Proposal No:

Name of the Prospect/Policyholder: Mr. Name of the Product: Axis Max Life Savings Advantage Plan
Age & Gender: 39 Years, Male Tag Line: A Non-Linked Participating Individual Life Insurance Savings Plan
Name of the Life Assured: Mr. Unique Identification No: 104N111V03
Age & Gender: 39 Years, Male GST Rate: 4.50%
Policy Term: 20 Years Axis Max Life State: Delhi
Premium Payment Term: 10 Years Policyholder Residential State: Delhi
Amount of Installment Premium: `10,45,000
Mode of payment of premium: Annual

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 benefits then these
will be clearly marked “guaranteed” in the illustration table on this page. If your policy offers variable benefits then the illustration on 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
Policy Option Sum Assured (in Rs.) 91,35,757
Bonus Type Paid Up Additions Sum Assured on Death (at inception of the policy) (in Rs.) 1,10,00,000

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

Premium Summary
Base Plan Riders Total Installment Premium
Installment Premium without GST (in Rs.) 10,00,000 - 10,00,000
Installment Premium with first year GST (in Rs.) 10,45,000 - 10,45,000
Installment Premium with GST 2nd year onwards (in Rs.) 10,22,500 - 10,22,500

UIN: 104N111V03 Page 1 of 3

 (Amount in Rupees)

Total Benefits including Guaranteed and Non-Guaranteed

Non-Guaranteed Benefits Non-Guaranteed Benefits Benefits
Guaranteed Benefits
@ 4% p.a. @ 8% p.a.
Maturity Benefit Death Benefit
Single/
Policy Annualized Total Maturity Total Death
Total Maturity Total Death
Year Premium Guranteed Guranteed Benefit, incl. Benefit, incl.
Special Special Benefit, incl. Benefit, incl.
Surrender Surrender Terminal of Terminal
Guaranteed Survival Death Maturity Paid Up Cash Surrender Surrender Paid Up Cash Surrender Surrender Terminal of Terminal
Value Value Bonus, if any Bonus, if any
Additions Benefit Benefit Benefit Additions Bonus Value Benefit Additions Bonus Value Benefit Bonus, if any Bonus, if any
(GSV) (GSV) @ @ 4%(5+7+8)
(SSV) (SSV) @ 4%(6+7+8) @
8%(6+12+13)
8%(5+12+13)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
10,00,00 1,10,00,0 3,92,99
1 5,02,467 - - - - - 3,92,990 - - - 3,92,990 3,92,990 - - 1,15,02,467 1,15,02,467
0 00 0
10,00,00 1,10,00,0 8,78,61 1,13,46
2 5,02,467 - - 1,28,463 81,856 7,59,877 8,78,615 2,69,388 7,79,756 9,17,597 9,17,597 - - 1,21,33,396 1,22,74,321
0 00 5 6
10,00,00 1,10,00,0 1,69,06 13,26,99 14,33,4 14,33,41 2,41,56 13,72,15 15,18,90 15,18,90
3 5,02,467 - - 1,30,320 2,77,386 - - 1,27,66,183 1,30,54,173
0 00 3 0 12 2 5 6 8 8
10,00,00 1,10,00,0 2,61,82 24,18,71 20,64,8 24,18,71 3,85,63 24,95,68 22,05,49 24,95,68
4 5,02,467 - - 1,32,124 2,85,419 - - 1,34,00,773 1,38,42,060
0 00 9 9 97 9 8 4 6 4
10,00,00 1,10,00,0 3,60,46 31,89,28 27,81,4 31,89,28 5,47,28 33,05,93 29,87,06 33,05,93
5 5,02,467 - - 1,34,014 2,93,911 - - 1,40,37,254 1,83,33,733
0 00 3 8 83 8 7 0 3 0
10,00,00 1,10,00,0 4,65,18 39,24,97 35,98,5 39,24,97 7,28,21 40,90,75 41,36,28 41,36,28
6 - - - 1,35,853 3,02,601 - - 1,41,73,107 1,87,45,301
0 00 5 9 81 9 1 2 3 3
10,00,00 1,10,00,0 5,76,31 47,15,44 46,08,4 47,15,44 9,30,28 49,41,65 55,31,92 55,31,92
7 - - - 1,37,779 3,11,440 - - 1,43,10,886 1,91,68,891
0 00 6 0 00 0 2 8 8 8
10,00,00 1,10,00,0 6,94,26 56,26,84 57,85,3 57,85,39 11,55,7 59,27,06 71,60,06 71,60,06
8 - - - 1,39,770 3,20,769 - - 1,44,50,657 1,96,05,169
0 00 5 4 90 0 61 9 3 3
10,00,00 1,10,00,0 8,19,30 66,22,73 71,43,5 71,43,55 14,06,3 70,13,11 90,38,76 90,38,76
9 - - - 1,41,696 3,30,075 - - 1,45,92,352 2,00,54,105
0 00 2 1 58 8 80 2 1 1
10,00,00 1,10,00,0 9,51,69 76,89,06 87,01,0 87,01,05 16,84,6 81,88,90 1,11,95, 1,11,95,
10 - - - 1,43,707 3,39,879 - - 1,47,36,059 2,05,16,375
0 00 1 4 52 2 73 8 481 481
1,21,00,0 10,91,8 81,64,25 96,43,1 96,43,19 19,93,5 87,96,59 1,26,40, 1,26,40,
11 - - - - 1,45,654 3,49,892 - - 1,59,81,713 2,20,92,263
00 06 4 95 5 61 3 694 694
1,21,00,0 12,40,1 86,79,31 1,00,61, 1,00,61, 23,35,7 94,71,55 1,34,61, 1,34,61,
12 - - - - 1,47,797 3,60,305 - - 1,61,29,509 2,25,82,313
00 40 2 787 787 95 0 752 752
1,21,00,0 13,97,1 92,18,87 1,04,88, 1,04,88, 27,14,4 1,02,03,6 1,43,36, 1,43,36,
13 - - - - 1,49,861 3,70,894 - - 1,62,79,370 2,30,86,765
00 43 4 273 273 96 72 537 537
1,21,00,0 15,62,9 97,98,28 1,09,22, 1,09,22, 31,32,7 1,10,14,6 1,52,68, 1,52,68,
14 - - - - 1,51,865 3,81,845 - - 1,64,31,235 2,36,06,113
00 82 5 018 018 72 15 786 786
1,21,00,0 17,38,3 1,04,33, 1,13,64, 1,13,64, 35,95,1 1,19,28,0 1,62,67, 1,62,67,
15 - - - - 1,54,044 3,93,016 - - 1,65,85,279 2,41,40,654
00 63 920 231 231 50 89 561 561
1,21,00,0 19,23,4 1,11,13, 1,20,53, 1,20,53, 41,06,0 1,29,40,3 1,76,38, 1,76,38,
16 - - - - 1,56,166 4,04,704 - - 1,67,41,445 2,46,91,092
00 40 052 442 442 28 88 277 277
1,21,00,0 21,19,4 1,18,54, 1,27,75, 1,27,75, 46,69,3 1,40,80,5 1,91,15, 1,91,15,
17 - - - - 1,58,426 4,16,586 - - 1,68,99,871 2,52,57,691
00 04 276 716 716 63 24 452 452
1,21,00,0 23,26,2 1,26,77, 1,33,45, 1,33,45, 52,91,2 1,53,81,1 2,07,09, 2,07,09,
18 - - - - 1,60,614 4,28,856 - - 1,70,60,485 2,58,40,978
00 34 524 327 327 10 55 999 999

UIN: 104N111V03 Page 2 of 3

 Total Benefits including Guaranteed and Non-Guaranteed
Non-Guaranteed Benefits Non-Guaranteed Benefits Benefits
Guaranteed Benefits
@ 4% p.a. @ 8% p.a.
Maturity Benefit Death Benefit
Single/
Policy Annualized Total Maturity Total Death
Total Maturity Total Death
Year Premium Guranteed Guranteed Benefit, incl. Benefit, incl.
Special Special Benefit, incl. Benefit, incl.
Surrender Surrender Terminal of Terminal
Guaranteed Survival Death Maturity Paid Up Cash Surrender Surrender Paid Up Cash Surrender Surrender Terminal of Terminal
Value Value Bonus, if any Bonus, if any
Additions Benefit Benefit Benefit Additions Bonus Value Benefit Additions Bonus Value Benefit Bonus, if any Bonus, if any
(GSV) (GSV) @ @ 4%(5+7+8)
(SSV) (SSV) @ 4%(6+7+8) @
8%(6+12+13)
8%(5+12+13)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1,21,00,0 25,45,0 1,35,74, 1,41,12, 1,41,12, 59,76,4 1,68,48,9 2,24,30, 2,24,30,
19 - - - - 1,62,938 4,41,522 - - 1,72,23,422 2,64,41,491
00 29 499 965 965 93 73 757 757
1,21,00,0 1,25,61,6 27,76,2 1,42,88, 1,53,37, 1,53,37, 67,33,0 1,82,45,3 2,50,09, 2,50,09,
20 - - - 1,65,161 4,54,566 1,53,37,916 2,50,09,080 1,73,88,583 2,70,59,747
00 66 50 583 916 916 54 88 080 080

Notes: 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.

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: 7/13/25 Signature / OTP Confirmation Date / Thumb Impression / Date:7/13/25 Signature / OTP Confirmation Date / Thumb Impression /
Electronic Signature of Agent/ Intermediary / Official of the Electronic Signature of Prospect/ Policyholder
insurer
This system generated benefit illustration shall be treated as signed by me.

UIN: 104N111V03 Page 3 of 3