manojup61@g

312253538_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Allahabad District
LIC OF INDIA,ALLAHABAD DISTRICT
Transaction No : 22474942
INDIRA BHAWAN, 4TH FLOOR,CIVIL
Date ( Time ): 20/10/2022 ( 10:35:59 ) ALLAHABAD,211001
Email: BO_242@LICINDIA.COM
Receipt No : PR2247494200012223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 1,019.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Manoj Kushwaha

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) (`) (`) (`)
312253538 179 / 20 1,019.00 1 1,019.00 0.00 242
Manoj 23/12/2006 QLY 09/22 0.00 0.00 12/22
No 09/22 0.00 1,019.00 09AAACL0582HFZ6
06531242 1,10,000

Page Total (`) 1,019.00 1,019.00 0.00

0.00 0.00
0.00 1,019.00
Grand Total (`) 1,019.00 1,019.00 0.00
0.00 0.00
0.00 1,019.00

GST borne by LIC of India ` 22.92

ONE THOUSAND NINETEEN RUPEES AND ZERO PAISE ONLY

Manoj Kushwaha
33 Dhooman Ganj
Allahabad
Allahabad.

211001 Payment Acknowledgement generated through

Online Portal on 20-Oct-22 Time : 10:45:39.
Mobile: 98******63
Email: ma********61@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!