Collecting Branch : EPS1 Servicing Branch : 114
E-mail : bo_eps1@licindia.com LIC of India, Delhi Br Unit 114
Phone : +91-022-1251 Sterling House, 15/16
Netaji Subhash Marg
Transaction No. : PR0092773900011415 Darya Ganj
New Delhi
Date ( Time ): 28/04/2014 ( 21:56:21 ) New Delhi 110002
RENEWAL PREMIUM RECEIPT
Received with thanks Rs. 5448.00 through Payment Gateway over the Internet from:
Smt./Ms./Shri : Dr.Anita Arora
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 Total Amt
120758828 93 5,448.00 1 5,448.00 0.00 114
Arora A 25 YLY 04/14 0.00 0.00 04/15
64829111 28/04/1998 1,00,000.00 04/14 5,448.00
Page Total (Rs) 5,448.00 5,448.00 0.00
0.00 0.00
5,448.00
Grand Total (Rs) 5,448.00 5,448.00 0.00
0.00 0.00
5,448.00
RUPEES FIVE THOUSAND FOUR HUNDRED FORTY-EIGHT ONLY
Dr.Anita Arora A.Mu.Sh.2014/486/C.R 64/M-1 Dated 17/02/2014
A-4/66 Konark Apptt.
Kalkaji Extn.
New Delhi 110019
This receipt is electronically generated.
Signature Not Verified
Digitally signed by Rekha Varshney
Date: April 28, 2014 9:56:21 PM IST
Reason: Premium Receipt
Location: LIC OF INDIA
Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi
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