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Max New York Life Insurance Company Ltd.

Agent Compensation Statement


16-JUL-10 to 31-JUL-10

Agent ID 328534 Agent Name Sachin Garg Office ADL18 PAN No. AERPG6026K
Date Contracted 30-MAY-09 Payment Mode Direct Credit Segment Platinum Segment Effective Date 01-JUL-10
Bank Name AXIS Bank Ltd A/C # 909010033151664

Policy No. Plan Mode Effective Benefit Comp Desc Reason Premium Rate% Gross TDS TDS Net Amount
Insured Date Split Type Amt Rate% Amt
740758420 URPCUP Monthly 07-Jul-2009 100% Comm RYC 2,000.00 2% 40.00 10% 4.00 36.00
Insured: Rakesh Sharma Total: 2,000.00 36.00
740758453 UNMPE Yearly 16-Jul-2009 100% Comm RYC 50,000.00 3% 1,500.00 10% 150.00 1,350.00
Insured: Mohit Kumar Total: 50,000.00 1,350.00
740841218 URPCUP Quarterly 30-Jun-2009 100% Comm RYC 6,000.00 2% 120.00 10% 12.00 108.00
Insured: Pankaj Goel Total: 6,000.00 108.00
740914585 URPCUP Half Yearly 22-Jun-2009 100% Comm RYC 25,000.00 2% 500.00 10% 50.00 450.00
Insured: Shekhar . Total: 25,000.00 450.00
748440278 ULXPE5 Quarterly 12-Jul-2009 100% Comm RYC 12,500.00 2% 250.00 10% 25.00 225.00
Insured: Rajesh Kumar Total: 12,500.00 225.00
762227858 USLPE Half Yearly 20-Dec-2009 100% Comm FYC 10,000.00 17% 1,700.00 10% 170.00 1,530.00
Insured: Vinod . Total: 10,000.00 1,530.00

TOTAL COMMISSION FOR THE PERIOD 105,500.00 4,110.00 411.00 3,699.00


MISC JE CASE RATE BONUS FOR THE MONTH OF JUNE'10 20,975.02
MISC JE RECOVERY OF S.TAX ON CASE RATE BONUS FOR THE MONTH OF -864.17
JUNE'10
MISC JE TDS ON CASE RATE BONUS FOR THE MONTH OF JUNE'10 -2,097.50
MISC JE TPR 6/2010 0 CS 01 PRP 500.00
Segment Bonus SB 765.00 10% 76.50 688.50
TOTAL FEE FOR THE PERIOD 19,201.85
Recovery of Service Charges 4,875.00 200.85
GRAND TOTAL FOR THE PERIOD : 22,700.00
TOTAL AMOUNT DISBURSED# : 22,700.00

'*' = Commission hold against premium monies not realized

COR = Correction, NTU = Not taken up, 6LH = Commission withheld on own life (till 6 lives are covered), MISC =Miscellaneous

Information contained herein is confidential and for internal use and may be used only for business purposes authorized by Max New York Life Insurance Co. Ltd.

Agent ID : 328534 Page: 1 of 1 Date : 04-Aug-2010 Time : 12:45:34:PM

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