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RenewalPremium 35616458

This document is a receipt for the renewal premium payment of Rs. 14,371.05 made through an online payment gateway by Deekshith La for two life insurance policies. The payment is for the renewal of Policy Nos. 616066903 and 616066904 with LIC of India, with a total sum assured of Rs. 5,00,000. The receipt acknowledges receipt of the payment amount along with details of the policies, insured person, and payment transaction.

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Raghavendra Chinnu
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96 views1 page

RenewalPremium 35616458

This document is a receipt for the renewal premium payment of Rs. 14,371.05 made through an online payment gateway by Deekshith La for two life insurance policies. The payment is for the renewal of Policy Nos. 616066903 and 616066904 with LIC of India, with a total sum assured of Rs. 5,00,000. The receipt acknowledges receipt of the payment amount along with details of the policies, insured person, and payment transaction.

Uploaded by

Raghavendra Chinnu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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mr.

raghubs@r

We observe

Collecting Branch : EPS1 Servicing Branch : LIC of India, Bangalore DAB


LIC OF INDIA,BANGALORE DAB
Transaction No : 35616458
DIRECT AGENTS BRANCH (CITY BR
Date ( Time ): 09/02/2023 ( 10:22:15 ) J.C.ROAD BANGALORE,,560002
Email: BO_610@LICINDIA.COM
Receipt No : PR3561645800022223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 14,371.05 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Deekshith La
towards the following :

Policy No Plan / Term Inst. Premium No Of Inst Total Premium CGST Branch
Name D.O.C. Mode Due From Late Fee SGST/UTGST Next Due
Revival Sum Assured Due To CD Charges Total Amt Reg. No.
Agency Code
(Yes/No) (`) (`) (`)
616066903 184 / 22 8,414.00 1 8,414.00 4.50 610
Deekshith La 28/12/2013 HLY 12/22 49.99 4.50 06/23
Yes 12/22 0.00 8,472.99 29AAACL0582H2ZH
00000 3,00,000

616066904 185 / 22 5,857.00 1 5,857.00 3.13 610


Deekshith La 28/12/2013 HLY 12/22 34.80 7.63 06/23
Yes 12/22 0.00 5,898.06 29AAACL0582H2ZH
00000 2,00,000

Page Total (`) 14,271.00 14,271.00 7.63


84.79 7.63
0.00 14,371.05
Grand Total (`) 14,271.00 14,271.00 7.63
84.79 7.63
0.00 14,371.05

GST borne by LIC of India ` 321.10 Late Fee Waived : ` 16.66

FOURTEEN THOUSAND THREE HUNDRED SEVENTY ONE RUPEES AND FIVE PAISE ONLY

Deekshith La
Consolidated Stamp Duty Paid
S/O. B.S. Raghavendra Prop ,
S/O. Sahadeva Rao Bagawadi, Hosahalli , LOA/CSD/526/4822 DTD- 14.11.2022 valid from 16.12.2022 to
Honnali Taluk, Davanagere District

577243 Payment Acknowledgement generated through


Online Portal on 09-Feb-23 Time : 10:23:24.
Mobile: 81******38
Email: mr********bs@rediffmail.com
This receiptbo_eps1@licindia.com
For Payment related queries-Email: is electronically generated and no signature is required.

Har Pal Aapke Saath!

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