Zindagi Ke Saath Bhi, Zindagi Ke Baad Bhi

Collecting Branch : EPS1E-mail : bo_eps1@licindia.comPhone : +91-022-1251

Transaction No. : PR0173721700011516

Date ( Time ): 16/05/2015 ( 09:00:44 )

Servicing Branch : 92HLIC of India, Kopri Branch OfficeBhivra Bhavan Nr Mangala Hindi HighSchool Above Thane Janata Sahakari BankThane (East) Dist-ThaneThane(East)Maharashtra

RENEWAL PREMIUM RECEIPT

Received with thanks Rs. 7292.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Shri.Hande Pramod Bhimrao

Towards the following

Policy NoName

Agency Code

PlanTerm

D.O.C.

Inst. Prem(Rs)Mode

Sum Assured

No Of InstDue FrDue To

Total PremiumLate Fee

Service TaxEdu CessTotal Amt

BranchNext Due

922992838Hande P B

0093892H

15279

28/05/2004

7,292.00YLY

2,00,000.00

105/1505/15

7,292.000.00

0.000.00

7,292.00

92H05/16

Page Total (Rs) 7,292.00 7,292.000.00

0.000.00

7,292.00Grand Total (Rs) 7,292.00 7,292.00

0.000.000.00

7,292.00

RUPEES SEVEN THOUSAND TWO HUNDRED NINETY-TWO ONLY

Shri.Hande Pramod Bhimrao305,Deep Chs Ltd,Plot No.44Sector No.14,Koparkhairane,Navi-Mumbai400702

A.Mu.Sh.2015/610/CR 157/M-1 Dated 04/04/2015

This receipt is electronically generated.

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