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 Branch Code 1717
LIC Branch Address
Paladugu Subba Rao & Sons Building

1-241/3 Main Road.

Vuyyur

Vuyyur 521165

Email bo_67R@licindia.com

Agency Code No. 80001884(IDBI Bank Ltd) S.P. Code No. SP0135243042

Access Id 448692220 CRM Id 71382

Name BODAS NAGESH

Email ibkl0001717@idbi.co.in Mobile No. 9908952553

Plan-Policy Term 833-23 Premium Paying Term 20

Mode Yearly NACH Indication N

Sum Proposed 200000 PAN Details FORM60

PROPOSAL DEPOSIT RECEIPT

Received with thanks Rs. 9930 from

Smt./ Ms./ Shri :

towards the following :

Transaction No. : 32637 Date (Time) : 10/10/2019 11:28:36

BOC Number : 32637 Proposal Deposit (Rs.) : 9930

Amount in Words : Nine Thousand Nine Hundred and Thirty

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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