Collecting Branch : EPS1

E-mail : bo_eps1@licindia.com
Phone : +91-022-1251

Servicing Branch : 41M

LIC of India, Amtala Branch Office
Calcutta Amtala
Amtalahat.
Kanya Nagar
Amtala

Transaction No. : PR0981631000011415

Date ( Time ): 13/12/2014 ( 07:40:17 )

RENEWAL PREMIUM ACKNOWLEDGEMENT

Received with thanks Rs. 6606.00 through Payment Gateway over the Internet from:
Smt./Ms./Shri : Shuvajoy Chakraborty
Towards the following
Policy No
Name
Agency Code
487302870

Plan
Term
D.O.C.
14
SS
16
1075041M
19/12/2013
Page Total (Rs)

Grand Total (Rs)

Inst. Prem(Rs)
Mode
Sum Assured
6,606.00
QLY
4,10,000.00
6,606.00

6,606.00

No Of Inst
Due Fr
Due To
1
12/14
12/14

Total Premium
Late Fee
6,606.00
0.00
6,606.00
0.00
6,606.00
0.00

Service Tax
Edu Cess
Total Amt
0.00
0.00
6,606.00
0.00
0.00
6,606.00
0.00
0.00
6,606.00

Branch
Next Due
41M
03/15

RUPEES SIX THOUSAND SIX HUNDRED SIX ONLY

Shuvajoy Chakraborty
S/O-Bijoy Chakraborty
Nu-Mans Park,Po-=Pailan
Kolkata
700104

Payment Acknowledgement generated through Online

Portal on 13-Dec-2014 Time : 07:52:51.

This receipt is electronically generated.

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi

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