Collecting Branch : EPS1 Servicing Branch : LIC of India, Dadar (W) Branch

Prasad Gokhale Road (North)

Transaction No : 24013252
Dadar (W).,Mumbai
Date ( Time ): 16/10/2020 ( 18:22:06 ) Dadar(W),400028
Email: bo_eps1@licindia.com
Receipt No : PR2401325200012021
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 6,005.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Harshad Vinay Savant

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) (`) (`) (`)
884002582 165 / 30 6,005.00 1 6,005.00 0.00 938
Harshad Vinay 15/10/2011 YLY 10/20 0.00 0.00 10/21
No 10/20 0.00 6,005.00 27AAACL0582H1ZM
00798938 1,25,000

Page Total (`) 6,005.00 6,005.00 0.00

0.00 0.00
0.00 6,005.00
Grand Total (`) 6,005.00 6,005.00 0.00
0.00 0.00
0.00 6,005.00

GST borne by LIC of India ` 135.12

SIX THOUSAND FIVE RUPEES AND ZERO PAISE ONLY

Harshad Vinay Savant

Consolidated Stamp Duty Paid
301 Riddhi Siddhi Apts.,
Murbad Road, CSD/113/2020/1936 DTD. 18.09.2020
Kalyan West

421301 Payment Acknowledgement generated through

Online Portal on 16-Oct-20 Time : 18:24:25.
Mobile: 99******89
Email: sa********.v@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!