anil_nift2004@

864770471_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Vapi Br 868
LIC OF INDIA, BRANCH OFFICE - 868
Transaction No : 32866618
NAGARPALIKA BUILDING, PB NO-
Date ( Time ): 17/01/2023 ( 23:03:53 ) NEAR POLICE STATION, VAPI,
Email: BO_868@LICINDIA.COM
Receipt No : PR3286661800022223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 11,023.54 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Anil Kumar

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) (`) (`) (`)
864770471 149 / 74 10,723.00 1 10,723.00 22.92 868
Anil Kumar 20/10/2009 YLY 10/22 254.70 22.92 10/23
Yes 10/22 0.00 11,023.54 24AAACL0582H2ZR
02506868 1,50,000

Page Total (`) 10,723.00 10,723.00 22.92

254.70 22.92
0.00 11,023.54
Grand Total (`) 10,723.00 10,723.00 22.92
254.70 22.92
0.00 11,023.54

GST borne by LIC of India ` 241.26

ELEVEN THOUSAND TWENTY THREE RUPEES AND FIFTY FOUR PAISE ONLY

Anil Kumar
Consolidated Stamp Duty Paid
Saivilla Appartment, R.No.403,
Near Jhil Hill Bar, LOA/CSD/526/4822 DTD- 14.11.2022 valid from 16.12.2022 to
Khadiwad, Daman.

396210 Payment Acknowledgement generated through

Online Portal on 17-Jan-23 Time : 23:06:06.
Mobile: 97******23
Email: an********04@yahoo.com
For Payment related queries-Email: bo_eps1@licindia.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!

 anil_nift2004@

864770470_2
Collecting Branch : EPS1 Servicing Branch : LIC of India, Vapi Br 868
LIC OF INDIA, BRANCH OFFICE - 868
Transaction No : 32866618
NAGARPALIKA BUILDING, PB NO-
Date ( Time ): 17/01/2023 ( 23:03:53 ) NEAR POLICE STATION, VAPI,
Email: BO_868@LICINDIA.COM
Receipt No : PR3286661800022223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 10,199.07 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Anil Kumar

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) (`) (`) (`)
864770470 179 / 16 9,921.00 1 9,921.00 21.21 868
Anil Kumar 20/10/2009 YLY 10/22 235.65 21.21 10/23
Yes 10/22 0.00 10,199.07 24AAACL0582H2ZR
02506868 2,00,000

Page Total (`) 9,921.00 9,921.00 21.21

235.65 21.21
0.00 10,199.07
Grand Total (`) 9,921.00 9,921.00 21.21
235.65 21.21
0.00 10,199.07

GST borne by LIC of India ` 223.22

TEN THOUSAND ONE HUNDRED NINETY NINE RUPEES AND SEVEN PAISE ONLY

Anil Kumar
Consolidated Stamp Duty Paid
Saivilla Appartment, R.No.403,
Near Jhil Hill Bar, LOA/CSD/526/4822 DTD- 14.11.2022 valid from 16.12.2022 to
Khadiwad, Daman.

396210 Payment Acknowledgement generated through

Online Portal on 17-Jan-23 Time : 23:06:06.
Mobile: 97******23
Email: an********04@yahoo.com
For Payment related queries-Email: bo_eps1@licindia.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!