Collecting Branch : EPS1 Servicing Branch : LIC of India, Pimpri Br 95V

Sunshine Plaza Cts No.4713

Transaction No : 12232670
Station Road.,Pimpri Pune
Date ( Time ): 07/09/2019 ( 14:53:22 ) Pimpri,411018
bo_eps1@licindia.com
Receipt No : PR1223267000011920
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 6,409.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Savita Prakash Dhasade

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.
(`) (`) (`)
952867693 75 6,409.00 1 6,409.00 0.00 95V
Savita Prakash 20 YLY 08/19 0.00 0.0 08/20
0111295V 28/08/2002 1,00,000 08/19 0.00 6,409.00 0

Page Total (`) 6,409.00 6,409.00 0.00

0.00 0.00
0.00 6,409.00
Grand Total (`) 6,409.00 6,409.00 0.00
0.00 0.00
0.00 6,409.00

GST borne by LIC of India ` 144.20

SIX THOUSAND FOUR HUNDRED NINE RUPEES AND ZERO PAISE ONLY

Savita Prakash Dhasade

Consolidated Stamp Duty Paid
Hinge Mala,Hadapsar,
Pune. CSD/328/2019/646/19 DTD.15/02/2019

0 Payment Acknowledgement generated through

Online Portal on 07-Sep-19 Time : 14:54:52.
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Email: sagarraut3737@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!