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Collecting Branch : EPS1

Transaction No. : SR03370716000217659


Date ( Time ): 20/11/2015 ( 18:26:52 )

Branch Code : EPS1


PCMC, Network Operating Center
1st Floor, Jeevan Seva Annexe,
S.V.Road, Santacruz(W)
Mumbai - 400 054
Ph. : +91-022-1251
e-mail : bo_eps1@licindia.com

RENEWAL PREMIUM RECEIPT


Received with thanks Rs. 80,028.00 through Payment Gateway over the Internet
from: Smt./Ms./Shri : Satyender Kumar
Towards the following
Policy No
Name
Agency Code
111987028
Satyender
Kumar

Plan
Term
D.O.C.
74

3
19/11/2016
36930111
Page Total (Rs)
Grand Total (Rs)

Inst. Prem(Rs)
Mode
Sum Assured
80,028.00
YLY
25,00,000
80,028.00
80,028.00

No Of Inst
Due Fr
Due To
1
02/14
02/14

Total Premium
Late Fee
Total Amt
80,028.00
0.00
80,028.00
80,028.00
0.00
80,028.00
80,028.00
0.00
80,028.00

Branch
Next Due
127
02/15

RUPEES EIGHTEEN THOUSAND TWENTY-EIGHT


ONLY
Sh Satyender
Kumar
VPO-Chandhat,
Distt. Palwal
Haryana

This receipt is electronically generated and is digitally signed.

Signature Not Verified


Digitally signed by REKHA VARSHNEY
Date: Feb 20, 2014 6:26:53 PM IST
Reason: Premium Receipt
Location: LIC OF INDIA

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi


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