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Received With Thanks ' 9,545.04 Through Payment Gateway Over The Internet From

This document is a renewal premium receipt for an LIC insurance policy held by Patel Pritesh Kishankumar. It acknowledges receipt of Rs. 9,545.04 through an online payment gateway for renewal of policy number 874634991. The receipt provides details of the policy such as the plan, sum assured, premium amount paid, and next due date.

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Patel Prit
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37 views1 page

Received With Thanks ' 9,545.04 Through Payment Gateway Over The Internet From

This document is a renewal premium receipt for an LIC insurance policy held by Patel Pritesh Kishankumar. It acknowledges receipt of Rs. 9,545.04 through an online payment gateway for renewal of policy number 874634991. The receipt provides details of the policy such as the plan, sum assured, premium amount paid, and next due date.

Uploaded by

Patel Prit
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, Vadodara City

4th Flr Baroda Co-Op. Bank Building


Transaction No : 6192912
Near Paradise Complex
Date ( Time ): 17/05/2020 ( 09:27:58 ) Vadodara,390005
[email protected]
Receipt No : PR0619291200012021
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 9,545.04 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Patel Pritesh Kishankumar


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
Revival D.O.C. Sum Assured Due To CD Charges Total Amt Reg. No.
(Yes/No) (`) (`) (`)
874634991 836 9,335.00 1 9,335.00 105.02 876
Patel Pritesh 25 YLY 04/20 0.00 105.02 04/21
No 25/04/2016 04/20 0.00 9,545.04 24AAACL0582H2ZR
2,00,000

Page Total (`) 9,335.00 9,335.00 105.02


0.00 105.02
0.00 9,545.04
Grand Total (`) 9,335.00 9,335.00 105.02
0.00 105.02
0.00 9,545.04

NINE THOUSAND FIVE HUNDRED FORTY FIVE RUPEES AND FOUR PAISE ONLY

Patel Pritesh Kishankumar


Consolidated Stamp Duty Paid
I/202,2nd Floor,Viram -3
Maneja Jakatnaka CSD/323/2020/802/2020 DTD.20/02/2020
Vadodara

100000 Payment Acknowledgement generated through


Online Portal on 17-May-20 Time : 09:30:00.
Mobile: 7405329442
Email: [email protected]

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!

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