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 2023-2024

DATE OF ISSUE :09/01/2024

The following premium has been received for life insurance policies of Parthiban S

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 (`) (`)
325267827 01/04/2023 1 B071
01/01/2022 4,970.00 111.82 07/04/2023
Parthiban S 01/04/2023 Mly 71X

325267827 01/05/2023 1 B071

01/01/2022 4,970.00 111.82 07/05/2023
Parthiban S 01/05/2023 Mly 71X

325267827 01/06/2023 1 B071

01/01/2022 4,970.00 111.82 07/06/2023
Parthiban S 01/06/2023 Mly 71X

325267827 01/07/2023 1 EPS1

01/01/2022 4,970.00 134.32 15/07/2023
Parthiban S 01/07/2023 Mly 71X

325267827 01/08/2023 1 B071

01/01/2022 4,970.00 111.82 07/08/2023
Parthiban S 01/08/2023 Mly 71X

325267827 01/09/2023 1 B071

01/01/2022 4,970.00 111.82 07/09/2023
Parthiban S 01/09/2023 Mly 71X

325267827 01/10/2023 1 B071

01/01/2022 4,970.00 111.82 07/10/2023
Parthiban S 01/10/2023 Mly 71X

325267827 01/11/2023 1 B071

01/01/2022 4,970.00 111.82 07/11/2023
Parthiban S 01/11/2023 Mly 71X

325267827 01/12/2023 1 B071

01/01/2022 4,970.00 111.82 07/12/2023
Parthiban S 01/12/2023 Mly 71X

325267827 01/01/2024 1 B071

01/01/2022 4,970.00 111.82 07/01/2024
Parthiban S 01/01/2024 Mly 71X
All the above payments are subject to cheque realisation, wherever applicable.

Total amount received towards premium for the policies listed above is ` 49,700.00 for the financial year
2023-2024.

Total amount received towards Service Tax / GST for the policies listed above is ` 1140.70 for the financial
year 2023-2024.

* 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.