Non-Linked Participating Individual Life Insurance Savings Plan | UIN : 104N135V01

Mr.

(UIN : 104N135V01)

LIFELONG INCOME

You shall pay Rs.1,00,000 (excluding taxes) on an Annual mode

for 12 years.Your Policy Term is for 65 years.

Starting from 04/Mar/2025 an

Income of Rs.30,250* shall ***
***
be payable. After age 65 an
income of Rs.1,21,000, which
is 4 times of your previous
From 1st year
income shall be payable Not Not
till Rs.30,250^ Rs.30,250
Annually to you till the Applicable Applicable
age of 100 years. The Total Income
12th year
over the policy term shall be
Rs.50,51,750*.
From 13th year
Not
till 65 years of Rs.9,000 Rs.21,250& Rs.30,250
Applicable
age

From 32th year

Not
till 100 years Rs.36,000 Rs.85,000% Rs.1,21,000
Applicable
of age
Please note all the incomes listed above shall be paid on Annual Mode
^Cash Bonus of Rs.30,250 (@8% Illustration)/ Rs.2,313 (@4% Illustration) will be payable Annually from 1st Policy year onwards till year 12
&Cash Bonus of Rs.21,250 (@8% Illustration)/ Rs.1,625 (@4% Illustration) will be payable Annually from year 13 onwards till year 65
%Cash Bonus of Rs.85,000 (@8% Illustration)/ Rs.6,500 (@4% Illustration) will be payable Annually from year 32 onwards till year 100
 On 04/Mar/2089 the policy
will mature, Maturity Benefit of
Rs.2,12,80,560* will be paid to the
policyholder. In case, any survival
benefits were accrued during the
policy term, will also be provided
at maturity.

Sum Assured
Rs.12,00,000
on Maturity

Cash Bonus and Terminal Bonus

figures mentioned above are Additional
Rs.0
variable and depend on the Bonus. Benefits#
Rate declared by the company
from time to time.

Terminal
Rs.2,00,80,560
Bonus @8%$

Total Maturity
Rs.2,12,80,560
Benefit

$The Terminal Bonus of Rs.2,00,80,560 (@8% Illustration)/Rs.58,60,200 (@4% Illustration) will be paid in addition to
Sum Assured on Maturity.
#Only Applicable In case the life insured is female.
*The figures are illustrated @8%. For more information please refer to the benefit illustration attached in the policy pack

Cash Bonus of
Rs.30,250 @8%

Maturity Benefit
Rs.2,12,80,560

Cash Bonus +
Cash Bonus + Guaranteed Income***
Guaranteed Income***
of Rs.1,21,000 @8%
of Rs.30,250 @8%
Rs.85,000 @8% + Rs.36,000
Rs.21,250 @8% +
Rs.9,000

Premium Payment Term

Age Age
of 12 years
35 years 100 years

Total Premium : Rs. 12,00,000 @4%# : 727% | @8%# : 2194%

#Kindly note that the above scenarios are only illustrations and does not create any rights and / or obligations. The assumed non-guaranteed rates of return
chosen in the above illustration are 4% and 8%. These assumed rates of return are not guaranteed and are not the upper or lower limit of what you might get
back as the value of your policy is dependent on a number of factors including future investment performance. The actual experience on the contract may be
different from the illustrated.
 The minimum death benefit at inception is Rs.12,00,000.

Any accrued survival benefit, if not paid earlier, shall be paid in addition to death benefit.

^Individual
Death Claims Paid Ratio as per IRDAI Annual Report FY 2021-2022. | *As per Public Disclosures 2022.
LIFE INSURANCE COVERAGE IS AVAILABLE IN THIS PRODUCT.

@Policy Continuance Benefit is available in all plan variants except for 100 – Age at Entry Variant & Accidental Death Benefit (ADB) is available in all plan variants for ages greater than or equal to 18 years.
***Guaranteed Income is a % of Annualised Premium and shall depend on the Guaranteed Income Payout Frequency, Age of the life insured, Plan variant, PCB Option and Premium Payment Term.

Guaranteed Income shall be applicable provided all due premiums are paid. All applicable Guaranteed Benefits in the product are subject to payment of all due premiums. Max Life Smart Wealth Advantage Growth Par Plan (UIN: 104N135V01) is a non linked participating
Individual Life Insurance Savings plan which provides Cash Bonuses and Terminal Bonus, which are variable in nature and declared by the company from time to time.
For further information on the product and its plan variants please refer to the Prospectus. If you wish to refer to the Terms and Conditions of the product please read the Policy Document available on the company website.
Max Life Insurance Company Limited is a joint venture between Max Financial Services Limited and Axis Bank Ltd. Max Life Insurance Co. Ltd., Corporate Office: 11th Floor, DLF Square Building, Jacaranda Marg, DLF City Phase II,
Gurugram - 122 002 (Haryana). Insurance is the subject matter of solicitation. For more details on the risk factors, Terms and Conditions, please read the prospectus carefully before concluding a sale. You may be entitled to
certain applicable tax benefits on your premiums and policy benefits. Please note all the tax benefits are subject to tax laws prevailing at the time of payment of premium or receipt of benefits by you. Tax benefits are subject to
changes in tax laws. Trade logos displayed belongs to Max Financial Services Ltd. and Axis Bank Ltd. respectively and with their consents, are used by Max Life Insurance Co. Ltd. Customer Helpline Number: 1860 120 5577.
Website: www.maxlifeinsurance.com, SMS 'LIFE' to 5616188

ARN: Max Life/FCB/Marketing/SWAG Par_Lifelong Income BI/May 2023

 BENEFIT ILLUSTRATION
[Date and Time of Illustration – 04 March 2024, 06:11 PM]

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

Age & Gender: 35 Years, Male Name of the Product: Max Life Smart Wealth Advantage Growth Par Plan

Name of the Life Assured: Mr. Tag Line: A Non-Linked Participating Individual Life Insurance Savings Plan

Age & Gender: 35 Years, Male Unique Identification No: 104N135V01

GST Rate (Base Policy, First Year): 4.50%
Policy Term: 65 Years GST Rate (Base Policy, Subsequent Year): 2.25%
GST Rate (Rider Policy, First Year): NA
Premium Payment Term: 12 Years
GST Rate(Rider Policy,Subsequent Year): NA
Amount of Installment Premium: `1,04,500
Max Life State: West Bengal
Mode of payment of premium: Annual Policyholder Residential State: West Bengal

How to read and understand this benefit illustration?

This benefit illustration is intended to show year-wise premiums payable and benefits under the policy, at two assumed rates of interest i.e., 8% p.a. and 4% p.a.
Some benefits are guaranteed and some benefits are variable with returns based on the future performance of your Insurer carrying on life insurance business. If your policy offers guaranteed returns benefits then these will be
clearly marked “guaranteed” in the illustration table on the next this page. If your policy offers variable returns benefits then the illustration on the next this page will show two different rates of assumed future investment returns,
of 8% p.a. and 4% p.a..These assumed rates of return are not guaranteed and they are not the upper or lower limits of what you might get back, as the value of your policy is dependent on a number of factors including future
investment performance.

Policy Details
Variant Name Lifelong Income Sum Assured on Maturity (in Rs.) 12,00,000
Policy Continuance Benefit Option No Additional Benefit on Maturity (only applicable for female lives) (in Rs.) -
Payment Frequency for Guaranteed Income & Cash Bonus Annual Sum Assured on Death (at inception of the policy) (in Rs.) 12,00,000
Save the date Option No Date of first Survival Benefit payment Tuesday, March 04, 2025

Rider Details
Accidental Death & Dismemberment (ADD) Rider Premium Payment Term and Rider Term NA Accidental Death & Dismemberment (ADD) Rider Sum Assured (in Rs.) NA
Term Plus Rider Term - Premium Payment Term and Rider Term NA Term Plus Rider Sum Assured (in Rs.) NA
Waiver of Premium (WOP) Plus Rider Term NA Critical Illness and Disability Rider - Coverage Variant NA
Critical Illness and Disability Rider - Rider Premium Payment Term and Rider Term NA Critical Illness and Disability Rider - Rider Sum Assured NA

Premium Summary

Accidental Death & Waiver of Premium Critical Illness and Total Installment
Base Plan Term Plus Rider
Dismemberment Rider Plus Rider Disability Rider Premium

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: 104N135V01 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 6
 (Amount in Rupees)

Non-Guaranteed Benefit @ Non-Guaranteed Benefit @

Total Benefits including Guaranteed and Non- Guaranteed
Guaranteed Benefits 4% per 8% per
Benefits
annum investment return annum investment return

Age at the
Single/
Policy start of
Annualized
Year the Policy
Premium Total Survival Total Survival
Year Guaranteed Additional Special Special Total Death Total Death
Survival Death Maturity & Maturity & Maturity
Surrender Accidental Cash Bonus Surrender Cash Bonus Surrender Benefit Benefit
Benefit Benefit Benefit Benefit @ 4% Benefit @ 8%
Value (GSV) Death Benefit Value (SSV) Value (SSV) @4% @8%
(4+7+9) (4+7+11)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

1 35 1,00,000 - - 12,00,000 - - 2,313 - 30,250 - 12,00,000 12,00,000 2,313 30,250

2 36 1,00,000 - 60,000 12,00,000 - - 2,313 70,000 30,250 70,000 12,00,000 12,00,000 2,313 30,250

3 37 1,00,000 - 1,05,000 12,00,000 - - 2,313 1,20,000 30,250 1,22,766 12,00,000 12,00,000 2,313 30,250

4 38 1,00,000 - 2,00,000 12,00,000 - - 2,313 2,08,000 30,250 2,08,000 12,00,000 12,00,000 2,313 30,250

5 39 1,00,000 - 2,50,000 12,00,000 - - 2,313 2,70,000 30,250 2,70,000 12,00,000 12,00,000 2,313 30,250

6 40 1,00,000 - 3,00,000 12,00,000 - - 2,313 3,48,000 30,250 3,48,000 12,00,000 12,00,000 2,313 30,250

7 41 1,00,000 - 3,50,000 12,00,000 - - 2,313 4,34,000 30,250 4,44,676 12,00,000 12,00,000 2,313 30,250

8 42 1,00,000 - 4,45,680 12,00,000 - - 2,313 5,28,000 30,250 5,62,900 12,00,000 12,00,000 2,313 30,250

9 43 1,00,000 - 5,52,870 12,00,000 - - 2,313 6,49,804 30,250 6,97,034 12,00,000 12,00,000 2,313 30,250

10 44 1,00,000 - 6,71,400 12,00,000 - - 2,313 7,75,948 30,250 8,48,354 12,00,000 12,00,000 2,313 30,250

11 45 1,00,000 - 8,01,460 12,00,000 - - 2,313 9,11,587 30,250 10,19,519 12,00,000 12,00,000 2,313 30,250

12 46 1,00,000 - 9,42,840 12,60,000 - - 2,313 10,59,685 30,250 12,12,128 12,60,000 12,60,000 2,313 30,250

13 47 - 9,000 10,11,480 12,60,000 - 6,00,000 1,625 11,33,949 21,250 13,39,291 12,60,000 12,60,000 10,625 30,250

14 48 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 11,89,857 21,250 14,11,126 12,60,000 12,60,000 10,625 30,250

15 49 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 12,11,037 21,250 14,74,967 12,60,000 12,60,000 10,625 30,250

16 50 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 12,33,277 21,250 15,42,001 12,60,000 12,60,000 10,625 30,250

17 51 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 12,56,787 21,250 16,12,865 12,60,000 12,60,000 10,625 30,250

UIN: 104N135V01 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 6
 Non-Guaranteed Benefit @ Non-Guaranteed Benefit @
Total Benefits including Guaranteed and Non- Guaranteed
Guaranteed Benefits 4% per 8% per
Benefits
annum investment return annum investment return

Age at the
Single/
Policy start of
Annualized
Year the Policy
Premium Total Survival Total Survival
Year Guaranteed Additional Special Special Total Death Total Death
Survival Death Maturity & Maturity & Maturity
Surrender Accidental Cash Bonus Surrender Cash Bonus Surrender Benefit Benefit
Benefit Benefit Benefit Benefit @ 4% Benefit @ 8%
Value (GSV) Death Benefit Value (SSV) Value (SSV) @4% @8%
(4+7+9) (4+7+11)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

18 52 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 12,81,569 21,250 16,87,560 12,60,000 12,96,401 10,625 30,250

19 53 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 13,07,691 21,250 17,66,298 12,60,000 13,51,943 10,625 30,250

20 54 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 13,35,297 21,250 18,49,505 12,70,320 14,11,954 10,625 30,250

21 55 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 13,64,526 21,250 19,37,607 12,91,783 14,76,647 10,625 30,250

22 56 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 13,95,450 21,250 20,30,815 13,15,011 15,46,660 10,625 30,250

23 57 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 14,28,280 21,250 21,29,770 13,40,145 16,22,419 10,625 30,250

24 58 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 14,63,157 21,250 22,34,896 13,67,256 17,04,136 10,625 30,250

25 59 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 15,00,153 21,250 23,46,406 13,96,627 17,92,664 10,625 30,250

26 60 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 15,39,619 21,250 24,65,364 14,28,327 18,88,213 10,625 30,250

27 61 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 15,81,627 21,250 25,91,984 14,62,569 19,91,424 10,625 30,250

28 62 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 16,26,389 21,250 27,26,903 14,99,635 21,03,147 10,625 30,250

29 63 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 16,74,186 21,250 28,70,972 15,39,666 22,23,808 10,625 30,250

30 64 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 17,25,232 21,250 30,24,830 15,83,016 23,54,470 10,625 30,250

31 65 - 9,000 10,80,000 12,60,000 - 6,00,000 1,625 17,79,807 21,250 31,89,329 16,29,896 24,95,773 10,625 30,250

32 66 - 36,000 10,80,000 12,60,000 - 6,00,000 6,500 18,36,430 85,000 33,59,999 16,55,665 25,73,447 42,500 1,21,000

33 67 - 36,000 10,80,000 12,60,000 - 6,00,000 6,500 18,69,754 85,000 34,60,443 16,83,553 26,57,506 42,500 1,21,000

34 68 - 36,000 10,80,000 12,60,000 - 6,00,000 6,500 19,00,042 85,000 35,51,737 17,13,771 27,48,586 42,500 1,21,000

UIN: 104N135V01 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 6
 Non-Guaranteed Benefit @ Non-Guaranteed Benefit @
Total Benefits including Guaranteed and Non- Guaranteed
Guaranteed Benefits 4% per 8% per
Benefits
annum investment return annum investment return

Age at the
Single/
Policy start of
Annualized
Year the Policy
Premium Total Survival Total Survival
Year Guaranteed Additional Special Special Total Death Total Death
Survival Death Maturity & Maturity & Maturity
Surrender Accidental Cash Bonus Surrender Cash Bonus Surrender Benefit Benefit
Benefit Benefit Benefit Benefit @ 4% Benefit @ 8%
Value (GSV) Death Benefit Value (SSV) Value (SSV) @4% @8%
(4+7+9) (4+7+11)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

35 69 - 36,000 10,80,000 12,60,000 - 6,00,000 6,500 19,32,802 85,000 36,50,479 17,46,530 28,47,328 42,500 1,21,000

36 70 - 36,000 10,80,000 12,60,000 - 6,00,000 6,500 19,68,314 85,000 37,57,520 17,82,043 29,54,369 42,500 1,21,000

37 71 - 36,000 10,80,000 12,60,000 - 6,00,000 6,500 20,06,863 85,000 38,73,712 18,20,592 30,70,561 42,500 1,21,000

38 72 - 36,000 10,80,000 12,60,000 - 6,00,000 6,500 20,48,730 85,000 39,99,906 18,62,388 31,96,542 42,500 1,21,000

39 73 - 36,000 10,80,000 12,60,000 - 6,00,000 6,500 20,94,127 85,000 41,36,740 19,07,856 33,33,589 42,500 1,21,000

40 74 - 36,000 10,80,000 12,60,000 - 6,00,000 6,500 21,43,549 85,000 42,85,704 19,57,206 34,82,340 42,500 1,21,000

41 75 - 36,000 10,80,000 12,60,000 - 6,00,000 6,500 21,97,277 85,000 44,47,649 20,10,864 36,44,072 42,500 1,21,000

42 76 - 36,000 10,80,000 12,60,000 - 6,00,000 6,500 22,55,735 85,000 46,23,852 20,69,322 38,20,275 42,500 1,21,000

43 77 - 36,000 10,80,000 12,60,000 - 6,00,000 6,500 23,19,418 85,000 48,15,802 21,32,935 40,12,013 42,500 1,21,000

44 78 - 36,000 10,80,000 12,60,000 - 6,00,000 6,500 23,88,820 85,000 50,24,990 22,02,266 42,20,988 42,500 1,21,000

45 79 - 36,000 10,80,000 12,60,000 - 6,00,000 6,500 24,64,646 85,000 52,53,543 22,77,951 44,49,116 42,500 1,21,000

46 80 - 36,000 10,80,000 12,60,000 - 6,00,000 6,500 25,47,392 85,000 55,02,952 23,60,697 46,98,524 42,500 1,21,000

47 81 - 36,000 10,80,000 12,60,000 - - 6,500 26,37,974 85,000 57,75,981 24,51,138 49,71,128 42,500 1,21,000

48 82 - 36,000 10,80,000 12,60,000 - - 6,500 27,37,100 85,000 60,74,760 25,50,193 52,69,694 42,500 1,21,000

49 83 - 36,000 10,80,000 12,60,000 - - 6,500 28,45,897 85,000 64,02,694 26,58,779 55,96,989 42,500 1,21,000

50 84 - 36,000 10,80,000 12,60,000 - - 6,500 29,65,285 85,000 67,62,548 27,78,025 59,56,418 42,500 1,21,000

51 85 - 36,000 10,80,000 12,60,000 - - 6,500 30,96,676 85,000 71,58,579 29,09,204 63,51,811 42,500 1,21,000

UIN: 104N135V01 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 4 of 6
 Non-Guaranteed Benefit @ Non-Guaranteed Benefit @
Total Benefits including Guaranteed and Non- Guaranteed
Guaranteed Benefits 4% per 8% per
Benefits
annum investment return annum investment return

Age at the
Single/
Policy start of
Annualized
Year the Policy
Premium Total Survival Total Survival
Year Guaranteed Additional Special Special Total Death Total Death
Survival Death Maturity & Maturity & Maturity
Surrender Accidental Cash Bonus Surrender Cash Bonus Surrender Benefit Benefit
Benefit Benefit Benefit Benefit @ 4% Benefit @ 8%
Value (GSV) Death Benefit Value (SSV) Value (SSV) @4% @8%
(4+7+9) (4+7+11)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

52 86 - 36,000 10,80,000 12,60,000 - - 6,500 32,41,410 85,000 75,94,831 30,53,656 67,87,211 42,500 1,21,000

53 87 - 36,000 10,80,000 12,60,000 - - 6,500 34,01,253 85,000 80,76,623 32,13,216 72,68,152 42,500 1,21,000

54 88 - 36,000 10,80,000 12,60,000 - - 6,500 35,78,111 85,000 86,09,701 33,89,650 77,99,953 42,500 1,21,000

55 89 - 36,000 10,80,000 12,60,000 - - 6,500 37,74,172 85,000 92,00,662 35,85,359 83,89,850 42,500 1,21,000

56 90 - 36,000 10,80,000 12,60,000 - - 6,500 39,92,191 85,000 98,57,805 38,02,813 90,45,291 42,500 1,21,000

57 91 - 36,000 10,80,000 12,60,000 - - 6,500 42,35,203 85,000 1,05,90,282 40,45,190 97,75,853 42,500 1,21,000

58 92 - 36,000 10,80,000 12,60,000 - - 6,500 45,06,950 85,000 1,14,09,371 43,16,090 1,05,92,388 42,500 1,21,000

59 93 - 36,000 10,80,000 12,60,000 - - 6,500 48,11,669 85,000 1,23,27,840 46,19,820 1,15,07,878 42,500 1,21,000

60 94 - 36,000 10,80,000 12,60,000 - - 6,500 51,54,512 85,000 1,33,61,224 49,61,533 1,25,37,857 42,500 1,21,000

61 95 - 36,000 10,80,000 12,60,000 - - 6,500 56,04,529 85,000 1,47,17,647 54,11,197 1,38,93,216 42,500 1,21,000

62 96 - 36,000 10,80,000 12,60,000 - - 6,500 60,96,060 85,000 1,61,99,199 59,02,517 1,53,74,130 42,500 1,21,000

63 97 - 36,000 10,80,000 12,60,000 - - 6,500 66,28,682 85,000 1,78,04,605 64,35,280 1,69,79,961 42,500 1,21,000

64 98 - 36,000 10,80,000 12,60,000 - - 6,500 71,99,993 85,000 1,95,26,628 68,97,158 1,87,03,899 42,500 1,21,000

65 99 - 36,000 - 12,60,000 12,00,000 - 6,500 - 85,000 - 72,79,891 2,05,02,532 71,02,700 2,14,01,560

UIN: 104N135V01 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 5 of 6
Notes:
1. Annualized Premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any, and Goods and Service Tax. Refer Sales literature for explanation of terms used in
this illustration.
2. The survival benefits are payable at the end of the policy year.
3. The surrender benefit, death benefit and maturity benefit shown above are at the end of the Policy Year.
4. The Surrender Value is higher of the Guaranteed Surrender Value (GSV) and the Special Surrender Value (SSV).In case survival benefits have been paid out, the same shall be deducted from the Surrender Values indicated, at
the time of pay out.
5. Refer Sales literature (Prospectus) and Policy Document for explanation of terms used in this illustration.
6. Above benefits include terminal bonus payable,if any.
7. The above benefits are with assumptions that save the date option is not selected by you. For details on save the date option , please refer the Policy Document.
8. Under column 15 and 16,Maturity Benefit also includes the 'Terminal Bonus (If Declared) at Maturity'.

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: Date: 3/4/24

Signature / OTP Confirmation Date/ Thumb Impression / Signature / OTP Confirmation Date / Thumb Impression /
Date: 3/4/24 Electronic Signature of Agent / Intermediary / Official Electronic Signature of Prospect / Policyholder
This system generated benefit illustration shall be treated as signed by me.

UIN: 104N135V01 Max Life Insurance Company Limited having its Corporate Office at 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 6 of 6