skroy_1964@y

458396048_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Calcutta Branch 4
LIC OF INDIA,CALCUTTA BRANCH 4
Transaction No : 34874151
29 NETAJI SUBHAS
Date ( Time ): 03/02/2022 ( 09:11:51 ) ,700001
Email: BO_422@LICINDIA.COM
Receipt No : PR3487415100012122
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 48,183.26 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Swapan Kumar Roy

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) (`) (`) (`)
458396048 815 / 15 47,123.00 1 47,123.00 530.13 422
Swapan Kumar 11/02/2015 YLY 02/22 0.00 530.13 02/23
No 02/22 0.00 48,183.26 19AAACL0582H1ZJ
21171412 5,00,000

Page Total (`) 47,123.00 47,123.00 530.13

0.00 530.13
0.00 48,183.26
Grand Total (`) 47,123.00 47,123.00 530.13
0.00 530.13
0.00 48,183.26

FORTY EIGHT THOUSAND ONE HUNDRED EIGHTY THREE RUPEES AND TWENTY SIX PAISE ONLY

Swapan Kumar Roy

170 / 1 C Road
Bamangachi
Salkia,Howrah

711106 Payment Acknowledgement generated through

Online Portal on 03-Feb-22 Time : 09:15:46.
Mobile: 94******09
Email: sk********64@yahoo.in
For Payment related queries-Email: bo_eps1@licindia.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!