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Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi

Collecting Branch : EPS1


E-mail : bo_eps1@licindia.com
Phone : +91-022-1251
Transaction No. : PR0989612700011314
Date ( Time ): 25/01/2014 ( 16:27:28 )
Servicing Branch : 17M
LIC of India, Hissar Br Office - 2
Urban Estate - 2
Behind Commercial Exchange.
Hissar
Hissar-Ii
RENEWAL PREMIUM ACKNOWLEDGEMENT
Received with thanks Rs. 4602.00 through Payment Gateway over the Internet from:
Smt./Ms./Shri : Anil Kumar
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
179112265
Ak
0091217M
179
20
28/01/2012
4,602.00
HLY
2,50,000.00
1
01/14
01/14
4,602.00
0.00
0.00
0.00
4,602.00
17M
07/14
Page Total (Rs) 4,602.00 4,602.00
0.00
0.00
0.00
4,602.00
Grand Total (Rs) 4,602.00 4,602.00
0.00
0.00
0.00
4,602.00
RUPEES FOUR THOUSAND SIX HUNDRED TWO ONLY
Anil Kumar
S/O Sh Ranbir Singh
H No 2582 Sector 9&11
Hisar
100000
Payment Acknowledgement generated through Online
Portal on 25-Jan-2014 Time : 16:28:49. Digitally Signed
Premium Receipt sent by email
This receipt is electronically generated.
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