shankar1975@

146529550_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Udaipur CAB
LIC OF INDIA, BRANCH OFFICE - 18H
Transaction No : 23793378
CARREAR AGENT BRANCH, POST
Date ( Time ): 01/11/2022 ( 20:07:17 ) RAJASTHAN.,313001
Email: BO_18H@LICINDIA.COM
Receipt No : PR2379337800012223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 6,186.98 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Shankar Lal Meena

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) (`) (`) (`)
146529550 823 / 19 5,202.00 1 5,202.00 471.89 18H
Shankar Lal 28/03/2017 HLY 09/22 41.20 471.89 03/23
Yes 09/22 0.00 6,186.98 08AAACL0582H2ZL
1050318H 25,00,000

Page Total (`) 5,202.00 5,202.00 471.89

41.20 471.89
0.00 6,186.98
Grand Total (`) 5,202.00 5,202.00 471.89
41.20 471.89
0.00 6,186.98

SIX THOUSAND ONE HUNDRED EIGHTY SIX RUPEES AND NINETY EIGHT PAISE ONLY

Shankar Lal Meena

Consolidated Stamp Duty Paid
S/O Sh Basant Kumar Meena
30th Kherwara,Satsagra LOA NO/CSD/390/2022 Dtd - 28.06.2022 valid from 05.07.2022 to
Harshawara, Udaipur

313001 Payment Acknowledgement generated through

Online Portal on 01-Nov-22 Time : 20:20:04.
Mobile: 81******20
Email: sh********75@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!