1

phoolsinghkan

358715552_1

Collecting Branch : EPS1 Servicing Branch : LIC of India, Naila Branch

LIC OF INDIA,
Transaction No : 29288114
M.L.T.COMPLEX,LINK
Date ( Time ): 24/12/2023 ( 10:21:42 ) ,495668
Email: BO_38A@LICINDIA.COM
Receipt No : PR2928811400022324
Call Center No: 022 6827 6827

DEPOSIT RECEIPT FOR ADVANCE PREMIUM

Received with thanks ` 17,624.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Sri Phul Singh Kanwar

towards Advance Premium payment for the following policy/ies:

Policy No Plan Inst. Premium No Of Inst Total Premium Branch

Name Term Mode Due From CGST Reg. No.
Agency Code D.O.C. Sum Assured Due To SGST/UTGST Total Amt
(`) (`) (`)
358715552 179 17,624.00 1 17,624.00 38A
Phool Singh 20 YLY 01/24 0.00 22AAACL0582H2ZV

0095038A 24/01/2012 5,00,000 01/24 0.00 17,624.00

Page Total (`) 17,624.00 17,624.00

0.00
Sri Phul Singh Kanwar 0.00 17,624.00
Grand Total (`) 17,624.00 17,624.00
0.00
0.00 17,624.00

GST borne by LIC of India ` 396.54

SEVENTEEN THOUSAND SIX HUNDRED TWENTY FOUR RUPEES AND ZERO PAISE ONLY

The above mentioned Deposit amount for advance premium will get adjusted as Renewal Premium on next due date of
policy/ies.
Sri Phul Singh Kanwar
At.Dhanpur
Po.Nagarda,Via.Sakti
Dist Janjgir Champa Cg

495668 Payment Acknowledgement generated through

Online Portal on 24-Dec-23 Time : 10:23:21.
Mobile: 95******77
Email: ph********09@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!

 1
phoolsinghkan

381810042_2

Collecting Branch : EPS1 Servicing Branch : LIC of India, Naila Branch

LIC OF INDIA,
Transaction No : 29288114
M.L.T.COMPLEX,LINK
Date ( Time ): 24/12/2023 ( 10:21:42 ) ,495668
Email: BO_38A@LICINDIA.COM
Receipt No : PR2928811400022324
Call Center No: 022 6827 6827

DEPOSIT RECEIPT FOR ADVANCE PREMIUM

Received with thanks ` 3,840.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Sri Phul Singh Kanwar

towards Advance Premium payment for the following policy/ies:

Policy No Plan Inst. Premium No Of Inst Total Premium Branch

Name Term Mode Due From CGST Reg. No.
Agency Code D.O.C. Sum Assured Due To SGST/UTGST Total Amt
(`) (`) (`)
381810042 179 3,840.00 1 3,840.00 38A
Shri Phool Singh 20 YLY 03/24 0.00 22AAACL0582H2ZV

0095038A 23/03/2007 1,05,000 03/24 0.00 3,840.00

Page Total (`) 3,840.00 3,840.00

0.00
Sri Phul Singh Kanwar 0.00 3,840.00
Grand Total (`) 3,840.00 3,840.00
0.00
0.00 3,840.00

GST borne by LIC of India ` 86.40

THREE THOUSAND EIGHT HUNDRED FORTY RUPEES AND ZERO PAISE ONLY

The above mentioned Deposit amount for advance premium will get adjusted as Renewal Premium on next due date of
policy/ies.
Sri Phul Singh Kanwar
At.Dhanpur
Po.Nagarda,Via.Sakti
Dist Janjgir Champa Cg

495668 Payment Acknowledgement generated through

Online Portal on 24-Dec-23 Time : 10:23:21.
Mobile: 95******77
Email: ph********09@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!