Collecting Branch : EPS1 Servicing Branch : LIC of India, Mumbai B O 895

United India Bldg 1st Flr.

Transaction No : 8882158
P M Road Fort,Mumbai
Date ( Time ): 06/06/2020 ( 20:01:00 ) Fort,400001
bo_eps1@licindia.com
Receipt No : PR0888215800022021
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 743.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Aba Rajaram Sargar.

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
Revival D.O.C. Sum Assured Due To CD Charges Total Amt Reg. No.
(Yes/No) (`) (`) (`)
905082232 14 743.00 1 743.00 0.00 895
Aba Rajaram 18 QLY 05/20 0.00 0.00 08/20
No 09/02/2005 05/20 0.00 743.00 27AAACL0582H1ZM
50,000.00

Page Total (`) 743.00 743.00 0.00

0.00 0.00
0.00 743.00
Grand Total (`) 743.00 743.00 0.00
0.00 0.00
0.00 743.00

GST borne by LIC of India ` 16.72

SEVEN HUNDRED FORTY THREE RUPEES AND ZERO PAISE ONLY

Aba Rajaram Sargar.

Utkarsha C.H.S. D-9-3-13,
Sector No.11, Khanda Colony,
New Panvel West.

410206 Payment Acknowledgement generated through

Online Portal on 06-Jun-20 Time : 20:03:16.
Mobile: 87******55
Email: sa********ba@rediffmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!

 Collecting Branch : EPS1 Servicing Branch : LIC of India, Mumbai B O 895
United India Bldg 1st Flr.
Transaction No : 8882158
P M Road Fort,Mumbai
Date ( Time ): 06/06/2020 ( 20:01:00 ) Fort,400001
bo_eps1@licindia.com
Receipt No : PR0888215800022021
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 766.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Aba Rajaram Sargar.

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
Revival D.O.C. Sum Assured Due To CD Charges Total Amt Reg. No.
(Yes/No) (`) (`) (`)
906015916 165 766.00 1 766.00 0.00 895
Aba Rajaram 21 QLY 04/20 0.00 0.00 07/20
No 27/01/2009 04/20 0.00 766.00 27AAACL0582H1ZM
62,500.00

Page Total (`) 766.00 766.00 0.00

0.00 0.00
0.00 766.00
Grand Total (`) 766.00 766.00 0.00
0.00 0.00
0.00 766.00

GST borne by LIC of India ` 17.24

SEVEN HUNDRED SIXTY SIX RUPEES AND ZERO PAISE ONLY

Aba Rajaram Sargar.

Utkarsha C.H.S. D-9-3-13,
Sector No.11, Khanda Colony,
New Panvel West.

410206 Payment Acknowledgement generated through

Online Portal on 06-Jun-20 Time : 20:03:16.
Mobile: 87******55
Email: sa********ba@rediffmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!