Collecting Center : A001 Branch Code : 113

LIC of India, Branch Office 113

Transaction No. : 83853846 Jeevan Tara Bldg. Gate No.4 Ist Floor
5 Parliament Street.
Date ( Time ): 18/01/2018 ( 23:21:59 ) New Delhi, 110001
email: bo_113@licindia.com
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks Rs. 3,988.00 from policyholder Shri/Smt.Sachin Kumar

towards the following policy/ies

Policy No Plan Inst. Prem(Rs) No Of Inst Total Premium CGST Branch

Name Term Mode Due Fr Late Fee SGST/UTGST Next Due
Agency D.O.C. Sum Assured Due To CD Chgs Total Amt Reg. No.
Code
116975071 820 3,870.00 1 3,870.00 43.88 113
Sachin S 20 QLY 12/17 30.60 43.88 03/18
86181111 08/03/2014 2,00,000.00 12/17 0.00 3,988.36 07AAACL0582H1ZO
Page Total (Rs) 3,870.00 3,870.00 43.88
30.60 43.88
0.00 3,988.36
Grand Total (Rs) 3,870.00 3,870.00 43.88
30.60 43.88
0.00 3,988.36

RUPEES THREE THOUSAND NINE HUNDRED EIGHTY-EIGHT ONLY

Paid by Cash/Card :0.00
Paid by Cheque :3,988.00
Cheque No :40220
Cheque Date :18/01/2018

Sachin Kumar Consolidated Stamp Duty Paid

A - 1 Nihfw Campus
Munirka
New Delhi For Life Insurance Corporation of India,
110067. Smt Punam Batra(86181111)
Mobile:
Email:

**GST borne by LIC of India is Rs 0.00

This receipt is subject to realisation of cheque amount.

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi