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Collecting Branch : EPS1

E-mail : bo_eps1@licindia.com
Phone : +91-022-1251

Servicing Branch : 67C


LIC of India, Br Office, P B No 14
P B No. 14 Kota Vari Street
Railpet.
Repalle (Ap)
Repalle
522265

Transaction No. : PR1097887800011516


Date ( Time ): 16/12/2015 ( 07:24:06 )

RENEWAL PREMIUM ACKNOWLEDGEMENT


Received with thanks Rs. 7338.00 through Payment Gateway over the Internet from:
Smt./Ms./Shri : Chitte Hari Prasad
Towards the following
Policy No
Name
Agency Code
676381441

Plan
Term
D.O.C.
149
Prasad Chh
72
0067767C
15/12/2009
Page Total (Rs)

Grand Total (Rs)

Inst. Prem(Rs)
Mode
Sum Assured
7,338.00
HLY
2,00,000.00
7,338.00

No Of Inst
Due Fr
Due To
1
12/15
12/15

Total Premium
Late Fee
7,338.00
0.00
7,338.00
0.00

7,338.00

7,338.00
0.00

Service Tax
Edu Cess
Total Amt
0.00
0.00
7,338.00
0.00
0.00
7,338.00
0.00
0.00
7,338.00

Branch
Next Due
67C
06/16

RUPEES SEVEN THOUSAND THREE HUNDRED THIRTY-EIGHT ONLY


Chitte Hari Prasad
S/O Ch P Rangaiah
C/O Ch Murali Krishna,D No 6-280,
Dwaraka Nagar,Tirupathi,Chittor D
517505

Payment Acknowledgement generated through Online


Portal on 28-Dec-2015 Time : 15:37:16.

This receipt is electronically generated.

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi


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