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Name of the Prospect / abc Proposal No: 12707251

Policyholder:
Name of the Product: Tata AIA Life Guaranteed
Age (years) : 35 Gender:Male Return Insurance Plan

Tag Line : Individual, Non-Linked Non-Participating

Name of the Life Assured 1 : abc Life Insurance Savings Plan
Age (years) : 35 Gender:Male Unique Identification No.: 110N152V12

Name of the Life Assured 2 : NA I GST Rate: 4.5% for first year
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Age (years) : red I am red 2.25% second year onwards
NA Gender:NA
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Policy Term (years) : 12
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Premium Payment Term (years) : 7
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Amount of Instalment Premium 104500
(Rs.): I am red I am red

Mode of Payment of Premium : Annual 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. 1475000
Policy Option Endowment
Basic Sum Assured (Second Death, if any) Rs. NA

Sum Assured on First Death (at inception of the policy) Rs. 1475000
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 option Term Term (Rs.) (Rs.) (Rs.)
Payout Option) Name Age(yrs) Gender Lumpsum Income Duration
(Rs.) p.a.(Rs.)
(yrs)

Premium Summary
I am red Base Plan Riders Total Instalment Premium

Instalment Premium without GST (Rs.) 100000 0 100000

Instalment Premium with First year GST (Rs.) 104500 0 104500

Instalment Premium post applicable discount with First year GST (Rs.) 104500 0 104500

Instalment Premium with GST 2nd year onwards (Rs.) 102250 0 102250
 (Amount in Rupees)
Guaranteed Non - Guaranteed
Other Benefits,
Survival if any Death
Policy Single/ Annualized Death
Benefit / (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 100000 34853 0 0 1475000 NA 0 0

2 100000 69706 0 0 1509853 NA 64217 95945

3 100000 104559 0 0 1544706 NA 114201 165801

4 100000 139412 0 0 1579559 NA 215161 246411

5 100000 174265 0 0 1614412 NA 272167 344148

6 100000 209118 0 0 1649265 NA 330322 455330

7 100000 243971 0 0 1684118 NA 389732 579954

8 0 278824 0 0 1718971 NA 470746 658722

9 0 313677 0 0 1753824 NA 553572 741672

10 0 348530 0 0 1788677 NA 638419 849019

11 0 383383 0 0 1823530 NA 725497 951487

12 0 418236 697060 1115296 1858383 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 I,______________________________ (name), having received the information
the premiums and benefits under the product fully to the prospect/ with respect to the above, have understood the above statement before entering
policyholder. into the contract.

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

Unique Reference Number - L&C/Advt/2023/Sep/3194 (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_Q4/RELEASE 01-01-24/EXPIRY 31-03-2024 004515330BCGRIPSLVBN1 19-02-2024,04:31 PM