Collecting Center : A001 Branch Code : 28L

LIC of India, Khalilabad Branch Off 28L

Transaction No. : 69966144 Khalilabad.
Dist Basti
Date ( Time ): 30/11/2017 ( 13:39:14 ) Khalilabad, 0
email: bo_28L@licindia.com
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks Rs. 1,723.90 from policyholder Shri/Smt.Tillu

towards the following policy/ies

Policy No Plan Inst. Prem(Rs) No Of Inst Total Premium Tax * Branch

Name Term Mode Due Fr Late Fee Total Amt Next Due
Agency Code D.O.C. Sum Assured Due To CD Chgs Reg. No.
293824550 179 1,696.00 1 1,696.00 1.00 28L
Tillu T 12 HLY 09/17 26.90 1,723.90 03/18
0135828L 18/09/2006 50,000.00 09/17 0.00
Page Total (Rs) 1,696.00 1,696.00 1.00
26.90 1,723.90
0.00
Grand Total (Rs) 1,696.00 1,696.00 1.00
26.90 1,723.90
0.00

RUPEES ONE THOUSAND SEVEN HUNDRED TWENTY-THREE AND NINETY PAISE ONLY
Paid by Cash/Card :1,723.90
Paid by Cheque :0.00
Cheque No :0
Cheque Date :

Tillu Consolidated Stamp Duty Paid

S/O-Sri Ram Adharey
Vill-Bakerganj,Po-Pachpokhari Bazar
Ditt-Sant Kabir Nagar For Life Insurance Corporation of India,
272178. Phool Chandra Mishra(0037528L)
Mobile:
Email:

*Tax here indicates Goods and Services Tax(GST) from 1 July 2017 or Service Tax prior to 1 July 2017.

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