Received With Thanks ' 5,912.00 Through Payment Gateway Over The Internet From

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153823835_1

Collecting Branch : EPS1 Servicing Branch : LIC of India, Una Br Office


LIC OF INDIA,UNA BR OFFICE
Transaction No : 14761768
NANGAL ROAD,UNA.
Date ( Time ): 10/08/2021 ( 05:41:59 ) H P,174303
Email: BO_13D@LICINDIA.COM
Receipt No : PR1476176800022122
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 5,912.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Mr Summukh L.A


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) (`) (`) (`)
153823835 184 / 22 5,912.00 1 5,912.00 0.00 13D
Mr Summukh 19/08/2010 YLY 08/21 0.00 0.00 08/22
No 08/21 0.00 5,912.00 02AAACL0582H1ZY
0078713D 1,00,000

Page Total (`) 5,912.00 5,912.00 0.00


0.00 0.00
0.00 5,912.00
Grand Total (`) 5,912.00 5,912.00 0.00
0.00 0.00
0.00 5,912.00

GST borne by LIC of India ` 133.02


FIVE THOUSAND NINE HUNDRED TWELVE RUPEES AND ZERO PAISE ONLY

Mr Summukh L.A
Consolidated Stamp Duty Paid
S/O Sh Surinder Kumar P
Vpo-Rait,Teh-Shahpur CSD/70/2021/2092 DATED - 24.06.2021
Dt.Kangra Hp

176208 Payment Acknowledgement generated through


Online Portal on 10-Aug-21 Time : 05:45:40.
Mobile: 94******37
Email: su********ri@gmail.com
For Payment related queries-Email: bo_eps1@licindia.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!


153823836_2

Collecting Branch : EPS1 Servicing Branch : LIC of India, Una Br Office


LIC OF INDIA,UNA BR OFFICE
Transaction No : 14761768
NANGAL ROAD,UNA.
Date ( Time ): 10/08/2021 ( 05:41:59 ) H P,174303
Email: BO_13D@LICINDIA.COM
Receipt No : PR1476176800022122
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 6,007.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Mr Summukh L.A


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) (`) (`) (`)
153823836 185 / 22 6,007.00 1 6,007.00 0.00 13D
Mr Summukh 19/08/2010 YLY 08/21 0.00 0.00 08/22
No 08/21 0.00 6,007.00 02AAACL0582H1ZY
0078713D 1,00,000

Page Total (`) 6,007.00 6,007.00 0.00


0.00 0.00
0.00 6,007.00
Grand Total (`) 6,007.00 6,007.00 0.00
0.00 0.00
0.00 6,007.00

GST borne by LIC of India ` 135.16


SIX THOUSAND SEVEN RUPEES AND ZERO PAISE ONLY

Mr Summukh L.A
Consolidated Stamp Duty Paid
S/O Sh Surinder Kumar P
Vpo-Rait,Teh-Shahpur CSD/70/2021/2092 DATED - 24.06.2021
Dt.Kangra Hp

176208 Payment Acknowledgement generated through


Online Portal on 10-Aug-21 Time : 05:45:40.
Mobile: 94******37
Email: su********ri@gmail.com
For Payment related queries-Email: bo_eps1@licindia.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!

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