barman_abhis

hek@yahoo.co

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

LIC OF INDIA,HALDIA BRANCH
Transaction No : 30530131
BASUDEBPUR POST
Date ( Time ): 29/12/2021 ( 11:06:22 ) ,721507
Email: BO_43A@LICINDIA.COM
Receipt No : PR3053013100012122
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 5,782.24 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Abhishek Barman

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) (`) (`) (`)
401591089 836 / 21 5,655.00 1 5,655.00 63.62 43A
Abhishek 27/06/2018 QLY 12/21 0.00 63.62 03/22
No 12/21 0.00 5,782.24 19AAACL0582H1ZJ
0232743A 4,00,000

Page Total (`) 5,655.00 5,655.00 63.62

0.00 63.62
0.00 5,782.24
Grand Total (`) 5,655.00 5,655.00 63.62
0.00 63.62
0.00 5,782.24

FIVE THOUSAND SEVEN HUNDRED EIGHTY TWO RUPEES AND TWENTY FOUR PAISE ONLY

Abhishek Barman
Consolidated Stamp Duty Paid
59a,Sikdar Bagan Street
Shyambazar CSD/70/2021/2092 DATED - 24.06.2021
Kolkata

700004 Payment Acknowledgement generated through

Online Portal on 29-Dec-21 Time : 11:07:32.
Mobile: 86******58
Email: ba********ek@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!