IN THIS POLICY, THE INVESTMENT RISK IN INVESTMENT PORTFOLIO IS BORNE BY THE POLICYHOLDER.

Dear MR. PRASHANT SAMANTA,

Congratulations on becoming your family's Param Rakshakarta !!
Today, protection is the need of the hour and we are privileged that you have chosen us as your Rakshakaran partner. We are delighted that you have
opted for one of our comprehensive solutions that will provide Life Cover as well as market-linked returns and protection for your health - helping you secure
your loved ones' financial future. Param Rakshakaran also offers a holistic wellness program- Tata AIA Vitality - which partners with you to help you focus
on your physical and mental wellbeing while keeping you motivated with various discounts and benefits.
The comprehensive solutions will provide following benefits:

Comprises of Tata AIA Life Insurance Smart Sampoorna Raksha, Tata Comprises of Tata AIA Life Insurance Smart Sampoorna Raksha, Tata
AIA Vitality Protect Plus and Tata AIA Vitality Health Plus AIA Vitality Protect Plus

Life Insurance Cover Life Insurance Cover

Accidental Death Accidental Death

Accidental Total & Permanent Disability Accidental Total & Permanent Disability

Tata AIA Vitality*

CritiCare Plus

HospiCare

Tata AIA Vitality*

All in all, these solutions will cater to your protection, wealth and health protection needs. At Tata AIA Life Insurance, we are committed to help you with
solutions that will provide Param Rakshakaran to your family so that you can enjoy life without any worries.

Best Wishes
Tata AIA Life Insurance Company Limited
Param Rakshak solution comprises of Tata AIA Life Insurance Smart Sampoorna Raksha and Tata AIA Vitality Protect Plus

Param Rakshak Plus solution comprises of Tata AIA Life Insurance Smart Sampoorna Raksha, Tata AIA Vitality Protect Plus and Tata AIA Vitality Health
Plus

Tata AIA Life Insurance Smart Sampoorna Raksha, A Unit-linked, Non-participating, Individual Life Insurance Plan for Savings and Protection
(UIN:110L156V02); Tata AIA Vitality Protect Plus, A Non-linked, Non-participating, Individual Health Rider (UIN: 110A048V01) and Tata AIA Vitality Health
Plus, A Non-linked, Non-participating, Individual Health Rider (UIN: 110A047V01).

*Tata AIA Vitality: A Wellness Program that offers you an upfront discount at policy inception. You can also earn premium discount / cover booster (as
applicable) for subsequent years on policy anniversary basis your Vitality Status (tracked on Vitality app)

Disclaimers: THE LINKED INSURANCE PRODUCT DO NOT OFFER ANY LIQUIDITY DURING THE FIRST FIVE YEARS OF THE CONTRACT. THE
POLICY HOLDER WILL NOT BE ABLE TO SURRENDER/WITHDRAW THE MONIES INVESTED IN LINKED INSURANCE PRODUCTS COMPLETELY
OR PARTIALLY TILL THE END OF THE FIFTH YEAR. For more details please refer to the customized benefit illustration and terms & conditions of the
product. In case of any inconsistency between this letter and policy document, the policy document shall always prevail. Vitality is a trademark licensed to
Tata AIA Life by Amplify Health Assets PTE. Limited, a joint venture between Vitality Group International, INC. and AIA Company Limited. The assessment
under the wellness program shall not be considered as a medical advice or a substitute to a consultation/treatment by a professional medical practitioner.
All investments made by the Company are subject to market risks. The Company does not guarantee any assured returns. The Investment income and
price may go down as well as up depending on several factors influencing the market. Please know the associated risks and the applicable charges, from
your Insurance Agent or the Intermediary or Policy Document issued by the Insurance Company. Please make your own independent decision after
consulting your financial or other professional advisor. The performance of the managed portfolios and funds is not guaranteed and the value may increase
or decrease in accordance with the future experience of the managed portfolios and funds. The solutions are underwritten by Tata AIA Life Insurance
Company Limited.

The solutions are not guaranteed issuance solutions and it will be subject to Company's underwriting and acceptance. Buying a Life Insurance Policy is a
long-term commitment. An early termination of the policy usually involves high costs and the surrender value payable may be less than all the premium
paid. Unit Linked Life Insurance products are different from traditional insurance products and are subject to risk factors. The fund is managed by Tata AIA
Life Insurance Company Ltd. (hereinafter the "Company"). Tata AIA Life Insurance Company Limited is only the name of the Insurance Company & Tata
AIA Life Insurance Smart Sampoorna Raksha is only the name of the Unit Linked Life Insurance contract and does not in any way indicate the quality of the
contract, its future prospects or returns. Various funds offered under this contract are the names of the funds and do not in any way indicate the quality of
these plans, their future prospects and returns. Premium paid in Unit Linked Life Insurance policies are subject to investment risks associated with capital
markets and the NAVs of the units may go up or down based on the performance of fund and factors influencing the capital market and the insured is
responsible for his/her decisions. Past performance is not indicative of future performance. Returns are calculated on an absolute basis for a period of less
than (or equal to) a year, with reinvestment of dividends (if any). Life insurance cover is available under the solution. For details on products, associated risk
factors, terms and conditions please read Sales Brochure carefully before concluding a sale. The precise terms and condition of this plan are specified in
the Policy Contract. L&C/Advt/2022/Oct/2547.

#TataAIAKaBharosa

Tata AIA Life Insurance Company Limited (IRDAI Regn. No.110) CIN: U66010MH2000PLC128403. Registered & 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 & AIA Group Ltd.
& is used by Tata AIA Life Insurance Company Ltd under a license. For any information including cancellation, claims & complaints, please contact our
Insurance Advisor / Intermediary or visit Tata AIA Life's nearest branch office or call 1-860-266-9966 (local charges apply) or write to us at
customercare@[Link]. Visit us at:[Link].

BEWARE OF SPURIOUS PHONE CALLS IRDAI is not involved in activities like selling insurance policies, announcing bonus or investment of
AND FICTITIOUS / FRAUDULENT OFFERS premiums. Public receiving such phone calls are requested to lodge a police complaint
 IN THIS POLICY, THE INVESTMENT RISK IN INVESTMENT PORTFOLIO IS BORNE BY THE POLICYHOLDER.

Dear MR. PRASHANT SAMANTA,

Thank you for choosing us to protect your loved ones.
Your decision to select Param Rakshak - III with a Life Cover of INR 7000000 will help secure the financial future of your loved ones as it comprises Tata
AIA Life Insurance's Smart Sampoorna Raksha, Accidental Death, Accidental Total & Permanent Disability, and Term Booster under Tata AIA Vitality
Protect Plus.

In case of any eventuality during the Policy Term, you are entitled to a life cover of INR 7000000 which is inclusive of sum assured of INR 6300000 under
the base plan (Tata AIA Life Insurance Smart Sampoorna Raksha) and INR 700000 under Term Booster (Tata AIA Vitality Protect Plus). In case of no
claims during policy term, total premiums paid with respect to Accidental Death, Accidental Total & Permanent Disability, and Term Booster will be returned
to you at Maturity. Kindly refer to our benefit illustration here for all requisite details.

At Tata AIA Life Insurance, we are committed to help you live happier, healthier lives through solutions that provide Sampoorna Rakshakaran to your family
so that you can be happy, with no worries.

Best Wishes
Tata AIA Life Insurance Company Limited

Disclaimer: Param Rakshak III solution comprises of Tata AIA Life Insurance Smart Sampoorna Raksha, A Unit-linked, Non-participating, Individual Life
Insurance Plan for Savings and Protection (UIN: 110L156V02) and Tata AIA Vitality Protect Plus, A Non-linked, Non-participating, Individual Health Rider
(UIN: 110A048V01). Insurance cover is available under the solution. | The solution is underwritten by Tata AIA Life Insurance Company Ltd. This is not a
guaranteed issuance solution and it will be subject to Company's underwriting and acceptance. | For more details on risk factors, terms and conditions
please read sales brochure carefully before concluding a sale.

#TataAIAKaBharosa
Tata AIA Life Insurance Company Limited (IRDAI Regn. No.110) CIN: U66010MH2000PLC128403. Registered & 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 & AIA Group Ltd.
& is used by Tata AIA Life Insurance Company Ltd under a license. For any information including cancellation, claims & complaints, please contact our
Insurance Advisor / Intermediary or visit Tata AIA Life's nearest branch office or call 1-860-266-9966 (local charges apply) or write to us at
customercare@[Link]. Visit us at: [Link].

BEWARE OF SPURIOUS PHONE CALLS IRDAI is not involved in activities like selling insurance policies, announcing bonus or investment of
AND FICTITIOUS / FRAUDULENT OFFERS premiums. Public receiving such phone calls are requested to lodge a police complaint.
 Proposal No: 1691850096025

Name of the Prospect / PRASHANT Name of the Product: Tata AIA Life Insurance Smart Sampoorna Raksha
Policyholder: SAMANTA
Tag Line : Unit-linked, Non-Participating, Individual Life Insurance Plan for
Age (yrs) : 43 Savings and Protection

Name of the Life Assured : PRASHANT Unique Identification 110L156V02

SAMANTA No.:

Age (yrs) : 43 GST Rate: 18.0%

Sum Assured (Rs.): 6300000 Investment Strategy NIL

Opted for:
Policy Term (yrs): 40
Funds opted for along with their risk level
Premium Payment Term 12
(yrs):

Amount of Instalment 118929

Premium (Rs.):

Mode of Payment of Annual

Premium :

Fund Name Allocation Percentage Risk Profile

Large Cap Equity Fund (ULIF 017 07/01/08 TLC 110) 0%
Whole Life Mid-cap Equity Fund (ULIF 009 04/01/07 WLE 110) 100% High
Whole Life Aggressive Growth Fund (ULIF 010 04/01/07 WLA 110) 0%
Whole Life Stable Growth Fund (ULIF 011 04/01/07 WLS 110) 0%
Whole Life Income Fund (ULIF 012 04/01/07 WLI 110) 0%
Whole Life Short Term Fixed Income Fund (ULIF 013 04/01/07 WLF 110) 0%
Multi Cap Fund (ULIF 060 15/07/14 MCF 110) 0%
India Consumption Fund (ULIF 061 15/07/14 ICF 110) 0%
Super Select Equity Fund (ULIF 035 16/10/09 TSS 110) 0%
Top 50 Fund (ULIF 026 12/01/09 ITF 110) 0%
Top 200 fund (ULIF 027 12/01/09 ITT 110) 0%
Emerging Opportunities Fund (ULIF 064 12/09/22 EOF 110) 0%
Sustainable Equity Fund (ULIF 065 12/09/22 ESG 110) 0%
Dynamic Advantage Fund (ULIF 066 12/09/22 DAF 110) 0%
Flexi Growth Fund (ULIF 068 25/04/23 FGF 110) 0%
Constant Maturity Fund (ULIF 069 17/05/23 CMF 110) 0%
Target Maturity Fund (ULIF 070 17/05/23 TMF 110) 0%
Small Cap Discovery Fund (ULIF 071 22/05/23 SCF 110) 0%

Rider Details
Tata AIA Vitality Utilization of rewards (if Wellness program
Yes Premium Discount
(Wellness Program) opted)
Details of Life Insured/Partner Premium
Rider Name/UIN^ Benefit Payout
Return
under the Benefit Option Benefit Premium Sum p.a. Year 1
(Benefit of
Option/Benefit Income premium Option Payment Assured without Discount
Lumpsum Income Term Term (Rs.) GST (Rs.)
Payout Option) Name Age(yrs) Gender Duration option
(Rs.) p.a.(Rs.) (Rs.)
(yrs)
VP - Accidental Total
and Permanent PRASHANT
43 M 6300000 0 0 YES 40 12 6300000 7245 362
Disability (Lumpsum SAMANTA
Benefit)
VP - Accidental
PRASHANT
Death (Lumpsum 43 M 6300000 0 0 YES 40 12 6300000 9954 498
SAMANTA
Benefit)
VP - Term Booster PRASHANT
43 M 700000 0 0 YES 40 12 700000 9436 944
(Lumpsum Benefit)# SAMANTA

^VPP - Tata AIA Vitality Protect Plus,(A Non-Linked, Non-Participating Individual Health Rider UIN:110A048V01)
#Premium calculated for Term with Terminal Illness on PRASHANT SAMANTA is considering underwriting class as super preferred

Premium Summary
 Premium Summary
Base Plan Riders Total Instalment Premium
Instalment Premium without GST (Rs.) 87500 26635 114135
Instalment Premium with First year GST (Rs.) 87500 31429 118929
Instalment Premium post applicable discount with First year GST
87500 29301 116801
(Rs.)
Instalment Premium with GST 2nd year onwards (Rs.) 87500 31429 118929

Discount applicable and Installment Premium payable 2nd year onwards will depend on the Wellness status of the Insured
How to read and understand this benefit illustration?
This benefit illustration is intended to show what charges are deducted from your premiums and how the unit fund, net of charges and taxes, may grow over
the years of the policy term if the fund earns a gross return of 8% p.a. or 4% p.a. These rates, i.e., 8% p.a. and 4% p.a. are assumed only for the purpose of
illustrating the flow of benefits if the returns are at this level. It should not be interpreted that the returns under the plan are going to be either 8% p.a. or 4%
p.a.
Net Yield mentioned corresponds to the gross investment return of 8% p.a., net of all charges but does not consider mortality, morbidity charges,
underwriting extra, if any, guarantee charges and cost of riders, if deducted by cancellation of units. It demonstrates the impact of charges and taxes on the
net yield. Please note that the mortality charges per thousand sum assured in general, increases with age.
The actual returns can vary depending on the performance of the chosen fund, charges towards mortality, morbidity, underwriting extra, cost of riders, etc.
The investment risk in this policy is borne by the policyholder, hence, for more details on terms and conditions please read sales literature carefully.
Some benefits are guaranteed and some benefits are variable with returns based on the future performance of your insurer carrying on life insurance
business. If your policy offers guaranteed benefits then these will be clearly marked "guaranteed" in the illustration table on this page. If your policy offers
variable benefits then the illustration on this page will show two different rates of assumed future investment returns, of 8% p.a. and 4% p.a. These
assumed rates of return are not guaranteed and they are not the upper or lower limits of what you might get back, as the value of your policy is dependant
on a number of factors including future investment performance.
Part A of this statement presents a summary view of year-by-year charges deducted under the policy, fund value, surrender value and the death benefit, at
two assumed rates of return. Part B of this statement presents a detailed break-up of the charges, and other values.
Part A
(Amount in Rupees)
At 4% p.a. Gross Investment Return At 8% p.a. Gross Investment Return Commission
Annualized Mortality, Mortality, payable to
Policy Year Other Fund at End Surrender Other Fund at End Surrender
Premium Morbidity GST Death Benefit Morbidity GST Death Benefit intermediary
Charges* of Year Value Charges* of Year Value (Rs.)
Charges Charges
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

1 87,500 11,287 11,327 4,071 63,514 59,017 6,300,000 11,285 11,345 4,073 66,198 61,512 6,300,000 30,625
2 87,500 12,206 6,919 3,443 133,893 129,763 6,300,000 12,196 6,988 3,453 142,171 138,041 6,300,000 875
3 87,500 13,269 6,906 3,631 205,844 202,747 6,300,000 13,242 7,062 3,655 222,889 219,792 6,300,000 875
4 87,500 14,489 6,047 3,697 280,279 278,214 6,300,000 14,435 6,332 3,738 309,581 307,516 6,300,000 875
5 87,500 15,899 8,627 4,415 352,942 352,942 6,300,000 15,801 9,083 4,479 398,265 398,265 6,300,000 875
6 87,500 17,528 9,713 4,904 425,242 425,242 6,300,000 17,366 10,387 4,996 490,522 490,522 6,300,000 875
7 87,500 19,380 10,803 5,433 496,892 496,892 6,300,000 19,125 11,744 5,556 586,334 586,334 6,300,000 875
8 87,500 21,453 11,896 6,003 567,595 567,595 6,300,000 21,069 13,156 6,160 685,692 685,692 6,300,000 875
9 87,500 23,736 12,987 6,610 637,063 637,063 6,300,000 23,177 14,622 6,804 788,610 788,610 6,300,000 875
10 87,500 26,189 14,073 7,247 726,046 726,046 6,300,000 25,396 16,142 7,477 916,168 916,168 6,300,000 875
11 87,500 28,617 15,536 7,948 826,388 826,388 6,300,000 27,519 18,111 8,213 1,061,798 1,061,798 6,300,000 875
12 87,500 31,080 16,978 8,651 926,164 926,164 6,300,000 29,584 20,145 8,951 1,214,186 1,214,186 6,300,000 875
13 0 34,109 17,116 9,220 933,778 933,778 6,300,000 32,117 20,943 9,551 1,278,841 1,278,841 6,300,000 0
14 0 37,233 17,198 9,798 935,067 935,067 6,300,000 34,645 21,741 10,149 1,341,804 1,341,804 6,300,000 0
15 0 40,459 17,204 10,379 935,381 935,381 6,300,000 37,165 22,519 10,743 1,408,581 1,408,581 6,300,000 0
16 0 43,750 17,201 10,971 935,065 935,065 6,300,000 39,627 23,347 11,335 1,479,903 1,479,903 6,300,000 0
17 0 47,118 17,191 11,576 934,457 934,457 6,300,000 42,026 24,235 11,927 1,556,537 1,556,537 6,300,000 0
18 0 50,610 17,180 12,202 933,851 933,851 6,300,000 44,387 25,191 12,524 1,639,257 1,639,257 6,300,000 0
19 0 54,274 17,169 12,860 933,467 933,467 6,300,000 46,728 26,224 13,131 1,728,818 1,728,818 6,300,000 0
20 0 58,186 17,161 13,563 933,356 933,356 6,300,000 49,086 27,344 13,757 1,825,873 1,825,873 6,300,000 0
21 0 62,423 17,154 14,324 933,087 933,087 6,300,000 51,489 28,556 14,408 1,930,654 1,930,654 6,300,000 0
22 0 67,087 17,142 15,161 932,216 932,216 6,300,000 53,976 29,862 15,091 2,043,441 2,043,441 6,300,000 0
23 0 72,270 17,125 16,091 931,250 931,250 6,300,000 56,560 31,272 15,810 2,165,594 2,165,594 6,300,000 0
24 0 78,067 17,103 17,131 929,645 929,645 6,300,000 59,243 32,798 16,567 2,297,591 2,297,591 6,300,000 0
25 0 84,586 17,069 18,298 926,729 926,729 6,300,000 62,011 34,445 17,362 2,439,950 2,439,950 6,300,000 0
26 0 91,938 17,013 19,611 921,604 921,604 6,300,000 64,833 36,220 18,190 2,593,155 2,593,155 6,300,000 0
27 0 100,237 16,924 21,089 913,236 913,236 6,300,000 67,650 38,129 19,040 2,757,788 2,757,788 6,300,000 0
28 0 109,625 16,788 22,754 900,490 900,490 6,300,000 70,385 40,181 19,902 2,934,607 2,934,607 6,300,000 0
29 0 120,245 16,591 24,631 882,131 882,131 6,300,000 72,922 42,385 20,755 3,124,606 3,124,606 6,300,000 0
30 0 132,275 16,318 26,747 856,832 856,832 6,300,000 75,112 44,755 21,576 3,329,093 3,329,093 6,300,000 0
31 0 145,927 15,952 29,138 823,134 823,134 6,300,000 76,761 47,311 22,333 3,549,763 3,549,763 6,300,000 0
32 0 161,435 15,473 31,844 779,468 779,468 6,300,000 77,605 50,075 22,982 3,788,817 3,788,817 6,300,000 0
33 0 177,493 15,466 34,733 802,610 802,610 6,300,000 77,312 53,077 23,470 4,049,035 4,049,035 6,300,000 0
34 0 193,617 16,026 37,736 853,787 853,787 6,300,000 75,438 56,355 23,723 4,333,920 4,333,920 6,300,000 0
35 0 210,956 16,696 40,978 912,718 912,718 6,300,000 71,411 59,958 23,646 4,647,873 4,647,873 6,300,000 0
36 0 229,551 17,470 44,464 980,522 980,522 6,300,000 64,466 63,945 23,114 4,996,449 4,996,449 6,300,000 0
37 0 249,364 18,362 48,191 1,058,532 1,058,532 6,300,000 53,599 68,392 21,958 5,386,666 5,386,666 6,300,000 0
38 0 270,298 19,390 52,144 1,148,334 1,148,334 6,300,000 37,462 73,397 19,955 5,827,483 5,827,483 6,300,000 0
39 0 292,182 20,578 56,297 1,251,822 1,251,822 6,300,000 14,249 79,082 16,800 6,330,403 6,330,403 6,330,403 0
40 0 314,759 21,951 60,608 1,371,256 1,371,256 6,300,000 0 85,508 15,391 6,888,014 6,888,014 6,888,014 0

*Other charges includes Premium Allocation Charge, Policy Admin Charge, Fund Management Charge and Rider Charges, if any. See Part B for details.

IN THIS POLICY, THE INVESTMENT RISK IS BORNE BY THE POLICYHOLDER AND THE ABOVE INTEREST RATES ARE ONLY FOR
ILLUSTRATIVE PURPOSE.

I ___________________________ (name), have explained the

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

Place:
Date: Signature of Prospect/ Policyholder
Date: Signature of Agent/ Intermediary/ Official
Part B
Gross Yield 8% p.a Net Yield 7.86% Amount in Rupees

Annualized
Premium
Annualized Premium
Allocation Mortality Policy Admin Guarantee Rider Additions to Fund before Fund at End Surrender Death
Policy Year Premium - Premium GST FMC
Charge charge Charge Charge Charges the Fund* FMC of Year Value Benefit
(AP) Allocation
(PAC)
Charges

1 87,500 10,500 77,000 11,285 4,073 0 NA 0 0 66,277 845 66,198 61,512 6,300,000
2 87,500 5,250 82,250 12,196 3,453 0 NA 0 0 142,339 1,738 142,171 138,041 6,300,000
3 87,500 4,375 83,125 13,242 3,655 0 NA 0 0 223,153 2,687 222,889 219,792 6,300,000
4 87,500 2,625 84,875 14,435 3,738 0 NA 0 0 309,947 3,707 309,581 307,516 6,300,000
5 87,500 0 87,500 15,801 4,479 4,305 NA 0 0 398,736 4,778 398,265 398,265 6,300,000
6 87,500 0 87,500 17,366 4,996 4,520 NA 0 0 491,101 5,867 490,522 490,522 6,300,000
7 87,500 0 87,500 19,125 5,556 4,746 NA 0 0 587,027 6,998 586,334 586,334 6,300,000
8 87,500 0 87,500 21,069 6,160 4,984 NA 0 0 686,502 8,172 685,692 685,692 6,300,000
9 87,500 0 87,500 23,177 6,804 5,233 NA 0 0 789,542 9,389 788,610 788,610 6,300,000
10 87,500 0 87,500 25,396 7,477 5,494 NA 0 21,000 896,226 10,648 916,168 916,168 6,300,000
11 87,500 0 87,500 27,519 8,213 5,769 NA 0 33,070 1,050,656 12,342 1,061,798 1,061,798 6,300,000
12 87,500 0 87,500 29,584 8,951 6,000 NA 0 33,142 1,204,825 14,145 1,214,186 1,214,186 6,300,000
13 0 0 0 32,117 9,551 6,000 NA 0 31,734 1,272,886 14,943 1,278,841 1,278,841 6,300,000
14 0 0 0 34,645 10,149 6,000 NA 0 28,869 1,340,981 15,741 1,341,804 1,341,804 6,300,000
15 0 0 0 37,165 10,743 6,000 NA 0 31,601 1,407,609 16,519 1,408,581 1,408,581 6,300,000
16 0 0 0 39,627 11,335 6,000 NA 0 34,732 1,478,754 17,347 1,479,903 1,479,903 6,300,000
17 0 0 0 42,026 11,927 6,000 NA 0 38,249 1,555,186 18,235 1,556,537 1,556,537 6,300,000
18 0 0 0 44,387 12,524 6,000 NA 0 42,138 1,637,681 19,191 1,639,257 1,639,257 6,300,000
19 0 0 0 46,728 13,131 6,000 NA 0 46,353 1,726,998 20,224 1,728,818 1,728,818 6,300,000
20 0 0 0 49,086 13,757 6,000 NA 0 50,793 1,823,800 21,344 1,825,873 1,825,873 6,300,000
21 0 0 0 51,489 14,408 6,000 NA 0 55,037 1,928,362 22,556 1,930,654 1,930,654 6,300,000
22 0 0 0 53,976 15,091 6,000 NA 0 59,168 2,040,943 23,862 2,043,441 2,043,441 6,300,000
23 0 0 0 56,560 15,810 6,000 NA 0 64,233 2,162,822 25,272 2,165,594 2,165,594 6,300,000
24 0 0 0 59,243 16,567 6,000 NA 0 69,289 2,294,558 26,798 2,297,591 2,297,591 6,300,000
25 0 0 0 62,011 17,362 6,000 NA 0 74,330 2,436,670 28,445 2,439,950 2,439,950 6,300,000
26 0 0 0 64,833 18,190 6,000 NA 0 79,254 2,589,651 30,220 2,593,155 2,593,155 6,300,000
27 0 0 0 67,650 19,040 6,000 NA 0 84,052 2,754,085 32,129 2,757,788 2,757,788 6,300,000
28 0 0 0 70,385 19,902 6,000 NA 0 88,774 2,930,728 34,181 2,934,607 2,934,607 6,300,000
29 0 0 0 72,922 20,755 6,000 NA 0 93,456 3,120,570 36,385 3,124,606 3,124,606 6,300,000
30 0 0 0 75,112 21,576 6,000 NA 0 98,172 3,324,917 38,755 3,329,093 3,329,093 6,300,000
31 0 0 0 76,761 22,333 6,000 NA 0 102,978 3,545,459 41,311 3,549,763 3,549,763 6,300,000
32 0 0 0 77,605 22,982 6,000 NA 0 107,951 3,784,395 44,075 3,788,817 3,788,817 6,300,000
33 0 0 0 77,312 23,470 6,000 NA 0 113,120 4,044,507 47,077 4,049,035 4,049,035 6,300,000
34 0 0 0 75,438 23,723 6,000 NA 0 118,485 4,329,302 50,355 4,333,920 4,333,920 6,300,000
35 0 0 0 71,411 23,646 6,000 NA 0 124,021 4,643,189 53,958 4,647,873 4,647,873 6,300,000
36 0 0 0 64,466 23,114 6,000 NA 0 129,666 4,991,735 57,945 4,996,449 4,996,449 6,300,000
37 0 0 0 53,599 21,958 6,000 NA 0 135,299 5,381,977 62,392 5,386,666 5,386,666 6,300,000
38 0 0 0 37,462 19,955 6,000 NA 0 140,771 5,822,899 67,397 5,827,483 5,827,483 6,300,000
39 0 0 0 14,249 16,800 6,000 NA 0 145,844 6,326,039 73,082 6,330,403 6,330,403 6,330,403
40 0 0 0 0 15,391 6,000 NA 0 150,225 6,884,002 79,508 6,888,014 6,888,014 6,888,014
 Gross Yield 4% p.a Amount in Rupees

Annualized
Premium
Annualized Premium
Allocation Mortality Policy Admin Guarantee Rider Additions to Fund before Fund at End Surrender Death
Policy Year Premium - Premium GST FMC
Charge charge Charge Charge Charges the Fund* FMC of Year Value Benefit
(AP) Allocation
(PAC)
Charges

1 87,500 10,500 77,000 11,287 4,071 0 NA 0 0 63,589 827 63,514 59,017 6,300,000
2 87,500 5,250 82,250 12,206 3,443 0 NA 0 0 134,051 1,669 133,893 129,763 6,300,000
3 87,500 4,375 83,125 13,269 3,631 0 NA 0 0 206,087 2,531 205,844 202,747 6,300,000
4 87,500 2,625 84,875 14,489 3,697 0 NA 0 0 280,610 3,422 280,279 278,214 6,300,000
5 87,500 0 87,500 15,899 4,415 4,305 NA 0 0 353,359 4,322 352,942 352,942 6,300,000
6 87,500 0 87,500 17,528 4,904 4,520 NA 0 0 425,745 5,193 425,242 425,242 6,300,000
7 87,500 0 87,500 19,380 5,433 4,746 NA 0 0 497,479 6,057 496,892 496,892 6,300,000
8 87,500 0 87,500 21,453 6,003 4,984 NA 0 0 568,266 6,912 567,595 567,595 6,300,000
9 87,500 0 87,500 23,736 6,610 5,233 NA 0 0 637,815 7,754 637,063 637,063 6,300,000
10 87,500 0 87,500 26,189 7,247 5,494 NA 0 21,000 705,879 8,579 726,046 726,046 6,300,000
11 87,500 0 87,500 28,617 7,948 5,769 NA 0 33,074 814,967 9,767 826,388 826,388 6,300,000
12 87,500 0 87,500 31,080 8,651 6,000 NA 0 33,163 916,459 10,978 926,164 926,164 6,300,000
13 0 0 0 34,109 9,220 6,000 NA 0 31,787 927,409 11,116 933,778 933,778 6,300,000
14 0 0 0 37,233 9,798 6,000 NA 0 28,978 933,752 11,198 935,067 935,067 6,300,000
15 0 0 0 40,459 10,379 6,000 NA 0 31,797 933,830 11,204 935,381 935,381 6,300,000
16 0 0 0 43,750 10,971 6,000 NA 0 35,057 933,241 11,201 935,065 935,065 6,300,000
17 0 0 0 47,118 11,576 6,000 NA 0 38,759 932,323 11,191 934,457 934,457 6,300,000
18 0 0 0 50,610 12,202 6,000 NA 0 42,906 931,370 11,180 933,851 933,851 6,300,000
19 0 0 0 54,274 12,860 6,000 NA 0 47,473 930,603 11,169 933,467 933,467 6,300,000
20 0 0 0 58,186 13,563 6,000 NA 0 52,379 930,082 11,161 933,356 933,356 6,300,000
21 0 0 0 62,423 14,324 6,000 NA 0 57,235 929,415 11,154 933,087 933,087 6,300,000
22 0 0 0 67,087 15,161 6,000 NA 0 62,161 928,132 11,142 932,216 932,216 6,300,000
23 0 0 0 72,270 16,091 6,000 NA 0 68,218 926,660 11,125 931,250 931,250 6,300,000
24 0 0 0 78,067 17,131 6,000 NA 0 74,465 924,531 11,103 929,645 929,645 6,300,000
25 0 0 0 84,586 18,298 6,000 NA 0 80,918 921,073 11,069 926,729 926,729 6,300,000
26 0 0 0 91,938 19,611 6,000 NA 0 87,500 915,393 11,013 921,604 921,604 6,300,000
27 0 0 0 100,237 21,089 6,000 NA 0 94,236 906,452 10,924 913,236 913,236 6,300,000
28 0 0 0 109,625 22,754 6,000 NA 0 101,220 893,108 10,788 900,490 900,490 6,300,000
29 0 0 0 120,245 24,631 6,000 NA 0 108,548 874,117 10,591 882,131 882,131 6,300,000
30 0 0 0 132,275 26,747 6,000 NA 0 116,371 848,135 10,318 856,832 856,832 6,300,000
31 0 0 0 145,927 29,138 6,000 NA 0 124,846 813,690 9,952 823,134 823,134 6,300,000
32 0 0 0 161,435 31,844 6,000 NA 0 134,174 769,193 9,473 779,468 779,468 6,300,000
33 0 0 0 177,493 34,733 6,000 NA 0 219,946 787,788 9,466 802,610 802,610 6,300,000
34 0 0 0 193,617 37,736 6,000 NA 0 265,841 837,415 10,026 853,787 853,787 6,300,000
35 0 0 0 210,956 40,978 6,000 NA 0 292,658 894,677 10,696 912,718 912,718 6,300,000
36 0 0 0 229,551 44,464 6,000 NA 0 321,862 960,698 11,470 980,522 980,522 6,300,000
37 0 0 0 249,364 48,191 6,000 NA 0 353,589 1,036,812 12,362 1,058,532 1,058,532 6,300,000
38 0 0 0 270,298 52,144 6,000 NA 0 387,941 1,124,616 13,390 1,148,334 1,148,334 6,300,000
39 0 0 0 292,182 56,297 6,000 NA 0 424,975 1,226,017 14,578 1,251,822 1,251,822 6,300,000
40 0 0 0 314,759 60,608 6,000 NA 0 464,704 1,343,303 15,951 1,371,256 1,371,256 6,300,000

Notes:

1. Refer the sales literature for explanation of terms used in this illustration.
2. Fund management charge is based on the specific fund option(s) chosen.
3. *Additions to the Fund refers to the periodic additions through A) Refund of 2X Mortality Charges, B) Refund of 2X Premium Allocation Charges and C)
Cover Continuance Booster.

The rider sum assured shall remain unchanged for a period as specified under ‘Guaranteed Period’ from the Date of Commencement of the benefit option.
Upon the completion of ‘Guaranteed Period’, the sum assured as applicable for the benefit option may be revised or the policyholder may be given an
option of top up premium to restore the benefit to original amount, subject to IRDAI’s approval. The top up premium may be payable as a single premium/
level premium during the block of next guarantee period. The requirement of paying the Top up premium in order to continue with the current level of
benefit may be applicable even after expiry of limited pay premium term.

I ___________________________ (name), have explained the

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

Place:
Date: Signature of Prospect/ Policyholder
Date: Signature of Agent/ Intermediary/ Official
 Unique Reference Number - L&C/Advt/2023/Jun/1932 (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: [Link]

(I)V.99.00/FY2023-2024_Q2/RELEASE 01-07-23/EXPIRY 31-10-2023 SB 12-08-2023,08:04 PM