BENEFIT ILLUSTRATION

[Date and Time of Illustration – 11 September 2023, 03:09 PM]

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

Age & Gender: 35 Years, Male Name of the Product: Max Life Smart Wealth Advantage Guarantee Plan
Name of the Life Assured: Mr. NAME Tag Line: A Non-linked Non Participating Individual Life Insurance Savings Plan
Age & Gender: 35 Years, Male Unique Identification No: 104N124V04
Policy Term: 39 Years GST Rate (Base Policy, First Year): 4.50%
Premium Payment Term: 8 Years GST Rate (Base Policy, Subsequent Year): 2.25%
Amount of Installment Premium: `1,04,500 GST Rate (Rider, First Year): NA
Mode of payment of premium: Annual
GST Rate (Rider, Subsequent Year): NA
Annual Income Amount: `70,057
Income Start Year, if applicable: NA
Income Period, if applicable: 30 years Max Life State: Tamil Nadu
Deferment Period, if applicable: 1 year Policyholder Residential State: Tamil Nadu

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.) 8,00,000
Death Benefit Multiple NA Sum Assured (at inception of the policy) upon Death (in Rs.) 11,00,000
Policy Continuance Benefit Option No Sum Assured (Inbuilt Additional Accidental Death Benefit) (in Rs.) 5,50,000
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.) 1,00,000 0 0 0 0 1,00,000
Installment Premium with first year GST (in Rs.) 1,04,500 0 0 0 0 1,04,500
Installment Premium with GST 2nd year onwards (in Rs.) 1,02,250 0 0 0 0 1,02,250

UIN: 104N124V04 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 1,00,000 1,00,000 - - - - - - - - 11,00,000 - - -

2 1,00,000 1,00,000 - - - - - - - - 11,00,000 - 60,000 69,763
3 1,00,000 1,00,000 - - - - - - - - 11,00,000 - 1,05,000 1,14,054
4 1,00,000 1,00,000 - - - - - - - - 11,00,000 - 2,00,000 2,14,500
5 1,00,000 1,00,000 - - - - - - - - 11,00,000 - 2,50,000 2,92,255
6 1,00,000 1,00,000 - - - - - - - - 11,00,000 - 3,00,000 3,82,286
7 1,00,000 1,00,000 - - - - - - - - 11,00,000 - 3,50,000 4,86,115
8 1,00,000 1,00,000 7,000 - - - - - - - 11,00,000 - 4,10,320 7,15,572
9 - - - - - - - - - - 11,00,000 5,50,000 4,20,640 7,80,063
10 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 4,30,960 8,50,280
11 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 3,71,223 8,50,365
12 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 3,11,486 8,50,571
13 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 2,51,748 8,50,773
14 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 1,92,011 8,51,000
15 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 1,32,274 8,51,195
16 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 72,537 8,51,460
17 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 12,800 8,51,727
18 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,52,006
19 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,52,298
20 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,52,677
21 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,53,052
22 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,53,480
23 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,53,932
24 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,54,367
25 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,54,893
26 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,55,528
27 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,56,118
28 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,56,810

UIN: 104N124V04 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 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,57,580

30 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,58,388
31 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,59,331
32 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,60,252
33 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,61,368
34 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,62,475
35 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,63,743
36 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,65,152
37 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,66,656
38 - - - 58,381 11,676 - 70,057 - - - 11,00,000 5,50,000 - 8,68,250
39 - - - 58,381 11,676 - 70,057 - 8,00,000 8,00,000 11,00,000 5,50,000 - 8,70,057
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 (name), having received the information with respect to the above, have understood
under the product fully to the prospect / policyholder. the above statement before entering into the contract.

Place: Signature / Thumb Impression / Electronic Signature of Date:9/11/23 Signature / Thumb Impression / Electronic Signature of
Date: 9/11/23 Agent/ Intermediary / Official Prospect/ Policyholder
This system generated benefit illustration shall be treated as signed by me.

UIN: 104N124V04 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