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

JAYANTI BHABAN,COLLEGE ROAD
Transaction No : 15125018
POST+PS-BAGNAN,DIST-HOWRAH
Date ( Time ): 31/07/2020 ( 16:14:24 ) HOWRAH,711303
bo_eps1@licindia.com
Receipt No : PR1512501800012021
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 5,930.50 through Payment Gateway over the Internet from:

Smt./Ms./Shri : SM
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) (`) (`) (`)
403709423 836 5,800.00 1 5,800.00 65.25 43J
Shantanu Metay 25 QLY 08/20 0.00 65.25 11/20
No 14/11/2018 08/20 0.00 5,930.50 19AAACL0582H1ZJ
5,00,000

Page Total (`) 5,800.00 5,800.00 65.25

0.00 65.25
0.00 5,930.50
Grand Total (`) 5,800.00 5,800.00 65.25
0.00 65.25
0.00 5,930.50

FIVE THOUSAND NINE HUNDRED THIRTY RUPEES AND FIFTY PAISE ONLY

SM
Consolidated Stamp Duty Paid
104/1 B Road Bamungachi
Po-Salkia Dt Howrah CSD/323/2020/802/2020 DTD.20/02/2020

711106 Payment Acknowledgement generated through

Online Portal on 31-Jul-20 Time : 16:17:15.
Mobile: 89******82
Email: me********an@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!