Disclaimers ========1.The premium calculated above is based on the data provided by you in the application form.2. The above information must be read in conjuction with the sales brochure and policy document.3. Surrenders are not allowed in case of Regular Pay.4. ICICI Pru iCare II is only the name of the policy and does not in any way indicate the quality of the policy.5. Tax benefits would be available as per the prevailing Income Tax laws.6. The Policyholder shall be required to pay service tax, Swachh Bharat Cess or any other taxes as per prevailing tax laws. Tax laws are subject to amendments fromtime to time.7. For any further clarifications, please feel free to contact us or e-mail us on lifeline@iciciprulife.com8. Insurance is the subject matter of this solicitation.

ICICI Prudential Life Insurance Company Limited.

1089, Appasaheb Marathe Marg, Prabhadevi,Mumbai - 400025Email: lifeline@iciciprulife.com

www.iciciprulife.com

Benefit Illustration of ICICI Pru iCare II Option I Page 1 of 1

This shall form a part of the policy documentPrepared For : Mr. NAVISH KUMAR GUPTA

Age 34 yearsGender MalePolicy Term 30 yearsSum Assured on death Rs. 10,000,000Premium Frequency AnnualPremium Payment Option Regular PayStaff No

Modal Premium Rs. 20,196Annual Premium Rs. 20,196Service Tax,as applicable Rs. 2,827Swacch Bharat Cess, as applicable: Rs. 0Total Annual Premium Rs. 23,023

Surrender:No surrenders are allowed in case of Regular Pay.In case of One Pay, Surrender Value will be calculated as:Surrender Value = Surrender Value Factor X Single Premium

UIN: 105N140V01

I ______________________________________ (Name), havingreceived the information with respect to the above,haveunderstood the above illustration before entering into the contract.

I _____________________________________(Name), haveexplained the above illustration and the terms and conditions of

this product to the Policyholder.

Policyholder's Signature:________________________

Place:

Date:

Marketing official's Signature:

Company's Seal:

Place:

Date: