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Consolidated Premium Paid Statement Page 1 of 1

Life Insurance Corporation of India


PCMC, Network Operating Center
1st Floor, Jeevan Seva Annexe
S.V.Road, Santacruz(W)
Mumbai - 400 054

PREMIUM PAID STATEMENT FOR THE YEAR 2016-2017


DATE OF ISSUE: 18/10/2017

The following premia have been received under the following life insurance
policies of Vaibhav Kumar Totla

Number Of
Instalments Premium
Dt of Due Received Collecting Servicing Email id of Servicing
Policy No. Due To and Amount
Commencement From Date Branch Branch Branch
Payment Received
Mode
188508348 18/04/2014 04/2016 04/2016 1 HLY 18,348.00 05/05/2016 CBK1 198 bo_198@licindia.com
188508348 18/04/2014 10/2016 10/2016 1 HLY 18,348.00 28/10/2016 198 198 bo_198@licindia.com

All the above payments are subject to cheque realisation, wherever applicable.

Total amount received towards premium for the policies listed above is Rs.36,696.00 for the financial year 2016-2017.

This document is electronically generated, for any queries please contact the servicing branch of respective policies.

https://customer.onlinelic.in/LICEPS/appmanager/LICeService/LICeServiceHome?_... 18-10-2017

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