manish.

idealey

826855579_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Siwan Branch
LIC OF INDIA,SIWAN BR OFFICE
Transaction No : 39077733
NAI BAZAR,GOLPATTI,POST/DIST-
Date ( Time ): 01/03/2024 ( 18:28:28 ) BIHAR,841226
Email: BO_546@LICINDIA.COM
Receipt No : PR3907773300012324
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 14,648.34 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Manish Kumar Singh

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) (`) (`)
826855579 914 / 21 14,326.00 1 14,326.00 161.17 546
Manish Kumar 28/02/2021 HLY 02/24 0.00 161.17 08/24
No 02/24 0.00 14,648.34 10AAACL0582H2Z0
01932546 6,20,000

Page Total (`) 14,326.00 14,326.00 161.17

0.00 161.17
0.00 14,648.34
Grand Total (`) 14,326.00 14,326.00 161.17
0.00 161.17
0.00 14,648.34

FOURTEEN THOUSAND SIX HUNDRED FORTY EIGHT RUPEES AND THIRTY FOUR PAISE ONLY

Manish Kumar Singh

Consolidated Stamp Duty Paid
S/O-Anil Kumar Singh
Vill-Pipara-Po-Khedhay LOA/CSD/16/2023/4476 dtd 06/11/2023 valid from 10/11/2023 to
Via-Andar-Dt-Siwan Bihar

841231 Payment Acknowledgement generated through

Online Portal on 01-Mar-24 Time : 18:33:11.
Mobile: 93******95
Email: ma********es@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!