abhijitghosh28

081993@gmail

857588264_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Rourkela Branch
LIC OF INDIA,ROURKELA BRANCH
Transaction No : 27218885
SECTOR NO 19 MARKET
Date ( Time ): 04/12/2022 ( 13:06:11 ) ,769005
Email: BO_589@LICINDIA.COM
Receipt No : PR2721888500012223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 46,190.42 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Abhijit Ghosh

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) (`) (`) (`)
857588264 936 / 25 45,174.00 1 45,174.00 508.21 589
Abhijit Ghosh 21/12/2020 YLY 12/22 0.00 508.21 12/23
No 12/22 0.00 46,190.42 21AAACL0582H1ZY
06124589 10,00,000

Page Total (`) 45,174.00 45,174.00 508.21

0.00 508.21
0.00 46,190.42
Grand Total (`) 45,174.00 45,174.00 508.21
0.00 508.21
0.00 46,190.42

FORTY SIX THOUSAND ONE HUNDRED NINETY RUPEES AND FORTY TWO PAISE ONLY

Abhijit Ghosh
Consolidated Stamp Duty Paid
S/O-Jiban Kumar Ghosh
House No.60/B,Shiv Path,Shivnagar LOA NO/CSD/390/2022 Dtd - 28.06.2022 valid from 05.07.2022 to
Kadma,Jamshedpur,Jharkhand

831005 Payment Acknowledgement generated through

Online Portal on 04-Dec-22 Time : 13:07:55.
Mobile: 62******94
Email: ab********93@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!