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Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi

Collecting Branch : EPS1


E-mail : bo_eps1@licindia.com
Phone : +91-022-1251
Transaction No. : PR0430722100011415
Date ( Time ): 01/08/2014 ( 10:10:49 )
Servicing Branch : 76H
LIC of India, Sathyamangalam Branch
P B No 15
Shiva Complex No 33-A Athani Rd.
Sathyamangalam T N
Sathyamangalam
Tamilnadu 638401
RENEWAL PREMIUM ACKNOWLEDGEMENT
Received with thanks Rs. 10000.00 through Payment Gateway over the Internet from:
Smt./Ms./Shri : S.Sineeya
Towards the following
Policy No
Name
Agency Code
Plan
Term
D.O.C.
Inst. Prem(Rs)
Mode
Sum Assured
No Of Inst
Due Fr
Due To
Total Premium
Late Fee
Service Tax
Edu Cess
Total Amt
Branch
Next Due
765355198
Sineeya S
1507976H
180
20
06/08/2007
10,000.00
YLY
1,00,000.00
1
08/14
08/14
10,000.00
0.00
0.00
0.00
10,000.00
76H
08/15
Page Total (Rs) 10,000.00 10,000.00
0.00
0.00
0.00
10,000.00
Grand Total (Rs) 10,000.00 10,000.00
0.00
0.00
0.00
10,000.00
FUND TYPE: Growth
UNITS ALLOCATED WILL BE INTIMATED SEPARATELY IN THIS POLICY. THE INVESTMENT RISK IN
INVESTMENT PORTFOLIO IS BORNE BY THE P/HOLDER.
RUPEES TEN THOUSAND ONLY
S.Sineeya
D/O K.Sivakumar
Panaimarathu Thottam,Ariappam Palayam Po
Sathy Tk
638402
Payment Acknowledgement generated through Online
Portal on 01-Aug-2014 Time : 10:12:14. Digitally Signed
Premium Receipt sent by email
This receipt is electronically generated.
Page 1of1
Digitally signed by Rekha Varshney
Date: August 1, 2014 10:12:15 AM IST
Reason: Premium Receipt
Location: LIC OF INDIA
Signature Not Verified

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