Collecting Branch : EPS1 Servicing Branch : LIC of India, Hydeabad C B 6 ,

Taramandal Complex 2nd Floor

Transaction No : 18122455
Sectl Rd,
Date ( Time ): 23/01/2018 ( 14:25:32 ) Hyderabad,500029
bo_eps1@licindia.com
Receipt No : PR1812245500011718
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 18,426.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Pathakota Sainiranjankumar

towards the following :

Policy No Plan Inst. Premium No Of Inst Total Premium CGST Branch

Name Term Mode Due From Late Fee SGST/UTGST Next Due
Agency Code D.O.C. Sum Assured Due To CD Charges Total Amt Reg. No.
(`) (`) (`)
648628591 149 18,426.00 1 18,426.00 0.00 800
P Sai Niranjan 68 HLY 02/18 0.00 0.00 08/18
01854800 19/08/2013 5,00,000 02/18 0.00 18,426.00

Page Total (`) 18,426.00 18,426.00 0.00

0.00 0.00
0.00 18,426.00
Grand Total (`) 18,426.00 18,426.00 0.00
0.00 0.00
0.00 18,426.00

GST borne by LIC of India ` 414.58

EIGHTEEN THOUSAND FOUR HUNDRED TWENTY SIX RUPEES AND ZERO PAISE ONLY

Pathakota Sainiranjankumar Consolidated Stamp Duty Paid

9-1-34/30/39, 1st Floor,Nr. St.Anthony AMuSh2016/2967/CR747/M1 w.e.f. 30/11/2016
School, Bapu Nagar
Langer House, Hyderabad

500008 Payment Acknowledgement generated through

Online Portal on 23-Jan-18 Time : 14:26:43.
Mobile: 8125134598
Email: niranjan.merits@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!