malleswararao.

v84@gmail.co

844991371_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Ongole Branch
LIC OF INDIA,ONGOLE BRANCH
Transaction No : 1423489
D NO 37 1 1 C SOUTH
Date ( Time ): 11/04/2022 ( 22:03:26 ) SANTHAPET ONGOLE
Email: BO_305@LICINDIA.COM
Receipt No : PR0142348900012223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 12,130.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Malleswararao Vadlamudi

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) (`) (`) (`)
844991371 165 / 16 12,130.00 1 12,130.00 0.00 305
Vadlamudi 14/09/2013 HLY 03/22 0.00 0.00 09/22
No 03/22 0.00 12,130.00 37AAACL0582H2ZK
03232305 5,00,000

Page Total (`) 12,130.00 12,130.00 0.00

0.00 0.00
0.00 12,130.00
Grand Total (`) 12,130.00 12,130.00 0.00
0.00 0.00
0.00 12,130.00

GST borne by LIC of India ` 272.92

TWELVE THOUSAND ONE HUNDRED THIRTY RUPEES AND ZERO PAISE ONLY

Malleswararao Vadlamudi
Consolidated Stamp Duty Paid
S/O V Peda Narasimham
Vadlamudivaripalem LOA/CSD/280/2022 DTD- 24.02.2022 VALID FROM 14.03.2022 TO
Rompicherla Mdl Guntur Dist

522617 Payment Acknowledgement generated through

Online Portal on 11-Apr-22 Time : 22:05:54.
Mobile: 72******05
Email: ma********84@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!