Collecting Branch : EPS1

E-mail : bo_eps1@licindia.com
Phone : +91-022-1251
Transaction No. : PR1434361900041516
Date ( Time ): 15/02/2016 ( 18:39:03 )

Servicing Branch : 68B

LIC of India,
Ramagundam Br Office P B No 26
Jyothi Nagar Opp Ntpc Ramagundam.
Karimnagar A P
Ramagundam
505215

RENEWAL PREMIUM ACKNOWLEDGEMENT

Received with thanks Rs. 17385.00 through Payment Gateway over the Internet from:
Smt./Ms./Shri : Guduru Swarna Latha
Towards the following
Policy No
Name
Agency Code
682751690

Plan
Term
D.O.C.
14
Swarnalatha G
20
15255652
15/06/2001
683429258
14
Swarnalatha G
20
15255652
01/09/2001
686173284
14
Swarnalatha G
10
0154168B
24/11/2011
807422093
827
Swarnalatha G
10
0154168B
20/02/2015
Page Total (Rs)

Grand Total (Rs)

Inst. Prem(Rs)
Mode
Sum Assured
1,326.00
QLY
1,00,000.00
928.00
QLY
70,000.00
1,567.00
QLY
55,000.00
13,323.00
YLY
1,50,000.00
17,144.00

17,144.00

No Of Inst
Due Fr
Due To
1
03/16
03/16
1
03/16
03/16
1
02/16
02/16
1
02/16
02/16

Total Premium
Late Fee
1,326.00
0.00
928.00
0.00
1,567.00
0.00
13,323.00
0.00
17,144.00
0.00
17,144.00
0.00

Service Tax
Edu Cess
Total Amt
0.00
0.00
1,326.00
0.00
0.00
928.00
0.00
0.00
1,567.00
241.00
0.00
13,564.00
241.00
0.00
17,385.00
241.00
0.00
17,385.00

Branch
Next Due
68B
06/16
68B
06/16
68B
05/16
68B
02/17

RUPEES SEVENTEEN THOUSAND THREE HUNDRED EIGHTY-FIVE ONLY

Guduru Swarna Latha
Teacher, W/O. Shenkaraiah
Q.No. T2-72. Power House Colony
Po Godavarikhani, Dtkarimnagar
505209

Payment Acknowledgement generated through Online

Portal on 15-Feb-2016 Time : 18:40:32.

This receipt is electronically generated.

Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi

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