Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi

Collecting Branch : EPS1

E-mail : bo_eps1@licindia.com
Phone : +91-022-1251
Transaction No. : PR0723537800011314
Date ( Time ): 25/11/2013 ( 21:00:51 )
Servicing Branch : 43F
LIC of India, Egra Br Office
P O Egra.
Dist Midnapore
Egra
721429
RENEWAL PREMIUM ACKNOWLEDGEMENT
Received with thanks Rs. 1028.00 through Payment Gateway over the Internet from:
Smt./Ms./Shri : Tulasi Ghorai.
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
433087697
T.Ghorai.
0049343F
14
20
25/05/1999
1,028.00
HLY
40,000.00
1
11/13
11/13
1,028.00
0.00
0.00
0.00
1,028.00
43F
05/14
Page Total (Rs) 1,028.00 1,028.00
0.00
0.00
0.00
1,028.00
Grand Total (Rs) 1,028.00 1,028.00
0.00
0.00
0.00
1,028.00
RUPEES ONE THOUSAND TWENTY-EIGHT ONLY
Tulasi Ghorai.
C/O-Badal Chandra Ghorai
At-Mallickpur
Po-Balighai Dt-Mid
Payment Acknowledgement generated through Online
Portal on 25-Nov-2013 Time : 21:04:23. Digitally Signed
Premium Receipt sent by email
This receipt is electronically generated.
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