akashdas.

1916
25@gmail.com

857341141_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Dhanbad Branch
LIC OF INDIA,DHANBAD BRANCH
Transaction No : 38490117
ICA BLDG OPP HOWRAH MOTOR
Date ( Time ): 03/03/2023 ( 20:06:13 ) DHANBAD,826001
Email: BO_55A@LICINDIA.COM
Receipt No : PR3849011700012223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 43,397.96 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Akash Das

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) (`) (`) (`)
857341141 915 / 25 42,443.00 1 42,443.00 477.48 55A
Akash Das 28/02/2022 YLY 02/23 0.00 477.48 02/24
No 02/23 0.00 43,397.96 20AAACL0582H1Z0
0075855A 10,00,000

Page Total (`) 42,443.00 42,443.00 477.48

0.00 477.48
0.00 43,397.96
Grand Total (`) 42,443.00 42,443.00 477.48
0.00 477.48
0.00 43,397.96

FORTY THREE THOUSAND THREE HUNDRED NINETY SEVEN RUPEES AND NINETY SIX PAISE
ONLY

Akash Das
Consolidated Stamp Duty Paid
S/O-Rajesh Kumar Das
Q. No.-R N K-4-242 Rangamati Near LOA/CSD/526/4822 DTD- 14.11.2022 valid from 16.12.2022 to
D A V School Sindri Dhanbad Jharkh

828122 Payment Acknowledgement generated through

Online Portal on 03-Mar-23 Time : 20:08:49.
Mobile: 87******47
Email: ak********25@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!