Aviva Life Insurance Company India Limited Premium Quotation Version Number: 42.

0 Prepared on: 8/12/2012 Proposed Date of Commencement:8/12/2012 Age of the Life Proposal Number: Insured:31Years Age of the Child:1Years Product Features 1. 2. 3. 4. 5. 6. Name of the Product: Aviva Young Scholar Secure UIN:122N092V01 Plan Option: Gold Premium Paying Frequency: Monthly Premium as per Plan Option:4,400 Cover Description and Premium:

Coverage

Sum Assured

Coverage Term

Premium Payment Term

Service Service Modal Tax Tax (Year 2 onwards) 68

Total Amount (Year 1)

Total Amount (Year 2 onwards) 4468

Premium (Year 1) 4400 136

Base Cover Accidental Death Benefit Rider Aviva

1243000

20

12

4536

50000

12

12

Term Plus 50000 Rider Aviva Dread Disease Rider 200000

12

12

10

11

11

12

12

46

52

52

Total Amount

4,602

4,534

7.

Illustration Benefits

Policy

Annualised

Guaranteed

Guaranteed

Guaranteed

Guaranteed

Non

Duration

Premium + Service Tax

Survival Benefit

Death Benefit (Base Plan During the year)

Maturity Benefit (At year end)

Surrender Value (GSV)

Guaranteed Special Surrender Value(At year end)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Notes:

55,224 54,408 54,408 54,408 54,408 54,408 54,408 54,408 54,408 54,408 54,408 54,408 20,000 20,000 20,000 20,000 20,000 100,000

1,823,800 1,771,000 1,718,200 1,665,400 1,612,600 1,559,800 1,507,000 1,454,200 1,401,400 1,348,600 1,295,800 1,243,000 1,243,000 1,243,000 1,243,000 1,243,000 1,243,000 1,243,000 1,243,000 1,243,000 1,043,000 31,680 47,520 63,360 79,200 95,040 110,880 126,720 142,560 158,400 174,240 174,240 174,240 174,240 174,240 174,240 174,240 174,240 174,240 106,836 151,563 201,521 257,301 319,327 388,313 464,820 549,613 643,315 734,901 769,439 805,505 843,059 882,282 857,450 913,459 973,432 1,043,000

1.

All the benefits shown in the above table are guaranteed provided all the due premiums are paid except the special surrender values. Special Surrender Values may change as decided by the company from time to time.

2.

The Modal premium is exclusive of Service Tax and other taxes which will be levied on the Modal Premium as per the prevailing laws.

3.

In case of Accidental Death Benefit (ADB) Rider, rider cover ceases from the policy anniversary when life insured attains age 60 years last birthday or at the end of Premium Paying Term (PPT), whichever is earlier.

4.

In case of Aviva Dread Disease (DD) Rider, rider cover ceases from the policy anniversary when life insured attains age 65 years last birthday or at the end of Premium Paying Term (PPT), whichever is earlier.

5.

In case of Aviva Term Plus Rider, rider cover ceases from the policy anniversary when life insured attains age 70 years last birthday or at the end of Premium Paying Term (PPT), whichever is earlier.

6. 7.

This illustration does not include any additional premium payable due to underwriting. The policy will acquire a minimum guaranteed surrender va lue after payment of one years

premium and after completion of two policy years which will be equal to 30% premiums paid till date of surrender excluding first year premium, rider premium, extra premium and taxes, if any. 8. 9. Riders are not mandatory and are available for a nominal extra cost. For more details on Benefits and terms & conditions please read sales brochure carefully before concluding a sale. 10. Insurance is the subject matter of the solicitation.

I ______________________, having received the information with respect to the above, have understood the above statement before entering into the contract.

FPAs / FPCs Signature Company Seal

Policyholders Signature: Place: Date:

Aviva Young Scholar Secure

Important points you must know about this policy
What is Aviva Young Scholar Secure? What is the guarantee under this plan? Aviva Young Scholar Secure is a life insurance plan that helps you secure your childs education by giving you guaranteed lump sum payouts for your childs high school, college admission & post-graduation expenses. The death benefit and payouts for educational milestones for the child are guaranteed if all due premiums have been paid.

What is the Term of this The policy term would be equal to 21 minus the entry age of child. policy? Your policy term is 20 years. The Premium Paying Term would depend on the age of the child: For entry age 0 to 8 of child: 13 minus age of child What are the Premium Payment Term options under this plan? For entry age 9 to 12 of child: Fixed 5 years The premium payment frequency allowed is Yearly, Half-Yearly and Monthly (For monthly mode only ECS or Direct Debit is allowed). Since your childs age is 1 years, you will have to pay premiums regularly for 12 years at Monthly frequency as opted by you. Death Benefit: Sum Assured will be paid immediately and the policy will continue without any liability to pay future premiums till maturity for the benefit of your child. All survival benefits will continue to be paid as per schedule. Survival & Maturity Benefit: TFS: Tuition Fee Support Paid every year starting end of premium paying term till age What are the benefits under this plan? 17 of child CAF: College Admission Fund At age 18 of child HER: Higher Education Reserve Maturity at age 21 of child The payments are made on the policy anniversary after the child attains the specified payout age. Please refer to the Key Feature brochure for details Rider Benefits: Are applicable as per the riders opted by you If you discontinue paying premiums within the first year of the policy; the policy will be terminated without any benefit or value. If you discontinue paying premiums after the first year of the policy, your policy becomes What happens if I stop paying my premiums? a paid-up policy and: Death benefits will be reduced Survival Benefits will not be payable Maturity Benefit will be equal to paid up Sum Assured Please refer to the Key Feature brochure for details. Can I cash in (surrender) the policy during the term of the policy? You do have an option to cash-in (surrender) this policy after completion of 2 policy years if premiums were paid for at least 1 year after deduction of surrender penalty. The surrender amount will be less than the amount of premiums paid in most cases. Please refer the Key Feature brochure for details.

What is not covered under Only surrender value will be paid in case of death because of actual or attempted suicide this policy (Exclusions)? within one year from the date of issuance of policy or date of revival.

Please refer rider key features for rider exclusions. You have Freelook Period of 15 days from the date you receive your policy document. Do I have a right to review my purchase? In case you do not agree with terms and conditions, you may cancel the policy where the premium you have paid will be refunded after deducting proportionate risk charges, stamp duty and cost of medical examination, if any. We request you to personally fill the proposal form and provide accurate information to ensure that your claim is not reduced or declined because of non-disclosure or misrepresentation of information. Please note: Aviva is not liable for any claim until receipt of premium in full, completion of underwriting and

acceptance of risk. This document does not contain the full terms and conditions of the Policy.Details of the terms and conditions, and exclusions of the insurance contract are contained in the Key Feature brochure. It is important that you read the entire Key Feature brochure. I confirm that I have read the Key Feature brochure and the Official Illustration of the insurance product along with this document and understand the features such as policy benefits, premium payable including the number of years for which premium is required to be paid, lock-in period, whether any guarantee is available and if yes then subject to what conditions. Signature of Life Assured Signature of the Proposer (In case different from Proposer) Proposer name Proposal number Name of Life Assured Proposal Date