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Life Insurance Corporation of India

PCMC, Network Operating Center
1st Floor, Jeevan Seva Annexe
S.V.Road, Santacruz(W)
Mumbai - 400 054
PREMIUM PAID CERTIFICATE FOR THE YEAR 2014-2015
DATE OF ISSUE: 04/02/2015

This is to certify that the following premium have been received under the
following life insurance policy held by Bhalerao Vikrant Hemant
Name

Bhalerao Vikrant Hemant

Policy Number

959249184

Plan

165(Jeevan Saral)

Policy Term

20

Premium Paying Term

20

Commencement Date

28/10/2010

Instalment Premium

2,042.00

Mode Of Premium Payment

MLY

Reference Code

92169254

Due
From

Premium Amount Received

Received
Date

Collecting
Branch

Status

04/2014 04/2014 1

2,042.00

28/04/2014

B095

Normal

05/2014 05/2014 1

2,042.00

28/05/2014

B095

Normal

06/2014 06/2014 1

2,042.00

28/06/2014

B095

Normal

07/2014 07/2014 1

2,042.00

28/07/2014

B095

Normal

08/2014 08/2014 1

2,042.00

28/08/2014

B095

Normal

09/2014 09/2014 1

2,042.00

29/09/2014

B095

Normal

10/2014 10/2014 1

2,042.00

28/10/2014

B095

Normal

Due To

Number Of
Instalments

11/2014 11/2014 1

2,042.00

28/11/2014

B095

Normal

12/2014 12/2014 1

2,042.00

29/12/2014

B095

Normal

01/2015 01/2015 1

2,042.00

28/01/2015

B095

Normal

Total amount received towards premium for the policy number 959249184
is Rs. 20,420.00 for the financial year 2014-2015

This certificate is electronically generated

04-02-2015 09:58