Statement of Account
601145113                                                                                                                                                                                                  02-APR-2023
Ms. Monika Duggal
W/O SANJIV KUMAR WARD NUMBER 5
LASHHMAN COLONY,giddarbaha
Muktsar 152101
Punjab India
Dear Ms. Monika Duggal,
Greetings from Max Life Insurance Company!
Mentioned below is the performance update of your product 601145113 for the period 30-JUN-2018 to 01-APR-2023.
Life Insured                                           Ms. Monika Duggal                Sum Assured                                                                       `0.00
Product Name                                           Max Life Fast Track Super (5 Pay)Rider Sum Assured                                                                 `0.00
UIN no.                                                104L082V03                       Policy Status                                                                     DISCONTINUED
Policy Issue Date                                      30-Jun-2018                      Next Premium Due                                                                  30-Jun-2019
Frequency of Premium Payment                           Annual                           Premium Paying Term                                                               5 years
Annual Premium                                         `2,00,000.00
  Premium Paid                                             Total Policy Value
  as 01-APR-2023                                           as 01-APR-2023
  `2,00,000.00                                              `2,07,955.14
Your Transaction Summary
 Policy Value              Premium Paid                   Charges                     GST****                 Gain/Loss Due                 Guaranteed                      Interest               Policy Value
     as on                   (Including                  Deducted*                    Deducted                  to Market                     Loyalty                                                 as on
 30-JUN-2018          +   Top-ups, if any)        -                           -                          +     Conditions             +      Additions            +                           =   01-APR-2023***
    `0.00                  `2,00,000.00                 `30,780.96                   `5,540.60                   `44,276.70                      `0.00                        `.00                  `2,07,955.14
                                                                                                     *For details of charges, please see overleaf. **Includes wealth booster(if any) for Guaranteed Loyalty Additions
                                                                                                                   ***In case of non business day, previous working day's NAV is applied for calculating policy value.
            ****GST   shall comprise of CGST, SGST/UTGST or IGST (whichever is applicable) including cesses and levies, if any. All applicable taxes, cesses and levies, as per prevailing laws, shall be borne by you.
                                                      This is a computer generated letter and it doesn't requires any signatures.
UAS12 V3.3 10072021
                                                                * Details of charges applied (`)
                                                        Premium Allocation Charge              8,000.00
                                                        Policy Administrative Charge           7,500.00
                                                        Mortality Charge                      10,280.96
                                                        Surrender/Discontinuance Charge        5,000.00
                                                        Total                                 30,780.96
Policy Value is same as Fund Value as defined in the policy document. Guaranteed loyalty additions may also be referred to as Persistency
Bonus in the policy document. #Total Premium paid till date is inclusive of top ups, if any that you have paid. For more details, please refer to
your original policy document.
Discontinuance fund individual- ULIF02021/06/13LIFEDISCON104 Guaranteed Loyalty Additions (persistency units) as applicable in plan.
Charges may include Premium Allocation Charge, Policy Administration Charge, Mortality Charge, Rider Charge, Surrender/ Discontinuance
Charge, Switching Charge, Partial Withdrawal Charge and in any other charge as applicable and as stated in the policy document. The Charges will
be recovered in accordance with the Policy terms and conditions by cancellation of units. Charges and GST are deducted on premium paid. In the
initial years of the policy term, the Policy Value may be less than the total premiums paid due to higher charges. This is an authenticated statement
and does not require any signature.
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. Insurance is the
subject matter of solicitation.
We request you to verify your email Id, mobile number, bank account details etc. made available to us and inform us changes, if any, at the earliest to
avoid any inconvenience. To update, please visit us at https://www.maxlifeinsurance.com/customer-service
Max Life Insurance Co. Ltd. Operation Center, 90 C, Sector 18, Udyog Vihar, Gurugram-122015, Haryana, India
 UAS12 V3.3 10072021