BENEFIT ILLUSTRATION

[Date and Time of Illustration – 12 September 2025, 03:42 PM]

Name of the Prospect/Policyholder: Mr. Sanjeev Kumar Proposal No: 183494723

Name of the Product: Axis Max Life Smart Wealth Advantage Guarantee Plan
Age & Gender: 58 Years, Male A Non-linked Non Participating Individual Life
Name of the Life Assured: Mr. Sanjeev Kumar Tag Line:
Insurance Savings Plan
Unique Identification No: 104N124V15
Age & Gender: 58 Years, Male
GST Rate (Base Policy, First Year): 4.50%
Policy Term: 10 Years
Premium Payment Term: 5 Years GST Rate (Base Policy, Subsequent 2.25%
Amount of Installment Premium: `1,15,202 Year):
GST Rate (Rider, First Year): 18.00%
Mode of payment of premium: Annual
Annual Income Amount: NA GST Rate (Rider, Subsequent Year): 18.00%
Income Start Year, if applicable: NA
Axis Max Life State: Uttar Pradesh
Income Period, if applicable: NA
Policyholder Residential State: UTTAR PRADESH
Deferment Period, if applicable: NA
This benefit illustration is intended to show year-wise premiums payable and benefits under the policy.
Policy Details
Policy Option Wealth for Milestones Sum Assured on Maturity (in Rs.) 4,15,235
Sum Assured (at inception of the policy) upon Death (in
Death Benefit Multiple NA 11,01,100
Rs.)
Sum Assured (Inbuilt Additional Accidental Death
Policy Continuance Benefit Option No 5,50,550
Benefit) (in Rs.)
Special Date Option No Opted Special Date NA

Rider Details
Accidental Death & Dismemberment (ADD) Rider Accidental Death & Dismemberment (ADD) Rider Sum
10 Years 10,01,000
Term Assured (in Rs.)
Term Plus Rider Term 5 Years Term Plus Rider Sum Assured (in Rs.) 4,00,000
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: 104N124V15 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 1 of 4
 Premium Summary
Accidental Death &
Waiver of Premium Critical Illness and Total Installment
Base Plan Dismemberment Term Plus Rider
Plus Rider Disability Rider Premium
Rider

Installment Premium without GST (in Rs.) 1,00,100 1,804 7,176 0 0 1,09,080

Installment Premium with first year GST (in Rs.) 1,04,605 2,129 8,468 0 0 1,15,202
Installment Premium with GST 2nd year onwards
1,02,352 2,129 8,468 0 0 1,12,949
(in Rs.)

(Amount in Rupees)

Guaranteed Non Guaranteed

Single/ Total Other

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

15,01,10
1 1,00,100 1,09,080 - - - - - - - - - - 49,298 49,298
0

15,01,10 1,04,44 1,04,4

2 1,00,100 1,09,080 - - - - - - - - - 60,060
0 9 49

15,01,10 1,65,99 1,65,9

3 1,00,100 1,09,080 - - - - - - - - - 1,05,105
0 2 92

15,01,10 2,34,51 2,34,5

4 1,00,100 1,09,080 - - - - - - - - - 2,00,200
0 1 11

UIN: 104N124V15 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 2 of 4
 Guaranteed Non Guaranteed

Single/ Total Other

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

15,01,10 3,10,64 3,10,6

5 1,00,100 1,09,080 4,004 - - - - - - - - 2,50,250
0 5 45

11,01,10 3,29,08 3,29,0

6 - - - - - - - - - - 5,50,550 2,50,250
0 4 84

11,01,10 3,87,72 3,87,7

7 - - - - - - - 49,828 - - 5,50,550 2,65,198
0 3 23

11,01,10 4,54,15 4,54,1

8 - - - - - - - 99,656 - - 5,50,550 3,80,247
0 6 56

11,01,10 5,29,39 5,29,3

9 - - - - - - - 1,49,485 - - 5,50,550 4,95,295
0 4 94

11,01,10 6,14,54 6,14,5

10 - - - - - - - 1,99,313 4,15,235 6,14,548 5,50,550 5,10,244
0 8 48

UIN: 104N124V15 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 3 of 4
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 0 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, Ms. Vasundhara Bajpai (name), have explained the premiums, and I, Mr. Sanjeev Kumar (name), having received the information with respect to
benefits under the product fully to the prospect / policyholder. the above, have understood the above statement before entering into the
contract.

Place Date:9/12/25 Signature / Thumb Impression / Electronic

Signature / Thumb Impression / Electronic
Date: 9/12/25 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: 104N124V15 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 4 of 4
 Version 27.0 Output form
July 7, 2025

Need analysis for SANJEEV KUMAR Age: 58

Occupation: SALARIED (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) 2000000

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)

Recommended products (as per standard product suitability matrix)

Axis Max Life Smart Wealth Advantage Guarantee Elite Plan, Axis Max Life Fast Track Super Plan,
Axis Max Life Platinum Wealth Plan, Axis Max Life Flexi Wealth Plus Plan, Axis Max Life Smart
Wealth Plan, Axis Max Life Smart Wealth Income 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 Savings Advantage
Plan, Axis Max Life Smart Term with Additional Returns ULIP, Axis Max Life Smart Value Income &
Benefit Enhancer Plan, Axis Max Life Forever Young Pension Plan, Axis Max Life VIBE Plus Solution

Selected product

Axis Max Life Smart Wealth Advantage Guarantee 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)

5 10 Annual

Mandatory field for all customers

Customer Name Sanjeev Kumar

Proposal no(s)
183494723 PSM Date 12 Sep 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 / Ms.
(This system generated
Thumb impression / Vasundhara
form shall be treated as
Electronic signature of Bajpai , 52647B
signed by me)
prospect/ policyholder )