QuotationNo :70014733305

Dear Sgk ,
Thank you for showing interest in our Canara HSBC Life Insurance Smart Guaranteed Pension. Based on the details provided by you, and reproduced below,
illustration customised to your requirements is appended.

Date: 29-Aug-2024

Name of the Prospect/ Policyholder Sgk

Age & Gender: 68 Male
Name of the Primary Annuitant Sgk
Age & Gender: 68 Male
Premium Payment Term 4 years
Deferment Period 4 years
Amount of Installment Premium Rs. 2,00,000
Mode of Payment of Premium Annual
Annuity Installment Frequency Yearly
Staff No

Proposal number NA
Name of the product: Canara HSBC Life Insurance Smart Guaranteed Pension
Tagline A Non-Linked Non-Par Individual Deferred Annuity Plan
Unique Identification No: 136N086V01
GST Rate (Year 1) 4.50%
GST Rate (Year 2 onwards) 2.25%
This benefit illustration is intended to show year-wise premiums payable and benefits under the policy.

Policy Details
Annuity Option Single Life Annuity

Benefit Details
Annuity Installment (as per chosen frequency) 85,790

Premium Summary (in Rs.)

Base Plan Premium Staff Discount Total Installment Premium
Installment Premium without GST 2,00,000 0 2,00,000
Installment Premium in First year with GST 2,09,000 0 2,09,000
Installment Premium 2nd year onwards with GST 2,04,500 0 2,04,500

Amount in Rs.

Guaranteed Non-Guaranteed
Policy Year Annualized Premium
Annuity Payable Accrued Guaranteed Additions Death Benefit Guaranteed Surrender Value Special Surrender Value
1 2,00,000 0 12,000 2,12,000 0 0
2 2,00,000 0 36,000 4,36,000 1,20,000 3,44,715
3 2,00,000 0 72,000 6,72,000 5,40,000 5,63,610

Page No. 1 Production Release Channel Name : Canara Bank Proc hub : Mangalore Curr Res State : KARNATAKA Version 1.0.0 N Illustration Number : 70014733305
 QuotationNo :70014733305

4 2,00,000 0 1,20,000 9,20,000 7,20,000 8,19,066

5 0 85,790 1,20,000 0 0 0
6 0 85,790 1,20,000 0 0 0
7 0 85,790 1,20,000 0 0 0
8 0 85,790 1,20,000 0 0 0
9 0 85,790 1,20,000 0 0 0
10 0 85,790 1,20,000 0 0 0
11 0 85,790 1,20,000 0 0 0
12 0 85,790 1,20,000 0 0 0
13 0 85,790 1,20,000 0 0 0
14 0 85,790 1,20,000 0 0 0
15 0 85,790 1,20,000 0 0 0
16 0 85,790 1,20,000 0 0 0
17 0 85,790 1,20,000 0 0 0
18 0 85,790 1,20,000 0 0 0
19 0 85,790 1,20,000 0 0 0
20 0 85,790 1,20,000 0 0 0
21 0 85,790 1,20,000 0 0 0
22 0 85,790 1,20,000 0 0 0
23 0 85,790 1,20,000 0 0 0
24 0 85,790 1,20,000 0 0 0
25 0 85,790 1,20,000 0 0 0
26 0 85,790 1,20,000 0 0 0
27 0 85,790 1,20,000 0 0 0
28 0 85,790 1,20,000 0 0 0
29 0 85,790 1,20,000 0 0 0
30 0 85,790 1,20,000 0 0 0
31 0 85,790 1,20,000 0 0 0
32 0 85,790 1,20,000 0 0 0
33 0 85,790 1,20,000 0 0 0

Notes:
1. Annualized Premium excludes underwri ng extra premium, frequency loading on premiums, the premiums paid towards the riders, if any and Goods &
Services Tax
2. Surrender values and death benefit have been calculated assuming the event occurring at the end of the policy year.

Important Notes
1. The Annuity Instalment given above is only indica ve. In case of any change in the annuity rates or change in the entry age of the Annuitant(s) before
issuance of the Policy, a revised quotation is to be signed and submitted.
2. Upon the payment of Death Benefit/ Surrender Benefit / CI Benefit / ATPD Benefit, the Policy terminates and no further benefit becomes payable.
3. If due premium is not paid within the Grace Period for first 2 consecu ve policy years: Policy shall acquire Lapse status at the expiry of grace period. If lapsed
policy is not revived by the end of revival period, it will terminate a er paying any Surrender Value, if applicable. If due premium is not paid within the Grace
Period a er paying premiums for first 2 consecu ve policy years: Policy will become a Paid-up policy and will con nue with reduced benefits. The Annuity
Installment will reduce to Paid-up Annuity Installment.
4. Your Policy will acquire a Guaranteed Surrender Value (GSV) a er payment of at least first 2 full years premium. However, the Company may oer a Special
However, the Company may over a Special Surrender Value (SSV), and the surrender benet will be higher of Guaranteed Surrender Value (GSV) and Special.
Surrender Value (SSV) subject to a minimum of zero and maximum of Death Benefit applicable. Surrender Value will be nil post Deferment Period. The
Illustra on shows both the GSV as well as the current SSV payable on surrender of the policy. SSV scales may be revised in the future by the Company with the
prior approval of the Authority.
5. Installment premium mentioned is inclusive of loadings for modal premium, if any.
6. Once the Policy is issued, the Annuity payable is guaranteed for life.

Page No. 2 Production Release Channel Name : Canara Bank Proc hub : Mangalore Curr Res State : KARNATAKA Version 1.0.0 N Illustration Number : 70014733305
 QuotationNo :70014733305
7. The Annuity Instalment is inclusive of High Premium Incentive (as applicable).
8. The illustra on takes into account currently applicable Goods and Services Tax & applicable cess (es)/other levy, if any. However, the applicable taxes may
change from time to time.
9. Tax benefits in accordance with the provision of Income Tax Act, 1961 as amended from me to me. Please consult your independent tax advisor for tax
related queries.
10. For more details on product features and terms and conditions please read sales brochure or sample policy contract carefully before concluding a sale.

I, _________________________________________(name), have explained the I .............................................. (Name), having received the informa on
premiums, charges and benefits under the product fully to the Prospect/ with respect to the above, have understood the above statement before
Policyholder. entering into the contract.
I understand that the Survivorship Cer ficate for the applicable Annuitant
shall be submi ed every year to the Company at least 15 days prior to the
policy anniversary date but not before 60 days prior to the policy anniversary
Place: date. Survivorship Cer ficate shall be signed by an official acceptable to the
Date: Signature of Agent/ Intermediary/ Official Company and shall be in accordance with the applicable administra ve
rules. In case the Survivorship Cer ficate is not received by the Company,
the payment of Annuity Instalments shall cease immediately. However,
upon receipt of the Survivorship Cer ficate, the payment of Annuity
Instalments shall resume and all the arrears without any interest on the
same will be settled.

Date: Signature of Prospect / Policyholder

Channel Name: _________________

Page No. 3 Production Release Channel Name : Canara Bank Proc hub : Mangalore Curr Res State : KARNATAKA Version 1.0.0 N Illustration Number : 70014733305
 Receipt & Dispatch Detail - Instrument /Application Form

DD/MM/YYYY

Date Of Receipt Of Proposal Form

Date Of Payment Instruction / Instrument

Date Of Dispatch Of Proposal Form

Signature Of the
Date Of Dispatch Of Instrument / Direct Debit Branch Seal
Bank Official
Version 1

Smart Guaranteed Pension

Key Information Document (KID) There is no compulsion or requirement to take this
Life Insurance Policy as a condition/part of bank Loan

2
Wide range of Annuity
Other Important Aspects you must know:
There are 4 different Annuity options available under the Plan:

1
1. Single Life Annuity with Return of Premiums
options available to
fulfill your need 2. Single Life Annuity with Return of Premiums on Critical Illness (CI) or

3
Accidental Total & Permanent Disability (ATPD) or Death
3. Single Life Annuity
Fixed Annuity 4. Joint Life Annuity with Return of Premiums
Payouts for Annuity option once
lifetime of the chosen at policy  There is no Maturity benefit available in this Plan.
Annuitant(s) inception cannot be
changed at a later
 Enhanced Annuity rates with higher Annualized Premium.
stage.
 Guaranteed Additons (GAs) accrue during the Deferment Period at the

7 7
end of every month. GAs stops accruing after the end of the Deferment
IMPORTANT Period.
ASPECTS ABOUT
For all the Annuity
options, Annuity is
payable after the
Deferment Period.
SMART
GUARANTEED
PENSION
4
Annuity Installment
 The Survivorship Certificate for the applicable Annuitant shall be
submitted every year to the Company at least 15 days prior to the Policy
Anniversary date but not before 60 days prior to the Policy Anniversary
date. In case the Survivorship Certificate is not received by the Company,
can be received
Yearly, Half-yearly, the payment of Annuity Installments shall cease immediately. However,
Quarterly and upon receipt of the due Survivorship Certificate, the payment of Annuity
Monthly basis your Installments shall resume and all the arrears, without any interest on the

6
need.
same, shall be settled.

Death benefit is
available as per the
Annuity option chosen.
5  Annuity rates are guaranteed once the contract is issued.

 If the last premium is paid on 1st Jan, 2031 and deferment period ends
on 31st December, 2036 then Annuity is payable from:
Premium Payment
Frequency cannot be
changed once  For Annual Mode: 31st December, 2037
selected at policy
inception.  For Half-yearly Mode: 30th June, 2037

 For Quarterly Mode: 31st March, 2037

 For Monthly Mode: 31st January, 2037

INCASE OF NON-PAYMENT OF PREMIUMS
 Tax benefits in accordance with the provision of Income Tax Act, 1961 as
• If you fail to pay due premium within the grace period for first 2 consecutive policy years: Your Policy amended from time to time. Please consult your independent tax advisor
shall acquire Lapse status at the expiry of grace period. If you do not revive the Lapsed policy by the for tax related queries.
end of revival period, it will terminate after paying any Surrender Value, if applicable.
• If you fail to pay due premium within the grace Period after paying premiums for first 2 consecutive  Goods and Services Tax & applicable cess (es)/levy, if any will be charged
policy years: Your policy will become a Paid-up policy and will continue with reduced benefits. The over and above the premium as per applicable laws as amended from
Annuity Installment will reduce to Paid-up Annuity Installment. time to time.
SURRENDER
 Policy can be surrendered anytime
• The Policy shall acquire a surrender value after payment of at least 2 full years premium.
• The surrender value payable is higher of Guaranteed Surrender Value and Special Surrender Value subject to a minimum of zero and maximum of Death Benefit applicable.
• For Annuity Option 3, Surrender value is nil post Deferment Period.
For details on the product features, please refer to the product brochure.

IMPORTANT DISCLOSURE REQUIREMENT:

Please provide correct and complete details, including information on all medical ailments such as diabetes, hypertension, heart diseases, cancer, etc. in the proposal form, otherwise,
there is a risk of your policy benefit/ claim being denied.
I have been briefed on the benefits and features of Canara HSBC Life Insurance Smart Guaranteed Pension. I have understood the information and risks associated with this Plan. I confirm
that my selection of the above policy is in keeping with my life insurance/ investment objectives

I have briefed ______________________________________in___________________________________________________language on the benefits and features of this insurance plan.

Name:_________________________________________________________Signature:____________________________________________ Date:________________________________

Code:_________________________________________________________________Proposal Number:___________________________________________________________________

IMPORTANT INFORMATION:
This is the Key Information document about the Canara HSBC Life Insurance Smart Guaranteed Pension and it doesn’t replace the full policy terms and conditions (which you should read
carefully on receipt). Canara HSBC Life Insurance Smart Guaranteed Pension is a Non-Linked Non-Par Individual Deferred Annuity Plan. We strongly advise that the policy should be
continued throughout the defined policy term to realize the full benefits. In case of surrender, the surrender value available may be lower than the premiums paid. Hence, we
recommend that you pay your premiums regularly and continue the policy till maturity. Early surrender should not be opted for unless there is no other alternative available, as it will
impact the policy value and intended goals may not be realised. Along with this document, you should also receive a personalised benefit illustration.
Purchase of any insurance products by a bank’s customer is purely voluntary and is not linked to availment of any other facility from the bank.
For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale. You can also speak to your sales representative, or visit our
website www.canarahsbclife.com. There are restrictions on requests of Revival of Policies, any request that results in change of policy feature while the customer is in the US. The
Company reserves the right to restrict any other policy servicing request basis the applicable US Laws.
You will shortly receive a call to verify the details filled up by you in the Proposal Form. Kindly attend the call to confirm your understanding of the proposed Life Insurance Plan.
Canara HSBC Life Insurance Smart Guaranteed Pension (UIN: 136N086V01)
The information provided here is indicative of your policy terms and conditions. The Insurance products are offered and
underwritten by Canara HSBC Life Insurance Company Limited (IRDAI Regn.No.136), 139 P, Sector 44, Gurgaon – 122003,
Haryana, India.