BENEFIT ILLUSTRATION

[Date and Time of Illustration – 30 November 2024, 11:33 AM]

Name of the First Annuitant: Mr. Abc Proposal No:

Age & Gender: 61 Years, Male
Name of the Second Annuitant, if any: Not Applicable Name of the Product: Max Life Smart Wealth Annuity Guaranteed Pension Plan
Age & Gender: Not Applicable
Non-linked Non Participating Individual/ Group General Annuity Savings
Policy Term: Not Applicable Tag Line:
Plan
Premium Payment Mode Annual
Unique Identification No: 104N137V06
Premium Payment Term 6 Years
Policy Sourced under: Individual
Amount of Installment Premium (excl. taxes) 5,00,000
Amount of Installment Premium (First Year Incl. taxes) 5,09,270 Max Life State: West Bengal

Amount allocated for investment (First Year) 4,48,500 Policyholder Residential State: West Bengal

Amount allocated for investment (Second Year) 4,83,500 GST Rate: 18%*

Annuity Payment Mode Annual

Annuity Purchased From Agent Assisted Issue Date of Quote: 30-Nov-24

Annual Income Amount Starting On 30-Nov-2031 (Guaranteed) 2,11,050 Annuity Start Date: 30-Nov-31

*0% if qualifies as zero-rated supply under GST law

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

Policy Details

Annuity Variant Deferred Annuity Sub-Variant Single Life with Death Benefit for Life - Limited Premium

Premium Payment Type Limited Pay Deferment Period 6 Years

Sum Assured on Death (at inception of the

Sum Assured Rs. NA 5,25,000
policy) Rs.

Waiver of Premium (WOP) Plus Rider Opted No Waiver of Premium (WOP) Plus Rider Term NA

Premium Summary

Base Plan Waiver of Premium Plus Rider Total Installment Premium

Installment Premium without GST (in Rs.) 5,00,000 0 5,00,000

Installment Premium with first year GST (in Rs.) 5,09,270 0 5,09,270
Installment Premium with GST 2nd year onwards (in Rs.) 5,02,970 0 5,02,970

UIN: 104N137V06 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 1 of 4
 (Amount in Rupees)

Guaranteed Non Guaranteed

Single/
Policy Annualized
Death Benefit (On first death
Year Premium (BOY) Base Annuity Loyalty Annuity Guaranteed Surrender Value Special Surrender Value Surrender Value (EOY)
Annuity Amount (EOY) Maturity Benefit of the annuitant(s)) (EOY)
(EOY) (EOY) (EOY) (EOY)

1 5,00,000 - - - - 5,29,556 - 3,29,735 3,29,735

2 5,00,000 - - - - 10,90,416 3,00,000 7,00,114 7,00,114
3 5,00,000 - - - - 16,84,430 5,25,000 11,15,025 11,15,025
4 5,00,000 - - - - 23,13,557 10,00,000 15,78,751 15,78,751
5 5,00,000 - - - - 29,79,873 22,50,000 20,96,100 22,50,000
6 5,00,000 - - - - 36,85,578 27,00,000 28,28,124 28,28,124
7 - 1,75,875 35,175 2,11,050 - 36,85,578 18,80,715 18,80,715 18,80,715
8 - 1,75,875 35,175 2,11,050 - 34,74,528 18,80,715 18,80,715 18,80,715
9 - 1,75,875 35,175 2,11,050 - 32,63,478 18,80,715 18,80,715 18,80,715
10 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
11 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
12 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
13 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
14 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
15 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
16 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
17 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
18 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
19 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
20 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
21 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
22 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
23 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
24 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
25 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
26 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
27 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
28 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715

UIN: 104N137V06 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 2 of 4
 Guaranteed Non Guaranteed
Single/
Policy Annualized
Death Benefit (On first death
Year Premium (BOY) Base Annuity Loyalty Annuity Guaranteed Surrender Value Special Surrender Value Surrender Value (EOY)
Annuity Amount (EOY) Maturity Benefit of the annuitant(s)) (EOY)
(EOY) (EOY) (EOY) (EOY)

29 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715

30 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
31 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
32 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
33 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
34 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
35 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
36 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
37 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
38 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
39 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
40 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
41 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
42 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
43 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
44 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
45 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
46 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
47 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
48 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
49 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
50 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
51 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
52 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
53 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
54 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
55 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
56 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
57 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
UIN: 104N137V06 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 3 of 4
 Guaranteed Non Guaranteed
Single/
Policy Annualized
Death Benefit (On first death
Year Premium (BOY) Base Annuity Loyalty Annuity Guaranteed Surrender Value Special Surrender Value Surrender Value (EOY)
Annuity Amount (EOY) Maturity Benefit of the annuitant(s)) (EOY)
(EOY) (EOY) (EOY) (EOY)

58 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715

59 - 1,75,875 35,175 2,11,050 - 31,50,000 18,80,715 18,80,715 18,80,715
60 - 1,75,875 35,175 2,11,050 - 31,50,000 - 18,80,715 18,80,715
Notes:
• EOY: End of Year, BOY: Beginning of Year
• Annualized Premium excludes underwriting extra Premium, frequency loadings on premiums, the Premium paid towards the riders, if any, and Goods and Service Tax.
• This illustration must be read in conjunction with the Sales literature (Prospectus) and Policy Document for explanation of the terms used in the illustration.
• The Annuity Amount, Death Benefit and Surrender value shown above are illustrated assuming that the event occurs at the end of the year.
• Surrender value paid will be higher of Guaranteed Surrender Value and Special Surrender Value.
• Tax benefits under the policy may be as per the prevailing Income Tax laws. Please consult your Tax advisor for more details.
• For Deferred Annuity - Limited Premium variants, Loyalty Annuity shall accrue on completion of deferment period, provided all premiums have been paid during the premium payment term and shall be payable in arrears along
with the base annuity payout as per chosen Annuity payment mode.

*GST of 18% is applied only on premium amount derived as per Rule 32(4) of CGST Rule (i.e. the amount of rider premium, if any, and the non-investible component of premium amount for base policy).

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

Place: Signature / Thumb Impression / Electronic Signature of Date:11/30/24 Signature / Thumb Impression / Electronic Signature of
Date: 11/30/24 Agent/ Intermediary / Official Prospect/ Policyholder
This system generated benefit illustration shall be treated as signed by me.

UIN: 104N137V06 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 4 of 4