316855410_1

Collecting Branch : EPS1 Servicing Branch : LIC of India, Chennai City Br

LIC OF INDIA,CHENNAI CITY BR
Transaction No : 22156146
140, MARSHALLS ROAD,EGMORE,
Date ( Time ): 08/10/2021 ( 12:50:30 ) TAMILNADU,600008
Email: BO_70S@LICINDIA.COM
Receipt No : PR2215614600012122
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 1,435.60 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Vignesh M
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) (`) (`) (`)
316855410 833 / 21 1,404.00 1 1,404.00 15.80 70S
M.Vignesh 07/04/2019 MLY 10/21 0.00 15.80 11/21
No 10/21 0.00 1,435.60 33AAACL0582H1ZT
0213370S 3,00,000

Page Total (`) 1,404.00 1,404.00 15.80

0.00 15.80
0.00 1,435.60
Grand Total (`) 1,404.00 1,404.00 15.80
0.00 15.80
0.00 1,435.60

ONE THOUSAND FOUR HUNDRED THIRTY FIVE RUPEES AND SIXTY PAISE ONLY

Vignesh M
No.413, Pilliyar Koil Street,
Kunnathur, Sengadu Post,
Nungambakkam,Thiruvallur

602002 Payment Acknowledgement generated through

Online Portal on 08-Oct-21 Time : 12:52:09.
Mobile: 97******13
Email: vi********31@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!