Aditya Birla Sun Life Insurance Version 1

Life Shield Plan UID : 3101a006111912

A non-linked participating term insurance plan Oct 31, 2019 12:05:26
Your Sales Illustration

LIFE INSURANCE
Aditya Birla Sun Life Insurance Company Limited

This shall form a part of the policy contract

Proposer Mr. aaa aaa Age : 29 years Gender : Male

Life Insured Mr. aaa aaa Age : 29 years Gender : Male

Policy Details
UIN : 109N109V02
Sum Assured : Rs. 2,500,000
Plan Option : Level Term Assurance Policy Term : 20 Years
Increasing Level : 0% Premium Paying Term : 20
Category : Non-Smoker Pay Frequency : Annual
Joint Life Protection : No

Premium Payable(in Rs.) Rider Name Sum Assured(Rs.) Annual Premium Term
Modal Premium 2,775.00 Accidental Death Benefit Rider Plus 0.00 0.00 --
GST 499.50 Accidental Death & Disability 0.00 0.00 --
Installment Premium Payable 3,274.50 Critical Illness 0.00 0.00 --
Surgical Care 0.00 0.00 --
Hospital Care 0.00 0.00 --

Policy Attn Premium Paid Death Maturity Surrender

Year Age During Year Cumulative Benefit Benefit Benefit
1 29 3,275 3,275 2,500,000 0 0
2 30 3,275 6,549 2,500,000 0 0
3 31 3,275 9,824 2,500,000 0 0
4 32 3,275 13,098 2,500,000 0 0
5 33 3,275 16,373 2,500,000 0 0
6 34 3,275 19,647 2,500,000 0 0
7 35 3,275 22,922 2,500,000 0 0
8 36 3,275 26,196 2,500,000 0 0
9 37 3,275 29,471 2,500,000 0 0
10 38 3,275 32,745 2,500,000 0 0
11 39 3,275 36,020 2,500,000 0 0
12 40 3,275 39,294 2,500,000 0 0
13 41 3,275 42,569 2,500,000 0 0
14 42 3,275 45,843 2,500,000 0 0
15 43 3,275 49,118 2,500,000 0 0
16 44 3,275 52,392 2,500,000 0 0
17 45 3,275 55,667 2,500,000 0 0
18 46 3,275 58,941 2,500,000 0 0
19 47 3,275 62,216 2,500,000 0 0
20 48 3,275 65,490 2,500,000 0 0

Terminal Illness Benefit

On diagnosis of Terminal Illness while the policy is in force, 50% of the applicable Sum Assured on Death subject to maximum of Rs. 2.5 Crore, shall be paid as Terminal
Illness Benefit. On subsequent death of the Life Insured during the policy term, the Sum Assured on Death shall be reduced by the amount of Terminal Illness Benefit already
paid.

Sum Assured on Death is highest of:

• 10 times of the annualised premium for all ages; or
• 105% of all the premium paid as on the date of death; or
• Maturity Sum Assured; or
• Absolute amount assured to be paid on death

Prepared for: Mr. aaa aaa ABSLI Life Shield Plan Page 1
 Aditya Birla Sun Life Insurance Version 1

Life Shield Plan UID : 3101a006111912

A non-linked participating term insurance plan Oct 31, 2019 12:05:26
Your Sales Illustration

LIFE INSURANCE
Aditya Birla Sun Life Insurance Company Limited

Maturity Sum Assured is nil under this plan.

The absolute amount assured to be paid on death is the Effective Sum Assured as on the date of death.

Premium shown above is inclusive of GST. Any applicable taxes will be additionally included to your premium and levied as per extant tax laws.

In "Your Sales Illustration" benefits are as of year end and assume:

Premiums are paid when due, there is no underwriting extra and current GST rates remain unchanged.

Prepared for: Mr. aaa aaa ABSLI Life Shield Plan Page 2
 Aditya Birla Sun Life Insurance Version 1

Life Shield Plan UID : 3101a006111912

A non-linked participating term insurance plan Oct 31, 2019 12:05:26
Your Sales Illustration

LIFE INSURANCE
Aditya Birla Sun Life Insurance Company Limited

Disclaimers

- The above information must be read in conjunction with the sales brochure and policy document.

- There is no surrender benefit for regular premium plan.

- GST would be levied as per applicable tax laws.

DECLARATION OF THE LIFE INSURED DECLARATION OF THE ADVISOR

I have read the product brochure and understand the values indicated in the I certify that this illustration has been fully explained to the Life Insured and have
illustration. made no statements that are inconsistent with this illustration or the product
brochure.

Date : --------------------- Code of the Agent/ Specified Person/

Unit Manager/ Corporate Agent/ Broker -------------------------

Signature or Thumb impression of the Life Insured Name of Agent/ Specified Person/ Unit Manager

Name & Signature of Witness(in case of Thumb Impression) Signature of Agent/ Specified Person/ Unit Manager

For further details please refer to the product brochure.

Aditya Birla Sun Life Insurance Company Limited Reg. No. 109

Prepared for: Mr. aaa aaa ABSLI Life Shield Plan Page 3