Collecting Branch : EPS1 Servicing Branch : LIC of India, Laxmi Road

Commonwealth Bldg.
Transaction No : 10986521
Ground Floor.Laxmi Road ,Pune
Date ( Time ): 07/10/2017 ( 10:25:25 ) Pune,411030
bo_eps1@licindia.com
Receipt No : PR1098652100031718
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received With Thanks ` 26,202.50 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Rahul M Upadhye

Towards The Following :

Policy No Plan Inst. Premium No Of Inst Total Premium Tax* Branch

Name Term Mode Due From Late Fee Total Amt Next Due
Agency Code D.O.C. Sum Assured Due To CD Charges Reg. No.
(`) (`) (`)
956471508 164 2,585.00 1 2,585.00 4.00 952
Rahul Mukund 25 Hly 09/17 20.50 2,609.50 03/18
29205956 18/09/2008 10,00,000 09/17 0.00

956471509 149 11,803.00 1 11,803.00 0.00 952

Rahul Mukund 66 Hly 09/17 0.00 11,803.00 03/18
29205956 18/09/2008 10,00,000 09/17 0.00

956474110 149 11,790.00 1 11,790.00 0.00 952

Sheetal Rahul 69 Hly 09/17 0.00 11,790.00 03/18
29205956 18/09/2008 10,00,000 09/17 0.00

Page Total (`) 26,178.00 26,178.00 4.00

20.50 26,202.50
0.00
Grand Total (`) 26,178.00 26,178.00 4.00
20.50 26,202.50
0.00

This receipt is electronically generated.

Har Pal Aapke Saath!

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TWENTY SIX THOUSAND TWO HUNDRED TWO RUPEES AND FIFTY PAISE ONLY

Rahul M Upadhye Consolidated Stamp Duty paid

16, Jeevan Heights., AMuSh2016/2967/CR747/M1 w.e.f. 30/11/2016
M I T College Road, Rambaug Colony,
Kothrud., Pune

411038 Payment Acknowledgement generated through

Online Portal on 07-Oct-17 Time : 10:26:53.
Mobile: 8600108482
Email: rahulupadhye@yahoo.com

*Tax here indicates Goods and Service Tax (GST) from 01/07/2017 or Service Tax prior to 01/07/2017.

This receipt is electronically generated.

Har Pal Aapke Saath!

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