anand8074@g

617704607_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Basavangudi
LIC OF INDIA, BRANCH OFFICE - 61A
Transaction No : 18961612
NO.1 (OLD NO.8/9), 1ST
Date ( Time ): 26/09/2023 ( 18:06:40 ) BANGALORE.,560018
Email: BO_61A@LICINDIA.COM
Receipt No : PR1896161200012324
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 13,687.18 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Ananda. S. K.
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) (`) (`)
617704607 815 / 21 13,386.00 1 13,386.00 150.59 61A
Ananda 26/09/2016 HLY 09/23 0.00 150.59 03/24
No 09/23 0.00 13,687.18 29AAACL0582H2ZH
0157961A 5,00,000

Page Total (`) 13,386.00 13,386.00 150.59

0.00 150.59
0.00 13,687.18
Grand Total (`) 13,386.00 13,386.00 150.59
0.00 150.59
0.00 13,687.18

THIRTEEN THOUSAND SIX HUNDRED EIGHTY SEVEN RUPEES AND EIGHTEEN PAISE ONLY

Ananda. S. K.
S/O S.H.Krishnappa,Thippasandra Hobli
Near Gopalakrishna Swamy Temple
Sankighatta,Bangalore

562131 Payment Acknowledgement generated through

Online Portal on 18-Jan-24 Time : 21:06:18.
Mobile: 99******32
Email: an********74@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!