Proposal No:

Name of the Prospect/Policyholder: [Link] Name of the Product: Axis Max Life Forever Young Pension Plan
A Unit-Linked Non-Participating Individual
Age & Gender: 35 Years, Male Tag Line:
Pension Plan
Name of the Life Assured: [Link] Unique Identification No: 104L075V07
GST Rate: 0.00%
Age & Gender: 35 Years, Male Axis Max Life State: Haryana
Policyholder Residential State: HR
Sum Assured on Death (at Inception): Rs. 10,500
Investment Strategy Opted for: NA
Policy Term & Premium Payment Term: 25 Years & 10 Years Axis Max Life BSE 500 Dividend leaders 50
Funds opted for along with their
Amount of Installment Premium: Rs. 10,000 Index Pension Fund (Risk Rating-Very High) :
risk level (Please specify the 100%
Mode of payment of premium: Monthly customer specific fund option):
Save More Tomorrow Option: No

Vesting Age 60 Years

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.

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: 104L075V07 Page 1 of 8
 Part A

At 4% p.a. Gross Investment Return At 8% p.a. Gross Investment Return

Policy Annualized Top Up Mortality, Mortality,
Year Premium Premium Other Fund at Surrender Death Other Fund at Surrender Death
Morbidity GST Morbidity GST
Charges* End of Year Value Benefit Charges* End of Year Value Benefit
Charges Charges

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

1 1,20,000 0 6 5,062 0 1,17,416 1,11,416 1,26,000 5 5,074 0 1,19,858 1,13,858 1,26,000

2 1,20,000 0 16 6,681 0 2,37,870 2,33,070 2,52,000 9 6,762 0 2,47,554 2,42,754 2,52,000

3 1,20,000 0 22 8,342 0 3,61,445 3,57,845 3,78,000 3 8,559 0 3,83,610 3,80,010 3,83,610

4 1,20,000 0 25 10,046 0 4,88,224 4,86,224 5,04,000 0 10,474 0 5,28,570 5,26,570 5,28,570

5 1,20,000 0 23 11,794 0 6,18,297 6,18,297 6,30,000 0 12,515 0 6,83,012 6,83,012 6,83,012

6 1,20,000 0 16 13,588 0 7,51,754 7,51,754 7,56,000 0 14,689 0 8,47,559 8,47,559 8,47,559

7 1,20,000 0 3 15,428 0 8,88,688 8,88,688 8,88,688 0 17,005 0 10,22,870 10,22,870 10,22,870

8 1,20,000 0 0 17,317 0 10,29,180 10,29,180 10,29,180 0 19,473 0 12,09,650 12,09,650 12,09,650

9 1,20,000 0 0 19,254 0 11,73,320 11,73,320 11,73,320 0 22,103 0 14,08,649 14,08,649 14,08,649

10 1,20,000 0 0 21,242 0 13,27,807 13,27,807 13,27,807 0 24,904 0 16,28,769 16,28,769 16,28,769

11 0 0 0 22,479 0 13,65,080 13,65,080 13,65,080 0 27,096 0 17,39,977 17,39,977 17,39,977

12 0 0 0 22,993 0 14,03,799 14,03,799 14,03,799 0 28,662 0 18,59,446 18,59,446 18,59,446

13 0 0 0 23,527 0 14,44,024 14,44,024 14,44,024 0 30,344 0 19,87,814 19,87,814 19,87,814

14 0 0 0 24,082 0 14,85,820 14,85,820 14,85,820 0 32,151 0 21,25,767 21,25,767 21,25,767

UIN: 104L075V07 Page 2 of 8

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

15 0 0 0 24,658 0 15,29,254 15,29,254 15,29,254 0 34,093 0 22,74,051 22,74,051 22,74,051

16 0 0 0 25,257 0 15,74,395 15,74,395 15,74,395 0 36,180 0 24,33,466 24,33,466 24,33,466

17 0 0 0 25,880 0 16,21,318 16,21,318 16,21,318 0 38,424 0 26,04,881 26,04,881 26,04,881

18 0 0 0 26,527 0 16,70,099 16,70,099 16,70,099 0 40,837 0 27,89,233 27,89,233 27,89,233

19 0 0 0 27,200 0 17,20,819 17,20,819 17,20,819 0 43,432 0 29,87,536 29,87,536 29,87,536

20 0 0 0 27,899 0 17,73,561 17,73,561 17,73,561 0 46,224 0 32,00,883 32,00,883 32,00,883

21 0 0 0 28,626 0 18,28,414 18,28,414 18,28,414 0 49,227 0 34,30,461 34,30,461 34,30,461

22 0 0 0 29,383 0 18,85,471 18,85,471 18,85,471 0 52,459 0 36,77,548 36,77,548 36,77,548

23 0 0 0 30,170 0 19,44,828 19,44,828 19,44,828 0 55,937 0 39,43,530 39,43,530 39,43,530

24 0 0 0 30,988 0 20,06,588 20,06,588 20,06,588 0 59,681 0 42,29,907 42,29,907 42,29,907

25 0 0 0 31,840 0 20,70,855 20,70,855 20,70,855 0 63,712 0 45,38,298 45,38,298 45,38,298

*See Part B for details

Annuity Option Selected (This option can be changed any time before vesting) Single Life Immediate Annuity with 100% ROP

Fund Value (FV) at Vesting #Annuity Payable p.a.

Minimum Sum Assured Benefit if any
Based on the
Accumulated at 4%p.a. (in Accumulated at 8% p. Minimum Returns on Based On FV accumulated Based on FV accumulated
Minimum Assured
Rs.) a. (in Rs.) In Rs. the premiums paid: % at4% p.a. (in Rs.) at 8% p.a. (in Rs.)
Benefit, if any (in Rs.)
p.a.

20,70,855 45,38,298 NA NA 1,41,232 3,09,512 NA

The values shown above are for illustration purpose only. The actual annuity amount depends on the prevailing annuity rates at the time of vesting. The amounts of annuity
based on the assumed investment returns of 8% p.a., and 4% p.a. are not upper or lower limits of what you might get back. For more details on risk factors, terms and conditions
please read sales brochure carefully.
UIN: 104L075V07 Page 3 of 8
#without Commutation

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

Part B
Gross Yield 8% p.a. Net Yield 6.77% Amount in Rupees
Annualized
Annualized Premium Premium - Mortality, Policy Fund Fund at
Policy Top Up Guarantee Other Additions to Surrender Death
Premium Allocation Premium Morbidity GST Admin. before FMC End of the
Year Premium Allocation Charge Charges* the fund* Value Benefit
(AP) Charge (PAC) Charge Charge FMC Year
Charges
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

1 1,20,000 0 0 1,20,000 5 0 4,200 0 0 0 1,20,733 874 1,19,858 1,13,858 1,26,000

2 1,20,000 0 0 1,20,000 9 0 4,200 0 0 0 2,50,116 2,562 2,47,554 2,42,754 2,52,000

3 1,20,000 0 0 1,20,000 3 0 4,200 0 0 0 3,87,969 4,359 3,83,610 3,80,010 3,83,610

4 1,20,000 0 0 1,20,000 0 0 4,200 0 0 0 5,34,844 6,274 5,28,570 5,26,570 5,28,570

5 1,20,000 0 0 1,20,000 0 0 4,200 0 0 0 6,91,327 8,315 6,83,012 6,83,012 6,83,012

6 1,20,000 0 0 1,20,000 0 0 4,200 0 0 0 8,58,048 10,489 8,47,559 8,47,559 8,47,559

7 1,20,000 0 0 1,20,000 0 0 4,200 0 0 0 10,35,675 12,805 10,22,870 10,22,870 10,22,870

8 1,20,000 0 0 1,20,000 0 0 4,200 0 0 0 12,24,923 15,273 12,09,650 12,09,650 12,09,650

UIN: 104L075V07 Page 4 of 8

 Annualized
Annualized Premium Premium - Mortality, Policy Fund Fund at
Policy Top Up Guarantee Other Additions to Surrender Death
Premium Allocation Premium Morbidity GST Admin. before FMC End of the
Year Premium Allocation Charge Charges* the fund* Value Benefit
(AP) Charge (PAC) Charge Charge FMC Year
Charges
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

9 1,20,000 0 0 1,20,000 0 0 4,200 0 0 0 14,26,551 17,903 14,08,649 14,08,649 14,08,649

10 1,20,000 0 0 1,20,000 0 0 4,200 0 0 8,103 16,41,370 20,704 16,28,769 16,28,769 16,28,769

11 0 0 0 0 0 0 4,200 0 0 9,001 17,53,873 22,896 17,39,977 17,39,977 17,39,977

12 0 0 0 0 0 0 4,200 0 0 9,987 18,73,921 24,462 18,59,446 18,59,446 18,59,446

13 0 0 0 0 0 0 4,200 0 0 11,070 20,02,887 26,144 19,87,814 19,87,814 19,87,814

14 0 0 0 0 0 0 4,200 0 0 12,258 21,41,460 27,951 21,25,767 21,25,767 21,25,767

15 0 0 0 0 0 0 4,200 0 0 13,563 22,90,380 29,893 22,74,051 22,74,051 22,74,051

16 0 0 0 0 0 0 4,200 0 0 14,995 24,50,451 31,980 24,33,466 24,33,466 24,33,466

17 0 0 0 0 0 0 4,200 0 0 16,565 26,22,540 34,224 26,04,881 26,04,881 26,04,881

18 0 0 0 0 0 0 4,200 0 0 18,288 28,07,582 36,637 27,89,233 27,89,233 27,89,233

19 0 0 0 0 0 0 4,200 0 0 20,178 30,06,590 39,232 29,87,536 29,87,536 29,87,536

20 0 0 0 0 0 0 4,200 0 0 22,250 32,20,657 42,024 32,00,883 32,00,883 32,00,883

21 0 0 0 0 0 0 4,200 0 0 24,523 34,50,965 45,027 34,30,461 34,30,461 34,30,461

22 0 0 0 0 0 0 4,200 0 0 27,014 36,98,792 48,259 36,77,548 36,77,548 36,77,548

23 0 0 0 0 0 0 4,200 0 0 29,745 39,65,522 51,737 39,43,530 39,43,530 39,43,530

24 0 0 0 0 0 0 4,200 0 0 32,738 42,52,650 55,481 42,29,907 42,29,907 42,29,907

UIN: 104L075V07 Page 5 of 8

 Annualized
Annualized Premium Premium - Mortality, Policy Fund Fund at
Policy Top Up Guarantee Other Additions to Surrender Death
Premium Allocation Premium Morbidity GST Admin. before FMC End of the
Year Premium Allocation Charge Charges* the fund* Value Benefit
(AP) Charge (PAC) Charge Charge FMC Year
Charges
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

25 0 0 0 0 0 0 4,200 0 0 36,018 45,61,792 59,512 45,38,298 45,38,298 45,38,298

Gross Yield 4% p.a. Amount in Rupees

Annualized
Annualized Premium Premium - Mortality, Policy
Policy Top Up Guarantee Other Additions to Fund before Fund at End Surrender Death
Premium Allocation Premium Morbidity GST Admin. FMC
Year Premium Charge Charges* the fund* FMC of the Year Value Benefit
(AP) Charge (PAC) Allocation Charge Charge
Charges

1 1,20,000 0 0 1,20,000 6 0 4,200 0 0 0 1,18,277 862 1,17,416 1,11,416 1,26,000

2 1,20,000 0 0 1,20,000 16 0 4,200 0 0 0 2,40,351 2,481 2,37,870 2,33,070 2,52,000

3 1,20,000 0 0 1,20,000 22 0 4,200 0 0 0 3,65,586 4,142 3,61,445 3,57,845 3,78,000

4 1,20,000 0 0 1,20,000 25 0 4,200 0 0 0 4,94,070 5,846 4,88,224 4,86,224 5,04,000

5 1,20,000 0 0 1,20,000 23 0 4,200 0 0 0 6,25,891 7,594 6,18,297 6,18,297 6,30,000

6 1,20,000 0 0 1,20,000 16 0 4,200 0 0 0 7,61,141 9,388 7,51,754 7,51,754 7,56,000

7 1,20,000 0 0 1,20,000 3 0 4,200 0 0 0 8,99,917 11,228 8,88,688 8,88,688 8,88,688

8 1,20,000 0 0 1,20,000 0 0 4,200 0 0 0 10,42,297 13,117 10,29,180 10,29,180 10,29,180

9 1,20,000 0 0 1,20,000 0 0 4,200 0 0 0 11,88,374 15,054 11,73,320 11,73,320 11,73,320

10 1,20,000 0 0 1,20,000 0 0 4,200 0 0 6,606 13,38,243 17,042 13,27,807 13,27,807 13,27,807

UIN: 104L075V07 Page 6 of 8

 Annualized
Annualized Premium Premium - Mortality, Policy
Policy Top Up Guarantee Other Additions to Fund before Fund at End Surrender Death
Premium Allocation Premium Morbidity GST Admin. FMC
Year Premium Charge Charges* the fund* FMC of the Year Value Benefit
(AP) Charge (PAC) Allocation Charge Charge
Charges

11 0 0 0 0 0 0 4,200 0 0 7,062 13,76,298 18,279 13,65,080 13,65,080 13,65,080

12 0 0 0 0 0 0 4,200 0 0 7,540 14,15,052 18,793 14,03,799 14,03,799 14,03,799

13 0 0 0 0 0 0 4,200 0 0 8,042 14,55,310 19,327 14,44,024 14,44,024 14,44,024

14 0 0 0 0 0 0 4,200 0 0 8,568 14,97,134 19,882 14,85,820 14,85,820 14,85,820

15 0 0 0 0 0 0 4,200 0 0 9,121 15,40,591 20,458 15,29,254 15,29,254 15,29,254

16 0 0 0 0 0 0 4,200 0 0 9,701 15,85,752 21,057 15,74,395 15,74,395 15,74,395

17 0 0 0 0 0 0 4,200 0 0 10,310 16,32,688 21,680 16,21,318 16,21,318 16,21,318

18 0 0 0 0 0 0 4,200 0 0 10,950 16,81,476 22,327 16,70,099 16,70,099 16,70,099

19 0 0 0 0 0 0 4,200 0 0 11,623 17,32,196 23,000 17,20,819 17,20,819 17,20,819

20 0 0 0 0 0 0 4,200 0 0 12,329 17,84,932 23,699 17,73,561 17,73,561 17,73,561

21 0 0 0 0 0 0 4,200 0 0 13,070 18,39,770 24,426 18,28,414 18,28,414 18,28,414

22 0 0 0 0 0 0 4,200 0 0 13,850 18,96,804 25,183 18,85,471 18,85,471 18,85,471

23 0 0 0 0 0 0 4,200 0 0 14,669 19,56,129 25,970 19,44,828 19,44,828 19,44,828

24 0 0 0 0 0 0 4,200 0 0 15,530 20,17,846 26,788 20,06,588 20,06,588 20,06,588

25 0 0 0 0 0 0 4,200 0 0 16,435 20,82,060 27,640 20,70,855 20,70,855 20,70,855

UIN: 104L075V07 Page 7 of 8

*There are no charges included in other charges. Guaranteed Loyalty Additions declared as per the product terms and conditions are included on Additions to the fund.
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. 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

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
Date: 11/21/25 Signature / OTP Confirmation Date / Thumb Date: 11/21/25
Impression / Electronic Signature of Agent/ Signature / OTP Confirmation Date / Thumb
Intermediary / Official Impression / Electronic Signature of Prospect/
Policyholder
This system generated benefit illustration shall be treated as signed by me.

UIN: 104L075V07 Page 8 of 8