CO02, LIC Of India, Central Office - MBAC (Hub)

4th Floor,Jeevan Seva Annexe Bldg,Santa Cruz (W),Mumbai-400054

Tel: 022-26100350/331/338, Email: co_mbac-hub@licindia.com

LIC Branch Code 719 Bank Sol Id 0756

LIC Branch Address

LIC OF INDIA, BRANCH OFFICE - 719

45, JAWAHARLAL NEHRU ROAD,

OPP. GOVT HOSPITAL

THIRUVALLUR 602001

BO_719@LICINDIA.COM

Agency Code 80001884(IDBI Bank Ltd) S.P. Code SP0135305261

Access Id 616812816 CRM Id 386781

Name D KANNIDEVATHEERTHAN

Email ibkl0000756@idbi.co.in Mobile No. 8122936003

Plan-Policy Term 852-10 Premium Paying Term 10

Mode Yearly NACH Indication D

Sum Proposed 500000 PAN Details DSEPS7061A

PROPOSAL DEPOSIT RECEIPT

Received with thanks Rs. 50000 from

Smt./ Ms./ Shri : D KANNIDEVATHEERTHAN

towards the following :

Transaction No. : 30952 Date (Time) : 22/07/2022 16:25:12

BOC Number : 30952 Proposal Deposit (Rs.) : 50000

Amount in Words : Fifty Thousand

Receipt of payment made online is issued subject to realisation

ACCEPTANCE OF THIS DEPOSIT DOES NOT MAKE THE CORPORATION LIABLE FOR ACCEPTANCE OF RISK

We may mention that your risk will be covered only after all the above documents and Medical / Special Reports are received and
accepted to the satisfaction of our underwriters. Hence, you are requested to kindly expedite the same.

This receipt is electronically generated.

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi

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