Collecting Branch : EPS1 Servicing Branch : LIC of India, Bagnan Br Office

JAYANTI BHABAN,COLLEGE ROAD

Transaction No : 32338776
POST+PS-BAGNAN,DIST-HOWRAH
Date ( Time ): 01/01/2021 ( 20:34:06 ) HOWRAH,711303
Email: bo_eps1@licindia.com
Receipt No : PR3233877600012021
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 12,122.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : SM
towards the following :

Policy No Plan / Term Inst. Premium No Of Inst Total Premium CGST Branch
Name D.O.C. Mode Due From Late Fee SGST/UTGST Next Due
Revival Sum Assured Due To CD Charges Total Amt Reg. No.
Agency Code
(Yes/No) (`) (`) (`)
409863391 936 / 25 11,600.00 1 11,600.00 261.00 43J
Shantanu Metay 13/10/2020 QLY 01/21 0.00 261.00 04/21
No 01/21 0.00 12,122.00 19AAACL0582H1ZJ
0465643J 10,00,000

Page Total (`) 11,600.00 11,600.00 261.00

0.00 261.00
0.00 12,122.00
Grand Total (`) 11,600.00 11,600.00 261.00
0.00 261.00
0.00 12,122.00

TWELVE THOUSAND ONE HUNDRED TWENTY TWO RUPEES AND ZERO PAISE ONLY

SM
Consolidated Stamp Duty Paid
S/O-Late Anil Kumar Metay
104/1 B Road Bamangachi CSD/113/2020/1936 DTD. 18.09.2020
Po-Salkia Dt-Howrah

711106 Payment Acknowledgement generated through

Online Portal on 01-Jan-21 Time : 20:36:11.
Mobile: 89******82
Email: me********an@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!