Collecting Branch : EPS1 Servicing Branch : 116

E-mail : bo_eps1@licindia.com LIC of India, Delhi 116

Phone : +91-022-1251 New Delhi Branch Unit 116
Lakshmi Insc Bldg 1st Flr Asaf Ali Rd.
Transaction No. : PR0733854000011617 New Delhi
Asaf Ali Road Cbo
Date ( Time ): 16/09/2016 ( 14:16:07 ) 110002

RENEWAL PREMIUM ACKNOWLEDGEMENT

Received with thanks Rs. 11448.90 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Rakesh Kumar & Rekha

Towards the following

Policy No Plan Inst. Prem(Rs) No Of Inst Total Premium Service Tax Branch
Name Term Mode Due Fr Late Fee Edu Cess Next Due
Agency Code D.O.C. Sum Assured Due To CD Charges Total Amt
125638081 89 11,359.00 1 11,359.00 0.00 116
Rakesh Kumar & 21 YLY 08/16 89.90 0.00 08/17
Rekha
05/08/2011 2,00,000.00 08/16 0.00 11,448.90
10739116
Page Total (Rs) 11,359.00 11,359.00 0.00
89.90 0.00
0.00 11,448.90
Grand Total (Rs) 11,359.00 11,359.00 0.00
89.90 0.00
0.00 11,448.90

RUPEES ELEVEN THOUSAND FOUR HUNDRED FORTY-EIGHT AND NINETY PAISE ONLY

Rakesh Kumar & Rekha Payment Acknowledgement generated through Online

H.No-32,Q-Block Mohan Garden Portal on 16-Sep-2016 Time : 14:29:10.
Uttam Nagar
Delhi
110059

This receipt is electronically generated.

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi

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