Name: Shivang Sum Assured: Not Applicable

DateOf Birth: 02/01/1997 Policy Term: 12

Age in(yrs): 26 PPT: 6

Gender: Male Mode: Yearly

Benefit Illustration for Shriram Life Premier Assured Benefit

128N094V02
(This Benefit Illustration forms part of the Policy Document)

Guaranteed Non Guaranteed

 Policy  Total Annualized   Survival Benefits /   Other Benefits     Guaranteed  Death Benefit   Min Guaranteed   Special Surrender Value 
  Year  Premium paid till Loyalty Additions  if any   Maturity Benefit Surrender Value  
date    
1 1500000.00 0 0 16500000 0 0

2 1500000.00 0 0 16500000 900000 619033

3 1500000.00 0 0 16500000 1575000 1494738

4 1500000.00 0 0 16500000 3000000 2858623

5 1500000.00 0 0 16500000 4125000 4768565

6 1500000.00 0 0 16500000 5850000 7322704

7 0 0 16500000 6750000 9059015

8 0 0 16500000 7020000 9753540

9 0 0 16500000 7290000 10599048

10 0 0 16500000 7560000 11595540

11 0 0 16500000 8100000 12743015

12 0 23198359 16500000 8100000 14041474

Notes:
(1) Annualized premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any
Goods & Service Tax. Refer Sales literature for explanation of terms used in this illustration.
(2) This is only an illustration and does not in any way create any rights and/or obligations.
(3) This illustration is applicable to a healthy individual and acceptance of the proposal is suject to underwriting. Premiums relating to riders and
non-standard risks are excluded from the above.
(4) The above amounts assume that all premiums have been paid on due date.
(5) The Death Benefit shown above equals sum of death SA payable in equal monthly installments, Income Benefit (if any) payable as and when
due and Maturity Benefit payable on maturity.
(6) Surrender value payable is higher of GSV or SSV. Please contact nearest branch office for latest surrender value payable on your policy.

Policy Details
Cover Option Life Sum Assured Rs. Not Applicable
Benefit Option Settlement - Lumpsum Sum Assured on Death (at inception of the policy) Rs. 16500000
Premium Summary
Base Plan Riders Total Instalment Premium
Instalment Premium without GST 1500000 0 1500000
Instalment Premium with First Year GST 1567500 1567500
Instalment Premium with GST 2nd Year Onwards 1533750 1533750

IRDAI Regn No:128

I, .........................................., have explained the premiums, and benefits I, Shivang
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: