Collecting Branch : EPS1 Servicing Branch : LIC of India, Bhilwara Br Office
Jeevan Raksha
Transaction No : 2106028
Bhopal Ganj Opp Jaswant
Date ( Time ): 29/04/2019 ( 17:50:49 ) Bhilwara,311001
[email protected]
Receipt No : PR0210602800011920
HelpDesk: +91-022-1251
RENEWAL PREMIUM RECEIPT
Received with thanks ` 18,760.84 through Payment Gateway over the Internet from:
Smt./Ms./Shri : Vaibhav Kumar Totla
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.
(`) (`) (`)
188508348 815 18,348.00 1 18,348.00 206.42 198
Vaibhav Kumar 16 HLY 04/19 0.00 206.42 10/19
04478198 18/04/2014 5,00,000 04/19 0.00 18,760.84
Page Total (`) 18,348.00 18,348.00 206.42
0.00 206.42
0.00 18,760.84
Grand Total (`) 18,348.00 18,348.00 206.42
0.00 206.42
0.00 18,760.84
EIGHTEEN THOUSAND SEVEN HUNDRED SIXTY RUPEES AND EIGHTY FOUR PAISE ONLY
Vaibhav Kumar Totla
Consolidated Stamp Duty Paid
S/O Gopal Lal Totla,Gopal Bhawan
Near Nilgaro Ki Masjid,Nala Bazar CSD/328/2019/646/19 DTD.15/02/2019
Bahla,Bhilwara
311001 Payment Acknowledgement generated through
Online Portal on 29-Apr-19 Time : 17:54:25.
Mobile: 9887917980
Email:
[email protected] This receipt is electronically generated and no signature is required.
Har Pal Aapke Saath!