BENEFIT ILLUSTRATION

[Date and Time of Illustration – 04 August 2025, 06:20 PM]

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

Name of the Product: Axis Max Life Smart Wealth Plan
Age & Gender: 35 Years, Male
Tag Line: A Non-Linked Non Participating Individual Life Insurance Savings Plan
Name of the Life Assured: Mr. Unique Identification No: 104N116V14
Age & Gender: 35 Years, Male GST Rate (Base Policy, First Year): 4.50%
Policy Term: 20 Years GST Rate (Base Policy, Subsequent Year): 2.25%
Premium Payment Term: 12 Years GST Rate (Rider, First Year): NA
Amount of Installment Premium: `5,22,500 GST Rate (Rider, Subsequent Year): NA
Mode of payment of premium: Annual
Annual Income Amount: NA Axis Max Life State: Bihar
Income Period, if applicable: NA Policyholder Residential State/Country: Bihar
Mode of Income, if applicable: NA

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

Policy Details
Policy Option Lump Sum Sum Assured (in Rs.) 75,00,000
Sum Assured on Death (at inception of the policy) (in Rs.) 55,00,000

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

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.) 5,00,000 0 0 0 0 5,00,000
Installment Premium with first year GST (in Rs.) 5,22,500 0 0 0 0 5,22,500
Installment Premium with GST 2nd year onwards (in Rs.) 5,11,250 0 0 0 0 5,11,250

UIN: 104N116V14 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 1 of 3
 (Amount in Rupees)

Guaranteed Non Guaranteed

Single/ Annualized Total Annual Premium
Policy Year Other Benefits, if any
Premium Accrued Guaranteed Guaranteed Surrender Special Surrender Surrender Value
(Guaranteed Sum Maturity Benefit Death Benefit
Additions Value Value Payable (EOY)
Assured at Maturity)
1 5,00,000 5,00,000 - - - 55,00,000 - 1,66,907 1,66,907
2 5,00,000 5,00,000 - - - 55,00,000 3,00,000 3,57,461 3,57,461
3 5,00,000 5,00,000 - - - 55,00,000 5,25,000 5,74,299 5,74,299
4 5,00,000 5,00,000 - - - 55,00,000 10,00,000 10,00,000 10,00,000
5 5,00,000 5,00,000 - - - 55,00,000 12,50,000 12,50,000 12,50,000
6 5,00,000 5,00,000 - - - 55,00,000 15,00,000 15,00,000 15,00,000
7 5,00,000 5,00,000 - - - 55,00,000 17,50,000 17,66,337 17,66,337
8 5,00,000 5,00,000 - - - 57,43,600 21,33,200 21,63,804 21,63,804
9 5,00,000 5,00,000 - - - 67,43,250 25,50,150 26,09,526 26,09,526
10 5,00,000 5,00,000 - - - 78,22,500 30,00,000 31,08,495 31,08,495
11 5,00,000 5,00,000 - - - 89,88,650 34,83,150 36,66,216 36,66,216
12 5,00,000 5,00,000 - - - 1,02,47,400 40,00,200 42,88,572 42,88,572
13 - - - - - 1,10,67,600 42,00,000 46,04,719 46,04,719
14 - - - - - 1,19,52,600 43,99,800 49,42,646 49,42,646
15 - - - - - 1,29,09,000 46,00,200 53,03,859 53,03,859
16 - - - - - 1,39,41,600 48,00,000 56,89,496 56,89,496
17 - - 21,38,900 - - 1,50,57,000 56,41,470 78,03,188 78,03,188
18 - - 42,77,800 - - 1,62,61,800 64,83,540 1,02,11,660 1,02,11,660
19 - - 64,16,700 - - 1,75,62,600 73,25,010 1,29,49,642 1,29,49,642
20 - - 85,55,600 75,00,000 1,60,55,600 1,89,67,800 79,66,680 1,60,55,600 1,60,55,600

Notes:
• 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.
• Refer Sales literature (Prospectus) for explanation of terms used in this illustration.

UIN: 104N116V14 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 2 of 3
I, ……………………………………………. (name),have explained the premiums, and benefits I, ……………………………………………. (name), having received the information with respect
under the product fully to the prospect / policyholder. to the above, have understood the above statement before entering into the contract.

Place: Signature / Thumb Impression / Electronic Signature of Date:8/4/25 Signature / Thumb Impression / Electronic Signature of
Date: 8/4/25 Agent/ Intermediary / Official of the insurer Prospect/ Policyholder
This system generated benefit illustration shall be treated as signed by me.

UIN: 104N116V14 Axis Max Life Insurance Limited, Corporate Office – 11th Floor, DLF Square, Jacaranda Marg, DLF City, Phase II, Gurugram – 122002 Page 3 of 3