BENEFIT ILLUSTRATION

[Date and Time of Illustration – 16 July 2023, 05:59 PM]

Name of the Prospect/Policyholder: Mr. Proposal No:

Age & Gender: 35 Years, Male Name of the Product: Max Life Smart Wealth Advantage Guarantee Plan
Name of the Life Assured: Mr. Tag Line: A Non-linked Non Participating Individual Life Insurance Savings Plan
Age & Gender: 25 Years, Male Unique Identification No: 104N124V03
Policy Term: 37 Years GST Rate (Base Policy, First Year): 4.50%
Premium Payment Term: 10 Years GST Rate (Base Policy, Subsequent Year): 2.25%
Amount of Installment Premium: `52,250 GST Rate (Rider, First Year): NA
Mode of payment of premium: Annual
GST Rate (Rider, Subsequent Year): NA
Annual Income Amount: `54,656
Income Start Year, if applicable: NA
Income Period, if applicable: 25 years Max Life State: Delhi
Deferment Period, if applicable: 2 years Policyholder Residential State: Delhi

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

Policy Details
Policy Option Long Term Wealth Sum Assured on Maturity (in Rs.) 5,00,000
Death Benefit Multiple NA Sum Assured (at inception of the policy) upon Death (in Rs.) 5,50,000
Policy Continuance Benefit Option No Sum Assured (Inbuilt Additional Accidental Death Benefit) (in Rs.) 2,75,000
Special Date Option No Opted Special Date NA

Rider Details

Accidental Death & Dismemberment (ADD) Rider Term NA Accidental Death & Dismemberment (ADD) Rider Sum Assured (in Rs.) NA

Term Plus Rider Term NA Term Plus Rider Sum Assured (in Rs.) NA
Waiver of Premium (WOP) Plus Rider Term NA
Critical Illness and Disability Rider - Rider Premium Payment
NA Critical Illness and Disability Rider - Coverage Variant NA
Term and Rider Term
Critical Illness and Disability Rider - Rider Sum Assured NA

Premium Summary
Accidental Death & Waiver of Premium Plus Critical Illness and Total Installment Premium
Base Plan Dismemberment Rider
Term Plus Rider Rider Disability Rider
Installment Premium without GST (in Rs.) 50,000 0 0 0 0 50,000
Installment Premium with first year GST (in Rs.) 52,250 0 0 0 0 52,250
Installment Premium with GST 2nd year onwards (in Rs.) 51,125 0 0 0 0 51,125

UIN: 104N124V03 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 3
 (Amount in Rupees)
Non Guaranteed
Guaranteed
Single/
Total Annual Other Benefits, if Inbuilt
Policy Annualized Money Back Accrued Minimum
Premium (BOY) Auto Debit any (Sum Additional Special
Year Premium (BOY) Base Income Loyalty Income (In case of Life Total Survival Guaranteed Total Maturity Guaranteed
Booster Assured on Death Benefit Accidental Surrender Value
(EOY) (EOY) Long Income) Benefit (EOY) Additions (if Benefit (EOY) Surrender Value
(EOY) Maturity) (EOY) Death Benefit (EOY)
any) (EOY) (EOY)

1 50,000 50,000 - - - - - - - - 5,50,000 - - -

2 50,000 50,000 - - - - - - - - 5,50,000 - 30,000 35,135
3 50,000 50,000 - - - - - - - - 5,50,000 - 52,500 57,442
4 50,000 50,000 - - - - - - - - 5,50,000 - 1,00,000 92,474
5 50,000 50,000 - - - - - - - - 5,50,000 - 1,25,000 1,38,211
6 50,000 50,000 - - - - - - - - 5,50,000 - 1,50,000 1,80,797
7 50,000 50,000 - - - - - - - - 5,50,000 - 1,75,000 2,29,921
8 50,000 50,000 - - - - - - - - 5,50,000 - 2,05,516 2,86,424
9 50,000 50,000 - - - - - - - - 5,50,000 - 2,37,411 3,51,201
10 50,000 50,000 4,500 - - - - - - - 6,25,851 - 2,70,685 5,00,681
11 - - - - - - - - - - 6,82,152 2,75,000 2,77,580 5,45,722
12 - - - - - - - - - - 7,43,584 2,75,000 2,84,475 5,94,867
13 - - - 45,547 9,109 - 54,656 - - - 8,10,481 2,75,000 2,91,370 6,48,385
14 - - - 45,547 9,109 - 54,656 - - - 8,08,970 2,75,000 2,43,609 6,47,176
15 - - - 45,547 9,109 - 54,656 - - - 8,07,307 2,75,000 1,95,847 6,45,846
16 - - - 45,547 9,109 - 54,656 - - - 8,05,483 2,75,000 1,48,086 6,44,387
17 - - - 45,547 9,109 - 54,656 - - - 8,03,488 2,75,000 1,00,324 6,42,790
18 - - - 45,547 9,109 - 54,656 - - - 8,01,359 2,75,000 52,563 6,41,087
19 - - - 45,547 9,109 - 54,656 - - - 7,99,010 2,75,000 4,807 6,39,208
20 - - - 45,547 9,109 - 54,656 - - - 7,96,463 2,75,000 - 6,37,170
21 - - - 45,547 9,109 - 54,656 - - - 7,93,676 2,75,000 - 6,34,941
22 - - - 45,547 9,109 - 54,656 - - - 7,90,593 2,75,000 - 6,32,475
23 - - - 45,547 9,109 - 54,656 - - - 7,87,274 2,75,000 - 6,29,819
24 - - - 45,547 9,109 - 54,656 - - - 7,83,704 2,75,000 - 6,26,963
25 - - - 45,547 9,109 - 54,656 - - - 7,79,733 2,75,000 - 6,23,786
26 - - - 45,547 9,109 - 54,656 - - - 7,75,442 2,75,000 - 6,20,354
27 - - - 45,547 9,109 - 54,656 - - - 7,70,778 2,75,000 - 6,16,623
28 - - - 45,547 9,109 - 54,656 - - - 7,65,669 2,75,000 - 6,12,535

UIN: 104N124V03 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 3
 Non Guaranteed
Guaranteed
Single/
Total Annual Other Benefits, if Inbuilt
Policy Annualized Money Back Accrued Minimum
Premium (BOY) Auto Debit any (Sum Additional Special
Year Premium (BOY) Base Income Loyalty Income (In case of Life Total Survival Guaranteed Total Maturity Guaranteed
Booster Assured on Death Benefit Accidental Surrender Value
(EOY) (EOY) Long Income) Benefit (EOY) Additions (if Benefit (EOY) Surrender Value
(EOY) Maturity) (EOY) Death Benefit (EOY)
any) (EOY) (EOY)

29 - - - 45,547 9,109 - 54,656 - - - 7,60,150 2,75,000 - 6,08,120

30 - - - 45,547 9,109 - 54,656 - - - 7,54,049 2,75,000 - 6,03,239
31 - - - 45,547 9,109 - 54,656 - - - 7,47,488 2,75,000 - 5,97,991
32 - - - 45,547 9,109 - 54,656 - - - 7,40,251 2,75,000 - 5,92,201
33 - - - 45,547 9,109 - 54,656 - - - 7,32,410 2,75,000 - 5,85,928
34 - - - 45,547 9,109 - 54,656 - - - 7,23,884 2,75,000 - 5,79,108
35 - - - 45,547 9,109 - 54,656 - - - 7,14,566 2,75,000 - 5,71,653
36 - - - 45,547 9,109 - 54,656 - - - 7,04,375 2,75,000 - 5,63,500
37 - - - 45,547 9,109 - 54,656 - 5,00,000 5,00,000 6,93,321 2,75,000 - 5,54,656
Notes:
• EOY: End of Year, BOY = Beginning of Year
• Annualized Premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any, and Goods and Service Tax.
• Total Annual Premium includes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any but excludes Goods and Service Tax.
• The Surrender Value payable shall be higher of ‘Minimum Guaranteed Surrender Value’ and ‘Special Surrender Value’. Any additional Surrender Value over and above the ‘Minimum Guaranteed Surrender Value’ is not
guaranteed.
• The above benefits are assuming income payment mode as Annual and with the assumption that no special date is opted by you. For details on other income payment modes and special date options, please refer the Policy
Document.
• The Net Rate of Return has been calculated based on the total survival (including auto-debit booster) and total maturity benefit, assuming that all premiums have been paid as and when due (excluding applicable taxes, cesses
and levies and rider premiums, if any).
• Refer Sales literature (Prospectus) and Policy Document for explanation of terms used in this illustration.
• Surrender value (both GSV and SSV) shown above is before payment of survival benefit applicable during the year of surrender.
• The above benefit illustration assumes that all premiums (excluding the first premium) are paid via auto debit mode of premium payment. Note that auto debit boosters are applicable only on the premiums paid via auto debit
mode of premium payment. Auto debit booster shall be payable only to the fully paid-up policies where all due premiums have been paid.

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: Signature / Thumb Impression / Electronic Signature of Date:7/16/23 Signature / Thumb Impression / Electronic Signature of
Date: 7/16/23 Agent/ Intermediary / Official Prospect/ Policyholder
This system generated benefit illustration shall be treated as signed by me.

UIN: 104N124V03 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 3