Lic receipt 766

Page 1

Servicing Branch : LIC of India, Churu Branch

Collecting Branch : EPS1

Jeevan Jyoti Opp Govt. D.B. Hospital Churu Dist.,Rajasthan Churu,331001 bo_eps1licindia.com HelpDesk: +91-022-1251

Transaction No : 6884295 Date ( Time ): 14/08/2017 ( 08:11:22 ) Receipt No :

PR0688429500011718

RENEWAL PREMIUM RECEIPT Received With Thanks ` 766.00 through Payment Gateway over the Internet from: Smt./Ms./Shri :

Singh B

Towards The Following : Policy No Name Agency Code

Plan Term D.O.C.

Inst. Premium Mode Sum Assured

No Of Inst Due From Due To

Total Premium Late Fee CD Charges

(`)

(`) 502202408 Bhawani Singh

165 10

01822186

28/11/2008

766.00

1

Qly

08/17

766.00 0.00

62,500.00

08/17

0.00

Tax* Total Amt Reg. No.

Branch Next Due

(`) 0.00

186

766.00

11/17

Page Total (`)

766.00

766.00 0.00 0.00

0.00 766.00

Grand Total (`)

766.00

766.00 0.00

0.00 766.00

0.00

SEVEN HUNDRED SIXTY SIX RUPEES AND ZERO PAISE ONLY Singh B

Consolidated Stamp Duty paid

S/O.Sh.Mangu Singh Shekhawat C/O Sh.Chhagansingh Rathore Vip.Kanrapura Po.Ladariya,Churu 331029 Mobile: 7014501532 Email: bssbhawanisingh@gmail.com

Payment Acknowledgement generated through Online Portal on 14-Aug-17 Time : 08:13:43.

*Tax here indicates Goods and Service Tax (GST) from 01/07/2017 or Service Tax prior to 01/07/2017.

This receipt is electronically generated. Har Pal Aapke Saath! Page 0 of 1


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