BENEFIT ILLUSTRATION

[Date and Time of Illustration – 08 July 2025, 03:24 PM]

Name of the Prospect/Policyholder: [Link] Verma

Proposal No: 180148660
Age & Gender: 36 Years, Female Name of the Product: Axis Max Life Smart Value Income & Benefit Enhancer Plan
Name of the Life Assured: [Link] Verma Tag Line: A Non-linked Non Participating Individual Life Insurance Savings Plan
Unique Identification No: 104N159V01
Age & Gender: 36 Years, Female
GST Rate (Base Policy, First Year): 4.50%
Policy Term 20 years
GST Rate (Base Policy, Subsequent Year): 2.25%
Premium Payment Term: 15 years
GST Rate (Rider, First Year): NA
Amount of Installment Premium: Rs. 1,04,500
Mode of payment of premium: Annual GST Rate (Rider, Subsequent Year): NA
Frequency of Income Payouts: Annual in Advance
Future Income Period, if applicable: 30 years
Axis Max Life State: Uttarakhand
Accumulation of Survival Benefits: No
Policyholder Residential State: UTTARAKHAND

This benefit illustration is intended to show year-wise premiums payable and benefits under the policy.

Policy Details
Enhanced Maturity Booster For Existing Customer/Staff/Transgender
Variant Insta Wealth NA
Lives^
Death Benefit Multiple 11 Enhanced Maturity Booster For Female Lives^ Rs. 10,000

Policy Continuance Benefit Option No Future Milestone Benefit Rs. 15,00,000

Sum Assured on Death at inception of the policy Rs. 11,00,000 Date of First Survival Benefit 08-07-2025

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

Premium Summary
Accidental Death & Waiver of Premium Plus Critical Illness and Total Installment Premium
Base Plan Dismemberment Rider
Term Plus Rider Rider Disability Rider
Installment Premium without GST (in Rs.) 1,00,000 0 0 0 0 1,00,000
Installment Premium with first year GST (in Rs.) 1,04,500 0 0 0 0 1,04,500
Installment Premium with GST 2nd year onwards (in Rs.) 1,02,250 0 0 0 0 1,02,250

UIN: 104N159V01 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 1 of 5
 (Amount in Rupees)

Guaranteed Non Guaranteed

Total
Annualized Total Accrued Future Total Guaranteed
Policy Annual Total Survival Base Future Accrued Enhanced Future Special Surrender
Premium Flexi Income Insta Income Income Booster Income Survival Death Surrender
Year Premium Benefit During Income Income Maturity Milestone (BOY) & Surrender Value
(BOY) (BOY) (A) Income Booster (BOY) (E) (Payable Benefit Benefit Value (EOY)
(BOY) Policy Term (BOY) (BOY) (D) Booster Booster (EOY) Benefit Maturity Value (EOY) Payable
(BOY) (B) (EOY) after policy term) (BOY) Benefit* (EOY)
(C= A+B) (EOY) (F) (EOY) (G) (EOY)
(H = D+E) (C+F+G+H)
11,00,00
1 1,00,000 1,00,000 44,109 - 44,109 - - - - - - - 44,109 - - -
0
11,00,00
2 1,00,000 1,00,000 - 44,109 44,109 - 388 388 - - - - 44,109 - - -
0
11,00,00
3 1,00,000 1,00,000 - 44,109 44,109 - 582 970 - - - - 44,109 - 921 921
0
11,00,00
4 1,00,000 1,00,000 - 44,109 44,109 - 776 1,746 - - - - 44,109 23,790 15,913 23,790
0
11,00,00
5 1,00,000 1,00,000 - 44,109 44,109 - 970 2,716 - - - - 44,109 29,838 38,210 38,210
0
11,00,00
6 1,00,000 1,00,000 - 44,109 44,109 - 1,164 3,880 - - - - 44,109 35,942 67,803 67,803
0
11,00,00
7 1,00,000 1,00,000 - 44,109 44,109 - 1,358 5,238 - - - - 44,109 42,115 1,04,613 1,04,613
0
11,00,00
8 1,00,000 1,00,000 - 44,109 44,109 - 1,552 6,790 - - - - 44,109 75,032 1,48,518 1,48,518
0
11,00,00
9 1,00,000 1,00,000 - 44,109 44,109 - 1,746 8,536 - - - - 44,109 1,14,721 1,99,322 1,99,322
0
11,00,00
10 1,00,000 1,00,000 - 44,109 44,109 - 1,940 10,476 - - - - 44,109 1,61,183 2,56,762 2,56,762
0
11,55,00
11 1,00,000 1,00,000 - 44,109 44,109 - 2,134 12,610 - - - - 44,109 2,14,446 3,20,418 3,20,418
0
12,60,00
12 1,00,000 1,00,000 - 44,109 44,109 - 2,328 14,938 - - - - 44,109 2,74,547 3,89,794 3,89,794
0
13,65,00
13 1,00,000 1,00,000 - 44,109 44,109 - 2,522 17,460 - - - - 44,109 3,41,489 4,64,242 4,64,242
0
14,70,00
14 1,00,000 1,00,000 - 44,109 44,109 - 2,716 20,176 - - - - 44,109 4,15,316 5,42,903 5,42,903
0
15,75,00
15 1,00,000 1,00,000 - 44,109 44,109 - 2,910 23,086 - - - - 44,109 4,96,077 6,24,703 6,24,703
0
15,75,00
16 - - - 44,109 44,109 - 2,910 25,996 - - - - 44,109 5,03,716 6,22,092 6,22,092
0
15,75,00
17 - - - 44,109 44,109 - 2,910 28,906 - - - - 44,109 5,11,608 6,19,028 6,19,028
0
UIN: 104N159V01 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 2 of 5
 Guaranteed Non Guaranteed
Total
Annualized Total Accrued Future Total Guaranteed
Policy Annual Total Survival Base Future Accrued Enhanced Future Special Surrender
Premium Flexi Income Insta Income Income Booster Income Survival Death Surrender
Year Premium Benefit During Income Income Maturity Milestone (BOY) & Surrender Value
(BOY) (BOY) (A) Income Booster (BOY) (E) (Payable Benefit Benefit Value (EOY)
(BOY) Policy Term (BOY) (BOY) (D) Booster Booster (EOY) Benefit Maturity Value (EOY) Payable
(BOY) (B) (EOY) after policy term) (BOY) Benefit* (EOY)
(C= A+B) (EOY) (F) (EOY) (G) (EOY)
(H = D+E) (C+F+G+H)
15,75,00
18 - - - 44,109 44,109 - 2,910 31,816 - - - - 44,109 5,19,799 6,15,452 6,15,452
0
15,75,00
19 - - - 44,109 44,109 - 2,910 34,726 - - - - 44,109 5,28,294 6,11,331 6,11,331
0
15,75,00
20 - - - 44,109 44,109 - 2,910 37,636 - 10,000 - - 54,109 4,87,153 6,06,584 6,06,584
0

21 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

22 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

23 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

24 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

25 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

26 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

27 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

28 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

29 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

30 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

31 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

32 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

33 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

34 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

UIN: 104N159V01 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 3 of 5
 Guaranteed Non Guaranteed
Total
Annualized Total Accrued Future Total Guaranteed
Policy Annual Total Survival Base Future Accrued Enhanced Future Special Surrender
Premium Flexi Income Insta Income Income Booster Income Survival Death Surrender
Year Premium Benefit During Income Income Maturity Milestone (BOY) & Surrender Value
(BOY) (BOY) (A) Income Booster (BOY) (E) (Payable Benefit Benefit Value (EOY)
(BOY) Policy Term (BOY) (BOY) (D) Booster Booster (EOY) Benefit Maturity Value (EOY) Payable
(BOY) (B) (EOY) after policy term) (BOY) Benefit* (EOY)
(C= A+B) (EOY) (F) (EOY) (G) (EOY)
(H = D+E) (C+F+G+H)

35 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

36 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

37 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

38 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

39 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

40 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

41 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

42 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

43 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

44 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

45 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

46 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

47 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

48 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

49 - - - - - 8,837 - - 35,272 - - 44,109 44,109 - - - -

15,00,00 15,44,10
50 - - - - - 8,837 - - 35,272 - 44,109 - - - -
0 9

UIN: 104N159V01 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 4 of 5
Notes:
*For Maturity Benefit the Future Income Payouts shall be as per the Frequency of Income Payouts Chosen at Inception. The Future Milestone Benefit, if applicable, shall be provided at the End of Year (EOY).
^ Enhanced Maturity Boosters may be applicable to customers as per the terms and conditions mentioned in the Policy Document. For more information, please refer to the Policy Schedule within your Policy Document. In the
event of any discrepancies, the Policy Schedule shall take precedence.
• 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 accumulation is not opted by you. For details on other income payment modes and accumulation options, please refer the Policy
Document.
• Refer Sales literature (Prospectus) and Policy Document for explanation of terms used in this illustration.
• Surrender value (both GSV and SSV) shown above is before payment of survival benefit applicable during the year of surrender.

I, Mrs. Lata Verma (name), have explained the premiums, and benefits under the product fully I, [Link] Verma (name), having received the information with respect to the above, have
to the prospect / policyholder. understood the above statement before entering into the contract.

Place: Signature / Thumb Impression / Electronic Signature of Date:7/8/25 Signature / Thumb Impression / Electronic Signature of
Date: 7/8/25 Agent/ Intermediary / Official of the insurer Prospect/ Policyholder
This system generated benefit illustration shall be treated as signed by me.

UIN: 104N159V01 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 5 of 5
 Version 24.0 Output form
May 28, 2025

Need analysis for LATA VERMA Age: 36

Occupation: SELF EMPLOYED (Salaried/ Self-employed/others)

(Details of prospect are mandatory)

Life stage: Select basis personal information of the customer (mandatory)

Close to retirement or
Married with Single with Married with
Single retired(Prospect age >= 45
no children Children children
years)

Gross annual income (Rs.) (mandatory) 1600000

Purpose of Insurance (mandatory, maximum 1 goal at a time)

Insurance need / Children’s Wealth

Regular
Investment Protection marriage/ Retirement accumulation/
income
objective education Investment

Tick the one

applicable

Any existing life insurance cover already held(mandatory) Yes No

Total sum assured (if answer to the above question is yes)

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Max Life Saral Pension Plan, Axis Max Life Guaranteed Lifetime Income Plan, Axis Max Life Smart
Wealth Income Plan, Axis Max Life Smart Guaranteed Pension Plan, Axis Max Life Flexi Wealth
Advantage Plan, Axis Max Life Smart Capital Guarantee Solution, Axis Max Life Smart Wealth
Advantage Guarantee Plan, Axis Max Life Smart Wealth Advantage Growth Par Plan, Axis Max Life
Smart Wealth Annuity Guaranteed Pension Plan, Axis Max Life Savings Advantage Plan, Axis Max
Life Smart Term with Additional Returns ULIP, Axis Max Life Smart Value Income & Benefit Enhancer
Plan

Selected product
Axis Max Life Smart Value Income & Benefit Enhancer Plan

Nature of the selected product

Traditional ULIP Combo Annuity

Premium payment term Policy term Mode of premium payment

(recommended for selected (recommended for selected (recommended for selected
product) product) product)

15 20 Annual

Mandatory field for all customers

Customer Name Lata Verma

Proposal no(s)
180148660 PSM Date 08 Jul 2025
(If proposal is applied)

I / We are aware that suitability information has been collected from me/us and recommendation on
purchase of life insurance product has been made only basis such information and any product
selected by me/us that differs from such recommendation is on the basis of my/our personal choice.

Customer signature
Seller signature
(OTP confirmation date /
(This system generated Mrs. Lata
Thumb impression /
form shall be treated as Verma , 56065E
Electronic signature of
signed by me)
prospect/ policyholder )