Life Insurance Corporation of India Please SMS LICHELP <Policy Number> to

PCMC Department, Central Office, 9222492224 and for your LIC policy
Mumbai enquires (24*7), call on 022 - 68276827

Email: pcmc.cbk1@licindia.com

Renewal Premium Receipt

GST No.09AAACL0582HFZ6

Receipt No:9164917 Order Id:HGAAP159F90241584318 Name:Shivam Dubey

Policy Number:258891463 Date:05-08-2023 19:54:40 Amount:12285.34

Policy Details
Servicing LIC Branch Code 290

Instalment Premium 12015.0

Mode / Number Of Instalments Quarterly / 1

Due from - Due To 08/08/2023 - 08/08/2023

Total Premium 12015.0

CDA Charges 0.0

Late Fee 0.0

SGST / UTGST 135.17

CGST 135.17

Next Due 08/11/2023

Grand Total 12285.34

Mudrank Number CSD/113/2020/1936

** GST borne by LIC of India is Rs.0.0

This receipt is electronically generated and no signature is required.