Benefit Illustration for SHRIRAM LIFE SUPER INCOME PLAN V03

UIN: 128N087V03

(This Benefit Illustration forms part of the Policy Document)

Name: surbhi garg Sum Assured: 1500000.00

Date Of Birth: 27/01/1996 Policy Term: 49
Age (in yrs): 26 PPT: 15
Gender: Female Mode: Yearly

Guaranteed Non Guaranteed

Survival Benefits/  Guaranteed 
 Policy   Total Annualised Other Benefits If Special Surrender 
Loyalty Additions Maturity Benefit Death Benefit Surrender Benefit
Year  Premiums paid till date Any Benefit 
   
1 150000 - - 1500000 0 -
2 150000 - - 1500000 90000 59359
3 150000 - - 1500000 157500 105227
4 150000 - - 1500000 300000 161888
5 150000 - - 1500000 375000 232040
6 150000 - - 1500000 522000 314063
7 150000 - - 1500000 693000 411736
8 150000 - - 1500000 900000 518042
9 150000 - - 1500000 1134000 641077
10 150000 - - 1575000 1410000 782459
11 150000 - - 1732500 1633500 937872
12 150000 - - 1890000 1872000 1120266
13 150000 - - 2125500 2125500 1325864
14 150000 - - 2394000 2394000 1541175
15 150000 - - 2700000 2700000 1780770
16 216012 - 2812500 2812500 1910280
17 216012 - 2776488 2776488 1985356
18 216012 - 2740476 2740476 2053519
19 216012 - 2704464 2704464 2122216
20 216012 - 2668452 2668452 2183569
21 216012 - 2609940 2609940 2237577
22 216012 - 2573928 2573928 2291039
23 216012 - 2537916 2537916 2336725
24 216012 - 2479404 2479404 2381001
25 216012 - 2443392 2443392 2417068
26 216012 - 2450861 2384880 2450861
27 216012 - 2476014 2326368 2476014
28 216012 - 2492526 2267856 2492526
29 216012 - 2505683 2231844 2505683
30 216012 - 2509769 2173332 2509769
31 216012 - 2509636 2114820 2509636
32 216012 - 2499998 2056308 2499998
33 216012 - 2480856 1975296 2480856
34 216012 - 2456416 1916784 2456416
35 216012 - 2422039 1858272 2422039
36 216012 - 2381500 1777260 2381500
37 216012 - 2362500 1696248 2330592
38 216012 - 2362500 1615236 2269316
39 216012 - 2362500 1534224 2200797
40 216012 - 2362500 1453212 2124388
41 216012 - 2362500 1349700 2034052
42 216012 - 2362500 1246188 1935393
43 216012 - 2362500 1142676 1827764
44 216012 - 2362500 1016664 1708470
45 216012 - 2362500 890652 1577512
46 216012 - 2362500 742140 1436503
47 216012 - 2362500 593628 1276407
48 216012 - 2362500 422616 1105192
49 216012 750000 2362500 251604 923507

Disclosures:
(1)This is only an illustration and does not in any way create any rights and/or obligations.
(2) This Illustration is applicable to a healthy individual and acceptance of the proposal is subjected to underwriting.Premiums relating to
riders and non-standard risks are excluded from the above.
(3) The above amounts that all premiums have been paid on due date.
(4) The surrender value payable will be the maximum of GSV and SSV.
(5) Please contact nearest branch office for latest surrender values payable on your policy.
 Policy Details
Policy Option NA Sum Assured Rs. 1500000.00
Monthly Super Income Benefit 18001.00 Sum Assured on Death (at inception of the policy) Rs. 1500000.00

Premium Summary
Base Plan Riders Total Instalment Premium
Instalment Premium without GST 150000 0 150000
Instalment Premium with First Year GST 156750 0 156750
Instalment Premium with GST 2nd Year Onwards 153375 0 153375

Notes: Annualized premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders,
if any Goods & Service Tax

IRDAI Regn No:128

I,..........................................,have explained the premiums, and I, .............................................

benefits under the product fully to the prospect / Policyholder. having received the information with respect to the above, have
understood the above statement before entering into the contract

Date : Signature of Agent /intermediary Date : Signature of the Prospect/

/ Official /Specified Person Policy holder’s signature
Place