For Office Use Only (w.e.f. Nov 19/ Ver 1.

0)

Illustration No: KETP-3639F-9066-Y30

Quotation Number: 01200123152653385

Proposal No:

Policy No:

Name of the Prospect/Policyholder Ms. ms Name of the Product Kotak e-Term Plan

DOB of the Prospect/Policyholder 04 November 1986 Tag Line Individual, Non-Linked, Non-Par,
Pure Protection Life Insurance Plan
Age of the Prospect/Policyholder 36
(in yrs) Unique Identification No UIN: 107N104V03

Name of Life Assured Ms. ms Goods and Services Tax and Cess 18%
Rate (GST)
DOB of Life Assured 04 November 1986
Rider Goods and Services Tax and 18%
Age of the Life Assured (in yrs) 36
Cess Rate (GST)
Gender of Life Assured Female
Existing Customer No
Tobacco User No
Existing Policy number Not Applicable
Policy Term (in yrs) 39
Kotak Group Employee No
Premium Payment Term (in yrs) 10
Backdation Date Chosen Not Applicable
Amount of Installment Premium (in 29,800
Channel Name Corporate Agents
Rs.)

Mode of Payment of Premium Yearly

Agent's Branch Location Gujarat

Prospect/Policyholder's Current Gujarat

Location

POLICY DETAILS

Plan Option : Life Plus Base Sum Assured (Rs.) : 50,00,000

Payout Option : Immediate Payout Sum Assured on Death (at inception of the policy) Rs. : 50,00,000

Step Up Option : Not Applicable

Yearly Step Up Fee (Rs.) : Not Applicable

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 Quotation Number:01200123152653385

Rider Sum Rider Premium

Rider Name Option Availed Rider Term Rider Premium
Assured Payment Term

Kotak Critical Illness Plus Benefit Rider

No Not Selected
(UIN: 107B020V01)

Kotak Permanent Disability Benefit Rider

No Not Selected
(UIN: 107B002V03)

PREMIUM SUMMARY

Base Plan Riders Total Installment Premiuim

Installment First Year Premium (including Step-Up Option

29,800 0 29,800
fee, if any) without GST (Rs.) :

Installment Second Year Premium (including Step-Up

29,800 0 29,800
Option fee, if any) without GST (Rs.) :

Installment First Year Premium (including Step-Up Option

35,164 0 35,164
fee, if any) with GST (Rs.) :

Installment Second Year Premium (including Step-Up

35,164 0 35,164
Option fee, if any) with GST (Rs.) :

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 Quotation Number:01200123152653385

BENEFIT ILLUSTRATION TABLE

Guaranteed Benefits

End of Policy Year Age of Life Assured Annualized Premium (Rs.) Death Benefit3 (Rs.) Surrender Value5 (Rs.)

1 37 29,800 50,00,000 0

2 38 29,800 50,00,000 0

3 39 29,800 50,00,000 36,654

4 40 29,800 50,00,000 47,680

5 41 29,800 50,00,000 58,110

6 42 29,800 50,00,000 67,944

7 43 29,800 50,00,000 77,182

8 44 29,800 50,00,000 83,440

9 45 29,800 50,00,000 91,188

10 46 29,800 50,00,000 98,340

11 47 0 50,00,000 95,360

12 48 0 50,00,000 92,380

13 49 0 50,00,000 89,400

14 50 0 50,00,000 86,420

15 51 0 50,00,000 80,460

16 52 0 50,00,000 77,480

17 53 0 50,00,000 74,500

18 54 0 50,00,000 71,520

19 55 0 50,00,000 68,540

20 56 0 50,00,000 65,560

21 57 0 50,00,000 62,580

22 58 0 50,00,000 56,620

23 59 0 50,00,000 53,640

24 60 0 50,00,000 50,660

25 61 0 50,00,000 47,680

26 62 0 50,00,000 44,700

27 63 0 50,00,000 41,720

28 64 0 50,00,000 38,740

29 65 0 50,00,000 32,780

30 66 0 50,00,000 29,800

31 67 0 50,00,000 26,820

32 68 0 50,00,000 23,840

33 69 0 50,00,000 20,860

34 70 0 50,00,000 17,880

35 71 0 50,00,000 14,900

36 72 0 50,00,000 8,940

37 73 0 50,00,000 5,960

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 38 74 0 50,00,000 2,980

39 75 0 50,00,000

Notes: Annualized Premium excludes underwriting extra Premium, Step-up Option fee, if any, frequency loadings on premiums, the premiums
paid towards the riders, if any and Goods and Services Tax.

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 Quotation Number:01200123152653385

Terms & Conditions:

1. This is non-participating term insurance plan. The illustration stated is for a healthy individual and under the assumption that this is the only policy
the client has with Kotak Life Insurance and would be subject to underwriting.

2. Premium payable in a policy year including Extra Premium (if any), but excluding Goods and Services Tax and Cess and Rider Premium, if any.

3. In case of an unfortunate event of death of the Life Insured during the term of the plan, the nominee / beneficiary shall receive the Sum Assured
on Death (on acceptance of the death claim).
Where Sum Assured on Death is as follows:

For Regular & Limited Premium,

Highest of the following:
a) Sum Assured# OR
b) 11 times Annualized Premium* OR
c) 105% of all premiums paid till the date of death

For Single Premium,

Higher of the following:
a) Basic Sum Assured, OR
b) 1.25 times the Single Premium

* Annualised Premium is the premium payable in a policy year, excluding the underwriting extra premiums, loadings for modal premium, Goods
and Services Tax, Cess and Rider Premium if any.
# Sum Assured shall be Basic Sum Assured adjusted for increase /decrease in Basic Sum Assured, due to exercising of Step-up /Step-down
option by the policyholder.

Additionally, since the policyholder has opted for Life Plus Option, an Accidental Death Benefit (equal to the Basic Sum Assured) shall be payable
as lump sum in the event of the Life Insured’s death due to any accident, to the Nominee / Beneficiary subject to a maximum of Rs 1 Cr.

Since the Payout Option mentioned above is 'Immediate Payout',the Sum Assured on Death shall be paid immediately on acceptance of death
claim.

4. There is no maturity benefit payable under this plan.

5. For Limited pay policies with Premium Payment Term of less than 10 years, the policy will acquire Surrender Value provided premiums due for at
least 2 consecutive policy years have been paid in full. For Limited pay policies with Premium Payment Term of 10 years and above, the policy will
acquire Surrender Value provided premiums due for at least 3 consecutive policy years have been paid in full.

Single pay policies will acquire Surrender Value immediately after the payment of Single Premium.

The Surrender Value for Limited pay policies shall be calculated as 60% xTotal Premiums Paid^ (including extra premium) x ((Policy Term -
Premium Payment Term)/Policy Term) x (Balance Policy Term to run / Policy Term).

The Surrender Value for Single pay policies shall be calculated as 60% x Total Premiums Paid^ (including extra premium) x ((Policy Term -
1)/Policy Term) x (Balance Policy Term to run / Policy Term).

For Regular pay policy, Surrender value is not available.For more details, please refer the sales brochure.

^ Total Premiums Paid means total of all the premiums received, excluding any extra premium, any rider premium and taxes.

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6. For the Limited pay policies, after the policy acquires Surrender Value, if the subsequent premiums are not paid within the Grace Period, the Base
Policy will be converted into a Reduced Paid-Up policy by default. Death benefit will be Reduced Paid-Up Sum Assured on death,where Reduced
Paid-Up Sum Assured on death is equal to the ratio of the total period for which Premiums have already been paid## bears to the maximum
period for which Premiums were originally payable multiplied by the Sum Assured on death.

Since the Policyholder has opted for ‘Life Plus’ Option, upon conversion to Reduced Paid-Up, the policy will continue with Reduced Paid-Up Sum
Assured on death and Reduced Paid-Up Accidental Death Benefit covering accidental death where,
Reduced Paid-Up Accidental Death Benefit = (Total Premiums Paid / Total Premiums Payable) X Accidental Death Benefit

Single Pay Policy will become fully Paid-Up after payment of Single Premium.

Reduced Paid-Up option will not be available for Regular Premium paying Policies.

Rider benefit (if opted) will be available as per Reduced Paid-Up Sum Assured.

##Total period for which Premiums have already been paid includes extra Premium and excluded rider Premium and taxes.

7. A lapsed or Reduced Paid-Up policy can be revived with or without riders within 5 years from the date of the first unpaid premium. The
Policyholder can revive the Policy without evidence of good health on payment of the outstanding premiums and interest charge, if the payment is
made within six months from the date of the first unpaid premium. Thereafter to revive the policy evidence of good health would be required along
with payment of the outstanding premiums and interest charge. On revival, all benefits under the policy will be reinstated.

8. The above illustrated benefits are derived on the basis of details of life insured provided at the time of filling the proposal form.If the details are
found inaccurate or there are any changes before or at the time of the policy issuance for eg: change in Age, The illustrated benefits will be
subject to revision.

9. Goods and Services Tax and Cess as applicable shall be levied at the applicable Tax rates in accordance with the prevailing Tax Laws. Prevailing
Tax Laws will be applicable on this policy which may vary from time to time.

10. TDS at prevailing rate will be deducted from any amount paid under a life insurance policy subject to the provisions of prevailing tax laws.In case
of non-availability of valid PAN, TDS will be deducted at higher rate. Tax laws are subject to changes from time to time. Kindly consult your tax
advisor for tax implication of your policy.

11. The values shown are for illustrative purposes only. for more details on risk factors, terms and conditions please read Sales Brochure carefully
before concluding a sale.

Section 41 of the Insurance Act, 1938, as amended from time to time states

(1) No person shall allow or offer to allow, either directly or indirectly, as an inducement to any person to take or renew or continue an insurance in
respect of any kind of risk relating to lives or property in India, any rebate of the whole or part of the commission payable or any rebate of the
premium shown on the policy, nor shall any person taking out or renewing or continuing a policy accept any rebate, except such rebate as may be
allowed in accordance with the published prospectuses or tables of the insurer:

(2) Any person making default in complying with the provisions of this section shall be liable for a penalty which may extend to ten lakh rupees.

I, I,
________________________________________________________ ________________________________________________________
__________(Name), have explained the premiums and benefits under _(Name), having received the information with respect to the above,
the product fully to the prospect / policyholder have understood the above statement before entering into the contract

Place : _______________ _________________________________ Place : _______________ _________________________________

Date : ________________ Signature of Agent /Intermediary/Official Date : ________________ Signature of Prospect / Policyholder

Kotak Mahindra Life Insurance Company Limited.

CIN: U66030MH2000PLC128503
Regd. Office: 8th Floor, Plot# C-12, G-Block, BKC, Bandra (E), Mumbai - 400 051
Regn. No: 107. Toll Free No.: 1800 209 8800. Website: https://www.kotaklife.com

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