Life Insurance Corporation of India
PCMC, Network Operating Center
1st Floor, Jeevan Seva Annexe
S.V. Road, Santacruz(W)
Mumbai 400 054
PREMIUM PAID CERTIFICATE FOR THE YEAR
2015-2016 DATE OF ISSUE: 12/02/2013
This is to certify that the following premium have been received under the following
life insurance by Mr. Shoeb Ahmed Siraj Ahmed Ansari
Name
Policy Number
Plan
Policy Term
Premium Paying Term
Commencement Date
Instalment Premium
Mode of Premium Payment
Reference Code
Due
Due To Numbers of
From
Instalments
06/2015 06/2015 1
Mr. Shoeb Ahmed Siraj Ahmed Ansari
31L2-000104226/44/00/000
75(The Money Back Policy 20 Years)
20
20
28/06/2013
70,205.00
YLY
Premium Amount
Received
70,205.00
Received
Date
11/06/2015
Collecting
Branch
60B
Total amount received towards premium for the policy number
Is Rs. 70,205.00 for the financial year 2015-2016
Status
Normal