Insurance Details Personal Details Name of the Life Insured Date of Birth Age at Entry Gender Nominee Details

Nominee Name : CH NAGA SRINIVAS : 03/08/1986 : 24 : MALE Coverage Details Master Policy : 128057222 Number Master Policy Name : BAJAJ FINANCE LTD Membership : 400BAL00105716 Number Loan Account : 4000CD00105714 Number Coverage Start Date : 13/12/2010 Sum Assured : 200000 Model Premium : 1215 Tenure : 2 Premium Mode : Single

: CH LAXMOMASWAMY Nominee Relationship: FATHER

COVER CONDITIONS 1.Bajaj Finance Ltd, the Master Policy Holder has proposed for Group Suraksha policy, on the life,of its members and the same has been agreed and accepted by the insurer Bajaj Allianz Life Insurance Co Ltd. 2.The Master Policy contract of this scheme is available at corporate office of Bajaj Allianz Life Insurance Co Ltd, GE Plaza,Airport Road, Pune-6 3.The Sum Assurance under the assurance is payable only on death of the life insured during currency of the coverage. The Benefits are strictly personal and cannot be assigned, charged.

Loan - Details Agreement No. Type Of Loan Loan Status Status As On Repayment Frequency Loan Amount. Disburse Amount

:400BAL00105716 :BALIC PREMIUM CD LOAN :Active :06/05/2011 :Monthly :1,215.00 :0.00

Repayment Mode Gross Tenor In Months Net Tenor In Months Balance Tenor In Months EMI Amount EMI Start Date EMI End Date

: ECS : 8 : 8 : 3 : 152.00 : 05/01/2011 : 05/08/2011