Collecting Branch : EPS1 Servicing Branch : LIC of India, Lucknow CAB

Career Agents Branch

Transaction No : 25932503
Jeevan Prakash.,30 Hazartganj
Date ( Time ): 03/11/2020 ( 17:58:07 ) Lucknow (Cab),226001
Email: bo_eps1@licindia.com
Receipt No : PR2593250300012021
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 28,517.52 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Aparna Bhatt

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) (`) (`) (`)
225886509 815 / 35 27,890.00 1 27,890.00 313.76 395
Aparna Bhatt 08/11/2016 YLY 11/20 0.00 313.76 11/21
No 11/20 0.00 28,517.52 09AAACL0582HFZ6
000762015 10,00,000

Page Total (`) 27,890.00 27,890.00 313.76

0.00 313.76
0.00 28,517.52
Grand Total (`) 27,890.00 27,890.00 313.76
0.00 313.76
0.00 28,517.52

TWENTY EIGHT THOUSAND FIVE HUNDRED SEVENTEEN RUPEES AND FIFTY TWO PAISE ONLY

Aparna Bhatt
Consolidated Stamp Duty Paid
Mm-4/61-Vinay Khand-4
Gomti Nagar CSD/113/2020/1936 DTD. 18.09.2020
Lucknow

226010 Payment Acknowledgement generated through

Online Portal on 03-Nov-20 Time : 18:00:26.
Mobile: 84******48
Email: ap********ow@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!