Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi

Collecting Branch : EPS1

E-mail : bo_eps1@licindia.com
Phone : +91-022-1251
Transaction No. : PR0858772400011314
Date ( Time ): 29/12/2013 ( 18:22:07 )
Servicing Branch : 583
LIC of India, Bhubaneswar Br I
Opp Raj Bhawan New Capital
Lic Building Unit-7.
Bhubaneswar
Bhubaneshwar I
751001
RENEWAL PREMIUM ACKNOWLEDGEMENT
Received with thanks Rs. 2746.00 through Payment Gateway over the Internet from:
Smt./Ms./Shri : Debasis Rath
Towards the following
Policy No
Name
Agency Code
Plan
Term
D.O.C.
Inst. Prem(Rs)
Mode
Sum Assured
No Of Inst
Due Fr
Due To
Total Premium
Late Fee
Service Tax
Edu Cess
Total Amt
Branch
Next Due
598324523
D.Rath
05585583
149
78
20/12/2011
2,746.00
HLY
1,00,000.00
1
12/13
12/13
2,746.00
0.00
0.00
0.00
2,746.00
583
06/14
Page Total (Rs) 2,746.00 2,746.00
0.00
0.00
0.00
2,746.00
Grand Total (Rs) 2,746.00 2,746.00
0.00
0.00
0.00
2,746.00
RUPEES TWO THOUSAND SEVEN HUNDRED FORTY-SIX ONLY
Debasis Rath
2ra(F)-15/1,Unit-Ix(F),
Bhubaneswar
751022
Payment Acknowledgement generated through Online
Portal on 29-Dec-2013 Time : 18:23:20. Digitally Signed
Premium Receipt sent by email
This receipt is electronically generated.
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