BENEFIT ILLUSTRATION

[Date and Time of Illustration – 28 June 2026, 09:31 AM] Proposal No:

Name of the Prospect/Policyholder: [Link] Name of the Product: Axis Max Life Online Savings Plan Plus
A Unit-Linked Non-Participating Individual Life
Age & Gender: 26 Years, Male Tag Line:
Insurance Savings Plan
Name of the Life Assured: [Link] Plan Variant: Wealth Variant
Unique Identification No: 104L131V02
Age & Gender: 26 Years, Male
Axis Max Life State: Haryana
Sum Assured: `12,00,000
Policyholder Residential State: HR
Policy Term & Premium Payment
30 Years & 10 Years
Term : Investment Strategy Opted for: Self Managed Portfolio Strategy
Amount of Installment Premium: `10,000 Funds opted for along with their BSE Dividend Stability Index Fund (Very High): 100%
Mode of payment of premium: Monthly risk level (Please specify the
customer specific fund option):

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 exclusive of 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.
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.
Note: 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. 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 dependent on a number of factors including actual future investment performance.

UIN: 104L131V02 Page 1 of 12

 Additional Benefit Details

Funding of Premium $$ NA

Existing Customer Benefit* No Women Empowerment Benefit NA

Smart Withdrawal plan No Smart Withdrawal Percentage NA

Opted Start Year for Smart Withdrawal Payouts NA Smart Withdrawal Payment Frequency NA

Rider Details
Rider Name Variant Rider Sum Assured Rider Term Rider Premium Payment Term
^SUPR - Term booster with Accelerated Terminal
NA NA NA NA
Illness
^SUPR - Accidental Death Benefit NA NA NA NA
^SUPR - Accidental Total & Permanent Disability NA NA NA NA
^SUPR - Payor Benefit NA NA NA NA
Critical Illness and Disability-Secure Rider NA NA NA NA

Premium Summary
Axis Max Life #SUPR - Term #SUPR -
#SUPR - Total
Critical Illness booster with Accidental Total #SUPR - Payor
Base Plan Accidental Installment
and Disability- Accelerated & Permanent Benefit
Death Benefit Premium
Secure Rider Terminal Illness Disability

Installment Premium (in Rs.) 10,000 0 0 0 0 0 10,000

UIN: 104L131V02 Page 2 of 12

 Part A (Amount in Rupees.)
At 4% p.a. Gross Investment Return At 8% p.a. Gross Investment Return Additional Benefits
Policy Annualize Mortality, Income Funding
Fund at Smart Mortality, Fund at Smart
Year d Premium Morbidity Other Surrender Death Other Surrender Death Benefit of
End of Withdrawa Morbidity End of Withdrawa
Charges** Value Benefit $ Charges** Value Benefit $ on Premium
Charges Year l Charges Year l $$
Death^^
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

1 1,20,000 1,000 4,453 1,17,022 0 1,11,022 12,00,000 1,000 4,465 1,19,455 0 1,13,455 12,00,000 0 0

2 1,20,000 906 6,056 2,37,187 0 2,32,387 12,00,000 902 6,136 2,46,839 0 2,42,039 12,00,000 0 0

3 1,20,000 798 7,703 3,60,594 0 3,56,994 12,00,000 785 7,918 3,82,689 0 3,79,089 12,00,000 0 0

4 1,20,000 702 9,394 4,87,312 0 4,85,312 12,00,000 675 9,819 5,27,553 0 5,25,553 12,00,000 0 0

5 1,20,000 599 11,131 6,17,438 0 6,17,438 12,00,000 551 11,845 6,82,036 0 6,82,036 12,00,000 0 0

6 1,20,000 486 12,914 7,51,067 0 7,51,067 12,00,000 412 14,006 8,46,785 0 8,46,785 12,00,000 0 0

7 1,20,000 373 14,745 8,88,294 0 8,88,294 12,00,000 261 16,311 10,22,484 0 10,22,484 12,00,000 0 0

8 1,20,000 245 16,626 10,29,225 0 10,29,225 12,00,000 86 18,769 12,09,876 0 12,09,876 12,09,876 0 0

9 1,20,000 103 18,557 11,73,972 0 11,73,972 12,00,000 0 21,390 14,09,635 0 14,09,635 14,09,635 0 0

10 1,20,000 2 20,541 13,22,593 0 13,22,593 13,22,593 0 24,183 16,22,482 0 16,22,482 16,22,482 0 0

11 0 0 21,690 13,53,402 0 13,53,402 13,53,402 0 26,259 17,25,057 0 17,25,057 17,25,057 0 0

12 0 0 22,112 13,85,013 0 13,85,013 13,85,013 0 27,694 18,34,352 0 18,34,352 18,34,352 0 0

13 0 0 22,545 14,17,447 0 14,17,447 14,17,447 0 29,222 19,50,808 0 19,50,808 19,50,808 0 0

14 0 0 22,989 14,50,727 0 14,50,727 14,50,727 0 30,850 20,74,894 0 20,74,894 20,74,894 0 0

15 0 0 23,445 14,84,874 0 14,84,874 14,84,874 0 32,585 22,07,110 0 22,07,110 22,07,110 0 0

UIN: 104L131V02 Page 3 of 12

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

16 0 0 23,913 15,19,910 0 15,19,910 15,19,910 0 34,434 23,47,988 0 23,47,988 23,47,988 0 0

17 0 0 24,393 15,55,859 0 15,55,859 15,55,859 0 36,404 24,98,096 0 24,98,096 24,98,096 0 0

18 0 0 24,885 15,92,745 0 15,92,745 15,92,745 0 38,503 26,58,039 0 26,58,039 26,58,039 0 0

19 0 0 25,390 16,30,592 0 16,30,592 16,30,592 0 40,739 28,28,461 0 28,28,461 28,28,461 0 0

20 0 0 25,909 16,69,425 0 16,69,425 16,69,425 0 43,122 30,10,049 0 30,10,049 30,10,049 0 0

21 0 0 26,441 17,09,270 0 17,09,270 17,09,270 0 45,661 32,03,534 0 32,03,534 32,03,534 0 0

22 0 0 26,987 17,50,153 0 17,50,153 17,50,153 0 48,367 34,09,696 0 34,09,696 34,09,696 0 0

23 0 0 27,547 17,92,101 0 17,92,101 17,92,101 0 51,249 36,29,365 0 36,29,365 36,29,365 0 0

24 0 0 28,121 18,35,142 0 18,35,142 18,35,142 0 54,321 38,63,426 0 38,63,426 38,63,426 0 0

25 0 0 28,711 18,79,304 0 18,79,304 18,79,304 0 57,594 41,12,822 0 41,12,822 41,12,822 0 0

26 0 0 29,316 19,24,617 0 19,24,617 19,24,617 0 61,081 43,78,558 0 43,78,558 43,78,558 0 0

27 0 0 29,936 19,71,111 0 19,71,111 19,71,111 0 64,797 46,61,705 0 46,61,705 46,61,705 0 0

28 0 0 30,573 20,18,816 0 20,18,816 20,18,816 0 68,756 49,63,403 0 49,63,403 49,63,403 0 0

29 0 0 31,227 20,67,763 0 20,67,763 20,67,763 0 72,974 52,84,867 0 52,84,867 52,84,867 0 0

30 0 0 31,897 22,79,986 0 22,79,986 22,79,986 0 77,469 57,89,393 0 57,89,393 57,89,393 0 0

*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.

UIN: 104L131V02 Page 4 of 12

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

Place
Signature / OTP Confirmation Date / Thumb
Date: 6/28/26
Impression / Electronic Signature of Agent/ Date: 6/28/26 Signature / OTP Confirmation Date / Thumb
Intermediary / Official of the insurer Impression / Electronic Signature of Prospect/
Policyholder
This system generated benefit illustration shall be treated as signed by me.

UIN: 104L131V02 Page 5 of 12

 Part B Gross Yield 8% p.a. Net Yield 6.44% Amount in Rupees
Additional Benefit
Annualized Surrender
Premium Premium - Value
Annualized Mortality, Policy Fund Fund at Smart Death Income Funding
Policy Allocation Premium Guarantee Other Additions Return of (post
Premium Morbidity Admin. before FMC End of the Withdrawa Benefit Benefit of
Year Charge Allocation Charge Charges** to the fund* Charges ~ smart
(AP) Charge Charge FMC Year l $ on Premiu
(PAC) Charges (AP- withdraw
PAC) al) Death^^ m$$

12,00,0
1 1,20,000 0 1,20,000 1,000 3,600 0 0 0 0 1,20,321 865 1,19,455 0 1,13,455 0 0
00
12,00,0
2 1,20,000 0 1,20,000 902 3,600 0 0 0 0 2,49,375 2,536 2,46,839 0 2,42,039 0 0
00
12,00,0
3 1,20,000 0 1,20,000 785 3,600 0 0 0 0 3,87,007 4,318 3,82,689 0 3,79,089 0 0
00
12,00,0
4 1,20,000 0 1,20,000 675 3,600 0 0 0 0 5,33,771 6,219 5,27,553 0 5,25,553 0 0
00
12,00,0
5 1,20,000 0 1,20,000 551 3,600 0 0 0 0 6,90,281 8,245 6,82,036 0 6,82,036 0 0
00
12,00,0
6 1,20,000 0 1,20,000 412 3,600 0 0 0 0 8,57,192 10,406 8,46,785 0 8,46,785 0 0
00
10,35,19 12,00,0
7 1,20,000 0 1,20,000 261 3,600 0 0 0 0 12,711 10,22,484 0 10,22,484 0 0
5 00
12,25,04 12,09,8
8 1,20,000 0 1,20,000 86 3,600 0 0 0 0 15,169 12,09,876 0 12,09,876 0 0
5 76
14,27,42 14,09,6
9 1,20,000 0 1,20,000 0 3,600 0 0 0 0 17,790 14,09,635 0 14,09,635 0 0
5 35
16,43,06 16,22,4
10 1,20,000 0 1,20,000 0 3,600 0 0 0 0 20,583 16,22,482 0 16,22,482 0 0
5 82
17,47,71 17,25,0
11 0 0 0 0 3,600 0 0 0 0 22,659 17,25,057 0 17,25,057 0 0
6 57
18,58,44 18,34,3
12 0 0 0 0 3,600 0 0 0 0 24,094 18,34,352 0 18,34,352 0 0
6 52
19,76,43 19,50,8
13 0 0 0 0 3,600 0 0 0 0 25,622 19,50,808 0 19,50,808 0 0
0 08
21,02,14 20,74,8
14 0 0 0 0 3,600 0 0 0 0 27,250 20,74,894 0 20,74,894 0 0
4 94

UIN: 104L131V02 Page 6 of 12

 Additional Benefit
Annualized Surrender
Premium Premium - Value
Annualized Mortality, Policy Fund Fund at Smart Death Income Funding
Policy Allocation Premium Guarantee Other Additions Return of (post
Premium Morbidity Admin. before FMC End of the Withdrawa Benefit Benefit of
Year Charge Allocation Charge Charges** to the fund* Charges ~ smart
(AP) Charge Charge FMC Year l $ on Premiu
(PAC) Charges (AP- withdraw
PAC) al) Death^^ m$$

22,36,09 22,07,1
15 0 0 0 0 3,600 0 0 0 0 28,985 22,07,110 0 22,07,110 0 0
5 10
23,78,82 23,47,9
16 0 0 0 0 3,600 0 0 0 0 30,834 23,47,988 0 23,47,988 0 0
2 88
25,30,90 24,98,0
17 0 0 0 0 3,600 0 0 0 0 32,804 24,98,096 0 24,98,096 0 0
0 96
26,92,94 26,58,0
18 0 0 0 0 3,600 0 0 0 0 34,903 26,58,039 0 26,58,039 0 0
2 39
28,65,60 28,28,4
19 0 0 0 0 3,600 0 0 0 0 37,139 28,28,461 0 28,28,461 0 0
1 61
30,49,57 30,10,0
20 0 0 0 0 3,600 0 0 0 0 39,522 30,10,049 0 30,10,049 0 0
1 49
32,45,59 32,03,5
21 0 0 0 0 3,600 0 0 0 0 42,061 32,03,534 0 32,03,534 0 0
5 34
34,54,46 34,09,6
22 0 0 0 0 3,600 0 0 0 0 44,767 34,09,696 0 34,09,696 0 0
2 96
36,77,01 36,29,3
23 0 0 0 0 3,600 0 0 0 0 47,649 36,29,365 0 36,29,365 0 0
4 65
39,14,14 38,63,4
24 0 0 0 0 3,600 0 0 0 0 50,721 38,63,426 0 38,63,426 0 0
7 26
41,66,81 41,12,8
25 0 0 0 0 3,600 0 0 0 0 53,994 41,12,822 0 41,12,822 0 0
6 22
44,36,03 43,78,5
26 0 0 0 0 3,600 0 0 0 0 57,481 43,78,558 0 43,78,558 0 0
9 58
47,22,90 46,61,7
27 0 0 0 0 3,600 0 0 0 0 61,197 46,61,705 0 46,61,705 0 0
1 05
50,28,55 49,63,4
28 0 0 0 0 3,600 0 0 0 0 65,156 49,63,403 0 49,63,403 0 0
8 03
53,54,24 52,84,8
29 0 0 0 0 3,600 0 0 0 0 69,374 52,84,867 0 52,84,867 0 0
1 67

UIN: 104L131V02 Page 7 of 12

 Additional Benefit
Annualized Surrender
Premium Premium - Value
Annualized Mortality, Policy Fund Fund at Smart Death Income Funding
Policy Allocation Premium Guarantee Other Additions Return of (post
Premium Morbidity Admin. before FMC End of the Withdrawa Benefit Benefit of
Year Charge Allocation Charge Charges** to the fund* Charges ~ smart
(AP) Charge Charge FMC Year l $ on Premiu
(PAC) Charges (AP- withdraw
PAC) al) Death^^ m$$

58,63,26 57,89,3
30 0 0 0 0 3,600 0 0 0 1,62,000 73,869 57,89,393 0 57,89,393 0 0
2 93

Gross Yield 4% p.a. Amount in Rupees

Annualized Surrender Additional Benefit
Premium Premium - Value
Annualize Mortality, Policy Additions Fund at Death Income Funding
Policy Allocation Premium Guarantee Other Return of Fund Smart (post
d Premium Morbidity Admin. to the FMC End of the Benefit Benefit of
Year Charge Allocation Charge Charges** charges ~ before FMC Withdrawal smart
(AP) Charge Charge fund* Year $ on Premium
(PAC) Charges (AP- withdraw $$
Death^^
PAC) al)
12,00,0
1 1,20,000 0 1,20,000 1,000 3,600 0 0 0 0 1,17,874 853 1,17,022 0 1,11,022 0 0
00
12,00,0
2 1,20,000 0 1,20,000 906 3,600 0 0 0 0 2,39,644 2,456 2,37,187 0 2,32,387 0 0
00
12,00,0
3 1,20,000 0 1,20,000 798 3,600 0 0 0 0 3,64,697 4,103 3,60,594 0 3,56,994 0 0
00
12,00,0
4 1,20,000 0 1,20,000 702 3,600 0 0 0 0 4,93,106 5,794 4,87,312 0 4,85,312 0 0
00
12,00,0
5 1,20,000 0 1,20,000 599 3,600 0 0 0 0 6,24,968 7,531 6,17,438 0 6,17,438 0 0
00
12,00,0
6 1,20,000 0 1,20,000 486 3,600 0 0 0 0 7,60,381 9,314 7,51,067 0 7,51,067 0 0
00
12,00,0
7 1,20,000 0 1,20,000 373 3,600 0 0 0 0 8,99,439 11,145 8,88,294 0 8,88,294 0 0
00
12,00,0
8 1,20,000 0 1,20,000 245 3,600 0 0 0 0 10,42,251 13,026 10,29,225 0 10,29,225 0 0
00
12,00,0
9 1,20,000 0 1,20,000 103 3,600 0 0 0 0 11,88,930 14,957 11,73,972 0 11,73,972 0 0
00
13,22,5
10 1,20,000 0 1,20,000 2 3,600 0 0 0 0 13,39,534 16,941 13,22,593 0 13,22,593 0 0
93
UIN: 104L131V02 Page 8 of 12
 Annualized Surrender Additional Benefit
Premium Premium - Value
Annualize Mortality, Policy Additions Fund at Death Income Funding
Policy Allocation Premium Guarantee Other Return of Fund Smart (post
d Premium Morbidity Admin. to the FMC End of the Benefit Benefit of
Year Charge Allocation Charge Charges** charges ~ before FMC Withdrawal smart
(AP) Charge Charge fund* Year $ on Premium
(PAC) Charges (AP- withdraw $$
Death^^
PAC) al)
13,53,4
11 0 0 0 0 3,600 0 0 0 0 13,71,491 18,090 13,53,402 0 13,53,402 0 0
02
13,85,0
12 0 0 0 0 3,600 0 0 0 0 14,03,525 18,512 13,85,013 0 13,85,013 0 0
13
14,17,4
13 0 0 0 0 3,600 0 0 0 0 14,36,392 18,945 14,17,447 0 14,17,447 0 0
47
14,50,7
14 0 0 0 0 3,600 0 0 0 0 14,70,116 19,389 14,50,727 0 14,50,727 0 0
27
14,84,8
15 0 0 0 0 3,600 0 0 0 0 15,04,719 19,845 14,84,874 0 14,84,874 0 0
74
15,19,9
16 0 0 0 0 3,600 0 0 0 0 15,40,223 20,313 15,19,910 0 15,19,910 0 0
10
15,55,8
17 0 0 0 0 3,600 0 0 0 0 15,76,652 20,793 15,55,859 0 15,55,859 0 0
59
15,92,7
18 0 0 0 0 3,600 0 0 0 0 16,14,030 21,285 15,92,745 0 15,92,745 0 0
45
16,30,5
19 0 0 0 0 3,600 0 0 0 0 16,52,383 21,790 16,30,592 0 16,30,592 0 0
92
16,69,4
20 0 0 0 0 3,600 0 0 0 0 16,91,734 22,309 16,69,425 0 16,69,425 0 0
25
17,09,2
21 0 0 0 0 3,600 0 0 0 0 17,32,111 22,841 17,09,270 0 17,09,270 0 0
70
17,50,1
22 0 0 0 0 3,600 0 0 0 0 17,73,539 23,387 17,50,153 0 17,50,153 0 0
53
17,92,1
23 0 0 0 0 3,600 0 0 0 0 18,16,047 23,947 17,92,101 0 17,92,101 0 0
01
18,35,1
24 0 0 0 0 3,600 0 0 0 0 18,59,663 24,521 18,35,142 0 18,35,142 0 0
42
18,79,3
25 0 0 0 0 3,600 0 0 0 0 19,04,415 25,111 18,79,304 0 18,79,304 0 0
04
19,24,6
26 0 0 0 0 3,600 0 0 0 0 19,50,333 25,716 19,24,617 0 19,24,617 0 0
17
UIN: 104L131V02 Page 9 of 12
 Annualized Surrender Additional Benefit
Premium Premium - Value
Annualize Mortality, Policy Additions Fund at Death Income Funding
Policy Allocation Premium Guarantee Other Return of Fund Smart (post
d Premium Morbidity Admin. to the FMC End of the Benefit Benefit of
Year Charge Allocation Charge Charges** charges ~ before FMC Withdrawal smart
(AP) Charge Charge fund* Year $ on Premium
(PAC) Charges (AP- withdraw $$
Death^^
PAC) al)
19,71,1
27 0 0 0 0 3,600 0 0 0 0 19,97,447 26,336 19,71,111 0 19,71,111 0 0
11
20,18,8
28 0 0 0 0 3,600 0 0 0 0 20,45,789 26,973 20,18,816 0 20,18,816 0 0
16
20,67,7
29 0 0 0 0 3,600 0 0 0 0 20,95,390 27,627 20,67,763 0 20,67,763 0 0
63
22,79,9
30 0 0 0 0 3,600 0 0 0 1,62,000 23,08,284 28,297 22,79,986 0 22,79,986 0 0
86

UIN: 104L131V02 Page 10 of 12

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. ‘Return of charges~’ means return of policy administration charges, if applicable.
a) Return of Policy Administration Charges: A fixed percentage of total Policy Administration Charges deducted shall be added back as Return of Policy Administration Charge to the
Fund Value at maturity or at the end of (85 minus Age at entry)th policy year, whichever is earlier provided the policy is in force and all due premium(s) have been paid. The structure of
return of Policy Administration Charges will be as follows:
•For Policy term < 15 years: 125% of total Policy Administration charge deducted throughout Policy Term (i.e. till maturity date) shall be returned.
• For Policy term > = 15 years: 150% of total Policy Administration charge deducted throughout Policy Term (i.e. till maturity date) shall be returned.
4. *The ‘Additions to Fund’ column refers here is a sum of Women Empowerment Benefit, Existing Customer Benefit, if applicable.
a) Women Empowerment Benefit: This is a Special benefit applicable only for Female lives where an amount equivalent to 1% of the Annualized Premium under Limited/Regular Pay
or 0.50% of the Single Premium under Single Pay shall be added to the Fund Value at the time of allocation of the first policy year’s premium or Single Premium, as applicable.
b) Existing Customer Benefit (ECB): This is an additional booster only for Existing customers wherein a fixed percentage of Annualized/Single Premium shall be payable at the end of
Policy Term (i.e. on Maturity) or at the end of (85 minus Age at entry)th policy year, whichever is earlier provided all due premium(s) have been paid. The Booster percentage shall be as
follows:
•For Policy term < 20 years: 2.5% of Annualized/Single Premium shall be payable.
•For Policy term > = 20 years: 5.0% of Annualized/Single Premium shall be payable.
5. The smart withdrawal amount chosen by you will vary between the % of fund chosen and zero, due to the variability of the actual fund returns and that the fund value has to be
maintained at least equal to 2 Annualised premium in case of Limited/ Regular Pay or 25% of Single Premium in case of Single Pay. Where the frequency of the Smart Withdrawal may be
other than Annual (Semi-Annual, Quarterly or Monthly), the above chosen percentage will be split over the number of instalments in a year. Please refer to policy contract and sales
literature for further details.
6. “Sum Assured” mentioned above refers to “Sum Assured under the base plan at inception” = Annualised Premium under the base plan * Cover Multiple.
7. $ Death Benefit mentioned herewith refers to the Death Benefit under the base plan that is payable immediately on death of Life insured under all plan variants.
8. ^^In case you have opted Gold and Platinum variant: An income benefit equal to 1% of Sum assured will be paid each month starting from the Policy anniversary date of every month
following or coinciding with the date of death of the Life Insured till the end of the policy term (including the payout at the maturity date), subject to a minimum of 36 monthly payments
and a maximum of 120 monthly payments. Income Benefit on death illustrated for each policy year here refers to the total income benefit payable under the policy.
9. $$In case you have opted Gold, Platinum and Titanium variant, Upon death of the life assured, the Company will fund 1X/2X/3X times (as applicable) of all future outstanding
premiums as and when due under the policy on each future premium due date(s). Funding of Premium on death illustrated for each policy year here refers to the total premium to be
funded by Axis Max Life if the event occurs at the end of that respective policy year.
10. In case rider charges are collected explicitly through collection of rider premium, and not by way of cancellation of units, then, such charges are not considered in this illustration. In
other cases, rider charges are included in other charges.

UIN: 104L131V02 Page 11 of 12

I, ……………………………………………. (name), have explained the
premiums, charges and benefits under the policy fully to the prospect / I, [Link] (name), having received the information with respect to the
policyholder. above, have understood the above statement before entering into the
contract.
Place
Date: 6/28/26 Signature / OTP Confirmation Date / Thumb
Impression / Electronic Signature of Agent/
Intermediary / Official of the insurer Date: 6/28/26 Signature / OTP Confirmation Date / Thumb
Impression / Electronic Signature of Prospect/
Policyholder
This system generated benefit illustration shall be treated as signed by me.

UIN: 104L131V02 Page 12 of 12