600136659 19-Mar-2011

Mr. Subham Gandhi

House No 17 Street No 12 J
Medical Campus
Rohtak 124001
Haryana
Statement of Account
Dear Mr. Subham Gandhi

Greetings from Max New York Life Insurance Company!

On behalf of Max New York Life Insurance, I would like to thank you for choosing us as your preferred life insurance partner and wish you good health
and prosperity. Max New York Life Insurance is committed to offer you world-class life insurance solutions, backed by highest standards of service.

With great pleasure, I inform you that your policy number 600136659 has completed another milestone with us. Here is wishing you Happy Policy
Anniversary!

With ten years of operations, today Max New York Life is a family with millions of satisfied customers, which makes us one of the leading private
life insurance companies in India:

Solid foundation: A capital investment of Rs. 1,973 crores. * National presence: 650 offices spread across 389 cities. * Large customer base: More
than 5.5 million polices sold. * Substantial life cover: Sum Assured (Insurance coverage to policyholders) of more than Rs. 1,470,681.68 crores. *
Quality certification: The first life insurance company in India to obtain the ISO 9001:2000 quality certification- based on our reliable service and
claim settlement that we provide to our customers

On the back of this letter please find enclosed the statement of accounts of your policy. In case of any clarification regarding your statement
of accounts please contact us through the below given touch points. You can also access your policy details & values at our customer portal
www.maxnewyorklife.com

As your trusted financial partner, it is our endeavor to provide you with best-in-class service and ensure your and your family's safe future- for which,
we advise you to stay invested with us and get Zyaada out of life. With Max New York Life you can assess the markets and manage your funds by
switching from one investment fund to another, which will help you achieve Zyaada returns.

We value your patronage and look forward to a long lasting relationship. Karo Zyaada Ka Iraada!

Sincerely,

Rajesh Sud
CEO & Managing Director

UAS11 V1.6 16032011

MAX NEW YORK LIFE INSURANCE CO.LTD.
Operation center, 90-A, Udyog Vihar, Sector 18, Gurgaon -- 122015
Phone: 2542001 Fax 4239683(From Delhi: 95124, Other cities +0124) Amsure Helpline: 1800 180 1288
Regd Office: Max House, 3rd Floor, 1 Dr. Jha Marg, Okhla, New Delhi 110 020, India
Visit us at: www.maxnewyorklife.com E-mail: service.helpdesk@maxnewyorklife.com
 The statement of account for your policy is as follows:
Sum Assured 1,21,550.63
Rider Sum Assured 0.00
Annual Premium 12,155.06
Death Benefit 1,21,550.63

Fund Value as on 18-MAR-11

Fund Name Units NAV (Rs) Amount
Growth Fund-Pr Driven 1,188.13 29.31 34,827.14
Summary of Transactions as on 18-MAR-11
Transactions Amount (Rs.)
Opening Balance 8,000.00
Premium Paid 43,101.00
Administrative Charge 12,308.15
Premium Allocation Charges 3,260.95
Mortality Charges 1,276.93
Closing Balance 34,827.14

Agent Adviser Name- Direct Customer Service Amsure Agent Contact No- 0124-2561717

*All the charges are inclusive of Service Tax. Service tax is applicable on the risk cover charges included in life insurance premium in accordance
with Sec. 65(105)(zx) of Finance Act 1994, as amended by Finance (No.2) Act 2004 at the applicable rate. ** Please turn overleaf for definitions of
the term used. The deductions mentioned in the statement are as per the IRDA regulation and not self imposed by Max New York life Insurance.
DEFINITIONS OF TERMS FOR THE MNYL ANNUAL POLICY SUMMARY
Fund Value Means the total number of Units held in Your Unit Account multiplied by the Unit Price
Cost of Insurance charges The amount deducted to pay the insurance cost of the base policy and any rider.
Administrative charges The amount of monthly administrative charges the premium expenses charges, any partial withdrawal service charge and
and other charges surrender charge assessment due to a decrease in face amount during the period of the summary.
Premium Allocation Charge This is the percentage of the premium appropriated towards charges from the premium/top- up received. The balance known as
allocation rate constitutes that part of the premium, which is utilized to purchase (Investment) units for the policy.
Partial surrender The amount(s) of money the company paid out of the policy as partial surrenders during the summary period.
Policy Owner The person or organization who has the rights of ownership in the policy during the lifetime of the primary insured.
Mode premium The frequency of premium payments.
Premium Paid The various payments made to the company for the policy during the summary period. (This includes premium paid towards
top-up)
Surrender charges The charge subtracted from the policy's cash value at the time of surrender or from the proceeds of a partial surrender of the fund
value.
Switching/Redirection Charges The charge subtracted from the policy's fund value at the time of switching or Redirection of funds.
Mortality Charge This is the cost of insurance cover. These are age specific and will be taken every month.
Service Tax A service tax shall be levied on the Mortality and Accident Benefit rider charge, if any, on a monthly basis. The level of this charge
will be as per the rate of service tax as applicable from time to time.
- Not all terms will appear nor will all be applicable on all Annual Policy Summaries