7-207 eG ie r MAS COMPUTER FORMS Ph: (044) - 2409 5576, 2489 4787 Cc 7 o areder tact ton Borat o7/ 3198112~ L | C Life Insurance Corporation of India 64Y WSe DIVISION: Secunderabad x1V, JEEVANJYOTHI BLDG Tet mete yez/2age-14:29 GRY NO 72/P &82 GUNROCK Oa 345 BOWENPALLY ROAD TRIMULGHERRY PLEF pEAGéay SECUNDERABAD. PH:27792171 PinsS9G15 Phs27792238 <) RENEWAL PREMIUM RECEIPT frafatas & fet aeere TeaT HRERS 147 OG Received with thanks Rs, NIL Rs. aaa dhym Sp a In cash and / or In cheque from, RAVIPUDI VENKATESWARA RAD ara savst— Smt/Ms./Sri. Towards the following 3147; 90- YLY Agent: S2ada6aY Due Frs @3/2808 Due To: 83/2088 Ins TOTAL Rs. REGISTER NOW ON wun. cand 2a OP St a aT wie os a GRAY Bh Receipt is issued subject to realisation of the cheque S /18249/22/ 112087 RAVIPUDI VENKATESWARA RAO Be Signature — 8/0 R BALAKOTESWARA RAQ,H NO 1-122 KANURU PO VIJAYAWADA Pin ~ S20@e7 Next Prem Due-#3/2989