vishjaiswal400

283692355_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Varanasi District
LIC OF INDIA,VARANASI DISTRICT BR
Transaction No : 27411080
Chhavi Complex,
Date ( Time ): 08/12/2023 ( 21:26:14 ) VARANASI,221002
Email: BO_292@LICINDIA.COM
Receipt No : PR2741108000012324
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 6,200.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Mr. Vishal Jaiswal

towards the following :

Policy No Plan / Term Inst. Premium No Of Inst Total Premium CGST Branch
Name D.O.C. Mode Due From Late Fee SGST/UTGST Next Due
Revival Sum Assured Due To CD Charges Total Amt Reg. No.
Agency Code
(Yes/No) (`) (`) (`)
283692355 75 / 20 6,200.00 1 6,200.00 0.00 292
Mr. Vishal 28/11/2004 YLY 11/23 0.00 0.00
No 11/23 0.00 6,200.00 09AAACL0582HFZ6
05921292 1,00,000

Page Total (`) 6,200.00 6,200.00 0.00

0.00 0.00
0.00 6,200.00
Grand Total (`) 6,200.00 6,200.00 0.00
0.00 0.00
0.00 6,200.00

GST borne by LIC of India ` 139.50

SIX THOUSAND TWO HUNDRED RUPEES AND ZERO PAISE ONLY

Mr. Vishal Jaiswal

Consolidated Stamp Duty Paid
Smt Baby Jaiswal P
J 8/72, Digiya, LOA/CSD/16/2023/4476 dtd 06/11/2023 valid from 10/11/2023 to
Jaitpura, Varanasi

221001 Payment Acknowledgement generated through

Online Portal on 08-Dec-23 Time : 21:28:06.
Mobile: 83******57
Email: vi********00@gmail.com
For Payment related queries-Email: bo_eps1@licindia.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!