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Collecting Branch : EPS1 Servicing Branch : LIC of India, Piler Branch

Cross Road Piler.


Transaction No : 1101245
Dist Chittoor,Andhra Pradesh
Date ( Time ): 15/04/2019 ( 07:56:14 ) Piler,517214
bo_eps1@licindia.com
Receipt No : PR0110124500011920
HelpDesk: +91-022-1251

RENEWAL PREMIUM RECEIPT

Received with thanks ` 21,147.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Mahesh Reddy Matavalam


towards the following :

Policy No Plan Inst. Premium No Of Inst Total Premium CGST Branch


Name Term Mode Due From Late Fee SGST/UTGST Next Due
Agency Code D.O.C. Sum Assured Due To CD Charges Total Amt Reg. No.
(`) (`) (`)
843182489 149 21,147.00 1 21,147.00 0.00 65T
M Mahesh 74 YLY 04/19 0.00 0.00 04/20
0036965T 11/04/2008 3,00,000 04/19 0.00 21,147.00

Page Total (`) 21,147.00 21,147.00 0.00


0.00 0.00
0.00 21,147.00
Grand Total (`) 21,147.00 21,147.00 0.00
0.00 0.00
0.00 21,147.00

GST borne by LIC of India ` 475.80

TWENTY ONE THOUSAND ONE HUNDRED FORTY SEVEN RUPEES AND ZERO PAISE ONLY

Mahesh Reddy Matavalam


Consolidated Stamp Duty Paid
H.No.8-3,Plot No.1,
S.V.U Non-Teaching Colony, CSD/328/2019/646/19 DTD.15/02/2019
Opp.Vidyanagar Colony,Tirupati.

517502 Payment Acknowledgement generated through


Online Portal on 15-Apr-19 Time : 07:58:09.
Mobile: 9487924370
Email: matavalam224@gmail.com

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!