CO02, LIC Of India, Central Office - MBAC (Hub)

4th Floor,Jeevan Seva Annexe Bldg,Santa Cruz (W),Mumbai-400054

Tel: 022-26100350/331/338, Email: co_mbac-hub@licindia.com

LIC Branch Code 67R Bank Sol Id 1717

LIC Branch Address

LIC OF INDIA,VUYYUR BR OFFICE

PALADUGU SUBBA RAO & SONS BUILDING

1-241/3,MAIN ROAD.

VUYYUR 521165

BO_67R@LICINDIA.COM

Agency Code 80001884(IDBI Bank Ltd) S.P. Code SP0135254379

Access Id 236938968 CRM Id 223721

Name AMAAN AKBAR ALI SHAIK

Email ibkl0001717@idbi.co.in Mobile No. 9966779585

Plan-Policy Term 934-22 Premium Paying Term 17

Mode Yearly NACH Indication D

Sum Proposed 200000 PAN Details AAMPZ0016D

PROPOSAL DEPOSIT RECEIPT

Received with thanks Rs. 10664 from

Smt./ Ms./ Shri : AMAAN AKBAR ALI SHAIK

towards the following :

Transaction No. : 9194 Date (Time) : 11/06/2021 13:14:12

BOC Number : 9194 Proposal Deposit (Rs.) : 10664

Amount in Words : Ten Thousand Six Hundred and Sixty Four

Receipt of payment made online is issued subject to realisation

ACCEPTANCE OF THIS DEPOSIT DOES NOT MAKE THE CORPORATION LIABLE FOR ACCEPTANCE OF RISK

We may mention that your risk will be covered only after all the above documents and Medical / Special Reports are received and
accepted to the satisfaction of our underwriters. Hence, you are requested to kindly expedite the same.

This receipt is electronically generated.

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi

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