BENEFIT ILLUSTRATION

[Date and Time of Illustration – 10 July 2025, 01:14 PM]

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

Name of the Product: Axis Max Life Smart Wealth Advantage Guarantee Plan
Age & Gender: 47 Years, Male A Non-linked Non Participating Individual Life
Name of the Life Assured: Mr. Sachin Ingale Tag Line:
Insurance Savings Plan
Unique Identification No: 104N124V14
Age & Gender: 47 Years, Male
GST Rate (Base Policy, First Year): 4.50%
Policy Term: 40 Years
Premium Payment Term: 10 Years GST Rate (Base Policy, Subsequent 2.25%
Amount of Installment Premium: `2,09,000 Year):
GST Rate (Rider, First Year): NA
Mode of payment of premium: Annual
Annual Income Amount: `1,63,554 GST Rate (Rider, Subsequent Year): NA
Income Start Year, if applicable: NA
Axis Max Life State: Maharashtra
Income Period, if applicable: 30 years
Policyholder Residential State: Maharashtra
Deferment Period, if applicable: 0 year
This benefit illustration is intended to show year-wise premiums payable and benefits under the policy.
Policy Details
Policy Option Long Term Wealth Sum Assured on Maturity (in Rs.) 20,00,000
Sum Assured (at inception of the policy) upon Death (in
Death Benefit Multiple NA 22,00,000
Rs.)
Sum Assured (Inbuilt Additional Accidental Death
Policy Continuance Benefit Option No 11,00,000
Benefit) (in Rs.)
Special Date Option No Opted Special Date NA

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

UIN: 104N124V14 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 1 of 7
 Premium Summary
Accidental Death & Waiver of Premium Critical Illness and
Term Plus Rider Total Installment
Base Plan Dismemberment Plus Rider Disability Rider
Premium
Rider

Installment Premium without GST (in Rs.) 2,00,000 0 0 0 0 2,00,000

Installment Premium with first year GST (in Rs.) 2,09,000 0 0 0 0 2,09,000
Installment Premium with GST 2nd year onwards
2,04,500 0 0 0 0 2,04,500
(in Rs.)

(Amount in Rupees)

Guaranteed Non Guaranteed

Single/ Total Other

Policy Accrued
Annualized Annual Auto Debit Money Back Benefits, if Inbuilt Guaranteed
Year Total Guaranteed Total Special Surrender
Premium Premium Booster Base Loyalty (In case of any (Sum Additional Surrender
Survival Additions (if Maturity Death Surrender Value
(BOY) (BOY) Income Income Life Long Assured on Accidental Value (EOY)
(EOY) Benefit any) (EOY) Benefit Benefit Value Payable
(EOY) (EOY) Income) Maturity) Death
(EOY) (EOY) (EOY) (EOY)
(EOY) Benefit

22,00,00
1 2,00,000 2,00,000 - - - - - - - - - - 86,041 86,041
0

22,00,00 1,84,72 1,84,7

2 2,00,000 2,00,000 - - - - - - - - - 1,20,000
0 1 21

22,00,00 2,97,45 2,97,4

3 2,00,000 2,00,000 - - - - - - - - - 2,10,000
0 2 52

22,00,00 4,25,77 4,25,7

4 2,00,000 2,00,000 - - - - - - - - - 4,00,000
0 3 73

UIN: 104N124V14 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 2 of 7
 Guaranteed Non Guaranteed

Single/ Total Other

Policy Accrued
Annualized Annual Auto Debit Money Back Benefits, if Inbuilt Guaranteed
Year Total Guaranteed Total Special Surrender
Premium Premium Booster Base Loyalty (In case of any (Sum Additional Surrender
Survival Additions (if Maturity Death Surrender Value
(BOY) (BOY) Income Income Life Long Assured on Accidental Value (EOY)
(EOY) Benefit any) (EOY) Benefit Benefit Value Payable
(EOY) (EOY) Income) Maturity) Death
(EOY) (EOY) (EOY) (EOY)
(EOY) Benefit

22,00,00 5,71,39 5,71,3

5 2,00,000 2,00,000 - - - - - - - - - 5,00,000
0 9 99

22,00,00 7,36,23 7,36,2

6 2,00,000 2,00,000 - - - - - - - - - 6,00,000
0 3 33

22,00,00 9,22,36 9,22,3

7 2,00,000 2,00,000 - - - - - - - - - 7,00,000
0 3 63

22,00,00 11,32,1 11,32,

8 2,00,000 2,00,000 - - - - - - - - - 8,20,000
0 68 168

22,00,00 13,68,2 13,68,

9 2,00,000 2,00,000 - - - - - - - - - 9,45,000
0 42 242

22,00,00 10,75,00 16,33,5 16,33,

10 2,00,000 2,00,000 18,000 - - - - - - - -
0 0 34 534

26,66,75 11,00,00 21,33,4 21,33,

11 - - - 1,16,824 46,730 - 1,63,554 - - - 9,36,446
6 0 05 405

26,64,83 11,00,00 21,31,8 21,31,

12 - - - 1,16,824 46,730 - 1,63,554 - - - 7,97,893
9 0 71 871

26,62,81 11,00,00 21,30,2 21,30,

13 - - - 1,16,824 46,730 - 1,63,554 - - - 6,59,339
6 0 53 253

UIN: 104N124V14 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 3 of 7
 Guaranteed Non Guaranteed

Single/ Total Other

Policy Accrued
Annualized Annual Auto Debit Money Back Benefits, if Inbuilt Guaranteed
Year Total Guaranteed Total Special Surrender
Premium Premium Booster Base Loyalty (In case of any (Sum Additional Surrender
Survival Additions (if Maturity Death Surrender Value
(BOY) (BOY) Income Income Life Long Assured on Accidental Value (EOY)
(EOY) Benefit any) (EOY) Benefit Benefit Value Payable
(EOY) (EOY) Income) Maturity) Death
(EOY) (EOY) (EOY) (EOY)
(EOY) Benefit

26,60,69 11,00,00 21,28,5 21,28,

14 - - - 1,16,824 46,730 - 1,63,554 - - - 5,20,786
6 0 57 557

26,58,40 11,00,00 21,26,7 21,26,

15 - - - 1,16,824 46,730 - 1,63,554 - - - 3,82,232
9 0 27 727

26,56,03 11,00,00 21,24,8 21,24,

16 - - - 1,16,824 46,730 - 1,63,554 - - - 2,43,678
0 0 24 824

26,53,46 11,00,00 21,22,7 21,22,

17 - - - 1,16,824 46,730 - 1,63,554 - - - 1,05,125
8 0 74 774

26,50,75 11,00,00 21,20,6 21,20,

18 - - - 1,16,824 46,730 - 1,63,554 - - - -
6 0 05 605

26,47,86 11,00,00 21,18,2 21,18,

19 - - - 1,16,824 46,730 - 1,63,554 - - - -
1 0 89 289

26,44,79 11,00,00 21,15,8 21,15,

20 - - - 1,16,824 46,730 - 1,63,554 - - - -
8 0 38 838

26,41,51 11,00,00 21,13,2 21,13,

21 - - - 1,16,824 46,730 - 1,63,554 - - - -
5 0 12 212

26,38,03 11,00,00 21,10,4 21,10,

22 - - - 1,16,824 46,730 - 1,63,554 - - - -
5 0 28 428

UIN: 104N124V14 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 4 of 7
 Guaranteed Non Guaranteed

Single/ Total Other

Policy Accrued
Annualized Annual Auto Debit Money Back Benefits, if Inbuilt Guaranteed
Year Total Guaranteed Total Special Surrender
Premium Premium Booster Base Loyalty (In case of any (Sum Additional Surrender
Survival Additions (if Maturity Death Surrender Value
(BOY) (BOY) Income Income Life Long Assured on Accidental Value (EOY)
(EOY) Benefit any) (EOY) Benefit Benefit Value Payable
(EOY) (EOY) Income) Maturity) Death
(EOY) (EOY) (EOY) (EOY)
(EOY) Benefit

26,34,33 11,00,00 21,07,4 21,07,

23 - - - 1,16,824 46,730 - 1,63,554 - - - -
4 0 67 467

26,30,39 11,00,00 21,04,3 21,04,

24 - - - 1,16,824 46,730 - 1,63,554 - - - -
0 0 12 312

26,26,19 11,00,00 21,00,9 21,00,

25 - - - 1,16,824 46,730 - 1,63,554 - - - -
9 0 59 959

26,21,69 11,00,00 20,97,3 20,97,

26 - - - 1,16,824 46,730 - 1,63,554 - - - -
0 0 52 352

26,16,90 11,00,00 20,93,5 20,93,

27 - - - 1,16,824 46,730 - 1,63,554 - - - -
6 0 25 525

26,11,73 11,00,00 20,89,3 20,89,

28 - - - 1,16,824 46,730 - 1,63,554 - - - -
7 0 90 390

26,06,20 11,00,00 20,84,9 20,84,

29 - - - 1,16,824 46,730 - 1,63,554 - - - -
5 0 64 964

26,00,24 11,00,00 20,80,1 20,80,

30 - - - 1,16,824 46,730 - 1,63,554 - - - -
1 0 93 193

25,93,80 11,00,00 20,75,0 20,75,

31 - - - 1,16,824 46,730 - 1,63,554 - - - -
6 0 45 045

UIN: 104N124V14 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 5 of 7
 Guaranteed Non Guaranteed

Single/ Total Other

Policy Accrued
Annualized Annual Auto Debit Money Back Benefits, if Inbuilt Guaranteed
Year Total Guaranteed Total Special Surrender
Premium Premium Booster Base Loyalty (In case of any (Sum Additional Surrender
Survival Additions (if Maturity Death Surrender Value
(BOY) (BOY) Income Income Life Long Assured on Accidental Value (EOY)
(EOY) Benefit any) (EOY) Benefit Benefit Value Payable
(EOY) (EOY) Income) Maturity) Death
(EOY) (EOY) (EOY) (EOY)
(EOY) Benefit

25,86,81 11,00,00 20,69,4 20,69,

32 - - - 1,16,824 46,730 - 1,63,554 - - - -
4 0 51 451

25,79,21 11,00,00 20,63,3 20,63,

33 - - - 1,16,824 46,730 - 1,63,554 - - - -
3 0 71 371

25,70,85 11,00,00 20,56,6 20,56,

34 - - - 1,16,824 46,730 - 1,63,554 - - - -
6 0 85 685

25,62,13 20,49,7 20,49,

35 - - - 1,16,824 46,730 - 1,63,554 - - - - -
6 09 709

25,52,50 20,42,0 20,42,

36 - - - 1,16,824 46,730 - 1,63,554 - - - - -
1 01 001

25,41,70 20,33,3 20,33,

37 - - - 1,16,824 46,730 - 1,63,554 - - - - -
4 63 363

25,29,58 20,23,6 20,23,

38 - - - 1,16,824 46,730 - 1,63,554 - - - - -
2 66 666

25,15,79 20,12,6 20,12,

39 - - - 1,16,824 46,730 - 1,63,554 - - - - -
3 34 634

20,00,00 20,00,00 25,00,00 20,00,0 20,00,

40 - - - 1,16,824 46,730 - 1,63,554 - - -
0 0 0 00 000

UIN: 104N124V14 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 6 of 7
Notes:
• EOY: End of Year, BOY = Beginning of Year
• Annualized Premium excludes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any, and Goods and Service Tax.
• Total Annual Premium includes underwriting extra premium, frequency loadings on premiums, the premiums paid towards the riders, if any but excludes Goods and Service Tax.
• The Surrender Value payable shall be higher of ‘Minimum Guaranteed Surrender Value’ and ‘Special Surrender Value’. Any additional Surrender Value over and above the ‘Minimum
Guaranteed Surrender Value’ is not guaranteed.
• The above benefits are assuming income payment mode as Annual and with the assumption that no special date is opted by you. For details on other income payment modes and
special date options, please refer the Policy Document.
• The Net Rate of Return has been calculated based on the total survival (including auto-debit booster) and total maturity benefit, assuming that all premiums have been paid as and
when due (excluding applicable taxes, cesses and levies and rider premiums, if any).
• Refer Sales literature (Prospectus) and Policy Document for explanation of terms used in this illustration.
• Surrender value (both GSV and SSV) shown above is after payment of survival benefit applicable during the year of surrender.
• The above benefit illustration assumes that all premiums (excluding the first premium) are paid via auto debit mode of premium payment. Note that auto debit boosters are
applicable only on the premiums paid via auto debit mode of premium payment. Auto debit booster shall be payable only to the fully paid-up policies where all due premiums have
been paid.

I, ………………………………….... (name), have explained the premiums, I, Sachin Ingale (name), having received the information with respect to the
and benefits under the product fully to the prospect / policyholder. above, have understood the above statement before entering into the
contract.

Place Date:7/10/25 Signature / Thumb Impression / Electronic

Signature / Thumb Impression / Electronic
Date: 7/10/25 Signature of Prospect/ Policyholder
Signature of Agent/ Intermediary / Official of
the insurer
This system generated benefit illustration shall be treated as signed by me.

UIN: 104N124V14 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 7 of 7