Mr.

Manoj Krishnani,

Cashback Pension Solution is a combination solution consisting of multiple policies of Kotak Assured Savings Plan (UIN No.: 107N081V01) and Kotak Lifetime
Income Plan (UIN No.: 107N103V02). These product are also available without this combination solution.

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 Pay Rs. 100,000/-* per annum for
only 10 years.

1 ......... 9 10 ......... 15 16 .......................... 56

You will receive ANNUAL regular pension of Rs.

133,788/- during your lifetime from 16th policy year.

Savings

Mr. Manoj Krishnani, at present when you are young, energetic and your
income earning capacity is high, we propose that you save Rs. 100,000*
every year for the next 10 years in this solution. This solution will provide
an umbrella of security to your family by providing you with a life cover
for first 15 years of the policy, of Rs. 1,110,000 in 1st policy year and it
increases during premium paying term.
*Service tax extra.

Regular
Pension
After 15 years when you reach the golden age of 59 years, it’s time for you
to relax and reap the fruits of your savings. Your pension will start now.
From here on you will receive Rs. 133,788 every year during your
lifetime.

The illustration shown is for annuity rates as on 14th November 2018. The pension will depend on annuity rates prevailing at the time of inception
for actual pension payment.

MySolutions : Cashback Pension Report Date : 16/03/2019

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 Proposer Name : Mr. Manoj Krishnani Proposer's Age : 44 yrs.

Benefit Illustration

End Of Annual Death

Year Age Premium Benefit Maturity Value Annuity^

1 45 100,000 1,110,000 - -
2 46 100,000 1,130,000 - -
3 47 100,000 1,160,000 - -
4 48 100,000 1,200,000 - -
5 49 100,000 1,250,000 - -
6 50 100,000 1,310,000 - -
7 51 100,000 1,380,000 - -
8 52 100,000 1,460,000 - -
9 53 100,000 1,550,000 - -
10 54 100,000 1,650,000 - -
11 55 - 1,650,000 - -
12 56 - 1,650,000 - -
13 57 - 1,650,000 - -
14 58 - 1,650,000 - -
15 59 - 1,650,000 1,502,560 -
16 - 59 - - - - 133,788
lifetime lifetime
^ Annuity is calculated on the Maturity Value.

Products behind the solution**

Policy Payment Payment Modal Sum

Product 1 Term Term Mode Premium* Assured Maturity

Kotak Assured Savings Plan 15 10 Yearly 100,000 793,800 1,502,560

Annuity Annuity Purchase Price* Annuity

Product 2 Option Mode Income
Kotak Lifetime Income Plan Lifetime Income Yearly 1,502,560 133,788
** The above illustration has been calculated for a 44 years old healthy Male

Advertisement Disclaimers :
“This advertisement is designed for combination of benefits of two or more individual and separate products name Kotak Assured Savings Plan and Kotak
Lifetime Income Plan (as applicable) etc. The customer has the choice of purchasing any one or more product as per his/her need and choice and there is no
compulsion whatsoever that these product are to be taken together as suggested by the insurer and presented in this advertisement. The customer is
expected to ask questions, understand and satisfy himself that the condition meets his/her specific needs better before deciding to purchase the combination.
This benefit illustration is the arithmetic combination and chronological listing of combined benefits of individual products. The customer is advised to refer the
detailed sales brochure of respective individual products mentioned herein”

Other Disclaimers :

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1) This combination solution comprises of set of policies across one or more products of the company. These products - Kotak Assured Savings Plan UIN
No.: 107N081V01 and Kotak Lifetime Income Plan UIN No.: 107N103V02 are also available individually with the Company and it is not mandatory for me to
apply for this combination only. Kotak Assured Savings Plan is a non-linked limited premium paying non-participating endowment plan. Kotak Lifetime
Income Plan is a non-linked non-participating annuity plan.
2) The benefits available under the combination solution shall be as per the respective product’s policy terms and conditions.
3) The benefit of this combination solution shall become payable only if all premiums for the entire premium payment term are paid in full, as the case may
be, and the policy is in force.
4) Annuity rates are not guaranteed and are subject to change from time to time. The actual Annuity amount will depend on the prevailing annuity rates at the
time of purchase of Annuity. The current illustration is based on Annuity Rates as on 14th November 2018.
5) *The above premium figures are exclusive of Goods and Services Tax and Cess, as applicable are levied at the applicable Tax rates in accordance with
the prevailing Tax Laws. Prevailing tax laws are applicable on this policy which may vary from time to time.

6) TDS at prevailing rate will be deducted from any amount paid under a life insurance policy subject to the provisions of prevailing tax laws. In case of non-
availability of valid PAN, TDS will be deducted at higher rate. Tax laws are subject to changes from time to time. Kindly consult your tax advisor for tax
implication of your policy.

7) The values shown are for illustrative purposes only. For more details on risk factors, terms and conditions please read sales brochure carefully before
concluding a sale.

8) You have the flexibility to choose any of the annuity options offered by the company at the time of vesting of the product i.e start of the annuity phase of
the combo solution.
9) Based on the combination option selected, after paying all premiums for the full premium payment term, the maturity amount will get automatically
transferred to the identified annuity product and the default annuity option will be Lifetime Income Annuity.
10) You have option to withdraw the maturity amount in lump sum.
11) It will be your responsibility to contact the company for selection of any options available at the time of maturity. At maturity additional confirmation
including documents necessary at that time will be required for processing.

12) Trade Logo displayed above belongs to Kotak Mahindra Bank Limited and is used by Kotak Mahindra Life Insurance Company Limited under
license

To know the details of each plan of this combination solution, please go through the benefit illustrations of individual products as provided to you.

BEWARE OF SPURIOUS / FRAUD PHONE CALLS

IRDAI is not involved in activities like selling insurance policies, announcing bonus or investment of premiums. Public receiving such phone calls
are requested to lodge a police complaint.

Kotak Assured Savings Plan UIN No.: 107N081V01, Form No.: N081 Kotak Lifetime Income Plan UIN No.: 107N103V02, Form No.: N103.
Ref No.: KLI/17-18/E-PB/508
Kotak Mahindra Life Insurance Company Ltd.,
CIN: U66030MH2000PLC128503
Regn. No.: 107, Regd. Office: 2nd Floor, Plot # C- 12, G- Block, BKC, Bandra (E), Mumbai- 400 051
Website: http://insurance.kotak.com | Email: clientservicedesk@kotak.com | Toll Free No.: 1800 209 8800

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 Customer Declaration Letter Cum Proposal Form Addendum

I/we Mr.Manoj Krishnani , declare & understand that I have opted for the MySolutions Cashback Pension, a combination solution offered by Kotak Life Insurance. This
combination solution consists of the products Kotak Assured Savings Plan UIN No.: 107N081V01 and Kotak Lifetime Income Plan UIN No.: 107N103V02. I have filled
the proposal form and request you to process the Proposal Numbers _______________________ and have also submitted all required documents.

I understand that this combination solution comprises of set of policies across one or more products of the company. I have been made aware that these products are
also available individually with the company and it is not mandatory for me to apply for this combination only.

I have separately gone through the product brochure of the above products and have taken the decision to opt for this combination solution after having fully understood
the risk factors, product terms and conditions.

I understand that the benefit of this combination solution shall become payable only if I continue to pay premiums for the entire policy term / premium payment term.

I understand that the annuity rates are not guaranteed and hence are subject to change from time to time. The actual annuity amount will depend on the prevailing
annuity rates at the time of purchase of annuity.

I understand that, I shall have the flexibility to choose any of the annuity options offered by the company at the maturity of base plan i.e. start of the annuity phase of the
combo solution.

I understand that based on the combination option selected after paying all premiums for the full term / premium payment term, the maturity amount will get
automatically transferred to the identified annuity product and the default annuity option will be Lifetime Income Annuity.

I also understand that I have option to withdraw the maturity amount in lump sum.

I understand that, it will be my responsibility to contact the company for any change in selection of any of the above mentioned options at the time of maturity. At the
maturity, additional confirmation including necessary documents at that time will be required for processing.

I declare that I have answered the questions in the proposal form to which this addendum is attached, after fully understanding the nature of the questions and the
importance of disclosing all information while answering such questions. I further declare that the details given by me to all the questions in this addendum to the
proposal form are true and complete in every respect and that I have not withheld any material information or suppressed any fact. I further understand that the details
given in the addendum shall form part of the proposal form. I understand that all polices of this combination solution will either be converted or declined collectively, as
per the underwriting rules of the company.

I declare that the contents in the proposal form, this addendum to the proposal form and documents forming part of this proposal form have been fully explained to me
and I have fully understood the significance of the proposed contract for each plan.

Date: ___________________________

Place: ___________________________
Signature of Life Assured Signature of Proposer
(If different from Proposer)

Section 41 of the Insurance Act, 1938 states:

1. No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take or renew or continue an insurance in respect of any
kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the policy,
nor shall any person taking out or renewing or continuing a policy accept any rebate, except such rebate as may be allowed in accordance with the published
prospectuses or tables of the insurer.
2. Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakhs rupees.

Section 38, 39 & 45 of the Insurance Act, 1938 states:

The above Proposal will be governed by the provisions of Section 38, Section 39 and Section 45 of the Insurance Act, 1938 and amendments thereto from time to time.

Kotak Mahindra Life Insurance Company Ltd.,

CIN: U66030MH2000PLC128503. Regn. No.: 107, Regd. Office: 2nd Floor, Plot # C- 12, G- Block, BKC, Bandra (E), Mumbai- 400 051.
Website: http://insurance.kotak.com Email: clientservicedesk@kotak.com. Toll Free No. - 1800 209 8800.