Life Insurance Corporation of India

PCMC,Network Operating Center

1st Floor,Jeevan Seva Annexe
S.V. Road,SantaCruz(W)
Mumbai - 400 054

PREMIUM PAID STATEMENT FOR THE YEAR 2021-2022

DATE OF ISSUE :17/05/2022

The following premium has been received for life insurance policies of Mareedu Kishore Babu

Premium/ Service
Number of Tax / GST
Instalments Additional Received
Policy Number Date Of Due From Amount Coll. Br.
and Premium Date
Policy Holder's Name Commence. Due To Received * Serv. Br.
Payment Amount
mode (`) (`)
659574622 01/05/2021 1 CBK1
01/03/2021 7,600.00 352.84 18/05/2021
Mareedu Kishore Babu 01/05/2021 Mly 69A

659574622 01/06/2021 1 CBK1

01/03/2021 7,600.00 342.00 27/05/2021
Mareedu Kishore Babu 01/06/2021 Mly 69A

659574622 01/07/2021 1 CBK1

01/03/2021 7,600.00 342.00 25/06/2021
Mareedu Kishore Babu 01/07/2021 Mly 69A

659574622 01/08/2021 1 B064

01/03/2021 7,600.00 342.00 07/08/2021
Mareedu Kishore Babu 01/08/2021 Mly 69A

659574622 01/09/2021 1 B064

01/03/2021 7,600.00 342.00 07/09/2021
Mareedu Kishore Babu 01/09/2021 Mly 69A

659574622 01/10/2021 1 B064

01/03/2021 7,600.00 342.00 07/10/2021
Mareedu Kishore Babu 01/10/2021 Mly 69A

659574622 01/11/2021 1 B064

01/03/2021 7,600.00 342.00 07/11/2021
Mareedu Kishore Babu 01/11/2021 Mly 69A

659574622 01/12/2021 1 B064

01/03/2021 7,600.00 342.00 07/12/2021
Mareedu Kishore Babu 01/12/2021 Mly 69A

659574622 01/01/2022 1 B064

01/03/2021 7,600.00 342.00 07/01/2022
Mareedu Kishore Babu 01/01/2022 Mly 69A

659574622 01/02/2022 1 B064

01/03/2021 7,600.00 342.00 07/02/2022
Mareedu Kishore Babu 01/02/2022 Mly 69A

659574622 01/03/2022 1 B064

01/03/2021 7,600.00 171.00 07/03/2022
Mareedu Kishore Babu 01/03/2022 Mly 69A
All the above payments are subject to cheque realisation, wherever applicable.

Total amount received towards premium for the policies listed above is ` 83,600.00 for the financial year
2021-2022.

Total amount received towards Service Tax / GST for the policies listed above is ` 3601.84 for the financial
year 2021-2022.

* Please note GST is applicable from 1st July, 2017.

This document is electronically generated. In case of any queries, please send SMS as follows -- type "LICHELP
<policy no>" and send it to 9222492224. Our Customerzone Official will get in touch with you shortly.