558051414_1

Collecting Branch : EPS1 Servicing Branch : LIC of India, Hinoo Branch

LIC OF INDIA,HINOO BRANCH
Transaction No : 3630882
SUSHILA NIWAS MAIN
Date ( Time ): 03/05/2021 ( 12:11:20 ) RANCHI,834002
Email: BO_55P@LICINDIA.COM
Receipt No : PR0363088200012122
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 6,010.26 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Suraj Kumar Singh

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) (`) (`) (`)
558051414 815 / 35 5,878.00 1 5,878.00 66.13 55P
Suraj Kumar 15/04/2017 YLY 04/21 0.00 66.13 04/22
No 04/21 0.00 6,010.26 20AAACL0582H1Z0
0242155P 2,00,000

Page Total (`) 5,878.00 5,878.00 66.13

0.00 66.13
0.00 6,010.26
Grand Total (`) 5,878.00 5,878.00 66.13
0.00 66.13
0.00 6,010.26

SIX THOUSAND TEN RUPEES AND TWENTY SIX PAISE ONLY

Suraj Kumar Singh

Consolidated Stamp Duty Paid
Opp. Akhil Memorial School,Hehal
Ps-Sukhdeo Nagar CSD/113/2020/1936 DTD. 18.09.2020
Dt-Ranchi Jharkhand

834005 Payment Acknowledgement generated through

Online Portal on 03-May-21 Time : 12:15:48.
Mobile: 83******65
Email: vi********gh@gmail.com
For Payment related queries-Email: bo_eps1@licindia.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!