EPS1 Servicing Branch : LIC of India,

Collecting Branch : Jammalamadugu

9132559 Nagireddy Street.

Transaction No : Jammalamadugu,Cu
ddapah Dist. Ap.
Date ( Time ): Receipt No : 16/08/2019 ( 18:50:06 ) J
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RENEWAL PREMIUM RECEIPT

Received with thanks ₹ 150000 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Udaya Kumar B

 towards the following :
Plan Inst. No Of Inst Total CGST Branch
Policy No
Term Premiu Due From Premium SGST/UTGST Next Due
Name D.O.C. Due To Total Amt
m Mode Late Fee Reg. No.
Agency Sum CD Charges
Code Assured

(₹) (₹) (₹)

165 150000 1 150000 0.00 65R
6566037
20 YLY 08/19 0.00 0.00 08/20
75
Udaya
Kumar

0178465R 22/08/2017 15,00,000 08/19 0.00

150000

150000 0.00
Page Total (₹) 150000 0.00
0.00 150000
0.00
0.00
Grand Total (₹) 150000 0.00
150000
150000
0.00
0.00

GST borne by LIC of India ₹ 6750

ONE LAKH AND FIFTY THOUSAND ONLY

Udaya Kumar B Consolidated Stamp Duty

S/O B. Padma Nabha Reddy,19/12, Etteri (V), Paid
G.D Nellore(M) Chittoor(D),517125.
CSD/64/2018/2366/18 dtd.
16/08/2019

Payment Acknowledgement generated through

Online Portal on 16-Aug-19 Time : 18:52:50.
Mobile: 9113803680
Email: udaykuamr85@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!