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

Jeevan Prakash Fraser Road.

Transaction No : 22451358
Patna,
Date ( Time ): 03/01/2020 ( 14:24:08 ) Patna,800001
bo_eps1@licindia.com
Receipt No : PR2245135800011920
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 8,966.01 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Ravi Shankar Pandey A

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.
(`) (`) (`)
512551146 14 8,883.00 1 8,883.00 6.33 550
Ravi Shankar 21 YLY 11/19 70.35 6.33 11/20
00956550 25/11/2002 11/19 0.00 8,966.01 10AAACL0582H2Z0
2,00,000

Page Total (`) 8,883.00 8,883.00 6.33

70.35 6.33
0.00 8,966.01
Grand Total (`) 8,883.00 8,883.00 6.33
70.35 6.33
0.00 8,966.01

GST borne by LIC of India ` 199.86

EIGHT THOUSAND NINE HUNDRED SIXTY SIX RUPEES AND ONE PAISE ONLY

Ravi Shankar Pandey A

Consolidated Stamp Duty Paid
Indrajeet Pandey P
Vill.Karawania, Po.Sataramganj CSD/328/2019/646/19 DTD.15/02/2019
Dist.Ghazipur, U.P

0 Payment Acknowledgement generated through

Online Portal on 03-Jan-20 Time : 14:26:07.
Mobile: 8349035152
Email: rvsh.pnd@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!