Collecting Center : A002 Branch Code : 231

LIC of India, Kanpur District Br 231

Transaction No. : 26404921 Shivoy Tower M G Marg
P B No.284.
Date ( Time ): 17/07/2020 ( 12:01:47 ) Kanpur , 208001
email: bo_231@licindia.com
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks Rs. 14,781.28 from policyholder Shri/Smt.Pallavi Saxena

towards the following policy/ies

Policy No Plan Inst. Prem(Rs) No Of Inst Total Premium CGST Branch | Agency
Name Term Mode Due Fr Late Fee SGST*/UTGST Code
Revival D.O.C. Sum Assured Due To CD Chgs + Total Amt Next Due
(Yes/No) Xcharge Reg. No.
234792804 165 14,412.00 1 14,412.00 20.54 231 |0048523C
Saxena 16 YLY 04/20 328.20 20.54 04/21
Yes 10/04/2009 3,00,000.00 04/20 0.00 + 0.00 14,781.28 09AAACL0582HFZ6
Page Total (Rs) 14,412.00 14,412.00 20.54
328.20 20.54
0.00 14,781.28
Grand Total (Rs) 14,412.00 14,412.00 20.54
328.20 20.54
0.00 14,781.28

RUPEES FOURTEEN THOUSAND SEVEN HUNDRED EIGHTY-ONE AND TWENTY-EIGHT PAISE

ONLY Paid by Cash/Card/Sr :14,781.28
Paid by Cheque :0.00
Cheque No/ChequeDate : 0/

Pallavi Saxena Consolidated Stamp Duty Paid CSD/

D/O Sri Anoop Kumar Saxena 323/2020/1707/2020 DTD.17/07/2020
H.No.451,Meerpur Cantt.
Kanpur For Life Insurance Corporation of India,
208004. S B Shukla(232722)
Mobile:

*SGST also includes cess amount of Rs. 0.00.

GST and Cess borne by LIC of India is Rs 324.28

Har Pal Aapke Sath!!