For Office Use Only (w.e.f. Mar 21 / Ver 1.

7)

Illustration No: KSIA-3510M-7299-S700

Quotation Number:BB240521115305891

Proposal No:

Policy No.:

Name of the Prospect/Policyholder Mr DR SANTOSH DARISETTY Name of the Product Kotak Single Invest Advantage

Age of the Prospect/Policyholder 62 Tag Line Individual, Unit-Linked, Non-Par,

(in yrs) Single Premium Life Insurance
Plan
Gender of the
Prospect/Policyholder Unique Identification No (UIN) 107L065V04

Name of Life Assured Mr SRIKAR DARISETTY Goods and Services Tax and Cess 18.0%
Rate (GST) (1st Year)
DOB of Life Assured 01 April 1986
Investment Strategy selected Self Managed Strategy
Age of the Life Assured (in yrs) 35
Fund Opted for Please refer to the section
Gender of the Life Assured Male
"Allocation of Premium"
Sum Assured (Rs.) 70,00,000
Destination Fund, if Systematic Not Applicable
Policy Term (in yrs) 10 Switching Starategy is chosen

Premium Payment Term (in yrs) Single Systematic Exit Strategy chosen Not Applicable

Amount of Installment Premium (in 7,00,000 Mode of Premium Payment Single Premium
Rs.)
Agent's Branch Location Telangana

Proposer's Current Location Telangana

Sales Channel Corporate Agent

Allocation of Premium

Classic Opportunities
Money Market Fund Dynamic Gilt Fund Dynamic Bond Fund Frontline Equity Fund
Fund

0% 0% 0% 0% 100%

SFIN Code : Money Market Fund (ULIF-041-05/01/10-MNMKKFND-107), Dynamic Gilt Fund (ULIF-006-27/06/03-DYGLTFND-107) ,Dynamic Bond Fund (ULIF-015-15/04/04-DYBNDFND-107), Frontline Equity Fund (ULIF-034-17/12/09-
FRLEQUFND-107), Classic Opportunities Fund (ULIF-033-16/12/09-CLAOPPFND-107)

How to read and understand this Benefit Illustration?

This Benefit Illustration is intended to show what charges are deducted from your premiums and how the unit fund, net of charges exclusive of taxes, may
grow over the years of the policy term if the fund earns a gross return of 8% p.a. or 4% p.a. These rates, i.e., 8% p.a. and 4% p.a. are assumed only for
the purpose of illustrating the flow of benefits if the returns are at this level. It should not be interpreted that the returns under the plan are going to be
either 8% p.a. or 4% p.a.
Net Yield mentioned corresponds to the gross investment return of 8% p.a., net of all charges but does not consider mortality, morbidity charges,
underwriting extra, if any, guarantee charges and cost of riders, if deducted by cancellation of units. It demonstrates the impact of charges exclusive of
taxes on the net yield. Please note that the mortality charges per thousand sum assured in general, increases with age.
The actual returns can vary depending on the performance of the chosen fund, charges towards mortality, morbidity, underwriting extra, cost of riders,
etc. The investment risk in this policy is borne by the policyholder, hence, for more details on terms and conditions please read sales literature carefully.
Part A of this statement presents a summary view of year-by-year charges deducted under the policy, fund value, surrender value and the death benefit,
at two assumed rates of return.
Part B of this statement presents a detailed break-up of the charges, and other values.

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Quotation Number:BB240521115305891

PART A Amount in Rupees

PART A : Year on Year summary of Charges deducted under the policy, fund value, surrender value and the death benefit at two assumed rate of return.
At 4% p.a. Gross Investment Return At 8% p.a. Gross Investment Return Commission
Policy Year Single Premium* payable to
Mortality Charges Other Charges* GST7 Fund at End of Year Surrender Value Death Benefit Mortality Charges Other Charges* GST7 Fund at End of Year Surrender Value$ Death Benefit intermediary (Rs.)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 7,00,000 8,094 23,344 5,659 6,89,837 6,86,837 70,00,000 8,079 23,538 5,691 7,16,558 7,13,558 70,00,000 14,000

2 0 8,566 9,427 3,239 6,95,779 6,93,779 70,00,000 8,512 10,000 3,332 7,51,186 7,49,186 70,00,000 0

3 0 9,119 9,504 3,352 7,01,200 6,99,700 70,00,000 9,018 10,482 3,510 7,87,371 7,85,871 70,00,000 0

4 0 9,753 9,573 3,479 7,05,989 7,04,989 70,00,000 9,597 10,986 3,704 8,25,124 8,24,124 70,00,000 0

5 0 10,489 9,633 3,622 7,10,012 7,10,012 70,00,000 10,264 11,511 3,919 8,64,434 8,64,434 70,00,000 0

6 0 11,338 9,681 3,784 7,13,114 7,13,114 70,00,000 11,029 12,056 4,155 9,05,280 9,05,280 70,00,000 0

7 0 9,232 9,742 3,416 7,18,806 7,18,806 70,00,000 8,923 12,650 3,883 9,51,261 9,51,261 70,00,000 0

8 0 10,078 9,813 3,580 7,23,621 7,23,621 70,00,000 9,673 13,289 4,133 9,99,214 9,99,214 70,00,000 0

9 0 11,056 9,871 3,767 7,27,379 7,27,379 70,00,000 10,534 13,956 4,408 10,49,130 10,49,130 70,00,000 0

10 0 12,192 9,912 3,979 7,66,217 11,523 14,649 4,711 11,53,464 0

*Single Premium is excluding GST

$ Surrender Value is exclusive of Goods and Services Tax & Cess deductions applicable on Surrender Charge
* See Part B for details

IN THIS POLICY, THE INVESTMENT RISK IS BORNE BY THE POLICYHOLDER AND THE ABOVE INTEREST RATES ARE ONLY FOR ILLUSTRATIVE PURPOSE.

I, __________________________________________________________________(Name), have I, Mr DR SANTOSH DARISETTY (Name), having received the information with respect to the
explained the premiums and benefits under the product fully to the prospect / policyholder above, have understood the above statement before entering into the contract

(Accepted vide a declaration (Customer Declaration Form)

signed by him/her)
Place : _______________ _________________________________ Place : _______________ _________________________________
Date : 24-May-2021 Signature of Agent /Intermediary/Official Date : 24-May-2021 Signature of Prospect / Policyholder

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Quotation Number:BB240521115305891

PART B

PART B : Detailed break-up of the charges and other values.

Gross Yield 8.00%

Net Yield* 6.82%
Amount in Rupees

Premium Allocation Single Premium -

Additions to the Fund at end
Policy Year Single Premium* Charge Premium Mortality Charge GST7 Policy Admin.Charge Guarantee Charge Fund before FMC FMC# Surrender Value$ Death Benefit
fund , if any of the Year
(PAC) Allocation Charges

1 7,00,000 14,000 6,83,480 8,079 5,691 0 0 0 6,83,480 9,538 7,16,558 7,13,558 70,00,000

2 0 0 0 8,512 3,332 0 0 0 7,16,558 10,000 7,51,186 7,49,186 70,00,000

3 0 0 0 9,018 3,510 0 0 0 7,51,186 10,482 7,87,371 7,85,871 70,00,000

4 0 0 0 9,597 3,704 0 0 0 7,87,371 10,986 8,25,124 8,24,124 70,00,000

5 0 0 0 10,264 3,919 0 0 0 8,25,124 11,511 8,64,434 8,64,434 70,00,000

6 0 0 0 11,029 4,155 0 0 0 8,64,434 12,056 9,05,280 9,05,280 70,00,000

7 0 0 0 8,923 3,883 0 0 0 9,05,280 12,650 9,51,261 9,51,261 70,00,000

8 0 0 0 9,673 4,133 0 0 0 9,51,261 13,289 9,99,214 9,99,214 70,00,000

9 0 0 0 10,534 4,408 0 0 0 9,99,214 13,956 10,49,130 10,49,130 70,00,000

10 0 0 0 11,523 4,711 0 0 52,489 10,49,130 14,649 11,53,464

*Single Premium is excluding GST

$ Surrender Value is exclusive of Goods and Services Tax & Cess deductions applicable on Surrender Charge
#Fund Management Charge is based on specific fund option(s) choosen.

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Quotation Number:BB240521115305891

Gross Yield 4.00%

Amount in Rupees

Single Premium -
Premium Allocation Additions to the Fund at end
Policy Year Single Premium* Premium Mortality Charge GST7 Policy Admin.Charge Guarantee Charge Fund before FMC FMC # Surrender Value$ Death Benefit
Charge (PAC) fund , if any of the Year
Allocation Charges

1 7,00,000 14,000 6,83,480 8,094 5,659 0 0 0 6,83,480 9,344 6,89,837 6,86,837 70,00,000

2 0 0 0 8,566 3,239 0 0 0 6,89,837 9,427 6,95,779 6,93,779 70,00,000

3 0 0 0 9,119 3,352 0 0 0 6,95,779 9,504 7,01,200 6,99,700 70,00,000

4 0 0 0 9,753 3,479 0 0 0 7,01,200 9,573 7,05,989 7,04,989 70,00,000

5 0 0 0 10,489 3,622 0 0 0 7,05,989 9,633 7,10,012 7,10,012 70,00,000

6 0 0 0 11,338 3,784 0 0 0 7,10,012 9,681 7,13,114 7,13,114 70,00,000

7 0 0 0 9,232 3,416 0 0 0 7,13,114 9,742 7,18,806 7,18,806 70,00,000

8 0 0 0 10,078 3,580 0 0 0 7,18,806 9,813 7,23,621 7,23,621 70,00,000

9 0 0 0 11,056 3,767 0 0 0 7,23,621 9,871 7,27,379 7,27,379 70,00,000

10 0 0 0 12,192 3,979 0 0 36,348 7,27,379 9,912 7,66,217

*Single Premium is excluding GST

$ Surrender Value is exclusive of Goods and Services Tax & Cess deductions applicable on Surrender Charge
#Fund Management Charge is based on specific fund option(s) choosen.

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 Quotation Number:BB240521115305891

Terms & Conditions:

1. This is non-participating unit-linked 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. The Maturity Benefit is the Fund Value.

3. Death Benefit will be higher of Basic Sum Assured (less partial withdrawal made during the two years preceding the date of death) , or Fund
Value, subject to minimum of 105% of all the premiums paid up to the date of death (less partial withdrawal made during the two years preceding
the date of death).

4. The policy can be discontinued after payment of Single Premium

In case a policy is discontinued during the first 5 years:
The benefits on discontinuance will be payable at the end of lock-in period . Fund Value net of discontinuance charges on the date of
discontinuance will be credited to the Discontinued Policy Fund.
In case a policy is discontinued after the first 5 years:
Fund Value (including Loyalty Additions, if any) will be paid. Policy is terminated thereafter.

In case of death during discontinuance, the Fund Value will be payable immediately and the policy will be terminated thereafter
Return on the discontinued policy fund will be subject to the minimum guaranteed interest rate declared by Insurance Regulatory and
Development Authority of India(IRDAI) from time to time.

5. The NAV is calculated on daily basis as.

(Market value of investment held by the fund + Value of any current assets - Value of any current liabilities & Provisions, if any)
Number of units existing on valuation date (before creation/ redemption of any units)

6. The above illustrated benefits are derived on the basis of details of life insured 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.

7. 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. The GST is applicable on all the charges i.e. Allocation charge,
Administration Charge, Mortality Charge, and Fund Management Charge

8. The values shown are for illustrative purpose only. This illustration is not a contract of insurance and must be read in conjuction with the Product
Brochure and Policy Document.

9. The illustration assumes no change during the Policy Term in Investment Strategy or Risk Appetite chosen at inception.

10. The benefits illustrated assume that no partial withdrawals will be made during the policy term. In case of partial withdrawals are made during the
policy term, the illustrative benefits will differ.

11. Premium Allocation Rates and Mortality Rates, are guaranteed for the lifetime of the policy. All other charges may be altered during the lifetime of
the policy with prior approval from IRDAI.

12. Tax benefits under the policy are subject to conditions under Sec 10 (10D) and Sec 80C of the Income Tax Act, 1961 in accordance with the
prevailing Tax Laws. Prevailing Tax Laws will be applicable on this policy which may vary from time to time. Please consult your tax advisor for
details.

13. 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. Prevailing 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:BB240521115305891

Risk Factors

• Unit Linked Life Insurance products are different from the traditional insurance products and are subject to the risk factors.

• The premium paid in Unit Linked Life Insurance policies are subject to investment risks associated with capital markets and the NAVs of the units
may go up or down based on the performance of fund and factors influencing the capital market and the insured is responsible for his/her
decisions.

• Kotak Mahindra Life Insurance Company Ltd. is only the name of the Insurance Company and Kotak Single Invest Advantage is only the name of
the unit linked life insurance contract and does not in any way indicate the quality of the contract, its future prospects or returns.

• The various funds offered under this contract are the names of the funds and do not in any way indicate the quality of these plans, their future
prospects and returns.

• Please know the associated risks and the applicable charges, from your Insurance Agent or Corporate Agent / Insurance Broker or policy
document of the insurer.

For more details on risk factors, terms and conditions please read the sales brochure carefully before concluding a sale.

I, _____________________________(Name), have explained the I, Mr DR SANTOSH DARISETTY (Name), having received the

premiums and benefits under the product fully to the prospect information with respect to the above, have understood the above

/policyholder. statement before entering into the contract.

(Accepted vide a declaration (Customer

Declaration Form) signed by him/her)

Place :_____________ __________________________________ Place :_____________ __________________________________

Date : 24-May-2021 Signature of Agent /Intermediary/Official Date : 24-May-2021 Signature of Prospect/Policyholder

Kotak Mahindra Life Insurance Company Limited

CIN: U66030MH2000PLC128503
Regd. Office: 2nd Floor, Plot# C-12, G-Block, BKC, Bandra (E), Mumbai - 400 051
Regn. No: 107. Toll Free No.: 1800 209 8800. Website: http://insurance.kotak.com

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