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Life Insurance Corporation of India

PCMC, Network Operating Center
1st Floor, Jeevan Seva Annexe
S.V.Road, Santacruz(W)
Mumbai - 400 054

PREMIUM PAID CERTIFICATE FOR THE YEAR 2017-2018

DATE OF ISSUE: 03/01/2019

This is to certify that the following premium have been received under the
following life insurance policy held by Rana Kumari

Name Rana Kumari

Policy Number 523282651
Plan 160(Jeevan Bharati)
Policy Term 20
Premium Paying Term 20
Commencement Date 19/08/2005
Instalment Premium 7,525.00
Mode Of Premium Payment YLY
Reference Code 56160221

Due Number Of Premium Amount Received Collecting

Due To Status
From Instalments Received Date Branch
08/2017 08/2017 1 7,525.00 12/09/2017 CBK1 Normal

Total amount received towards premium for the policy number 523282651
is Rs. 7,525.00 for the financial year 2017-2018

This certificate is electronically generated

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