IndiaFirst Life Insurance Company Limited

IndiaFirst Life Cash Back Plan - Non Linked Insurance Plan UIN: 143N024V03
Benefit Illustration

(This shall form a part of the policy document)

Name of the Life Assured : Mr. Thota Srinivasarao Age : 30 years Gender : Male
Proposal No : P01469674 Policy No : Policy Holder Is a Staff Member : No
Plan Term : 9 Premium Paying Term : 5 years Mode of Premium Payment : AP
Sum Assured at Maturity : 55000 Base Plan Premium (Rs.) : 11333
GST Rate (First Year) : 4.5% p.a.
GST Rate (Second Year onwards) : 2.25% p.a.
Premium inclusive of GST (First Year) : 11844 Death Benefit : In the unfortunate event of life assured’s demise, during the plan term,higher of Sum Assured or 10 times
Premium inclusive of GST (Second Year onwards) : 11589 of Annual Premium along with guaranteed additions, if any subject to minimum death benefit of 105% of premium paid as
on date of death, will be payable to the Nominee / Appointee / Legal Heir, irrespective of Survival Benefits already paid.
Guaranteed Survival Benefit - 11000 payable at regular intervals as mentioned below
Guaranteed Maturity Benefit - 38100

Plan Year Annualized Premium paid Guaranteed Additions Guaranteed Survival Benefit Guaranteed Maturity Benefit Death Benefit
every year exclusive of GST at end of plan year**
1 11333* 567 0 0 113900
2 11333* 567 0 0 114466
3 11333* 567 11000 0 115033
4 11333* 567 0 0 115600
5 11333* 567 0 0 116166
6 0 567 11000 0 116733
7 0 567 0 0 117300
8 0 567 0 0 117866
9 0 567 0 38100 118433
*GST will be applicable as per laws. This may change from time to time.
Notes :
1.Please consult our 'Insurance Consultant' for any clarifications on this illustration.
2.Exclusions under this plan are as per Sales Brochure.
3.Premiums payable are eligible for tax benefits under Section 80 (C) of the Income Tax Act 1961 (subject to applicable tax laws)
4.All benefits payable under the Plan are subject to the tax laws and other financial enactments, as they exist from time to time.
5.Surrender Value is payable after completion of one year provided one full year premium has been paid. Please see Sales Brochure for details.
6.The plan offers guaranteed additions as mentioned in the Sales Brochure.
7.The plan offers Maturity value equal to 60% of Sum Assured plus accrued guaranteed additions.
8.The Company declares that it may charge extra premium subject to underwriting of proposal before the acceptance of risk.
9.All benefits payable under the Policy are subject to the tax laws and other financial enactments, as they exist from time to time. Please see the sales brochure for details about the product.
10.The guaranteed additions are 5% p.a., 6% p.a., 7% p.a. for plan term 9 years, 12 years and 15 years respectively.
Insurance is the subject matter of the solicitation.

Declaration
I, Mr. Thota Srinivasarao, having received the information with respect to the above, have I, Shaik Basha, certify that I have fully explained this Illustration to the Proposer.
understood all the above statements before entering into the contract. I have also explained that the maturity value in this Illustration will vary depending on the actual
performance of the selected Funds.

Life Assured / Proposer's Signature Date and Place :18/09/2018

Signature of Insurance Advisor/Intermediary/Marketing Official

Code of Insurance Advisor/Marketing Official Company Seal

________________________________________________________________________________________________________________________
Request you to submit the following mandatory requirements along with the application form:
1) ID Proof
2) Physical ECS Mandate
3) Address Proof
4) Age Proof
5) Photograph
6) CDF
7) TIN Document
8) Bank Statement
9) General Correspondance

Disclaimer - IndiaFirst reserves the right to call for any additional documents/requirements basis the information provided by you in the application form. The requirements stated herein are applicable only in case of the current
application. Any simultaneous application or previous applications may necessitate additional requirements by the Company. Please get in touch with your BDM for scheduling of medicals if any. The AML / KYC documents for the
proposer / premium payor only are to be submitted.