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Collecting Branch : EPS1

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

Servicing Branch : 134


LIC of India, Jammu 1
Branch Unit I
Karan Bhawan Shalimar Road.
Jammu J & K
Jammu I
180001

Transaction No. : PR0853783300011516


Date ( Time ): 21/10/2015 ( 17:55:19 )

RENEWAL PREMIUM RECEIPT


Received with thanks Rs. 3020.00 through Payment Gateway over the Internet from:
Smt./Ms./Shri : Shenaya Gupta
Towards the following
Policy No
Name
Agency Code
143825975

Plan
Term
D.O.C.
832
GS
23
02932134
13/04/2015
Page Total (Rs)

Grand Total (Rs)

Inst. Prem(Rs)
Mode
Sum Assured
3,020.00
QLY
2,50,000.00
3,020.00

3,020.00

No Of Inst
Due Fr
Due To
1
10/15
10/15

Total Premium
Late Fee
3,020.00
0.00
3,020.00
0.00
3,020.00
0.00

Service Tax
Edu Cess
Total Amt
0.00
0.00
3,020.00
0.00
0.00
3,020.00
0.00
0.00
3,020.00

Branch
Next Due
134
01/16

RUPEES THREE THOUSAND TWENTY ONLY


Shenaya Gupta
D/O Sh K S Sahil Gupta
R/O H No 193-A Last Morh
Gandhi Nagar Jammu
100000
This receipt is electronically generated.

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi


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