suryasan@yah

694709054_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, JEEVAN
2ND FLOOR,DIVISIONAL OFFICE
Transaction No : 18084934
JEEVAN
Date ( Time ): 18/09/2023 ( 09:35:53 ) ,530004
Email: BO_69A@LICINDIA.COM
Receipt No : PR1808493400012324
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 26,556.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Surya Narayana

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) (`) (`)
694709054 149 / 67 26,556.00 1 26,556.00 0.00 69A
Vedula Venkata 21/08/2008 YLY 08/23 0.00 0.00 08/24
No 08/23 0.00 26,556.00 37AAACL0582H2ZK
0181569A 5,00,000

Page Total (`) 26,556.00 26,556.00 0.00

0.00 0.00
0.00 26,556.00
Grand Total (`) 26,556.00 26,556.00 0.00
0.00 0.00
0.00 26,556.00

GST borne by LIC of India ` 597.52

TWENTY SIX THOUSAND FIVE HUNDRED FIFTY SIX RUPEES AND ZERO PAISE ONLY

Surya Narayana
S/O Ramasasthry,Dr.No.39-23-28/1
Vamsinagar,Madhavadhara
Visakhapatnam

530007 Payment Acknowledgement generated through

Online Portal on 06-Feb-24 Time : 00:55:25.
Mobile: 94******81
Email: su********an@yahoo.com
For Payment related queries-Email: bo_eps1@licindia.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!