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Name of the Prospect / Policyholder: Deep Dholakiya Proposal No: 11862348

Age (years) : 28 Gender:Male Name of the Product: Tata AIA Life Guaranteed
Return Insurance Plan
Name of the Life Assured 1 : Deep Dholakiya Tag Line : Individual, Non-Linked Non-Participating
Life Insurance Savings Plan
Age (years) : 28 Gender:Male
Unique Identification No.: 110N152V11
Name of the Life Assured 2 : NA
I GST Rate: 4.5% for first year
Age (years) : am
NA Gender:NA red I am red 2.25% second year onwards

Policy Term (years) : 25 I am red I am red

Premium Payment Term (years) : 12 I am red I am red

Amount of Instalment Premium (Rs.): 31350 I am red I am red

Mode of Payment of Premium : Annual I am red I am red

I am red I am red

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

Policy Details
Basic Sum Assured (First Death) Rs. 495000
Policy Option Endowment
Basic Sum Assured (Second Death, if any) Rs. NA

Sum Assured on First Death (at inception of the policy) Rs. 540504
Guaranteed Annual Income (GAI)* NA
Sum Assured on Second Death, if any (at inception of the policy) Rs. NA

Rider Details

Tata AIA Vitality

(Wellness No
Program)

Details of Life
Rider Name/UIN^ Insured/Partner under the Benefit Payout
Benefit Option Return of Benefit Premium Sum Premium p.a. Year 1
(Benefit
premium Option Payment Assured without GST Discount
Option/Benefit Income
Lumpsum Income option Term Term (Rs.) (Rs.) (Rs.)
Payout Option) Name Age(yrs) Gender Duration
(Rs.) p.a.(Rs.)
(yrs)

Premium Summary

I am red Base Plan Riders Total Instalment Premium

Instalment Premium without GST (Rs.) 30000 0 30000

Instalment Premium with First year GST (Rs.) 31350 0 31350

Instalment Premium post applicable discount with First year GST (Rs.) 31350 0 31350

Instalment Premium with GST 2nd year onwards (Rs.) 30675 0 30675
 (Amount in Rupees)
Guaranteed Non - Guaranteed
Other Benefits,
Survival Benefit if any Death
Policy Single/ Annualized Death
/ (Guaranteed Benefit
Year Premium Maturity Benefit Min Guaranteed Special Surrender
Accrued Maturity (Second
Benefit (First Surrender Value Value
Guaranteed Benefit/ Death, if
Death)
Additions Guaranteed any)
Annual Income)
1 30000 27025 0 0 540504 NA 0 0

2 30000 54050 0 0 567529 NA 19000 16395

3 30000 81076 0 0 594554 NA 33662 28376

4 30000 108101 0 0 621580 NA 63567 44411

5 30000 135126 0 0 648605 NA 80189 59996

6 30000 162151 0 0 675630 NA 97162 81076

7 30000 189176 0 0 702655 NA 114405 100263

8 30000 216202 0 0 729680 NA 136907 126388

9 30000 243227 0 0 756706 NA 163634 155395

10 30000 270252 0 0 783731 NA 189728 194221

11 30000 297277 0 0 810756 NA 217401 229714

12 30000 324302 0 0 837781 NA 250550 276468

13 0 351328 0 0 864806 NA 263155 302682

14 0 378353 0 0 891832 NA 276597 338896

15 0 405378 0 0 918857 NA 294181 385920

16 0 432403 0 0 945882 NA 309110 435106

17 0 459428 0 0 972907 NA 329098 486454

18 0 486454 0 0 999932 NA 346649 539963

19 0 513479 0 0 1026958 NA 365443 605905

20 0 540504 0 0 1053983 NA 389161 674549

21 0 567529 0 0 1081008 NA 411225 756706

22 0 594554 0 0 1108033 NA 435397 853186

23 0 621580 0 0 1135058 NA 465439 953449

24 0 648605 0 0 1162084 NA 494313 1057496

25 0 675630 540504 1216134 1189109 NA 0 0

Note: Annualized premium excludes underwriting extra premium, frequency loadings on premiums, the premium paid towards the riders, if any, and Goods and
Services Tax.

*Under Option III: The policyholder shall also be given the option to receive the Guaranteed Annual Income (GAI) on a monthly basis. This option has to be
chosen at inception and cannot be altered once chosen. The GAI illustrated above is the total amount payable in a year on selection of monthly mode and 1/12th
of this amount will be payable monthly.

Income Tax benefits would be available as per the prevailing income tax laws, subject to fulfillment of conditions stipulated therein. Tata AIA Life Insurance
Company Ltd. does not assume responsibility on tax implication mentioned anywhere in this document. Please consult your own tax consultant to know the tax
benefits available to you.

I, ______________________________ (name), have explained the I,______________________________ (name), having received the information with
premiums and benefits under the product fully to the prospect/ respect to the above, have understood the above statement before entering into the
policyholder. contract.

Place: I am red
Date: Signature of Agent/ Intermediary/ Official Date: Signature of Prospect/ Policyholder

Unique Reference Number - L&C/Advt/2022/Jun/1085 (Rider- L&C/Advt/2022/Sep/2271)

 Tata AIA Life Insurance Company Ltd. (IRDA of India Regn No. 110) (CIN: U66010MH2000PLC128403)
Registered and Corporate Office: 14th Floor, Tower A, Peninsula Business Park, Senapati Bapat Marg, Lower Parel, Mumbai- 400013
Trade logo displayed above belongs to Tata Sons Ltd and AIA Group Ltd. and is used by Tata AIA Life Insurance Company Ltd under a license.
For more information, Call the Tata AIA Life Insurance Company Ltd Helpline number1860-266-9966 (local charges apply) or Visit us at: www.tataaia.com

(I)V.99.00/FY2023-2024_Q1/RELEASE 01-04-23/EXPIRY 30-06-2023 005427437SPGRIPSLVBN1 09-06-2023,11:04 AM