Version 1

Aditya Birla Sun Life Insurance UID : 40071021HH111P

Vision LifeIncome Plan Sep 07, 2019 21:24:30

LIFE INSURANCE
Aditya Birla Sun Life Insurance Company Limited

This shall form a part of the policy contract

Proposer Mr. Policy Holder Age : 35 years Gender : Male

Life Insured Mr. Policy Holder Age : 35 years Gender : Male

Policy Detail UIN : 109N079V04

Premium Paying Term : 10 years Sum Assured : Rs. 768,000
Policy Term : 65 years
Pay Frequency : Annual
ECS Option : No

Premium Payable (in Rs.) Rider Sum Assured Premium Term

Modal Premium 103,280.64 ADB Plus Rs. 0 0 --
Premium Rebate 3,098.42 AD&D Rs. 0 0 --
GST 4,508.2 Critical Illness Rs. 0 0 --
Installment Premium Payable 104,690.42 Surgical Care Rs. 0 0 --
Hospital Care Rs. 0 0 --
WOP Rs. 0 0 --

Premium Paid Guaranteed Death Benefit Total Survival Benefit

Policy Attn
Year Age Survival
During Year Cumulative Death Benefit at 4% p.a at 8% p.a at 4% p.a at 8% p.a
Benefit
1 35 104,690 104,690 1,032,806 0 1,033,958 1,065,830 0 0
2 36 102,436 207,126 1,032,806 0 1,035,110 1,098,854 0 0
3 37 102,436 309,562 1,032,806 0 1,036,262 1,131,878 0 0
4 38 102,436 411,998 1,032,806 0 1,037,414 1,164,902 0 0
5 39 102,436 514,434 1,032,806 0 1,038,566 1,197,926 0 0
6 40 102,436 616,870 1,032,806 0 1,039,718 1,230,950 0 0
7 41 102,436 719,306 1,032,806 0 1,040,870 1,263,974 0 0
8 42 102,436 821,742 1,032,806 0 1,042,022 1,296,998 0 0
9 43 102,436 924,178 1,032,806 0 1,043,174 1,330,022 0 0
10 44 102,436 1,026,614 1,051,913 0 1,063,433 1,382,153 11,520 330,240
11 to 64 - 0 1,026,614 1,051,913 38,400 1,053,065 1,084,937 39,552 71,424
65 99 0 1,026,614 1,051,913 1,090,311 1,053,065 1,084,937 1,091,463 1,123,335
Total Base: 1,026,614 3,163,911 3,238,791 5,310,471

The Sum Assured multiple for this policy is 7.67 times the Base Premium
If opted for any rider, the rider benefit is payable while the policy is not reduced paid-up.
In "Your Sales Illustration" benefits are as of year end and assume:
Premiums are paid when due, there is no underwriting extra and current GST rates remain unchanged.
Premium is inclusive of GST and any other applicable taxes. All applicable taxes will be additionally included to your premium and levied as per extant tax laws.
Some benefits are guaranteed and some benefits are variable with bonuses based on the future performance of the participating business and economic conditions. If
your policy offers guaranteed returns then these will be clearly marked “guaranteed” in the illustration table on this page. If your policy offers variable returns then
the illustrations on this page will show two different rates of assumed future investment returns. 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. In the
illustration above, the Sum Assured and Guaranteed Survival Benefit are fully guaranteed. The Total Death Benefit & Total Maturity Benefit in the illustration above
are not guaranteed and determined using assumed future investment returns of 4% and 8% as set by the Life Insurance Council.

Prepared for: Mr. Policy Holder ABSLI Vision LifeIncome Plan Page 1
 Aditya Birla Sun Life Insurance Version 1

Vision LifeIncome Plan UID : 40071021HH111P

Sep 07, 2019 21:24:30

Your Sales Illustration
LIFE INSURANCE
Aditya Birla Sun Life Insurance Company Limited

DECLARATION OF THE PROPOSER DECLARATION OF THE ADVISOR

I have read the product brochure and understand the values indicated in the I certify that this illustration has been fully explained to the Proposer and have
illustration. made no statements that are inconsistent with this illustration or the product
brochure.

Date : --------------------- Code of the Agent/ Specified Person/

Unit Manager/ Corporate Agent/ Broker -------------------------

Signature or Thumb impression of the PROPOSER Name of Agent/ Specified Person/ Unit Manager

Name & Signature of Witness(in case of Thumb Impression) Signature of Agent/ Specified Person/ Unit Manager

Insurance is the subject matter of the solicitation. For further details please refer to the product brochure.

Aditya Birla Sun Life Insurance Company Limited Reg. No. 109

Prepared for: Mr. Policy Holder ABSLI Vision LifeIncome Plan Page 2