Collecting Center : A001 Branch Code : 43D

LIC of India, Jhargram Br Office

Transaction No. : 93019557 LIC OF INDIA,JHARGRAM BR OFFICE
RAGHUNATHPUR P O JHARGRAM
Date ( Time ): 23/02/2024 ( 13:59:14 ) W B, 721507
email: BO_43D@LICINDIA.COM
Call Center No: 022-68276827

RENEWAL PREMIUM RECEIPT

Received with thanks Rs. 7,036.00 from policyholder Shri/Smt.Somnath Mahata

towards the following policy/ies

Policy No Plan Inst. Prem(Rs) No Of Inst Total Premium CGST Branch | Agency
Name Term Mode Due Fr Late Fee SGST*/UTGST Code
Revival D.O.C. Sum Assured Due To CD Chgs + Total Amt Next Due
(Yes/No) Xcharge Reg. No.
459242455 807 6,881.00 1 6,881.00 77.41 43D |0177143D
Mahata S 14 YLY 02/24 0.00 77.41 02/25
No 13/02/2012 1,00,000.00 02/24 0.00 + 0.00 7,035.82 19AAACL0582H1ZJ
Page Total (Rs) 6,881.00 6,881.00 77.41
0.00 77.41
0.00 7,035.82
Grand Total (Rs) 6,881.00 6,881.00 77.41
0.00 77.41
0.00 7,035.82

RUPEES SEVEN THOUSAND THIRTY-SIX ONLY

Paid by Cash/Card/SR :0.00
Paid by Cheque :7,036.00
Cheque No/ChequeDate : 504622/22/02/2024

Somnath Mahata Consolidated Stamp Duty Paid

Vill Raghunathpur, Near Durgamaidan. LOA/CSD/16/2023/4476 dtd 06/11/2023 valid from
Po Jhargram 10/11/2023 to 30/06/2024
Dt Paschim Medinipur
721507.
Mobile: 919932988265 For Life Insurance Corporation of India,
Tapas Kr.Kundu(0055043D)

*SGST also includes cess amount of Rs. 0.00.

GST and Cess borne by LIC of India is Rs 0.00
This receipt is subject to realisation of cheque amount.

Check the authenticity of the receipt using following url: https://services.licindia.in/validatereceipt

Har Pal Aapke Sath!!