00 7,890.00 0.00
0.00 0.00
0.00 7,890.00

GST borne by LIC of India ` 177.52


SEVEN THOUSAND EIGHT HUNDRED NINETY RUPEES AND ZERO PAISE ONLY

Smt.Pawan Kaur
Consolidated Stamp Duty Paid
W/O Sh.Prahlad Singh
Vill-Gothiya Chhoti CSD/323/2020/802/2020 DTD.20/02/2020
Po-Gothiya Badi, Dt.Churu

331023 Payment Acknowledgement generated through


Online Portal on 11-Sep-20 Time : 20:13:01.
Mobile: 98******08
Email: dh********e8@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!

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