For Office Use Only (w.e.f. Jul 21 \ Ver 1.

1)

Illustration No: KGSP-2420M-9995-Y100

Quotation Number:BB311222112135184

Proposal No:

Policy No:

Name of the Mr Customer .. Name of the Product Kotak Guaranteed Savings Plan
Prospect/Policyholder
Tag Line A Non-Linked Non Participating
Age of the 24 Endowment Life Insurance Plan
Prospect/Policyholder (in yrs)
Unique Identification No UIN: 107N100V03
DOB of the 12 February 1998
Base Goods and Services Tax and Cess Rate 4.5%
Prospect/Policyholder
(GST) (1st Year)
Name of Life Assured Mr Customer ..
Base Goods and Services Tax and Cess Rate 2.25%
DOB of Life Assured 12 February 1998 (GST) (2nd Year)

Age of Life Assured (in yrs) 24 Rider Goods and Services Tax and Cess Rate 18%
(GST)
Gender of Life Assured Male
Channel Name Individual Agents
Policy Term (in yrs) 20

Premium Payment Term (in 10

yrs)
Agent's Branch Location Puducherry
Amount of Installment 1,00,000
Prospect/Policyholder's Current Location Tamil Nadu
Premium (in Rs.)

Mode of Payment of Premium Yearly

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

POLICY DETAILS

Policy Option : Not Applicable Base Sum Assured (Rs.) : 17,47,620

Base Sum Assured on Death (at

: 19,27,620
inception of the policy) Rs.

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Quotation Number:BB311222112135184

Rider Details

Rider Premium Paying

Rider Name Rider Sum Assured Rider Policy Term Rider Premium
Term

Kotak Term Benefit Rider (UIN: 107B003V03) Not Selected

Kotak Accidental Death Benefit Rider

Not Selected
(UIN:107B001V03)

Kotak Permanent Disability Benefit Rider

Not Selected
(UIN:107B002V03)

Kotak Life Guardian Rider (UIN: 107B012V02) Not Selected

Kotak Accidental Disability Guardian Rider (UIN

Not Selected
107B011V02)

PREMIUM SUMMARY

Riders (Please refer Rider

Base Plan Total Installment Premium
Details table)

Installment Premium (without GST) 1,00,000 0 1,00,000

Installment Premium (with First Year GST) 1,04,500 0 1,04,500

Installment Premium (with GST, Second Year onwards) 1,02,250 0 1,02,250

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Quotation Number:BB311222112135184

BENEFIT ILLUSTRATION TABLE

Non-
Guaranteed Benefits Guaranteed
End of Policy Age of Life Annualised Benefits
Year Assured Premium Accrued Guaranteed Guaranteed Special
Guaranteed Maturity Death
Sum Assured Guaranteed Loyalty Surrender Surrender
Additions2 Benefit3 Benefit4
Additions Additions Value5 Value5

1 25 1,00,000 17,47,620 0 0 0 0 19,27,620 0 0

2 26 1,00,000 17,47,620 0 0 0 0 19,27,620 60,000 0

3 27 1,00,000 17,47,620 0 0 0 0 19,27,620 1,05,000 90,000

4 28 1,00,000 17,47,620 0 0 0 0 19,27,620 2,00,000 2,00,000

5 29 1,00,000 17,47,620 0 0 0 0 19,27,620 2,50,000 2,50,000

6 30 1,00,000 17,47,620 0 0 0 0 19,27,620 3,00,000 3,37,000

7 31 1,00,000 17,47,620 0 0 0 0 19,27,620 3,50,000 4,36,333

8 32 1,00,000 17,47,620 0 0 0 0 19,27,620 4,32,000 5,48,000

9 33 1,00,000 17,47,620 0 0 0 0 19,27,620 5,22,000 6,72,000

10 34 1,00,000 17,47,620 0 0 0 0 19,27,620 6,20,000 8,08,333

11 35 0 17,47,620 35,000 35,000 0 0 19,62,620 6,65,050 8,86,100

12 36 0 17,47,620 35,000 70,000 0 0 19,97,620 7,22,900 9,66,667

13 37 0 17,47,620 35,000 1,05,000 0 0 20,32,620 7,83,550 10,51,083

14 38 0 17,47,620 35,000 1,40,000 0 0 20,67,620 8,49,800 11,39,000

15 39 0 17,47,620 35,000 1,75,000 0 0 21,02,620 9,18,500 12,30,417

16 40 0 17,47,620 35,000 2,10,000 0 0 21,37,620 9,92,800 13,27,433

17 41 0 17,47,620 35,000 2,45,000 0 0 21,72,620 10,63,750 14,28,650

18 42 0 17,47,620 35,000 2,80,000 0 0 22,07,620 11,52,400 15,36,867

19 43 0 17,47,620 35,000 3,15,000 0 0 22,42,620 12,46,650 16,53,133

20 44 0 17,47,620 35,000 3,50,000 1,80,000 22,77,620 22,77,620

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

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Quotation Number:BB311222112135184

Terms & Conditions:

1. This is a limited pay non-participating endowment plan. The illustration stated is for a healthy individual and under the assumption that this is the
only policy the client has with Kotak Life Insurance and would be subject to underwriting.

2. Guaranteed Additions is a % of the Annualised Premium and it will start accruing from the end of the next policy year after completion of the PPT
and accrues till the end of the Policy Term.

3. Guaranteed Maturity Benefit payable at the end of the Policy Term is : Basic Sum Assured PLUS Accrued Guaranteed Additions PLUS
Guaranteed Loyalty Addition.

4. Death Benefit will be : Sum Assured on Death PLUS Accrued Guaranteed Additions till the date of death
Where Sum Assured on Death is : Highest of : 11 times of (Annualised Premium including extra premium, if any) OR
Basic Sum Assured PLUS Guaranteed Loyalty Addition OR
105% of all premiums paid (including extra premium, if any) till the date of death

5. The policy acquires a Guaranteed Surrender Value (GSV) after payment of full premiums for two consecutive years. The GSV is a percentage of
total premiums paid including extra premium, if any (but excluding Goods and Services Tax & Cess and Rider premium, if any) PLUS Value of
accrued Guaranteed Additions, if any. The Company may consider paying a Special Surrender Value after policy acquires GSV. In any case,
higher of the Guaranteed Surrender Value or Special Surrender Value will be payable. For more details on the GSV factors applicable on specific
policy years, please refer the sales brochure.

6. After the policy acquires GSV, if the subsequent premiums are not paid within the grace period the policy will be converted into a Reduced Paid-
Up policy by default. Policy will be eligible for Reduced Sum Assured, accruals of Reduced Guaranteed Additions and Reduced Guaranteed
Loyalty Addition once it has been converted into a Reduced Paid-Up policy. All rider benefits may cease depending upon rider features. For
further details, please refer the sales brochure.

7. A lapsed or a Reduced Paid-Up policy can be reinstated for full benefits on revival within five years of the first unpaid premium. The revival can be
done without evidence of good health on payment of the outstanding premiums with late payment charges, if the payment is made within six
months from the date of first unpaid premium. Thereafter to revive the policy, evidence of good health would be required along with payment of
the outstanding premiums with applicable interest rate.

8. The above illustrated benefits are derived on the basis of details of Life Assured provided at the time of filling the proposal form. If the details are
found inaccurate or there are any changes before or at the time of the policy issuance for eg: change in age, the illustrated benefits will be subject
to revision.

9. Goods and Services Tax and Cess, as applicable are levied at the applicable Tax rates in accordance with the prevailing Tax Laws. Prevailing tax
laws are applicable on this policy which may vary from time to time

10. The values shown are for illustrative purposes only. For more details on risk factors, terms and conditions please read sales brochure carefully
before concluding a sale.

11. TDS at prevailing rate will be deducted from any amount paid under a life insurance policy subject to the provisions of prevailing tax laws. In case
of non-availability of valid PAN, TDS will be deducted at higher rate. Tax laws are subject to changes from time to time. Kindly consult your tax
advisor for tax implication of your policy.

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Quotation Number:BB311222112135184

Section 41 of the Insurance Act, 1938 states

(1) No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take or renew or continue an insurance in
respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the
premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except such rebate as may be
allowed in accordance with the published prospectuses or tables of the insurer:

(2) Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakh rupees.

I, _____________________________(Name), have explained the I, Mr Customer .. (Name), having received the information with respect

premiums and benefits under the product fully to the prospect to the above, have understood the above statement before entering

/policyholder. into the contract.

(Accepted vide a declaration (Customer

Declaration Form) signed by him/her)

Place :_____________ __________________________________ Place :_____________ __________________________________

Date : 31 December 2022 Signature of Agent Date : 31 December 2022 Signature of Prospect/Policyholder

/Intermediary/Official

Kotak Mahindra Life Insurance Company Limited.

CIN: U66030MH2000PLC128503
Regd. Office: 8th Floor, Plot# C-12, G-Block, BKC, Bandra (E), Mumbai - 400 051
Regn. No: 107. Toll Free No.: 1800 209 8800. Website: www.kotaklife.com

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