You are on page 1of 1

Collecting Branch : EPS1 E-mail : bo_eps1@licindia.com Phone : +91-022-1251 Transaction No.

: PR0450603100011314 Date ( Time ): 10/09/2013 ( 19:29:54 )

Servicing Branch : 533 LIC of India, Sitamarhi Br Office Rajapatti Rd Opp Goenka College P O Sitamarhi. Muzaffarpur Bihar Sitamarhi Bihar 843004

RENEWAL PREMIUM ACKNOWLEDGEMENT


Received with thanks Rs. 1595.80 through Payment Gateway over the Internet from: Smt./Ms./Shri : Sri Kailash Choudhary Towards the following Plan Term D.O.C. 75 Choudhary K 20 01920492 28/03/2002 Page Total (Rs) Policy No Name Agency Code 441716561 Inst. Prem(Rs) Mode Sum Assured 1,535.00 HLY 40,000.00 1,535.00 No Of Inst Due Fr Due To 1 03/13 03/13 Total Premium Late Fee 1,535.00 60.80 1,535.00 60.80 1,535.00 60.80 Service Tax Edu Cess Total Amt 0.00 0.00 1,595.80 0.00 0.00 1,595.80 0.00 0.00 1,595.80 Branch Next Due 533 09/13

Grand Total (Rs)

1,535.00

RUPEES ONE THOUSAND FIVE HUNDRED NINETY-FIVE AND EIGHTY PAISE ONLY Sri Kailash Choudhary Vill & Po.Baghari Thana-Sursand Dt.Sitamari,Bihar 843331 Payment Acknowledgement generated through Online Portal on 10-Sep-2013 Time : 19:33:15. Digitally Signed Premium Receipt sent by email

This receipt is electronically generated.

Signature Not Verified


Digitally signed by REKHA VARSHNEY Date: September 10, 2013 7:33:15 PM IST Reason: Premium Receipt Location: LIC OF INDIA

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi


Page 1of1

You might also like