Collecting Branch : EPS1 Servicing Branch : Life Insurance Corporation of India

PCMC,Network Operating Center

Transaction No : 2231771
1st Floor,Jeevan Seva Annexe
Date ( Time ): 08/11/2022 ( 11:47:21 ) S.V. Road,SantaCruz(W)
Mumbai - 400 054
Receipt No : PR0223177100054659
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 55,578.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : T VISWESWARARAO
towards the following :
Policy No Plan Inst. Premium No Of Inst Total Premium CGST Branch
Name Term Mode Due From Late Fee SGST/UTGST Next Due
Agency Code D.O.C. Sum Assured Due To CD Charges Total Amt Reg. No.
(`) (`) (`)

696819664 91 55,578.00 1 55,578.00 0.00 69B

Shaik 16 HLY 11/22 0.00 0.00 05/23
0315269B 15/05/2022 15,00,000 11/22 0.00 55,578.00

Page Total (`) 55,578.00 55,578.00 0.00

0.00 0.00
0.00 55,578.00
Grand Total (`) 55,578.00 55,578.00 0.00
0.00 0.00
0.00 55,578.00

GST borne by LIC of India ` 145.00

FIFTY FIVE THOUSAND FIVE HUNDRED SEVENTY EIGHT RUPEES AND ZERO PAISE ONLY

T VISWESWARARAO
Consolidated Stamp Duty Paid
CSD/328/2022/646/19 DTD.19/10/2022

Payment Acknowledgement generated through

Online Portal on 08-Nov-22 Time : 11:48:31.
Mobile: 8099958699
Email: t.vijay6666@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!