mohammedmh

d652@gmail.c

318706595_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Nagarcoil Br I
LIC OF INDIA,NAGARCOIL BR I
Transaction No : 32673955

Date ( Time ): 16/01/2024 ( 08:23:31 ) NAGERCOIL,629001

Email: BO_754@LICINDIA.COM
Receipt No : PR3267395500012324
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 11,908.04 through Payment Gateway over the Internet from:

Smt./Ms./Shri : A.Mohammed Mahadi

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) (`) (`) (`)
318706595 836 / 25 11,437.00 1 11,437.00 144.97 754
A.Mohammed 26/11/2019 QLY 11/23 181.10 144.97 02/24
Yes 11/23 0.00 11,908.04 33AAACL0582H1ZT
02645754 10,00,000

Page Total (`) 11,437.00 11,437.00 144.97

181.10 144.97
0.00 11,908.04
Grand Total (`) 11,437.00 11,437.00 144.97
181.10 144.97
0.00 11,908.04

ELEVEN THOUSAND NINE HUNDRED EIGHT RUPEES AND FOUR PAISE ONLY

A.Mohammed Mahadi
Consolidated Stamp Duty Paid
3/54a,Aysha Shalih Cottage
Eravi Puthur Kadai,Kuru Vilai Kadu LOA/CSD/16/2023/4476 dtd 06/11/2023 valid from 10/11/2023 to
Kattathurai P.O., K K District

629158 Payment Acknowledgement generated through

Online Portal on 16-Jan-24 Time : 08:24:12.
Mobile: 63******20
Email: mo********52@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!