Quotation No : 60043570608

Bajaj Allianz Life Flexi Income Goal

A Non-Linked, Participating, Guaranteed Income Life Insurance Plan

Name of the Prospect/ Policyholder Mr XCXC Name of the Product: Bajaj Allianz Life Flexi Income Goal
Age (in years): 30 Tag Line: A Non-Linked, Participating, Guaranteed Income Life Insurance Plan
Gender: Male Unique Identification Number: 116N162V02
Name of the Life Assured Mr XCXC GST Rate(First Year): 4.50%
Age (in years): 30 GST Rate(2nd Year onwards): 2.25%
Gender: Male
Single/Joint Life: Single
Name of the Joint Life: NA
Age of Joint LIfe (in years): NA
Gender of Joint Life: NA
Sum Assured Of Joint Life: NA
Policy Term (in Years) 22
Premium Paying Term (in Years) 10
Amount of Installment Premium (in Rs.) 1,04,513
Mode of Payment of Premium Annual
Variant Income Benefit
Guaranteed Monthly Income 5,647
Receive GMI Annually
Receive Cash Bonus Annually

How to read and understand this benefit illustration?

This benefit illustration is intented to show year-wise premiums payable and benefits under the policy, at two assumed rates of interest i.e., 8% p.a. and 4% p.a.
Some benefits are guaranteed and some benefits are variable with returns based on the future performance of your insurer carrying on life insurance business. If your policy offers guaranteed benefits then these will be clearly marked "guaranteed" in the illustration
table on this page. If your policy offers variable benefits then the illustrations on this page will show two different rates of assumed future investment returns, of 8% p.a. and 4% p.a. These assumed rates of return are not guaranteed and they are not the upper or lower
limits of what you might get back, as the value of your policy is dependent on a number of factors including future investment performance.

Policy Details
Sum Assured Rs. 8,13,168
Bonus Type: Cash Bonus Sum Assured on Death (at inception of Policy) Rs. 10,00,120

Options Exercised

Accumulate Begin(Year) End(Year) Withdraw From Begin(Year) End(Year) Withdrawal

%
Cash Bonus 11 22
Guaranteed Monthly Income N.A N.A
Guaranteed Lump-Sum N.A N.A

Premium Summary

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Quotation No : 60043570608

Premium Summary
Base Plan Riders Total Installment Premium
Installment Premium without GST (after Channel Discount, if any) 1,00,012 0 1,00,012
Installment Premium with First Year GST 1,04,513 0 1,04,513
Installment Premium with GST 2nd year Onwards 1,02,262 0 1,02,262

(Amount in Rupees )
Total Benefits including Guaranteed and Non-Guaranteed Benefits

Guaranteed Benefis Non Guaranteed Benefit @ 4% p.a. Non Guaranteed Benefit @ 8% p.a. Surrender Benefit Total Survival Benefit Total Maturity Total Death Benefit
Receivable Receivable Benefit

Maturity Total Total Total Total

Survival Special Benefit Accrued Maturity Maturity Maturity Death Death
Annualized Benefit Death Death Accrued Guaranteed Surrender Guaranteed Special Benefit Surrender Surrender Total Total Benefit Benefit Benefit Benefit
Life Maturity Compound Cash Accumulation Surrender Under Compound Cash Accumulation Surrender Surrender Under Value Value Survival Survival
Policy Assured's Premium (Guaranteed Benefit Benefit Benefit Rev. Bonus of "Cash Withdrawals Value (GSV) Value Paid-Up Rev. Bonus of "Cash Withdrawals Value Value Benefit Benefit incl incl incl incl
Year (Excl of Monthly ^! of the EOY@ (SSV) Paid-Up Receivable## Receivable## Terminal Terminal Terminal Terminal
Age
GST) Income- EOY@ spouse
Bonus Payable Bonus & GMI" EOY
EOY Policy # Bonus Payable Bonus & GMI" (GSV) (SSV)
Policy # EOY@ 4% EOY@ 8%
Receivable Receivable
Bonus, if Bonus, if Bonus, if Bonus, if
GMI) EOY EOT EOY EOY EOY @4% @8% any any any any
EOT
@4% @8% @4% @8%

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
1 30 1,00,012 0 10,00,120 0 0 0 5,692 0 0 0 0 0 0 18,296 0 0 0 0 0 0 0 5,692 18,296 0 0 10,00,120 10,00,120
2 31 1,00,012 0 10,00,120 0 0 0 5,692 0 0 48,623 67,434 81,317 0 18,296 0 0 23,415 67,434 81,317 67,434 67,434 5,692 18,296 0 0 10,00,120 10,00,120
3 32 1,00,012 0 10,00,120 0 0 0 5,692 0 0 87,936 1,24,213 1,21,975 0 18,296 0 0 50,124 1,24,213 1,21,975 1,24,213 1,24,213 5,692 18,296 0 0 10,00,120 10,00,120
4 33 1,00,012 0 10,00,120 0 0 0 5,692 0 0 1,77,255 1,97,898 1,62,634 0 18,296 0 0 1,26,839 1,97,898 1,62,634 1,97,898 1,97,898 5,692 18,296 0 0 10,00,120 10,00,120
5 34 1,00,012 0 10,00,120 0 0 0 5,692 0 0 2,21,569 2,89,721 2,03,292 0 18,296 0 0 1,58,549 2,89,721 2,03,292 2,89,721 2,89,721 5,692 18,296 0 0 10,00,120 10,00,120
6 35 1,00,012 0 10,00,120 0 0 0 5,692 0 0 2,65,883 4,00,997 2,43,950 0 18,296 0 0 1,90,258 4,44,908 2,43,950 4,00,997 4,44,908 5,692 18,296 0 0 10,00,120 10,00,120
7 36 1,00,012 0 10,00,120 0 0 0 5,692 0 0 3,10,197 5,06,066 2,84,609 0 18,296 0 0 2,21,968 5,65,834 2,84,609 5,06,066 5,65,834 5,692 18,296 0 0 10,00,120 10,00,120
8 37 1,00,012 0 10,00,120 0 0 0 5,692 0 0 3,70,513 6,24,053 3,25,267 0 18,296 0 0 2,69,680 7,02,118 3,25,267 6,24,053 7,02,118 5,692 18,296 0 0 10,00,120 10,00,120
9 38 1,00,012 0 10,00,120 0 0 0 5,692 0 0 4,43,830 7,19,071 3,65,926 0 18,296 0 0 3,30,393 8,17,870 3,65,926 7,19,071 8,17,870 5,692 18,296 0 0 10,00,120 10,00,120
10 39 1,00,012 0 10,00,120 0 0 0 5,692 0 0 5,23,148 8,60,321 4,06,584 0 18,296 0 0 3,97,107 9,82,296 5,28,559 8,60,321 9,82,296 5,692 18,296 0 0 10,00,120 11,22,095
11 40 0 70,475 10,00,120 0 0 0 5,692 5,692 0 4,82,677 8,80,342 4,12,276 0 18,296 18,296 0 3,56,636 10,27,119 5,59,053 8,80,342 10,27,119 76,167 88,771 0 0 10,06,097 11,53,504
12 41 0 70,475 10,00,120 0 0 0 5,692 11,555 0 4,42,377 8,56,246 4,18,139 0 18,296 37,873 0 3,17,446 10,28,934 5,90,828 8,56,246 10,28,934 76,167 88,771 0 0 10,12,253 11,86,257
13 42 0 70,475 10,00,120 0 0 0 5,692 17,594 0 4,02,252 8,29,867 4,24,178 0 18,296 58,821 0 2,79,626 10,29,662 6,23,972 8,29,867 10,29,662 76,167 88,771 0 0 10,18,594 12,20,450
14 43 0 70,475 10,00,120 0 0 0 5,692 23,814 0 3,62,309 8,01,030 4,30,398 0 18,296 81,234 0 2,43,272 10,29,216 6,58,584 8,01,030 10,29,216 76,167 88,771 0 0 10,25,125 12,56,181
15 44 0 70,475 10,00,120 0 0 0 5,692 30,221 0 3,12,551 7,69,543 4,36,805 0 18,296 1,05,217 0 1,98,487 10,27,503 6,94,764 7,69,543 10,27,503 76,167 88,771 0 0 10,31,852 12,93,561
16 45 0 70,475 10,00,120 0 0 0 5,692 36,819 0 2,72,987 7,35,194 4,43,403 0 18,296 1,30,879 0 1,65,381 10,24,414 7,32,623 7,35,194 10,24,414 76,167 88,771 0 0 10,38,780 13,32,703
17 46 0 70,475 10,00,120 0 0 0 5,692 43,616 0 2,33,621 6,97,759 4,50,200 0 18,296 1,58,336 0 1,58,336 10,19,837 7,72,278 6,97,759 10,19,837 76,167 88,771 0 0 10,45,917 13,73,731
18 47 0 70,475 10,00,120 0 0 0 5,692 50,617 0 1,94,458 6,56,992 4,57,201 0 18,296 1,87,716 0 1,87,716 10,13,647 8,13,856 6,56,992 10,13,647 76,167 88,771 0 0 10,53,268 14,16,777
19 48 0 70,475 10,00,120 0 0 0 5,692 57,827 0 1,55,506 6,12,623 4,64,411 0 18,296 2,19,153 0 2,19,153 10,05,701 8,57,490 6,12,623 10,05,701 76,167 88,771 0 0 10,60,839 14,61,983
20 49 0 70,475 10,00,120 0 0 0 5,692 65,254 0 1,16,770 5,64,364 4,71,838 0 18,296 2,52,790 0 2,52,790 9,95,849 9,03,324 5,64,364 9,95,849 76,167 88,771 0 0 10,68,637 15,09,499
21 50 0 70,475 10,00,120 0 0 0 5,692 72,904 0 78,256 5,11,890 4,79,488 0 18,296 2,88,781 0 2,88,781 9,83,915 9,51,513 5,11,890 9,83,915 76,167 88,771 0 0 10,76,669 15,59,488
22 51 0 70,475 10,00,120 0 4,06,584 0 5,692 80,784 0 0 0 4,87,368 0 18,296 3,27,292 0 0 0 10,02,222 0 0 76,167 88,771 4,87,368 10,02,222 10,84,943 16,12,122

Notes : Annua lized premium excludes underwriting extra premium, the premiums pa id towa rds the riders , if a ny a nd Goods a nd Service Ta x. Refer Sa les litera ture for expla na tion of terms us ed in this illus tra tion. The Annua lis ed Premium, will be w.r.t. the life a s s ured or prima ry life a s s ured (in a joint life policy).
'@ EOY: End Of Policy Yea r @ EOT: End Of Policy Term
^! In ca s e of Dea th Benefit, the corres ponding number in the 'Policy Yea r' column s hould be rea d a s the Yea r in which Dea th ha ppens a t Yea r-End.
# In ca s e of 'Pa id-Up' Benefits , the corres ponding number in the 'Policy Yea r' column s hould be rea d a s the Number of Completed Yea rs ' Premiums Pa id.
## In ca s e of 'Surrender' Benefits , the corres ponding number in the 'Policy Yea r' column s hould be rea d a s the Yea r in which the Policy is Surrendered a t Yea r-End.

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Quotation No : 60043570608

I, ___ ____ (name), have explained the premiums and benefits under the policy fully to the prospect / policyholder. I, ___ Mr XCXC _____ (name) , having received the informa on with respect to the above, have understood the above statement before
entering into the contract.

Place:
Date: Date:
Signature of Agent/ Intermediary/ Official Signature of Prospect / Policyholder

Notes & Disclaimers:

1. The above information must be read in conjunction with Sales Literature.
2. This premium quotation is applicable only for a Standard Life (from medical, lifestyle and occupational point of view).
3. Further clarification can be sought by contacting company's sales representative or by sending an e-mail to customercare@bajajallianz.co.in.
4. The company may declare a rate of Compound Reversionary Bonus in a year applicable for that year. This rate will be expressed as a percentage of the Sum Assured. This percentage will be applied on the Sum Assured plus reversionary bonuses already a ached to the policy to determine the amount of
reversionary bonus to be added to the policy at that year end. Furthermore, for a policy that has completed ten (10) years and where all due premiums have been paid, the company may declare a Terminal Bonus. The Compound Reversionary Bonus and Terminal Bonus may vary with the policy term
chosen by the policyholder.
5. This product has two variants:
a. Income Benefit, where, one Sum Assured amount will be paid-out as survival benefits in GMIs, and the remaining 50% of Sum Assured amount will be paid as part of the maturity benefit. This variant provides Cash Bonus declared, if any.
b. Enhanced Benefit, where one Sum Assured amount will be paid-out as survival benefits in GMIs, one Sum Assured amount will be paid as part of the maturity benefit and 50% of the Sum Assured amount is payable at the end of premium payment term. This variant provides Compound Reversionary
Bonus declared, if any.
6. The plan can be taken as a single life cover or a joint-life cover along with the spouse.
7. Death Benefit:
If all due premiums have been paid, then, on death of the Life Assured, Death Benefit shall be equal to:
Income Benefit Enhanced Benefit
1. Sum Assured on Death* , plus
1. Sum Assured on Death*, plus 2. Attached compound Reversionary Bonus, plus
2. Terminal bonus, if any, plus 3. Terminal bonus, if any, plus
3. Accumulated Cash Bonus (ACB), if any, plus 4. Accumulated Guaranteed Monthly Income (AGMI), if any, plus
4. Accumulated Guaranteed Monthly Income (AGMI), if any, plus 5. Accumulated Guaranteed Lump-Sum at the end of PPT (AGLS –I), if
5. If there is any ACB and/or AGMI in the policy, then, an additional 5% of the any, plus
ACB and/or 5% of the AGMI (respectively) will be paid. 6. If there is any AGMI and/or AGLS-I, in the policy, then, an additional
5% of the AGMI and/or 5% of the AGLS -I (respectively) will be paid.
The Sum Assured on Death or sum assured (in the case of death of the
spouse) will be paid out, by default, in equal monthly instalments over a The death benefit by default will be paid-out as a lump-sum.
period equal to the Minimum of the Outstanding Policy Term or 12 years. However, the policyholder or nominee (as applicable) will have the
At the time of intimation of death, the policyholder or nominee (as option to take the death benefit in equal monthly instalments over a
applicable) will have the option to take the equal monthly instalments period of five (5) or ten (10) years (as per his/her choice) from the
w.r.t. the Sum Assured on Death or sum assured (in the case of death of date of intimation of death.
the spouse) in a lump-sum.

The benefit shown under “Death Benefit of the spouse” in above Benefit Illustration is the benefit payable to the spouse, if the spouse dies first in a Joint life policy. For further information on Spouse Death benefit, please refer to Sales literature.
*Sum assured on Death higher of the Sum Assured or 10 times of Annualised Premium.
8. Maturity Benefit:
If the policy is in-force at the maturity date and the Life Assured or Primary Life Assured (in a joint life policy) is alive, the maturity benefit shall be:
Income Benefit Enhanced Benefit
1. Sum Assured on Maturity of 50% of sum assured, plus 1. Sum Assured on Maturity of 100% of sum assured, plus
2. ACB, if any, plus 2. Attached compound Reversionary Bonus, if any, plus
3. AGMI, if any, plus 3. Terminal bonus, if any, plus
4. Terminal Bonus, if any 4. AGMI, if any
5. AGLS -I, if any
9. The policyholder will have an option to take the GMI in annual instalments. In this case, the Annual GMI payable will be 104% * Monthly GMI * 12
10. The policyholder will have an option to take the Cash Bonus in monthly instalments. In this case, the Monthly Cash Bonus payable will be [95% * Cash Bonus] / 12
11. Values under the head “Accumulation” under ‘Non-Guaranteed Benefit’ refers to the accumulated value of a) Cash Bonus, if retained b) GMI, if retained c) GLS-1, if retained (In Enhanced Benefit) before withdrawal.
12. The policyholder will have an option to take Maturity Benefit in instalments over a period of 5, 10, 15 or 20 years. For further information, please read the sales literature.
13. The policy can be surrendered by the policyholder at any me, provided at least two (2) full years premiums have been paid. The Surrender Value receivable will be the higher of the Guaranteed Surrender Value (GSV) and the Special Surrender Value (SSV). The policy will terminate on the Date of
Surrender.
14. The displayed Special Surrender Values (SSV) are only indicative and not guaranteed and therefore subject to change in future.
15. Any rider can be excluded at any time before the Maturity Date. The Rider Life Assured is eligible for Surrender Value on exclusion of the rider, if the Rider Premium Paying Term is less than Rider Policy Term and two full year’s Rider Premiums have been paid.
The Surrender Value of the chosen rider will be:
70%*{(n-t)/n}^2*Total Premiums paid for that par cular rider cover where n is the rider policy term and t is the elapsed dura on in years and frac on thereof from the date of commencement of the rider cover. Base policy will con nue as per its own provisions even a er cancella on of one or more

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Quotation No : 60043570608

rider(s).
16. The illustrated figures of 'Surrender Value Receivable' include the respective 'Base Policy Surrender Value' and 'Rider Surrender Value', if any.
17. The investment returns illustrated above are only for the illustrative purpose as mandated by the IRDA and do not in any way indicate the upper and lower limits of investment return.
18. Goods & Service Tax and Cess, if any would be payable as per applicable tax laws.
19. Terminal Bonus, if any, shall become payable along with Maturity Benefit or Death Benefit.
20. Premiums payable and benefits receivable would be eligible for tax benefits, as per the then existing tax laws.
Insurance is a subject matter of solicitation.
This illustration should be read along with the product brochure for detailed terms and conditions.

Bajaj Allianz Life Insurance Co. Ltd.

Bajaj Allianz House, Airport Road, Yerawada, Pune - 411006. Reg No.: 116.
Tel: (020) 66026777; Fax: (020) 66026789
Email: customercare@bajajallianz.co.in
www.bajajallianzlife.co.in

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