Statement of Account

601145113 02-APR-2023
Ms. Monika Duggal
W/O SANJIV KUMAR WARD NUMBER 5
LASHHMAN COLONY,giddarbaha
Muktsar 152101
Punjab India
Dear Ms. Monika Duggal,

Greetings from Max Life Insurance Company!

Mentioned below is the performance update of your product 601145113 for the period 30-JUN-2018 to 01-APR-2023.

Life Insured Ms. Monika Duggal Sum Assured `0.00

Product Name Max Life Fast Track Super (5 Pay)Rider Sum Assured `0.00
UIN no. 104L082V03 Policy Status DISCONTINUED
Policy Issue Date 30-Jun-2018 Next Premium Due 30-Jun-2019
Frequency of Premium Payment Annual Premium Paying Term 5 years
Annual Premium `2,00,000.00

Premium Paid Total Policy Value

as 01-APR-2023 as 01-APR-2023
`2,00,000.00 `2,07,955.14

Your Transaction Summary

Policy Value Premium Paid Charges GST**** Gain/Loss Due Guaranteed Interest Policy Value
as on (Including Deducted* Deducted to Market Loyalty as on
30-JUN-2018 + Top-ups, if any) - - + Conditions + Additions + = 01-APR-2023***

`0.00 `2,00,000.00 `30,780.96 `5,540.60 `44,276.70 `0.00 `.00 `2,07,955.14

*For details of charges, please see overleaf. **Includes wealth booster(if any) for Guaranteed Loyalty Additions
***In case of non business day, previous working day's NAV is applied for calculating policy value.
****GST shall comprise of CGST, SGST/UTGST or IGST (whichever is applicable) including cesses and levies, if any. All applicable taxes, cesses and levies, as per prevailing laws, shall be borne by you.

This is a computer generated letter and it doesn't requires any signatures.

UAS12 V3.3 10072021
 * Details of charges applied (`)
Premium Allocation Charge 8,000.00
Policy Administrative Charge 7,500.00
Mortality Charge 10,280.96
Surrender/Discontinuance Charge 5,000.00
Total 30,780.96

Policy Value is same as Fund Value as defined in the policy document. Guaranteed loyalty additions may also be referred to as Persistency
Bonus in the policy document. #Total Premium paid till date is inclusive of top ups, if any that you have paid. For more details, please refer to
your original policy document.
Discontinuance fund individual- ULIF02021/06/13LIFEDISCON104 Guaranteed Loyalty Additions (persistency units) as applicable in plan.
Charges may include Premium Allocation Charge, Policy Administration Charge, Mortality Charge, Rider Charge, Surrender/ Discontinuance
Charge, Switching Charge, Partial Withdrawal Charge and in any other charge as applicable and as stated in the policy document. The Charges will
be recovered in accordance with the Policy terms and conditions by cancellation of units. Charges and GST are deducted on premium paid. In the
initial years of the policy term, the Policy Value may be less than the total premiums paid due to higher charges. This is an authenticated statement
and does not require any signature.
Please note all the tax benefits are subject to tax laws prevailing at the time of payment of premium or receipt of benefits by you. Insurance is the
subject matter of solicitation.
We request you to verify your email Id, mobile number, bank account details etc. made available to us and inform us changes, if any, at the earliest to
avoid any inconvenience. To update, please visit us at https://www.maxlifeinsurance.com/customer-service
Max Life Insurance Co. Ltd. Operation Center, 90 C, Sector 18, Udyog Vihar, Gurugram-122015, Haryana, India
UAS12 V3.3 10072021