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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 2016-2017
DATE OF ISSUE: 02/12/2016

The following premia have been received under the following life
insurance policies of Kanubhai Dahyalal Patel

Policy No.

Dt of
Due
Commencement From

Number Of
Instalments Premium
Received Collecting Servicing Email id of
Due To and
Amount
Date
Branch
Branch Servicing Branch
Payment
Received
Mode

837946045 28/10/2012

04/2016 04/2016 1 HLY

15,818.00 11/05/2016 CBK1

873

bo_873@licindia.com

837946047 28/10/2012

04/2016 04/2016 1 HLY

14,722.00 11/05/2016 CBK1

873

bo_873@licindia.com

837946049 28/10/2012

04/2016 04/2016 1 HLY

13,909.00 11/05/2016 CBK1

873

bo_873@licindia.com

837946046 28/10/2012

04/2016 04/2016 1 HLY

15,214.00 11/05/2016 CBK1

873

bo_873@licindia.com

837946044 28/10/2012

04/2016 04/2016 1 HLY

16,520.00 11/05/2016 CBK1

873

bo_873@licindia.com

837946050 28/10/2012

04/2016 04/2016 1 HLY

13,589.00 11/05/2016 CBK1

873

bo_873@licindia.com

837946048 28/10/2012

04/2016 04/2016 1 HLY

14,291.00 11/05/2016 CBK1

873

bo_873@licindia.com

837946049 28/10/2012

10/2016 10/2016 1 HLY

13,909.00 27/11/2016 CBK1

873

bo_873@licindia.com

837946044 28/10/2012

10/2016 10/2016 1 HLY

16,520.00 27/11/2016 CBK1

873

bo_873@licindia.com

837946050 28/10/2012

10/2016 10/2016 1 HLY

13,589.00 27/11/2016 CBK1

873

bo_873@licindia.com

837946046 28/10/2012

10/2016 10/2016 1 HLY

15,214.00 27/11/2016 CBK1

873

bo_873@licindia.com

837946048 28/10/2012

10/2016 10/2016 1 HLY

14,291.00 27/11/2016 CBK1

873

bo_873@licindia.com

837946047 28/10/2012

10/2016 10/2016 1 HLY

14,722.00 27/11/2016 CBK1

873

bo_873@licindia.com

837946045 28/10/2012

10/2016 10/2016 1 HLY

15,818.00 27/11/2016 CBK1

873

bo_873@licindia.com

All the above payments are subject to cheque realisation, wherever applicable.
Total amount received towards premium for the policies listed above is Rs.2,08,126.00 for the financial year
2016-2017.
This document is electronically generated, for any queries please contact the servicing branch of respective
policies.

12/2/2016 1:02 PM