NG... EINE ...8.. Collecting Branch! EPS1 Servicing Branch: LIC OF INDIA.BRANCH ‘1stFLOORB WING.SAICLASSIC, 90 FEET ROAD.NEAR PALM ACRES. Date (Time): 04032019 (11:38:41 ) ‘Mumbai400081 bo_epst@iicndia.com Reesipt No: PR2590067600011819 havoc ror-aaaiuct Transaction No: 25300876 RENEWAL PREMIUM RECEIPT Received with thanks 1,531.00 through Payment Gateway over the Internet from: ‘SmtJMs./Shri: Yogesh Shyam Joshi towards the following Poliey No Plan That Promim | No Ofinst | Total Premium | _CGsT | Branch Name Tom ‘Mode Due From | LateFee | scsTiuTGsT| Next Due ‘Agency Gode| 0.0.6. | SumAssured | DueTo | cDCharges | Total Amt | Reg, No. ®. ® ® 885380882 165 1,534.00 1 1531.00 0.00 aK Yogesh Styam] 95 ay ang 000 0.00 osig coeseex | o1o62009 | 1.25.00 03/19 0.00 1,991.00 Page Total (2) 1,534.00] 1834.00 0.0] 0.00 0.00] o.00| 1,534.00] Grand Total ® 4,531.00 11531.00| 0° 0.00] oe 00] 1.8311 GST bore by LIC of india € 34.44 (ONE THOUSAND FIVE HUNDRED THIRTY ONE RUPEES AND ZERO PAISE ONLY Yogesh Shyam Joshi Mahalaxmi Darshan, Flat No 6, Ground Floor, Aaptewadi Ramnagar Kulgacn Badlapur E Near Sakshi Park 421503, Payment Acknowledgement generated through Folesgioaso5 508 Online Portal on Ge har-19 Time 1:37.08. mal: yjoshis6@yahoo.com This receipt is electronically generated and no signature is required Har Pal Aapke Saath!