Benefit Illustration

LIC's Dhan Rekha (T-863)

A Non-Linked, Non-Participating, Individual, Savings, Life Insurance Plan
(Unique Identification Number - 512N343V01)

Distribution channel Offline Agency name Agency code

Name of prospect AYAN DUTTA Age of prospect 34 Date of illustration 28-12-2021
Name of life assured AYAN DUTTA Age of life assured 34 Benefit UID 211228215349270957
Policy term 20 Premium paying term 1 Premium payment mode Single
Basic sum assured 1000000 Sum assured on death 1250000 Single premium 722050.00
Gender of life assured Female

Premium summary
Particular Base plan Riders1 Total single premium
Single premium without GST 722050.00 722050.00
Single premium with GST @ 4.50% 754542.00 754542.00
GST rate shall be as applicable from time to time

This benefit illustration is intended to show year-wise premiums payable and benefits under the policy.

Page 1
 (Amount in rupees)

Guaranteed benefits
Policy year (end of the year) Single premium2 Minimum guaranteed
Survival benefit Guaranteed additions Maturity benefit Death benefit3 surrender benefit
(1) (2) (3) (4) (5) (6) (7)
1 722050 0 0 0 1250000 541538

2 0 0 0 0 1250000 541538

3 0 0 0 0 1250000 541538

4 0 0 0 0 1250000 649845

5 0 0 0 0 1250000 649845

6 0 0 50000 0 1300000 658635

7 0 0 100000 0 1350000 667425

8 0 0 150000 0 1400000 676335

9 0 0 200000 0 1450000 685545

10 0 100000 250000 0 1500000 695245

11 0 0 300000 0 1550000 605645

12 0 0 350000 0 1600000 616975

13 0 0 400000 0 1650000 629565

14 0 0 450000 0 1700000 643670

15 0 100000 500000 0 1750000 659795

16 0 0 550000 0 1800000 578435

17 0 0 600000 0 1850000 600145

18 0 0 650000 0 1900000 625735

19 0 0 700000 0 1950000 659845

20 0 0 750000 1750000 2000000 712345

Notes:

The main objective of the illustration is that the client is able to appreciate the features of the product and the flow of the benefit with some level of quantification. This
illustration is applicable to a standard (from medical, life style and occupation point of view) life.

1. It includes rider(s) premiums in respect of all the rider(s) opted by the proposer/policyholder at inception of the policy.
2. Single premium excludes underwriting extra premium, the premiums paid towards the riders, if any, and goods & service tax. Refer sales literature for explanation of
terms used in this illustration.
3. In any case, the total death benefit at any time shall not be less than 125% of the single premium paid (excluding GST, extra premium and rider premiums, if any).

Page 2
 4. Special surrender value may however be payable, if it is more favourable to the policyholder. Special surrender value are subject to revision from time to time only after
prior approval of the regulator.

I, ________________________________________ (name), have explained the I, ________________________________________ (name), having received

premiums, charges and benefits under the policy fully to the prospect the information with respect to the above, have understood the above
/policyholder. statemement before entering into the contract.
Place : Place :
Date : Signature of agent/intermediary/official Date : Signature of prospect/policyholder

Page 3