dr.

nitinpatel13

933372237_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Vasna Br Office
LIC OF INDIA,VASNA BR OFFICE 83N
Transaction No : 30433395
SILVER SHINE COMPLEX,VASNA
Date ( Time ): 30/12/2023 ( 22:14:34 ) AHMEDABAD,380007
Email: BO_83N@LICINDIA.COM
Receipt No : PR3043339500012324
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 14,097.06 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Tushar Gulabrao Deshmukh

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) (`) (`) (`)
933372237 914 / 18 13,490.00 1 13,490.00 303.53 83N
Tushar Gulabrao 20/03/2023 QLY 12/23 0.00 303.53 03/24
No 12/23 0.00 14,097.06 24AAACL0582H2ZR
0124584C 9,50,000

Page Total (`) 13,490.00 13,490.00 303.53

0.00 303.53
0.00 14,097.06
Grand Total (`) 13,490.00 13,490.00 303.53
0.00 303.53
0.00 14,097.06

FOURTEEN THOUSAND NINETY SEVEN RUPEES AND SIX PAISE ONLY

Tushar Gulabrao Deshmukh

Consolidated Stamp Duty Paid
Plot No. 32, Gate No. 10/2, Dandekar
Nagar, Pimparala , Jalgaon LOA/CSD/16/2023/4476 dtd 06/11/2023 valid from 10/11/2023 to
Maharashtra

425002 Payment Acknowledgement generated through

Online Portal on 30-Dec-23 Time : 22:15:31.
Mobile: 98******19
Email: dr********32@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!