318866568_1

Collecting Branch : EPS1 Servicing Branch : LIC of India, Chennai City Br

LIC OF INDIA,CHENNAI CITY BR
Transaction No : 5862600
37,1ST MAIN ROAD,GANDHI NAGAR
Date ( Time ): 21/05/2021 ( 10:50:19 ) CHENNAI,600020
Email: BO_71M@LICINDIA.COM
Receipt No : PR0586260000012122
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 844.66 through Payment Gateway over the Internet from:

Smt./Ms./Shri : M.Varun Kumar La S.Murali P

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) (`) (`) (`)
318866568 934 / 15 797.00 1 797.00 18.83 71M
M.Varun Kumar 13/07/2020 MLY 05/21 0.00 18.83 06/21
No 05/21 10.00 844.66 33AAACL0582H1ZT
0238671M 1,00,000

Page Total (`) 797.00 797.00 18.83

0.00 18.83
10.00 844.66
Grand Total (`) 797.00 797.00 18.83
0.00 18.83
10.00 844.66

EIGHT HUNDRED FORTY FOUR RUPEES AND SIXTY SIX PAISE ONLY

M.Varun Kumar La S.Murali P

3/311 Mottathamman Koil Street
Mgr Nagar Manapakkam
Chennai

600125 Payment Acknowledgement generated through

Online Portal on 21-May-21 Time : 10:51:19.
Mobile: 73******08
Email: na********ar@yahoo.com
For Payment related queries-Email: bo_eps1@licindia.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!