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06/09/2013

Dear

MR MONAL BHOYAR,

Thank you for placing your trust in AEGON Religare Life Insurance Company Limited. This is an acknowledgement for your online transaction. Transaction Date Policyholder Name Policy No. Premium Amount `(In figures) Transaction No.
06/09/2013 MR MONAL BHOYAR 512083203678 11787 81784861

Authorised Signatory

Rajiv Shah Director - Operations Note: 1. Initial deposit amount will be appropriated towards first premium on acceptance of the proposal by AEGON Religare Life insurance Company Limited. If not accepted, it will be refunded without any interest. 2. In case we receive excess premium, the excess amount will be maintained in your policy account and will be adjusted towards your future premium payment/dues. 3. In case of ULIP, if your payment has been received in advance, it will be adjusted towards unit allocation on the due date. On receipt of the premium, units shall be allocated as per IRDA guidelines. The investment risk is borne by the policyholder. 4. Insurance is the subject matter of the solicitation For more information: Call us on our toll free 1800 209 9090 between 8:30 am to 8:30 pm, 7 days a week. Email us at customer.care@aegonreligare.com. Visit our website www.aegonreligare.com.