BENEFIT ILLUSTRATION

Name of the First Annuitant: Mr. Proposal No:

Age & Gender: 55 Years, Male Name of the Product: Max Life Guaranteed Lifetime Income Plan

Name of the Second Annuitant, if any: Not Applicable Tag Line: A Non-Linked Non Participating Individual General Annuity Savings Plan

Age & Gender: 60 Years, Male Unique Identification No: 104N076V16

Policy Term: Not Applicable GST Rate (First Year): 4.50%

Premium Payment Mode: Annual GST Rate (Subsequent Year): 2.25%

Premium Payment Term: 5 Max Life State: Kerala

Amount of Installment Premium: `10,45,000 Policyholder Residential State: Kerala

Annuity Payment Frequency: Monthly Issue Date of Quote: 14 July 2023
Annuity Purchased From: Agent Assisted Annuity Start Date: 14 August 2028
Monthly Income Amount Starting On 14-Aug-2028
`30,590
(Guaranteed)

This quote is valid for a period of 10 calendar days from the date of issue. Please ensure that your proposal form is submitted at any of our offices within this duration as annuity rates change frequently.
This benefit illustration is intended to show year-wise premiums payable and benefits under the policy.

Policy Details
Policy Option Deferred Annuity - Joint Life Sum Assured (in Rs.) Not Applicable
Deferment Period, if applicable 5 Years Sum Assured on Death (at inception of the policy) (in Rs.) `10,50,000
Death Benefit Opted Yes Payment Option Limited Pay

Premium Summary
Base Plan Riders Total Installment Premium
Installment Premium without GST (in Rs.) 10,00,000 NA 10,00,000
Installment Premium with first year GST (in Rs.) 10,45,000 NA 10,45,000
Installment Premium with GST 2nd year onwards (in Rs.) 10,22,500 NA 10,22,500

UIN: 104N076V16 Page 1 of 3

 (Amount in Rupees)

Guaranteed Non Guaranteed

Single/ Annualized
Policy Year
Premium Survival Benefits / Loyalty Min Guaranteed Surrender Value Special Surrender Value
Other Benefits, if any Maturity Benefit Death Benefit
Additions

1 10,00,000 0 3,82,380 0 13,82,380 0 0

2 10,00,000 0 7,64,760 0 27,64,760 6,00,000 12,72,589
3 10,00,000 0 11,47,140 0 41,47,140 21,00,000 21,00,000
4 10,00,000 0 15,29,520 0 55,29,520 36,00,000 36,00,000
5 10,00,000 0 19,11,900 0 69,11,900 45,00,000 45,00,000
6 0 3,67,085 19,11,900 0 65,44,815 41,32,915 41,92,329
7 0 3,67,085 19,11,900 0 61,77,730 37,65,830 42,02,257
8 0 3,67,085 19,11,900 0 58,10,646 33,98,746 42,12,684
9 0 3,67,085 19,11,900 0 54,43,561 30,31,661 42,24,403
10 0 3,67,085 19,11,900 0 52,50,000 26,64,576 42,36,782
11 0 3,67,085 19,11,900 0 52,50,000 22,97,491 42,50,078
12 0 3,67,085 19,11,900 0 52,50,000 19,30,406 42,64,194
13 0 3,67,085 19,11,900 0 52,50,000 15,63,322 42,78,887
14 0 3,67,085 19,11,900 0 52,50,000 11,96,237 42,93,487
15 0 3,67,085 19,11,900 0 52,50,000 8,29,152 43,09,253
16 0 3,67,085 19,11,900 0 52,50,000 4,62,067 43,25,013
17 0 3,67,085 19,11,900 0 52,50,000 94,982 43,40,988
18 0 3,67,085 19,11,900 0 52,50,000 0 43,57,436
19 0 3,67,085 19,11,900 0 52,50,000 0 43,74,076
20 0 3,67,085 19,11,900 0 52,50,000 0 43,91,128
21 0 3,67,085 19,11,900 0 52,50,000 0 44,07,740
22 0 3,67,085 19,11,900 0 52,50,000 0 44,24,559
23 0 3,67,085 19,11,900 0 52,50,000 0 44,41,767
24 0 3,67,085 19,11,900 0 52,50,000 0 44,58,902
25 0 3,67,085 19,11,900 0 52,50,000 0 44,75,573
26 0 3,67,085 19,11,900 0 52,50,000 0 44,92,819
27 0 3,67,085 19,11,900 0 52,50,000 0 45,09,600
28 0 3,67,085 19,11,900 0 52,50,000 0 45,26,419
29 0 3,67,085 19,11,900 0 52,50,000 0 45,43,664

UIN: 104N076V16 Page 2 of 3

 Guaranteed Non Guaranteed
Single/ Annualized
Policy Year
Premium Survival Benefits / Loyalty Min Guaranteed Surrender Value Special Surrender Value
Other Benefits, if any Maturity Benefit Death Benefit
Additions

30 0 3,67,085 19,11,900 0 52,50,000 0 45,60,652

31 0 3,67,085 19,11,900 0 52,50,000 0 45,77,699
32 0 3,67,085 19,11,900 0 52,50,000 0 45,94,903
33 0 3,67,085 19,11,900 0 52,50,000 0 46,12,858
34 0 3,67,085 19,11,900 0 52,50,000 0 46,30,977
35 0 3,67,085 19,11,900 0 52,50,000 0 46,49,418
36 0 3,67,085 19,11,900 0 52,50,000 0 46,69,113
37 0 3,67,085 19,11,900 0 52,50,000 0 46,90,133
38 0 3,67,085 19,11,900 0 52,50,000 0 47,13,068
39 0 3,67,085 19,11,900 0 52,50,000 0 47,37,886
40 0 3,67,085 19,11,900 0 52,50,000 0 47,66,635
41 0 3,67,085 19,11,900 0 52,50,000 0 47,99,117
42 0 3,67,085 19,11,900 0 52,50,000 0 48,37,946
43 0 3,67,085 19,11,900 0 52,50,000 0 48,84,810
44 0 3,67,085 19,11,900 0 52,50,000 0 49,42,375
45 0 3,67,085 19,11,900 0 52,50,000 0 50,16,000

Notes: Annualized Premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any, and Goods and Service Tax. Refer Sales literature for explanation of terms used in
this illustration.

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

Place:
Date: 7/14/23 Signature / OTP Confirmation Date / Thumb Impression / Date:7/14/23 Signature / OTP Confirmation Date / Thumb Impression /
Electronic Signature of Agent/ Intermediary / Official Electronic Signature of Prospect/ Policyholder
This system generated benefit illustration shall be treated as signed by me.

UIN: 104N076V16 Page 3 of 3