Life Insurance Corporation of India

PCMC,Network Operating Center

1st Floor,Jeevan Seva Annexe
S.V. Road,SantaCruz(W)
Mumbai - 400 054

PREMIUM PAID STATEMENT FOR THE YEAR 2018-2019

DATE OF ISSUE :02/12/2018

The following premium has been received for life insurance policies from the userid of Mrs Usha V Yewale

Premium/
Number of Additional Received Collecting Servicing
Instalments Premium Date Branch Branch
Policy No. Name Dt. Of Due Due To and
Commencement From Amount
Payment Received
mode (`)
Mrs Usha V 10/12/2008 10/04/2018 10/04/2018 1 1,021.00 E089
905981968 20/04/2018 912
Yewale Mly

Mrs Usha V 10/12/2008 10/05/2018 10/05/2018 1 1,021.00 E089

905981968 17/05/2018 912
Yewale Mly

Mrs Usha V 10/12/2008 10/06/2018 10/06/2018 1 1,021.00 E089

905981968 19/06/2018 912
Yewale Mly

Mrs Usha V 10/12/2008 10/07/2018 10/07/2018 1 1,021.00 E089

905981968 18/07/2018 912
Yewale Mly

Mrs Usha V 10/12/2008 10/08/2018 10/08/2018 1 1,021.00 E089

905981968 23/08/2018 912
Yewale Mly

Mrs Usha V 10/12/2008 10/09/2018 10/09/2018 1 1,021.00 E089

905981968 21/09/2018 912
Yewale Mly

Mrs Usha V 10/12/2008 10/10/2018 10/10/2018 1 1,021.00 E089

905981968 19/10/2018 912
Yewale Mly

Mrs Usha V 10/12/2008 10/11/2018 10/11/2018 1 1,021.00 E089

905981968 19/11/2018 912
Yewale Mly

All the above payments are subject to cheque realisation, wherever applicable.

Total amount received towards premium for the policies listed above is ` 8,168.00 for the financial year 2018-
2019.

This document is electronically generated. In case of any queries, please send SMS as follows -- type "LICHELP
<policy no>" and send it to 9222492224. Our Customerzone Official will get in touch with you shortly.