Name: Shivang Sum Assured: Not Applicable

DateOf Birth: 02/01/1997 Policy Term: 12

Age in(yrs): 26 PPT: 6

Gender: Male Mode: Yearly

Benefit Illustration for Shriram Life Premier Assured Benefit

128N094V02
(This Benefit Illustration forms part of the Policy Document)

Guaranteed Non Guaranteed

 Policy  Total Annualized   Survival Benefits /   Other Benefits      Guaranteed  Death Benefit   Min Guaranteed   Special Surrender Value 
  Year  Premium paid till Loyalty Additions  if any   Maturity Benefit Surrender Value  
date    
1 1000000.00 0 0 11000000 0 0

2 1000000.00 0 0 11000000 600000 412688

3 1000000.00 0 0 11000000 1050000 996492

4 1000000.00 0 0 11000000 2000000 1905748

5 1000000.00 0 0 11000000 2750000 3179043

6 1000000.00 0 0 11000000 3900000 4881803

7 0 0 11000000 4500000 6039344

8 0 0 11000000 4680000 6502360

9 0 0 11000000 4860000 7066032

10 0 0 11000000 5040000 7730360

11 0 0 11000000 5400000 8495343

12 0 15465573 11000000 5400000 9360982

Notes:
(1) Annualized premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any
Goods & Service Tax. Refer Sales literature for explanation of terms used in this illustration.
(2) This is only an illustration and does not in any way create any rights and/or obligations.
(3) This illustration is applicable to a healthy individual and acceptance of the proposal is suject to underwriting. Premiums relating to riders and
non-standard risks are excluded from the above.
(4) The above amounts assume that all premiums have been paid on due date.
(5) The Death Benefit shown above equals sum of death SA payable in equal monthly installments, Income Benefit (if any) payable as and when
due and Maturity Benefit payable on maturity.
(6) Surrender value payable is higher of GSV or SSV. Please contact nearest branch office for latest surrender value payable on your policy.

Policy Details
Cover Option Life Sum Assured Rs. Not Applicable
Benefit Option Settlement - Lumpsum Sum Assured on Death (at inception of the policy) Rs. 11000000
Premium Summary
Base Plan Riders Total Instalment Premium
Instalment Premium without GST 1000000 0 1000000
Instalment Premium with First Year GST 1045000 1045000
Instalment Premium with GST 2nd Year Onwards 1022500 1022500

IRDAI Regn No:128

I, .........................................., have explained the premiums, and benefits I, Shivang
under the product fully to the prospect / Policyholder. having received the information with respect to the above, have
understood the above statement before entering into the contract

Date : Signature of Agent / Intermediary / Date : Signature of the Prospect/

Official /Specified Person Policy holder's signature
Place: