Servicing Branch : 577

CALCUTTA CBO-17
LIC OF INDIA,KOLKATA CB NO 17
HINDUSTAN BLDG ANNEXE 3RD FLOOR.
Collecting Branch : PCMC 4 C R AVENUE CALCUTTA
Call Center (24X7) : 022 6827 6827
Transaction no. : 2257812 PIN:700072 Phone:
Date : 02/07/2022 Email: [email protected]

RENEWAL PREMIUM ACKNOWLEDGEMENT

through EBPP (Bill-

Received with thanks Rs. 6485.72 pay)
from Smt/Shri/Ms P
towards the following
Policy Number 458897021 Premium Due From 6/2022
Instalment Premium 6343.00 Premium Due Upto 6/2022
Premium Mode Yearly No. of Instalments 1
Plan, Term & PPT 815/20/20 Premium 6343.00
Date of Commence. 07/06/2016 Late Fee 0.00
Sum Assured 100000 CGST/SGST/UTGST 142.72
Next Premium Due on 07/06/2023
Total 6485.72

SUMAN PAL
1/11 NETAJI NAGAR
KOLKATA

PIN Code: 700092

This receipt is electronically generated

Mudrank: CSD/70/2022/2092

Kindly register your mobile no. for receiving your policy related information.
For SMS helpline, type LICHELP <policy-no> and send to 92224 92224

Har Pal Aapke Saath

 Servicing Branch : 577
CALCUTTA CBO-17
LIC OF INDIA,KOLKATA CB NO 17
HINDUSTAN BLDG ANNEXE 3RD FLOOR.
Collecting Branch : PCMC 4 C R AVENUE CALCUTTA
Call Center (24X7) : 022 6827 6827
Transaction no. : 1702065 PIN:700072 Phone:
Date : 14/06/2022 Email: [email protected]

RENEWAL PREMIUM ACKNOWLEDGEMENT

through EBPP (Bill-

Received with thanks Rs. 39069.00 pay)
from Smt/Shri/Ms PAL
towards the following
Policy Number 578382455 Premium Due From 5/2022
Instalment Premium 39069.00 Premium Due Upto 5/2022
Premium Mode Yearly No. of Instalments 1
Plan, Term & PPT 149/68/15 Premium 39069.00
Date of Commence. 19/05/2010 Late Fee 0.00
Sum Assured 500000 CGST/SGST/UTGST 0.00
Next Premium Due on 19/05/2023
GST Borne By LIC 879.06 Total 39069.00

SUMAN PAL
1/11, NETAJI NAGAR.
KOLKATA

PIN Code: 700092

This receipt is electronically generated

Mudrank: CSD/113/2022/1936 DTD

Kindly register your mobile no. for receiving your policy related information.
For SMS helpline, type LICHELP <policy-no> and send to 92224 92224

Har Pal Aapke Saath

 10-AUG-2022
Suman Pal
FLAT NO A3-011
DLF WESTEND HEIGHTS APARTS

BANGALORE
Karnataka-560068
Mobile No: 9051099226

Suman Pal Cash Advantage NA 18796712

SUMMARY OF PAYMENT DETAILS

Balance Dishonor Total
Next Premium Premium Balance Deposit
Date of Payment Premium Charges^ Premium Due
Policy Number Installment & (In `)
Receipt Mode Due (In `) (In `) (B) (In `)
Due on Frequency
(A) (C = A+B)
14826 / Website
14-07-2022 18796712 08-08-2023 0 0 0 0
YEARLY Payment

^ A charge of ` 150/- shall be levied in case of dishonor of premium payment. In ULIPs, this charge shall be deducted by way of cancellation of
units.

DETAILS OF THE POLICY PREMIUM PAID FOR FINANCIAL YEAR 2021 - 2022
Premium Total Premium
CGST^ SGST^ IGST^ CESS^ Eligible for
Amount** Paid
Policy Product/ @9% @9% @18% @1% Tax
Receipt no. In ` (A) In `
Number Rider Name In ` (B) In ` (C) In ` (D) In ` (E) Benefit*
F=(A)+(B)+(C)+
under
(D)+(E)
ICICI Pru Cash
18796712 L8219636 14500 0 0 326 0 14826 SEC 80 C
Advantage
Total Premium Paid ` 14826

GSTIN number of company for West Bengal : 19AAACI7351P1Z0

Place of Supply : Karnataka
HSN No. - 997132
Address of supplier : Flat No. 2B, 2nd Floor, Express Tower,42 A, Shakespeare Sarani, West Bengal, Kolkatta -700017

*Tax benefit on premium paid towards Life insurance policy u/s 80C, pension policy u/s 80CCC(1), health policy/ health related riders (if any) u/s
80D as per the conditions prescribed in the relevant sections of The Income Tax Act, 1961. Tax laws are subject to amendments made there from
time to time. UIN
105N132V01

**Premium amount is inclusive of reinstatement charges paid (If any).

^ Taxes and Cess (if any) is inclusive of tax on reinstatement charges (If any).
Please note:
• Premium paid in advance will be applied to the policy on premium due date.

• Premium due amount is considered from last unpaid premium.

• If the payment has been made other than in cash, this premium paid certificate is conditional upon credit in company's account post clearance
of the instrument/facility including electronic mode.
• For any confirmation / impact analysis customer is advised to refer the matter to his Tax consultant.

• CONSOLIDATED REVENUE STAMP DUTY PAID: NOTIFICATION NO - MUDRANK 2020 1466-22/06/2020.

• Goods and Service Tax and cess (if any) will be charged as per applicable rates and prevailing tax laws.
• Dishonor charges are inclusive of applicable Goods & Services Tax.

Registered Address: 1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai 400025. Reg No.: 105. CIN No.:L66010MH2000PLC127837. Call us on 1-860-266-7766
(10am-7pm, Monday to Saturday, except national holidays). Overseas customers can call us on +91 22 6193 0777. You can email us at [email protected]
or visit us at www.iciciprulife.com. UIN No. 105N132V01 COMP/DOC/Jul/2020/217/4017.
This is a system generated document, doesn’t require signature
 • Tax is not payable under reverse charge.

Registered Address: 1089, Appasaheb Marathe Marg, Prabhadevi, Mumbai 400025. Reg No.: 105. CIN No.:L66010MH2000PLC127837. Call us on 1-860-266-7766
(10am-7pm, Monday to Saturday, except national holidays). Overseas customers can call us on +91 22 6193 0777. You can email us at [email protected]
or visit us at www.iciciprulife.com. UIN No. 105N132V01 COMP/DOC/Jul/2020/217/4017.
This is a system generated document, doesn’t require signature
 suman_pal_78
@hotmail.com

417072190_1
Collecting Branch : EPS1 Servicing Branch : LIC of India, Gariahat Branch
LIC OF INDIA,GARIAHAT BRANCH
Transaction No : 25337100
GARIAHAT MUNICIPAL MKT
Date ( Time ): 16/11/2022 ( 12:40:17 ) KOLKATA,700019
Email: [email protected]
Receipt No : PR2533710000012223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 14,871.00 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Suman Pal

towards the following :

Policy No Plan / Term Inst. Premium No Of Inst Total Premium CGST Branch
Name D.O.C. Mode Due From Late Fee SGST/UTGST Next Due
Revival Sum Assured Due To CD Charges Total Amt Reg. No.
Agency Code
(Yes/No) (`) (`) (`)
417072190 159 / 26 14,871.00 1 14,871.00 0.00 41J
Shrestha Pal L/A 05/12/2006 YLY 12/22 0.00 0.00 12/23
No 12/22 0.00 14,871.00 19AAACL0582H1ZJ
1072541J 2,00,000

Page Total (`) 14,871.00 14,871.00 0.00

0.00 0.00
0.00 14,871.00
Grand Total (`) 14,871.00 14,871.00 0.00
0.00 0.00
0.00 14,871.00

GST borne by LIC of India ` 334.60

FOURTEEN THOUSAND EIGHT HUNDRED SEVENTY ONE RUPEES AND ZERO PAISE ONLY

Suman Pal
Suman Pal P , 1/11,Netaji Nagar,
Near Netaji Nagar College 1 No.Play Gr-
Ound ,Kolkata

700092 Payment Acknowledgement generated through

Online Portal on 21-Dec-22 Time : 15:11:06.
Mobile: 90******26
Email: su********[email protected]
For Payment related queries-Email: [email protected]

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!

 suman_pal_78
@hotmail.com

458897021_2
Collecting Branch : EPS1 Servicing Branch : LIC of India, Kolkata Cb No 17
LIC OF INDIA,KOLKATA CB NO 17
Transaction No : 4821364
HINDUSTAN BLDG ANNEXE 3RD
Date ( Time ): 11/05/2022 ( 22:19:25 ) ,700072
Email: [email protected]
Receipt No : PR0482136400022223
Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks ` 6,485.72 through Payment Gateway over the Internet from:

Smt./Ms./Shri : Suman Pal

towards the following :

Policy No Plan / Term Inst. Premium No Of Inst Total Premium CGST Branch
Name D.O.C. Mode Due From Late Fee SGST/UTGST Next Due
Revival Sum Assured Due To CD Charges Total Amt Reg. No.
Agency Code
(Yes/No) (`) (`) (`)
458897021 815 / 20 6,343.00 1 6,343.00 71.36 577
Suman Pal 07/06/2016 YLY 06/22 0.00 71.36 06/23
No 06/22 0.00 6,485.72 19AAACL0582H1ZJ
10245577 1,00,000

Page Total (`) 6,343.00 6,343.00 71.36

0.00 71.36
0.00 6,485.72
Grand Total (`) 6,343.00 6,343.00 71.36
0.00 71.36
0.00 6,485.72

SIX THOUSAND FOUR HUNDRED EIGHTY FIVE RUPEES AND SEVENTY TWO PAISE ONLY

Suman Pal
1/11 Netaji Nagar
Kolkata

700092 Payment Acknowledgement generated through

Online Portal on 21-Dec-22 Time : 15:11:06.
Mobile: 90******26
Email: su********[email protected]
For Payment related queries-Email: [email protected]

This receipt is electronically generated and no signature is required.

Har Pal Aapke Saath!