STATEMENT OF ACCOUNT AS ON 25/06/24

FUTURE_GAIN
To, Statement Date : 25-06-2024
Policy No. : 0598498394
Mr. ARUN KUMAR NISHAD Issued Date : 24-JUN-24
Sum Assured : Rs. 300000
Frequency Of Payment : Yearly
Premium Amount : Rs.
Policy is eligible for partial withdrawal post lock-in period 30468.720703125
Portfolio Strategy : Investor selectable portfolio strategy

Summary Top Up
Top Up
Regular
Regular
Fund Name & SFIN NAV Premium Premium Fund Capital Units
Premium Units Premium Units
Fund Value Value
PURE STOCK FUND II :
25.8196 0 0 310.6989 8022.12 0
ULIF07709/01/2017PURSTKFUN2116

FLEXI CAP FUND :

16.6236 0 0 482.5741 8022.12 0
ULIF07917/11/21FLXCAPFUND116

SMALL CAP FUND :

18.7006 0 0 285.9838 5348.07 0
ULIF08717/01/23SMALLCAPFU116

MIDCAP INDEX FUND :

12.6613 0 0 422.395 5348.07 0
ULIF08919/10/23MIDCPINDFD116

0 0 1501.6518 26740.38 0

*Account Value Rs. 26740.38

PURE STOCK FUND II SFIN : ULIF07709/01/2017PURSTKFUN2116

Net
Transaction Allocation Allocated
Req ID Transaction Amount (Rs) Investment Unit Price
Date Rate % Units
(Rs)
24-JUN-24 New Business Regular 30000 91 8190 25.8196 317.2009
Total Charges 0 0 -167.88 0 -6.5020
Balance c/f 310.6989

FLEXI CAP FUND SFIN : ULIF07917/11/21FLXCAPFUND116

Net
Transaction Allocation Allocated
Req ID Transaction Amount (Rs) Investment Unit Price
Date Rate % Units
(Rs)
24-JUN-24 New Business Regular 30000 91 8190 16.6236 492.6731
Total Charges 0 0 -167.88 0 -10.0990
Balance c/f 482.5741

Bajaj Allianz Life Insurance Co. Ltd., Regd. Office Address: Bajaj Allianz House, Airport Road, Yerawada, Pune - 411006., IRDAI Reg No.: 116, Visit : www.bajajallianzlife.com, CIN :
U66010PN2001PLC015959, Mail us : customercare@bajajallianz.co.in, Call on : Toll free no. 1800 209 7272, Fax No: 02066026789. The Logo of Bajaj Allianz Life Insurance Co. Ltd. is
provided on the basis of license given by Bajaj Finserv Ltd. to use its “Bajaj” Logo and Allianz SE to use its “Allianz” logo.
 SMALL CAP FUND SFIN : ULIF08717/01/23SMALLCAPFU116

Net
Transaction Allocation Allocated
Req ID Transaction Amount (Rs) Investment Unit Price
Date Rate % Units
(Rs)
24-JUN-24 New Business Regular 30000 91 5460 18.7006 291.9692
Total Charges 0 0 -111.93 0 -5.9854
Balance c/f 285.9838

MIDCAP INDEX FUND SFIN : ULIF08919/10/23MIDCPINDFD116

Net
Transaction Allocation Allocated
Req ID Transaction Amount (Rs) Investment Unit Price
Date Rate % Units
(Rs)
24-JUN-24 New Business Regular 30000 91 5460 12.6613 431.2353
Total Charges 0 0 -111.93 0 -8.8403
Balance c/f 422.3950

Foreclosure Pen in Rs : 0 ST/GST on Pen in Rs : 0

Partial Withdrawals and Fund Switch are allowed only from Accumulation Units as per terms and conditions of
the policy ,
Accumulation Units 0 & Unit Value is 0 as on
Lock- In Period
Withdrawal 5 Years from date of commencement
Surrender 5 Years from date of commencement
Top Up 5 Years from date of Top Up adjustment

*The Account Value on the basis of which your request shall be processed may be subject to revision at the time of final
verification of the Statement of Account. The Company reserves the right to make necessary corrections in the Statement of
Account to remove any inadvertent errors and prepare the same in accordance with Policy Terms

Disclaimer :
Tax will be deducted under section 194DA of the Income Tax Act, 1961 subject to conditions as mentioned in Section 10(10D)
of Income Tax Act,1961.If PAN is updated in system, TDS will be deducted @ 5% on income from policy. In the absence of PAN,
TDS will be deducted @ 20% on income from policy. TDS once deducted will not be refunded.
1. Please update your PAN in system so that TDS certificate can be issued. In the absence of PAN, TDS certificate cannot be
issued. Please consult your Income Tax advisor/consultant for tax treatment under Income Tax Act,1961.
For NRI customers TDS shall be deducted under section 195 of Income Tax Act,1961 at applicable rates.
2. You have the option to receive the claims/maturity payments/other sum due to you from the Company through electronic
mode. If you wish to receive the payment through electronic mode, kindly furnish your Bank Account details (Account No,

Bajaj Allianz Life Insurance Co. Ltd., Regd. Office Address: Bajaj Allianz House, Airport Road, Yerawada, Pune - 411006., IRDAI Reg No.: 116, Visit : www.bajajallianzlife.com, CIN :
U66010PN2001PLC015959, Mail us : customercare@bajajallianz.co.in, Call on : Toll free no. 1800 209 7272, Fax No: 02066026789. The Logo of Bajaj Allianz Life Insurance Co. Ltd. is
provided on the basis of license given by Bajaj Finserv Ltd. to use its “Bajaj” Logo and Allianz SE to use its “Allianz” logo.
 You have the option to receive the claims/maturity payments/other sum due to you from the Company through electronic
mode. If you wish to receive the payment through electronic mode, kindly furnish your Bank Account details (Account No,
Name & Address of the Bank and IFSC No.) along with a copy of cancelled cheque at the Office of the Company.

Please ensure to keep your bank particulars updated in case of any subsequent change.
* Account Value is based on NAV available on
Service tax or Goods and service tax is charged as applicable
Note : This is a computer generated letter. No signature is required.
Regd. Office Address: Bajaj Allianz House, Airport Road, Yerawada, Pune - 411006. Reg. No.: 116. CIN :
U66010PN2001PLC015959 | Mail us: customercare@bajajallianzlife.co.in | Call on : Toll free no. 1800 209 7272 | Fax No:
02066026789.

Collection Details
BS
Receipt Transaction Drawee Cheque Deposit
Receipt No. Pay Mode Amount Cheque No Cheque
Date Type Bank Date Bank
Status
1260965133 12-JUN-24 UPI FRP 30553 T HDFC

Assuring you the best of our services, always!

Your Life Goals enabler,
Bajaj Allianz Life

For any assistance

Call our Toll Free Number: 18002097272 Email us on: customercare@bajajallianz.co.in

Bajaj Allianz Life Insurance Co. Ltd., Regd. Office Address: Bajaj Allianz House, Airport Road, Yerawada, Pune - 411006., IRDAI Reg No.: 116, Visit : www.bajajallianzlife.com, CIN :
U66010PN2001PLC015959, Mail us : customercare@bajajallianz.co.in, Call on : Toll free no. 1800 209 7272, Fax No: 02066026789. The Logo of Bajaj Allianz Life Insurance Co. Ltd. is
provided on the basis of license given by Bajaj Finserv Ltd. to use its “Bajaj” Logo and Allianz SE to use its “Allianz” logo.