TATA AIA

m.m. LIFE INSURANCE

( POLICY SCHEDULE )

Tata AIA Life Insurance Smart Income Plus (UIN: 110N126V03)

THIS SCHEDULE MUST BE READ WITH THE ACCOMPANYING POLICY DOCUMENT AND IS PART OF THE LIFE INSURANCE CONTRACT
Personal Details
Name of Policyholder : MADAN LAL GUPTA Name of Life Insured : AANYA GUPTA
Address of Policyholder : SECTOR 19/289 Address of Life Assured : NOT APPLICABLE
KOHINOOR PLAZA NA
INDRANAGR ,.
UTTARPRADESH
LUCKNOW
226016
UTTAR PRADESH
INDIA •
Client ID of Policyholder : 251508232 Client ID of Life Insured : 251577649
Date of Birth of Policyholder : 1944/06/14 Date of Birth of Life Insured : 2012/01/19
Age at entry of Policyholder : 75 Age at entry of Life Insured :7
Gender : MALE Age Admitted : YES
Gender : FEMALE

Policy Details
Policy Number : C265056323 Policy Term : 25
Plan Option : E NDOW ME NT Premium Paying Term : 12
Date of Commencement of Policy : 2019/08/31 Mode of Premium Payment : Annual
Date of Commencement of Risk : 2019/08/31 Annualised Premium (Excl. taxes) (Rs.) : 50000.00
Date of Maturity of Policy : 2044/08/31 Modal Premium (Excl. taxes) (Rs.) : 50000.00
Premium Due Date (s) : 2020/08/31 Applicable Taxes, cessess and levies(Rs.) : 2,250.00
Total Modal Premium (Incl. taxes) (Rs.) : 52250.00

Base Plar /Rider Name Sum Assured Moda l Pre m i um Date of Maturity Due Date of Last Policy Premium
(Rs.) (Incl. taxes) (Rs.) of Policy Premium Payment Term Payment Term
(Years) (Years)
Tata AIA Life Insurance
5,50,000.00 52250.00 2044/08/31 2030/08/31 25 12
Smart Income Plus

Benefit Payable
Maturity Benefit As per clause 3.1 of Part C
Total Income Benefit As per clause 3.1 of Part C
Death Benefit As per clause 3.1 of Part C

Nominee details (under section 39 of the Insurance Act 1938)

Na m e of t he Nom i ne e (s) Relationship with Life Insured Age Nomination % '
See Application NA 0 N/A

Appointee Details (Applicable in case the Nominee is a minor)

Name of the Appointee (s) Relationship with nominee Age
See Application NA 0

On examination of the Policy, if you notice any mistake, please return the Policy to the Company immediately for correction.

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