suhasrenu85@

726827997_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Mandya Branch
LIC OF INDIA,MANDYA BRANCH
Transaction No : 12056376
BANDIGOWDA LAY
Date ( Time ): 19/07/2022 ( 17:11:51 ) ,571401
Email: BO_618@LICINDIA.COM
Receipt No : PR1205637600012223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 969.95 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Suhash.H.R
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) (`) (`) (`)
726827997 836 / 21 940.00 1 940.00 11.25 618
Suhash.H.R 28/01/2018 MLY 06/22 7.45 11.25 07/22
Yes 06/22 0.00 969.95 29AAACL0582H2ZH
0049872D 2,00,000

Page Total (`) 940.00 940.00 11.25

7.45 11.25
0.00 969.95
Grand Total (`) 940.00 940.00 11.25
7.45 11.25
0.00 969.95

NINE HUNDRED SIXTY NINE RUPEES AND NINETY FIVE PAISE ONLY

Suhash.H.R
S/O Renukumar.H.C, 19
Nalwadikrishnaraja Badavane,Kaluwe Road
Kiragandur,Mandya

571403 Payment Acknowledgement generated through

Online Portal on 19-Jul-22 Time : 17:13:41.
Mobile: 97******16
Email: su********85@gmail.com
For Payment related queries-Email: bo_eps1@licindia.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!