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

Baidehi Bhawan Akashwani

Transaction No : 2372387
Chowk ,Adityapur.
Date ( Time ): 07/05/2018 ( 20:33:47 ) Adityapur,831003
bo_eps1@licindia.com
Receipt No : PR0237238700011819
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 9,680.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : S Prasad
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.
(`) (`) (`)
558040817 815 9,467.00 1 9,467.00 106.50 55D
Shashi Prasad 21 QLY 04/18 0.00 106.50 07/18
0049755D 07/01/2017 7,00,000 04/18 0.00 9,680.00

Page Total (`) 9,467.00 9,467.00 106.50

0.00 106.50
0.00 9,680.00
Grand Total (`) 9,467.00 9,467.00 106.50
0.00 106.50
0.00 9,680.00

NINE THOUSAND SIX HUNDRED EIGHTY RUPEES AND ZERO PAISE ONLY

S Prasad
Consolidated Stamp Duty Paid
Vill-Sopodera Near Govin Mahato Talab
Po-Sarjamda,Ps-Parsudih CSD/347/2018/764/18 w.e.f. 22/02/2018
Jamshedpur Jharkhand

831002 Payment Acknowledgement generated through

Online Portal on 07-May-18 Time : 20:35:38.
Mobile: 8123204729
Email: shashi.prsd@yahoo.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!