Proposal No:

Name of the Name of the Product: Max Life Online Savings plan
sanish
Prospect/Policyholder: A Unit-Link ed Non-Participating Individual
Tag Line:
A ge & Gender: 33 Years, Male Life Insurance Plan
Name of the Life A ssured: sanish Policy Option: Variant 1
A ge & Gender: 33 Years, Male Unique Identification No: 104L098V05
Sum A ssured: Rs. 9,00,000 GST Rate: 18.00%
Policy Term & Premium Max Life State: Haryana
Payment Term: 30 Years & 5 Years
Policyholder Residential State:
A mount of Installment Rs. 5,000 Investment Strategy Opted for: NA
Premium:
Mode of payment of
Monthly
premium:

Funds opted for along with their risk level

[Please specify the customer specific
fund option):

NIFTY Sm all cap Q uality Index Fund (Risk

Rating-Very High) : 100%

How to read and understand this benefit illustration?

This benefit illustration is intended to show what charges are deducted from your premiums and how the unit fund, net of charges and taxes, may grow
over the years of the policy term if the fund earns a gross return of 8% p.a. or 4% p.a. These rates, i.e., 8% p.a. and 4% p.a. are assumed only for the
purpose of illustrating the flow of benefits if the returns are at this level. It should not be interpreted that the returns under the plan are going to be either
8% p.a. or 4% p.a.

Net Yield mentioned corresponds to the gross investment return of 8% p.a., net of all charges but does not consider mortality, morbidity charges,
underwriting extra, if any, guarantee charges and cost of riders, if deducted by cancellation of units. It demonstrates the impact of charges exclusive of
taxes on the net yield. Please note that the mortality charges per thousand sum assured in general, increases with age.

The actual returns can vary depending on the performance of the chosen fund, charges towards mortality, morbidity, underwriting extra, cost of riders,
etc. The investment risk in this policy is borne by the policyholder, hence, for more details on terms and conditions please read sales literature carefully.

Part A of this statement presents a summary view of year-by-year charges deducted under the policy, fund value, surrender value and the death benefit,
at two assumed rates of return. Part B of this statement presents a detailed break-up of the charges, and other values.

Note: 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 illustration on this page will show two different rates of assumed future investment returns. 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 actual future investment performance.

Rider Details
Critical Illness and Disability-Secure Rider -
NA
Critical Illness and Disability-Secure Rider - Rider Coverage Variant
NA
Prem ium Paym ent Term and Rider Term Critical Illness and Disability-Secure Rider - Rider
NA
Sum Assured

Premium Summary
Max Life Critical Illness and Disability-Secure
Base Plan Rider Total Installment Premium

Installment Premium without GST (in Rs.) 5,000 0 5,000

Installment Premium with First Year GST (in Rs.) 5,000 0 5,000
Installment Premium with GST 2nd Year Onwards (in 5,000 0 5,000
Rs.)

UIN: 104L098V05
 Part A
(A mount in Rupees)
A t 4% p.a. Gross Investment Return A t 8% p.a. Gross Investment Return
Commission
Policy A nnualized Mortality, Fund at Mortality, Other Fund at payable to
Year Premium Morbidity Other GST End of Surrender Death Morbidity GST End of Surrender Death
Charges* Value Benefit intermediary
Charges Year Charges Charges* Year Value Benefit

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 60,000 807 325 204 59,931 55,688 9,00,000 807 329 205 61,178 56,930 9,00,000 -
2 60,000 783 937 310 1,21,554 1,18,722 9,00,000 780 968 315 1,26,503 1,23,671 9,00,000 -
3 60,000 767 1,566 420 1,84,904 1,82,780 9,00,000 759 1,648 433 1,96,249 1,94,125 9,00,000 -
4 60,000 742 2,212 532 2,50,043 2,48,627 9,00,000 725 2,375 558 2,70,728 2,69,312 9,00,000 -
5 60,000 713 2,877 646 3,17,022 3,17,022 9,00,000 682 3,152 690 3,50,268 3,50,268 9,00,000 -
6 0 718 3,231 711 3,24,955 3,24,955 9,00,000 669 3,645 776 3,73,011 3,73,011 9,00,000 -
7 0 760 3,312 733 3,33,059 3,33,059 9,00,000 686 3,882 822 3,97,263 3,97,263 9,00,000 -
8 0 811 3,394 757 3,41,326 3,41,326 9,00,000 707 4,134 871 4,23,121 4,23,121 9,00,000 -
9 0 871 3,478 783 3,49,751 3,49,751 9,00,000 729 4,404 924 4,50,691 4,50,691 9,00,000 -
10 0 934 3,564 810 3,58,333 3,58,333 9,00,000 746 4,690 979 4,80,096 4,80,096 9,00,000 -
11 0 1,011 3,651 839 3,67,062 3,67,062 9,00,000 763 4,997 1,037 5,11,458 5,11,458 9,00,000 -
12 0 1,095 3,739 870 3,75,932 3,75,932 9,00,000 773 5,324 1,097 5,44,916 5,44,916 9,00,000 -
13 0 1,196 3,829 905 3,84,927 3,84,927 9,00,000 780 5,672 1,161 5,80,617 5,80,617 9,00,000 -
14 0 1,308 3,920 941 3,94,038 3,94,038 9,00,000 773 6,045 1,227 6,18,727 6,18,727 9,00,000 -
15 0 1,430 4,012 980 4,03,255 4,03,255 9,00,000 749 6,441 1,294 6,59,430 6,59,430 9,00,000 -
16 0 1,571 4,106 1,022 4,12,559 4,12,559 9,00,000 705 6,865 1,363 7,02,925 7,02,925 9,00,000 -
17 0 1,720 4,200 1,066 4,21,943 4,21,943 9,00,000 627 7,319 1,430 7,49,442 7,49,442 9,00,000 -
18 0 1,876 4,294 1,111 4,31,400 4,31,400 9,00,000 507 7,805 1,496 7,99,233 7,99,233 9,00,000 -
19 0 2,038 4,390 1,157 4,40,925 4,40,925 9,00,000 336 8,325 1,559 8,52,582 8,52,582 9,00,000 -
20 0 2,201 4,486 1,204 4,50,519 4,50,519 9,00,000 106 8,882 1,618 9,09,800 9,09,800 9,09,800 -
21 0 2,363 4,583 1,250 4,60,185 4,60,185 9,00,000 0 9,479 1,706 9,70,999 9,70,999 9,70,999 -
22 0 2,525 4,681 1,297 4,69,925 4,69,925 9,00,000 0 10,117 1,821 10,36,315 10,36,315 10,36,315 -
23 0 2,686 4,778 1,344 4,79,744 4,79,744 9,00,000 0 10,797 1,943 11,06,025 11,06,025 11,06,025 -
24 0 2,840 4,878 1,389 4,89,650 4,89,650 9,00,000 0 11,523 2,074 11,80,423 11,80,423 11,80,423 -
25 0 2,995 4,978 1,435 4,99,645 4,99,645 9,00,000 0 12,299 2,214 12,59,826 12,59,826 12,59,826 -
26 0 3,150 5,079 1,481 5,09,731 5,09,731 9,00,000 0 13,126 2,363 13,44,570 13,44,570 13,44,570 -
27 0 3,305 5,181 1,527 5,19,912 5,19,912 9,00,000 0 14,009 2,522 14,35,015 14,35,015 14,35,015 -
28 0 3,465 5,284 1,575 5,30,183 5,30,183 9,00,000 0 14,951 2,691 15,31,543 15,31,543 15,31,543 -
29 0 3,629 5,388 1,623 5,40,543 5,40,543 9,00,000 0 15,957 2,872 16,34,565 16,34,565 16,34,565 -
30 0 3,806 5,492 1,674 5,50,978 5,50,978 9,00,000 0 17,030 3,065 17,44,516 17,44,516 17,44,516 -
*See Part B for details

IN THIS POLICY, THE INVESTMENT RISK IS BORNE BY THE POLICYHOLDER AND THE ABOVE INTEREST RATES ARE ONLY FOR ILLUSTRATIVE
PURPOSE.

I, ................ (nam e), have ex plained the prem ium s, charges and
benefits under the policy fully to the prospect / policyholder.
I, ................ (nam e), having received the inform ation with respect to
the above, have understood the above statem ent before entering into
Place : Signature / O TP Confirm ation Date / the contract.
Date :22 Dec 2023 Thum b Im pression / Electronic
Signature of Agent/ Interm ediary /
O fficial Date :22 Dec 2023 Signature / O TP Confirm ation Date /
Thum b Im pression / Electronic
Signature of Prospect/ Policyholder
This system generated benefit illustration shall be treated as signed
by m e.

UIN: 104L098V05
 Gross
Part B 8% pa Net Yield 6.92% (A mounts in Rupees)
Yield
A nnualized
Premium Premium - Policy A dditions Fund Fund at
Policy A nnualized A llocation Mortality A dmin. Guarantee Other to End Surrender Death
Year Premium(A P) Charge Premium Charge GST Charge Charges* the before FMC of the value Benefit
A llocation FMC
(PA C) Charge fund* Year
Charges
1 60,000 - 60,000 807 205 - - - - 61,238 330 61,178 56,930 9,00,000
2 60,000 - 60,000 780 315 - - - - 1,26,629 967 1,26,503 1,23,671 9,00,000
3 60,000 - 60,000 759 433 - - - - 1,96,443 1,648 1,96,249 1,94,125 9,00,000
4 60,000 - 60,000 725 558 - - - - 2,70,995 2,375 2,70,728 2,69,312 9,00,000
5 60,000 - 60,000 682 690 - - - - 3,50,614 3,151 3,50,268 3,50,268 9,00,000
6 0 - 0 669 776 - - - - 3,73,380 3,645 3,73,011 3,73,011 9,00,000
7 0 - 0 686 822 - - - - 3,97,656 3,882 3,97,263 3,97,263 9,00,000
8 0 - 0 707 871 - - - - 4,23,540 4,134 4,23,121 4,23,121 9,00,000
9 0 - 0 729 924 - - - - 4,51,137 4,404 4,50,691 4,50,691 9,00,000
10 0 - 0 746 979 - - - - 4,80,571 4,691 4,80,096 4,80,096 9,00,000
11 0 - 0 763 1,037 - - - - 5,11,963 4,997 5,11,458 5,11,458 9,00,000
12 0 - 0 773 1,097 - - - - 5,45,455 5,324 5,44,916 5,44,916 9,00,000
13 0 - 0 780 1,161 - - - - 5,81,191 5,672 5,80,617 5,80,617 9,00,000
14 0 - 0 773 1,227 - - - - 6,19,339 6,044 6,18,727 6,18,727 9,00,000
15 0 - 0 749 1,294 - - - - 6,60,082 6,441 6,59,430 6,59,430 9,00,000
16 0 - 0 705 1,363 - - - - 7,03,620 6,866 7,02,925 7,02,925 9,00,000
17 0 - 0 627 1,430 - - - - 7,50,183 7,319 7,49,442 7,49,442 9,00,000
18 0 - 0 507 1,496 - - - - 8,00,023 7,805 7,99,233 7,99,233 9,00,000
19 0 - 0 336 1,559 - - - - 8,53,425 8,325 8,52,582 8,52,582 9,00,000
20 0 - 0 106 1,618 - - - - 9,10,700 8,882 9,09,800 9,09,800 9,09,800
21 0 - 0 0 1,706 - - - - 9,71,960 9,479 9,70,999 9,70,999 9,70,999
22 0 - 0 0 1,821 - - - - 10,37,340 10,117 10,36,315 10,36,315 10,36,315
23 0 - 0 0 1,943 - - - - 11,07,118 10,797 11,06,025 11,06,025 11,06,025
24 0 - 0 0 2,074 - - - - 11,81,590 11,523 11,80,423 11,80,423 11,80,423
25 0 - 0 0 2,214 - - - - 12,61,072 12,299 12,59,826 12,59,826 12,59,826
26 0 - 0 0 2,363 - - - - 13,45,900 13,126 13,44,570 13,44,570 13,44,570
27 0 - 0 0 2,522 - - - - 14,36,434 14,009 14,35,015 14,35,015 14,35,015
28 0 - 0 0 2,691 - - - - 15,33,058 14,951 15,31,543 15,31,543 15,31,543
29 0 - 0 0 2,872 - - - - 16,36,181 15,957 16,34,565 16,34,565 16,34,565
30 0 - 0 0 3,065 - - - - 17,46,241 17,030 17,44,516 17,44,516 17,44,516

UIN: 104L098V05
 Gross
4% pa (A mounts in Rupees)
Yield
A nnualized
Premium Policy A dditions Fund at
Premium - Fund
Policy A nnualized A llocation Mortality A dmin. Guarantee Other to End Surrender Death
Premium GST before FMC
Year Premium(A P) Charge A llocation Charge Charge Charges* the FMC of the value Benefit
(PA C) Charge fund* Year
Charges
1 60,000 - 60,000 807 204 - - - - 59,990 325 59,931 55,688 9,00,000
2 60,000 - 60,000 783 310 - - - - 1,21,674 937 1,21,554 1,18,722 9,00,000
3 60,000 - 60,000 767 420 - - - - 1,85,087 1,566 1,84,904 1,82,780 9,00,000
4 60,000 - 60,000 742 532 - - - - 2,50,290 2,213 2,50,043 2,48,627 9,00,000
5 60,000 - 60,000 713 646 - - - - 3,17,336 2,878 3,17,022 3,17,022 9,00,000
6 0 - 0 718 711 - - - - 3,25,277 3,231 3,24,955 3,24,955 9,00,000
7 0 - 0 760 733 - - - - 3,33,388 3,312 3,33,059 3,33,059 9,00,000
8 0 - 0 811 757 - - - - 3,41,664 3,394 3,41,326 3,41,326 9,00,000
9 0 - 0 871 783 - - - - 3,50,096 3,478 3,49,751 3,49,751 9,00,000
10 0 - 0 934 810 - - - - 3,58,687 3,564 3,58,333 3,58,333 9,00,000
11 0 - 0 1,011 839 - - - - 3,67,425 3,651 3,67,062 3,67,062 9,00,000
12 0 - 0 1,095 870 - - - - 3,76,304 3,739 3,75,932 3,75,932 9,00,000
13 0 - 0 1,196 905 - - - - 3,85,308 3,829 3,84,927 3,84,927 9,00,000
14 0 - 0 1,308 941 - - - - 3,94,428 3,920 3,94,038 3,94,038 9,00,000
15 0 - 0 1,430 980 - - - - 4,03,654 4,012 4,03,255 4,03,255 9,00,000
16 0 - 0 1,571 1,022 - - - - 4,12,967 4,106 4,12,559 4,12,559 9,00,000
17 0 - 0 1,720 1,066 - - - - 4,22,360 4,200 4,21,943 4,21,943 9,00,000
18 0 - 0 1,876 1,111 - - - - 4,31,826 4,294 4,31,400 4,31,400 9,00,000
19 0 - 0 2,038 1,157 - - - - 4,41,361 4,390 4,40,925 4,40,925 9,00,000
20 0 - 0 2,201 1,204 - - - - 4,50,965 4,486 4,50,519 4,50,519 9,00,000
21 0 - 0 2,363 1,250 - - - - 4,60,640 4,583 4,60,185 4,60,185 9,00,000
22 0 - 0 2,525 1,297 - - - - 4,70,390 4,680 4,69,925 4,69,925 9,00,000
23 0 - 0 2,686 1,344 - - - - 4,80,218 4,779 4,79,744 4,79,744 9,00,000
24 0 - 0 2,840 1,389 - - - - 4,90,134 4,878 4,89,650 4,89,650 9,00,000
25 0 - 0 2,995 1,435 - - - - 5,00,139 4,978 4,99,645 4,99,645 9,00,000
26 0 - 0 3,150 1,481 - - - - 5,10,235 5,079 5,09,731 5,09,731 9,00,000
27 0 - 0 3,305 1,527 - - - - 5,20,426 5,181 5,19,912 5,19,912 9,00,000
28 0 - 0 3,465 1,575 - - - - 5,30,707 5,284 5,30,183 5,30,183 9,00,000
29 0 - 0 3,629 1,623 - - - - 5,41,077 5,388 5,40,543 5,40,543 9,00,000
30 0 - 0 3,806 1,674 - - - - 5,51,522 5,492 5,50,978 5,50,978 9,00,000

*There are no charges included in other charges. There are no additions included on Additions to the fund.
Notes: 1. Refer the sales literature for explanation of terms used in this illustration.
2. Fund management charge is based on the specific fund option(s) chosen.
3. In case rider charges are collected explicitly through collection of rider premium, and not by way of cancellation of units, then, such charges are not
considered in this illustration. In other cases, rider charges are included in other charges.

I, ................ (nam e), have ex plained the prem ium s, charges and
benefits under the policy fully to the prospect / policyholder.
I, ................ (nam e), having received the inform ation with respect to
the above, have understood the above statem ent before entering into
Place : Signature / O TP Confirm ation Date the contract.
Date : 22 Dec 2023 / Thum b Im pression / Electronic
Signature of Agent/ Interm ediary /
O fficial Date : 22 Dec 2023 Signature / O TP Confirm ation Date
/ Thum b Im pression / Electronic
Signature of Prospect/ Policyholder
This system generated benefit illustration shall be treated as signed
by m e.

UIN: 104L098V05