Payment Acknowledgement

Policy Number: 256626102

Date & Time: 6/4/2018 9:19:48 PM
Name: MR. MANI RATHINAM RAJAMANI
Reference Number/Transaction ID: NUTI6361957291

Dear Policy Holder,

Thank you for being part of the Max Life Insurance Family. This is to acknowledge the receipt of Rs 25,562.49 towards the payment reason- Renewal
Premium for your insurance premium.

We value your patronage and are committed to providing you the best in class service.

Should you need any further assistance, please call our Customer Help Line - 1800 200 5577 (Toll free from any network)

You can also email at service.helpdesk@maxlifeinsurance.com.

Your Sincerely,
for Max Life Insurance Co Ltd.

Authorized Signatory

Note:

• In case premium for Unit Linked Insurance policies is received in Max Life Insurance designated offices vide cash, local cheques & local demand   drafts before
3:00 PM, Net Asset Value (NAV) of the same day will be applicable ; in case premium is received after 3:00 PM, the NAV of the next business day will be
applied. In case of premium received vide outstation cheques / demand drafts, the NAV of the business day on which such cheques / demand drafts are realised
& credited in Company's account will be applied.

• Monies received would be adjusted against the due premium as per the policy contract. In case policy status is lapsed, the risk coverage is subject to   the
reinstatement of the policy as per terms and conditions of the plan opted.

• Final receipt would be sent to you after adjustment of monies as per the policy terms & conditions.

• All premiums will be eligible for tax benefits (under section 80C/80CCC/80D/37(1) of Income Tax Act 1961, as per applicability) and subject to   levies  under
prevailing Tax Laws .

• For Max Vijay policies please contact us through E­mail: helpdesk@maxvijay.com,Phone(Tollfree):1800­419­4194 (Monday to Saturday 9:30 am to   6:30 pm)

• As per the recent Union Budget 2012 proposals, effective April 1, 2012, your Policy may be entitled to certain tax benefits or subject to deductions.
We request you to please consult with your tax consultant for more information

• All applicable taxes, cess or any other taxes, charges, levies as per prevailing laws, shall be borne by you.