Statement of Product Value

Registration No: 55635755 Login Date: 31/01/08

Policy holder ID. 7249404 Name of Policyholder Mr. MABIN
Address AT-DHANGAWAN, BERHO, PO-CHOUKI HARIPUR, KATIHAR, BIHAR, 855105

PART A
Premium Amt. Inc Premium Allocation Units as per Policy Admin Value per
Product Name UIN Top-up(`) Charge(`) Fund Allocated (`) System (PAS) Unit (`) Product Value
A
new_unitgain1 116l020v03 4690000 0 -2622.89 648.5591 48050.27 0

PART B
Particulars ulif03124/07/06accemidcap116 Total
Name of the Fund accelerator mid-cap fund
Units (as per Investment Management System) 648.5591 648.5591
Percentage of Allocation (as on Login Dt) 79% 79%
Funds Allocated -2622.89 -2622.89
Switch In (`) 0.00 0.00
Switch Out (`) 0.00 0.00
Withdrawals 0.00 0.00
Charges (`) M B
Allocation charges 0.00 0.00
Switch charge 0.00 0.00
Policy administration charge -15386.78 -15386.78
Mortality charges -7549.15 -7549.15
Other charges (specify) 0.00 0.00
Service tax/GST -3438.83 -3438.83
Total amount invested in segregated funds -2622.89 -2622.89
Current NAV 144.70 144.70
Fund value as on login Dt: -2622.89 -2622.89

PART - C (Product Statistics)

Insurance Cover over the interim reporting period from 28-JAN-08 To 31/01/08 L059A01
Total Premium Paid from inception(D) 5000
Total Risk premium from inception, for insurance cover(E) 0
Total Charges and deductions other than Mortality including Allocation charges till Login Dt. (including Service Charges)(F) 0 C
Difference between (A) (B) (unrealised Gain / Loss) 0
Portfolio value on Net Investment as per Benefit Illustration at 4% rate as prescribed in the regulations 0
Portfolio value on Net Investment as per Benefit Illustration at 8% rate as prescribed in the regulations 0
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