City*     Mobile Number* (+91)  
JetPrivilege A/c No*.(9w)   JetPrivilege Tier*  

* Review your financial health in just 15 minutes. Speak with our representative and boost your Jet Privilege account with assured 1250 JPMiles. What’s more? 5 lucky winners stand a chance to win 10,000 JPMiles.

Results of the lucky draw will be announced on 15th June, 2012.

This is only a financial planning exercise and there is no obligation to buy insurance.

Insurance is the subject matter of the solicitation. For more details on terms and conditions, please read the sales brochure carefully before concluding a sale. IRDA Company Registration No: 138. Registered Office: AEGON Religare Life Insurance Company Ltd., 2nd Floor, Paranjpe 'B' Scheme, Subhash Road, Near Garware House, Vile Parle (E.), Mumbai 400057. ADVT No.II/March 2012/1285