Collecting Center : A003 Branch Code : 70N

LIC of India, Chennai City Br Office-23

Transaction No. : 64850330 55, KALKI KRISHNAMURTHY ROAD
Thiruvanmiyur.
Date ( Time ): 29/10/2018 ( 13:05:35 ) Chennai, 600041
email: bo_70N@licindia.com
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks Rs. 13,221.36 from policyholder Shri/Smt.Kemila

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
706385126 165 12,250.00 1 12,250.00 8.73 70N
Kemila 15 QLY 09/18 97.00 8.73 12/18
0242670N 22/03/2013 10,00,000.00 09/18 0.00 12,364.46 33AAACL0582H1ZT
717985877 91 849.00 1 849.00 0.60 723
Jastinsekar S 16 QLY 09/18 6.70 0.60 12/18
01697723 22/03/2007 50,000.00 09/18 0.00 856.90 33AAACL0582H1ZT
Page Total (Rs) 13,099.00 13,099.00 9.33
103.70 9.33
0.00 13,221.36
Grand Total (Rs) 13,099.00 13,099.00 9.33
103.70 9.33
0.00 13,221.36

RUPEES THIRTEEN THOUSAND TWO HUNDRED TWENTY-ONE AND THIRTY-SIX PAISE ONLY
Paid by Cash/Card :13,221.36
Paid by Cheque :0.00
Cheque No :0
Cheque Date :

Kemila Consolidated Stamp Duty Paid

5/150, Pillaiyar Koil Street, CSD/64/2018/2366/18 dtd. 26/06/2018
Thuraipakkam,
Chennai,
600096. For Life Insurance Corporation of India,
Mobile: D M SUBRAMANIAN(07100002)
Email:

**GST borne by LIC of India is Rs 294.72

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