1. For the period 01 Aug 2007 to 25 Aug 2012
Mr. Lakshmi Barai Policy Id 07034457
At-Gandhi Tola Product Name PremierLife Pension
Po-Ps-Chaibasa
Dist-West Singhbhum Sum Assured 0.00
Chaibasa Page No 1 of 2
Jharkhand
9973738566
nrip.kumar@idbi.co.in
Premium Paid 300000.00 Top-Up Premium 0.00
Premium Allocation Charges 22000.00 Top-Up Charges 0.00
Net Charges 22000.00 Net Allocated Funds 278000.00
Transaction Date Transaction Description Amount (Rs) NAV as on date Units Total Units
TRANSACTION FOR FLEXI GROWTH FUND
01/08/2007 Opening Balance 0.00 0.00 0.00
18/12/2007 Allocated Premium 86000.00 15.02000 5725.69907
12/01/2009 Allocated Premium 96000.00 7.63000 12581.91350
07/01/2010 Allocated Premium 96000.00 14.09000 6813.34280
Policy Administration Charge -3420.00 0.00 -273.47664
Service Tax -1120.00 0.00 -111.60721
Education Cess -29.08 0.00 -2.90200
25/08/2012 Closing Balance 0.00 0.00 24732.96956
SUMMARY OF FUNDS
Premium Allocation Charges 22000.00
Top-Up Charges 0.00
Switch Charges 0.00
F.Growth
SFIN ULIF 030 20/03/07 PFlexiGro2 105
Funds Allocated 278000.00
Switch In 0.00
Switch Out 0.00
CHARGES
Policy Administration Charge -3420.00
Education Cess -29.08
Service Tax -1120.00
Fund Value - Closing bal(in Rs.) 370252.55431
Current NAV 14.97000
Closing balance (in units) 24732.96956

2. For the period 01 Aug 2007 to 25 Aug 2012
Mr. Lakshmi Barai Policy Id 07034457
At-Gandhi Tola Product Name PremierLife Pension
Po-Ps-Chaibasa
Dist-West Singhbhum Sum Assured 0.00
Chaibasa Page No 2 of 2
Jharkhand
9973738566
nrip.kumar@idbi.co.in
Premium Paid 300000.00 Top-Up Premium 0.00
Premium Allocation Charges 22000.00 Top-Up Charges 0.00
Net Charges 22000.00 Net Allocated Funds 278000.00
* IN ULIP POLICIES, THE INVESTMENT RISK IN THE INVESTMENT PORTFOLIO IS BORNE BY THE POLICYHOLDER. The past performance of
the Investment Funds is not indicative of their future performance. The names of the Investment Funds or of the Policy are not indicative of the
returns that may be expected of them.
* This is an authenticated statement which does not require any signature. In case of any discrepancies, please notify us immediately through any of
our contact points. The unit statement shall be read in conjunction with the terms and conditions mentionedin the policy document.
* Charges includes Mortality (Insurance) Charges, Policy Administration (Administration) & Fund Management Charges, Switching Charge, Partial
Withdrawal Charge, Surrender Charge and any other charge as stated in the Policy Document. The Charges will berecovered in accordance with the
Policy terms and conditions; by cancellation of units.
* For ULIPs, applicability of NAV (a) Renewal premium received by way of a local cheque /pay order/ demand draft/ECS/ Credit Card/ Direct Debit-
NAV of the date of receipt of instrument at ICICIs Office or the premium due date, whichever is later. (b) In case of payment made to collection centre
other than ICICIs Office or payment made by any other mode of payment apart from what is mentioned above, the date of intimation by the collection
center to the Office or the premium due date, whichever is later. (c) Renewal payment received by way of outstation cheque/pay order/demand drafts
NAV of the due date or the date of realizationof the amount by the company, whichever is later. (d) As per the current IRDA Guidelines w.e.f. June 1,
2007, the Cut off timing for NAV application in respect of allocation & redemption of the unit is 3.00 p.m. IST. For details refer to policy terms &
conditions.
* In the event of discontinuance of payment of premium, partwithdrawal or surrender of the policy, etc, benefits payable will be in accordance with the
policy terms and conditions. The surrender value may be different from the Fund Value as mentioned in this statement.
* The Fund Value may change as per the Net Asset Value (NAV)declared on a daily basis. The NAV is published in local newspapersand can be
accessed on our website www.iciciprulife.com.
* Tax benefits on premium paid under the Policy will be as per the provisions of the Income Tax Act, 1961. Tax laws are subject to amendment from
time to time.
* Service Tax details: Category of Service : Life Insurance and Management of Investment under ULIP; Service Tax Registration (STC)
AAACI7351PST001.
* Service Tax is calculated at 1.545% (1.50% Service Tax + 2% Education Cess on Service Tax + 1% Secondary and Higher Education Cess on
Service Tax) for Traditional Endowment and Annuity Products and 10.30% (10% Service Tax + 2% Education Cess on Service Tax + 1% Secondary
and Higher Education Cess on Service Tax) for ULIP, Pure Term and Health Products and Riders.
* The policyholder shall be required to pay Service Tax, Education Cess or any other form of taxes or charges or levies as per prevailing laws and
regulations, whichever applicable as perCompany's policy.
* As stipulated by the Insurance and Regulatory DevelopmentAuthority (IRDA) in its circular dated July 29, 2011, the formula for computation of the
Net Asset Value per Unit (NAV) for Linked funds stands modified. Old formula as prescribed by IRDA and as contained in the policy document:
Market value of the investmentplus / (minus) expenses incurred in the purchase / (sale) of assetsplus current assets and accrued interest (net of fund
management charges) less current liabilities and provisions, divided by, number of units outstanding under the fund at valuation date (beforecreation /
redemption of units). Modified formula as stipulated by IRDA effective August 18, 2011: Market value of theinvestment held by the fund plus value of
current assets less valueof current liabilities and provisions, if any and divided by the number of units existing on the valuation date (before
creation/redemption of units) The policy document shall accordinglystand modified. Please note that there would be no impact on the number of units
held on account of this change.
* 2011, ICICI Prudential Life Insurance Company Limited. RegdAddress: ICICI Prulife Towers, 1089 Appasaheb Marathe Marg,Prabhadevi, Mumbai-
400025. Reg No: 105. Insurance is the subject matter of the solicitation. Comp/doc/July/2011/340.