Name: Mihika Sum Assured: Not Applicable

DateOf Birth: 05/04/2001 Policy Term: 12

Age in(yrs): 21 PPT: 6

Gender: Female 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  Guaranteed  Maturity Benefit Surrender Value  
date    
1 1500000.00 0 0 16500000 0 0

2 1500000.00 0 0 16500000 900000 619322

3 1500000.00 0 0 16500000 1575000 1495436

4 1500000.00 0 0 16500000 3000000 2859957

5 1500000.00 0 0 16500000 4125000 4770792

6 1500000.00 0 0 16500000 5850000 7326123

7 0 0 16500000 6750000 9063246

8 0 0 16500000 7020000 9758094

9 0 0 16500000 7290000 10603997

10 0 0 16500000 7560000 11600954

11 0 0 16500000 8100000 12748965

12 0 6705409 23205409 16500000 8100000 14048031

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, Mihika
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: