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Vivek Lic

This receipt summarizes a life insurance policy renewal payment made through a collecting bank. The policy holder, Vivek Kumar, paid Rs. 7,953.90 towards renewal of policy number 559954963. The payment included a renewal premium of Rs. 7,439, a late fee of Rs. 294.50, and applicable GST of Rs. 220.40. The next premium due date for the policy is January 28, 2020.

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ranjeet kumar
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807 views

Vivek Lic

This receipt summarizes a life insurance policy renewal payment made through a collecting bank. The policy holder, Vivek Kumar, paid Rs. 7,953.90 towards renewal of policy number 559954963. The payment included a renewal premium of Rs. 7,439, a late fee of Rs. 294.50, and applicable GST of Rs. 220.40. The next premium due date for the policy is January 28, 2020.

Uploaded by

ranjeet kumar
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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Collecting Bank: CSC eGovernance Services India Ltd.

Branch Code: CBK1 Branch Code : CSC316654230012


PCMC,Network Operating Center,
Reciept No. : 3034162
1st Floor,Jeevan Seva Annexe, Date: 2019-12-21 18:24:26
S.V.Road,Santacruz(W), Mumbai-400054
Ref. No.: LICI1920000025004800
SMS: LICHELP "Policy Number" to 9222492224 CSC Ref. No.: 9355182420207465
Phone: +91-022-1251
Email: [email protected]
GSTN: N

RENEWAL PREMIUM RECIEPT

Received With Thanks Rs. 7,953.90 Through CSC EGovernance Services India Ltd. , Retailer ID: 316654230012
Policy Holder: Shri/Smt. Vivek Kumar
towards the following policy

CGST Branch
Plan Inst. Premium No. of Inst. Total Premium
Policy No.
SGST/UTGST Next Due
Term Mode Due From Late Fee
Name
Total Amt (Rs) Reg. No.
D.O.C Sum Assured (Rs) Due To CDA Charges
Agency Code

559954963 7,439.00 1 7,439.00 110.20 51A

Vivek Kumar Half Yearly 28/07/2019 294.50 110.20 28/01/2020

28/07/2019 0.00 220.40 10AAACL0582H2Z0

7,439.00 110.20
Page Total (Rs) 7,439.00 294.50 110.20
0.00 220.40

7,439.00 110.20
Grand Total (Rs) 7,439.00 294.50 110.20
0.00 220.40

In Words (Rupees) : Seven Thousand, Nine Hundred Fifty-Three Rupees And Nine Paise

Mudrank No.: CSD/328/2019/646/19 dtd. 15/02/2019

Retailer Signature
Retailer ID : 316654230012
Kunal Kumar

LIC PREMIUM PAYMENT FACILITY IS FREE OF COST. POLICY HOLDERS NEED NOT TO PAY ANY EXTRA AMOUNT AS SERVICE CHARGE OF
RETAILER/FRANCHISEES

Retailer : CSC e-Governanace Services India Ltd. 238, Okhla Industrial State, Phase-III, New Delhi-110020
Computer generated receipt. Receipt validity subject to payment realization.
PRINTED ON | 21-12-2019 18:24:28

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