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Name of the Prospect / Policyholder: Khursheed ahmad bhat Proposal No: 12108707

Age (years) : 51 Gender:Male Name of the Product: Tata AIA Life Guaranteed
Return Insurance Plan
Name of the Life Assured 1 : Khursheed ahmad bhat Tag Line : Individual, Non-Linked Non-Participating
Life Insurance Savings Plan
Age (years) : 51 Gender:Male
Unique Identification No.: 110N152V11
Name of the Life Assured 2 : NA
I GST Rate: 4.5% for first year
Age (years) : am
NA Gender:NA red I am red 2.25% second year onwards

Policy Term (years) : 15 I am red I am red

Premium Payment Term (years) : 7 I am red I am red

Amount of Instalment Premium (Rs.): 52250 I am red I am red

Mode of Payment of Premium : Annual I am red I am red

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

Policy Details
Basic Sum Assured (First Death) Rs. 540000
Policy Option Endowment
Basic Sum Assured (Second Death, if any) Rs. NA

Sum Assured on First Death (at inception of the policy) Rs. 540000
Guaranteed Annual Income (GAI)* NA
Sum Assured on Second Death, if any (at inception of the policy) Rs. NA

Rider Details

Tata AIA Vitality

Details of Life
Rider Name/UIN^ Insured/Partner under the Benefit Payout
Benefit Option Return of Benefit Premium Sum Premium p.a. Year 1
(Benefit
premium Option Payment Assured without GST Discount
Option/Benefit Income
Lumpsum Income option Term Term (Rs.) (Rs.) (Rs.)
Payout Option) Name Age(yrs) Gender Duration
(Rs.) p.a.(Rs.)
(yrs)

Premium Summary

I am red Base Plan Riders Total Instalment Premium

Instalment Premium without GST (Rs.) 50000 0 50000

Instalment Premium with First year GST (Rs.) 52250 0 52250

Instalment Premium post applicable discount with First year GST (Rs.) 52250 0 52250

Instalment Premium with GST 2nd year onwards (Rs.) 51125 0 51125
 (Amount in Rupees)
Guaranteed Non - Guaranteed
Other Benefits,
Survival Benefit if any Death
Policy Single/ Annualized Death
/ (Guaranteed Benefit
Year Premium Maturity Benefit Min Guaranteed Special Surrender
Accrued Maturity (Second
Benefit (First Surrender Value Value
Guaranteed Benefit/ Death, if
Death)
Additions Guaranteed any)
Annual Income)
1 50000 19189 0 0 540000 NA 0 0

2 50000 38378 0 0 559189 NA 31765 41228

3 50000 57566 0 0 578378 NA 56376 70998

4 50000 76755 0 0 597566 NA 106390 105209

5 50000 95944 0 0 616755 NA 134287 143861

6 50000 115133 0 0 635944 NA 162665 191202

7 50000 134321 0 0 655133 NA 191694 244465

8 0 153510 0 0 674321 NA 217357 279772

9 0 172699 0 0 693510 NA 240211 316998

10 0 191888 0 0 712699 NA 267313 356143

11 0 211076 0 0 731888 NA 295413 402964

12 0 230265 0 0 751076 NA 324625 452087

13 0 249454 0 0 770265 NA 351566 515794

14 0 268643 0 0 789454 NA 383350 576238

15 0 287831 383775 671606 808643 NA 0 0

Note: Annualized premium excludes underwriting extra premium, frequency loadings on premiums, the premium paid towards the riders, if any, and Goods and
Services Tax.

*Under Option III: The policyholder shall also be given the option to receive the Guaranteed Annual Income (GAI) on a monthly basis. This option has to be
chosen at inception and cannot be altered once chosen. The GAI illustrated above is the total amount payable in a year on selection of monthly mode and 1/12th
of this amount will be payable monthly.

Income Tax benefits would be available as per the prevailing income tax laws, subject to fulfillment of conditions stipulated therein. Tata AIA Life Insurance
Company Ltd. does not assume responsibility on tax implication mentioned anywhere in this document. Please consult your own tax consultant to know the tax
benefits available to you.

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

Place: I am red
Date: Signature of Agent/ Intermediary/ Official Date: Signature of Prospect/ Policyholder

Unique Reference Number - L&C/Advt/2022/Jun/1085 (Rider- L&C/Advt/2022/Sep/2271)

Tata AIA Life Insurance Company Ltd. (IRDA of India Regn No. 110) (CIN: U66010MH2000PLC128403)
Registered and Corporate Office: 14th Floor, Tower A, Peninsula Business Park, Senapati Bapat Marg, Lower Parel, Mumbai- 400013
Trade logo displayed above belongs to Tata Sons Ltd and AIA Group Ltd. and is used by Tata AIA Life Insurance Company Ltd under a license.
For more information, Call the Tata AIA Life Insurance Company Ltd Helpline number1860-266-9966 (local charges apply) or Visit us at: www.tataaia.com

(I)V.99.00/FY2023-2024_Q2/RELEASE 01-07-23/EXPIRY 31-10-2023 00WEBSITENQGRIPSLVBN1 14-08-2023,12:06 PM