Collecting Branch : EPS1 Servicing Branch : LIC of India, Mandi Br Office

Jagjit Complex Palace Colony

Transaction No : 13263169
Hospital Road Mandi.,H P
Date ( Time ): 10/10/2018 ( 17:34:40 ) Mandi,175001
bo_eps1@licindia.com
Receipt No : PR1326316900011819
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 413.90 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Sunel Kumar Sharma

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.
(`) (`) (`)
150883157 75 408.00 1 408.00 0.45 167
Sunel Kumar 20 QLY 09/18 5.00 0.45 12/18
01049167 08/03/2000 25,000.00 09/18 0.00 413.90

Page Total (`) 408.00 408.00 0.45

5.00 0.45
0.00 413.90
Grand Total (`) 408.00 408.00 0.45
5.00 0.45
0.00 413.90

GST borne by LIC of India ` 9.18

FOUR HUNDRED THIRTEEN RUPEES AND NINETY PAISE ONLY

Sunel Kumar Sharma

S/O Sh Chander Mani
Vill Kathwari P/O Tikkar
Distt Mandi H.P

175006 Payment Acknowledgement generated through

Online Portal on 10-Oct-18 Time : 17:36:48.
Mobile: 7018059139
Email: suneel.mnd@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!