Serial No.

0063598831032013

Statement Of Account

Ashwani Kumar Gupta H No 28 Ram Nagar Ambala Cantt Haryana Pin: 133001 Tel: 01712650503 -9416010026 Statement Date Date of Commencement Premium Paid Upto Branch Code Basic Premium Name of Life Insured Policy No. Plan Name Ashwani Kumar Gupta 00635988 Kotak Safe Investment Plan Policy Status Payment Mode (UIN-107L021V02) 31/03/2013 31/03/2007 31/03/2013 KA1N 25,200.00 In Force Annual

Statement for the Period 01/04/2012 to 31/03/2013

Main Funds
Kotak Guaranteed Growth Fund
Date 01/04/2012 24/04/2012 24/04/2012 30/04/2012 31/05/2012 30/06/2012 31/07/2012 31/08/2012 30/09/2012 31/10/2012 30/11/2012 31/12/2012 31/01/2013 28/02/2013 31/03/2013 Closing Balance Transaction Description Opening Balance Monthly Charges Premium Settlement Monthly Charges Monthly Charges Monthly Charges Monthly Charges Monthly Charges Monthly Charges Monthly Charges Monthly Charges Monthly Charges Monthly Charges Monthly Charges Monthly Charges Amount(Rs.) 0.0000 -108.1500 24,125.0000 -129.3600 -130.6200 -128.1600 -127.9700 -127.6900 -124.8800 -125.3800 -123.5800 -122.5100 -125.2800 -126.9300 -127.9700 Price(Rs.) 0.0000 33.2979 33.2979 33.3271 32.5878 33.8115 33.9663 33.9592 35.5542 35.4148 36.4268 36.8661 37.3691 36.3458 36.2545 Units 3,759.3130 -3.2480 724.5208 -3.8815 -4.0083 -3.7904 -3.7676 -3.7601 -3.5124 -3.5403 -3.3926 -3.3231 -3.3525 -3.4923 -3.5298 4,437.2350

Summary of Funds for the period

Main Funds
Fund Name Kotak Guaranteed Growth Fund Total value of funds Fund Value (Rs.) 159,878.3260 159,878.3260 Current Price (Rs.) 36.0311 Closing Units 4,437.2350

Summary of Charges for the period

Charges Mortality Charges Administration Fees Service Tax & Education Cess Total Charges Notes: 1 2 3 4 5 6 7 Amount (Rs.) 453.07 900.00 275.41 1628.48

The Premium allocation opted by you :

Main Funds Kotak Guaranteed Growth Fund Percentage 100%

The above mentioned premium allocation indicates the funds in which your next Renewal premium would be invested. In case you wish to change the allocation, please fill the Future Premium Allocation form.

The premium invested is calculated as Basic Premium less Premium Allocation Charges and the Service Tax is charged as applicable The monthly charges deducted are as per details given in your policy document. The total of monthly charges deducted from your funds for the period are stated under "Summary of charges ". Service Tax, Education Cess and Secondary & Higher Secondary Education Cess on Service Tax are levied at the applicable tax rates in accordance with the prevailing Tax Laws from time to time. Service Tax Registration Number: AAACO3983BST002. Service Tax Classification: Insurance Auxiliary Service, Life insurance services and Management of investment under ULIP services. Fund charges are a percentage of the value of the assets in each fund capped to 1.35% per annum. Service Tax, Education Cess and Higher Secondary Education Cess on Service Tax are levied on fund charges at the applicable Tax rates in accordance with the prevailing Tax Laws. Fund names prefixed with SSS denote funds applicable to Systematic Switching Strategy (SSS). For the Kotak Super Advantage & the Kotak Smart Advantage plan, your first year premium is set aside to provide the Assured Addition Advantage (AAA) at pre-specified intervals during the policy term & is hence not allocated to the investment funds. AAA has the following 2 benefits: a.Fixed advantage benefit, which is payable at the end of premium paying term. b.Dynamic Advantage benefit, which is calculated as percentage of average fund value for last three years & is payable at the end of premium paying term

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Yours sincerely For Kotak Mahindra Old Mutual Life Insurance Co.

Chief Manager - Policy Servicing

Help us service you better: (A) (B) Please quote your policy number in all your communication with us. For any clarifications, please call our Customer Service Officers on 1800 209 8800 or write to us at clientservicedesk@kotak.com

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