Collecting Branch : EPS1 Servicing Branch : LIC of India, Moradabad

BO-II,
Transaction No : 21369401
Ram Ganga Vihar,,Phase-II, Sonakpur,
Date ( Time ): 21/01/2019 ( 20:10:58 ) Moradabad,244001
bo_eps1@licindia.com
Receipt No : PR2136940100011819
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 17,172.88 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Prasoon Lata

towards the following :

Policy No Plan Inst. Premium No Of Inst Total Premium CGST Branch

Name Term Mode Due From Late Fee SGST/UTGST Next Due
Agency Code D.O.C. Sum Assured Due To CD Charges Total Amt Reg. No.
(`) (`) (`)
258180438 815 16,795.00 1 16,795.00 188.94 404
Prasoon Lata 15 YLY 12/18 0.00 188.94 12/19
01741404 28/12/2014 2,00,000 12/18 0.00 17,172.88

Page Total (`) 16,795.00 16,795.00 188.94

0.00 188.94
0.00 17,172.88
Grand Total (`) 16,795.00 16,795.00 188.94
0.00 188.94
0.00 17,172.88

SEVENTEEN THOUSAND ONE HUNDRED SEVENTY TWO RUPEES AND EIGHTY EIGHT PAISE ONLY

Prasoon Lata
Consolidated Stamp Duty Paid
W/O Sh Akhilesh Sharma
H.No-1335,Sec-2,Buddhi Vihar CSD/64/2018/2366/18 dtd. 26/06/2018
Majhola,Moradabad

244001 Payment Acknowledgement generated through

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Email: apktrd@gmail.com

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