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Received With Thanks ' 5,753.78 Through Payment Gateway Over The Internet From

This document is a renewal premium receipt from LIC of India acknowledging receipt of Rs. 5,753.78 through an online payment gateway for an insurance policy. The payment is for policy number 128149641 held by Ashok Kumar with a sum assured of Rs. 1,50,000 and an annual premium of Rs. 5,506. The receipt provides key details of the policy such as the plan name, term, installment due, agent code, and next due date.

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Ashok Pal
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78 views

Received With Thanks ' 5,753.78 Through Payment Gateway Over The Internet From

This document is a renewal premium receipt from LIC of India acknowledging receipt of Rs. 5,753.78 through an online payment gateway for an insurance policy. The payment is for policy number 128149641 held by Ashok Kumar with a sum assured of Rs. 1,50,000 and an annual premium of Rs. 5,506. The receipt provides key details of the policy such as the plan name, term, installment due, agent code, and next due date.

Uploaded by

Ashok Pal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Collecting Branch : EPS1 Servicing Branch : LIC of India, 12f Br Office Delhi

Tirupati Balaji Bldg


Transaction No : 15150887
13/14 D D A Shopping Centre.,Pocket
Date ( Time ): 09/11/2018 ( 11:45:28 ) New Delhi,110091
[email protected]
Receipt No : PR1515088700011819
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 5,753.78 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Ashok Kumar


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.
(`) (`) (`)
128149641 814 5,506.00 1 5,506.00 123.89 12F
Ashok Kumar 15 HLY 11/18 0.00 123.89 05/19
0230112F 18/05/2018 1,50,000 11/18 0.00 5,753.78

Page Total (`) 5,506.00 5,506.00 123.89


0.00 123.89
0.00 5,753.78
Grand Total (`) 5,506.00 5,506.00 123.89
0.00 123.89
0.00 5,753.78

FIVE THOUSAND SEVEN HUNDRED FIFTY THREE RUPEES AND SEVENTY EIGHT PAISE ONLY

Ashok Kumar
Consolidated Stamp Duty Paid
23/176 Trilok Puri
Delhi CSD/64/2018/2366/18 dtd. 26/06/2018

110091 Payment Acknowledgement generated through


Online Portal on 09-Nov-18 Time : 11:47:20.
Mobile: 9873617058
Email: [email protected]

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!

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