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Collecting Branch : EPS1

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

Servicing Branch : 64E


LIC of India, Peddapally Branch Office
2/1/12/A Pragathinagar.
Peddapally
AP
Peddapalli
505172

Transaction No. : PR1505626200011415


Date ( Time ): 18/03/2015 ( 20:54:04 )

RENEWAL PREMIUM ACKNOWLEDGEMENT


Received with thanks Rs. 5184.00 through Payment Gateway over the Internet from:
Smt./Ms./Shri : Thirunagari Chethana (La)
Towards the following
Policy No
Name
Agency Code
683917812

Plan
Term
D.O.C.
107
Chethana T
20
0086164E
28/03/2004
Page Total (Rs)

Grand Total (Rs)

Inst. Prem(Rs)
Mode
Sum Assured
5,184.00
YLY
60,000.00
5,184.00

No Of Inst
Due Fr
Due To
1
03/15
03/15

Total Premium
Late Fee
5,184.00
0.00
5,184.00
0.00

5,184.00

5,184.00
0.00

Service Tax
Edu Cess
Total Amt
0.00
0.00
5,184.00
0.00
0.00
5,184.00
0.00
0.00
5,184.00

Branch
Next Due
64E
03/16

RUPEES FIVE THOUSAND ONE HUNDRED EIGHTY-FOUR ONLY


Thirunagari Chethana (La)
Thirunagari Goverdhan Swamy
H No 9-4-23 Srinagar Colony,
Knr,
505001

Payment Acknowledgement generated through Online


Portal on 18-Mar-2015 Time : 20:57:05.

This receipt is electronically generated.

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi


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