Life Insurance Forms

The following life insurance forms will help you identify the terms and conditions of your individual life insurance policy from the providers below.

American General Life Companies

LTG – Ultra C (Form #06004)-10-year, 15- year, 20- year, 30-year is non-participating term life insurance to age 80. Coverage is renewable to age 95. Minimum issue amount is $100, 000 and Maximum issue amount is $250,000. American General Life Companies, Houston, TX 77017, underwrites policy. Non-Tobacco means no nicotine use or nicotine substitutes for 5 years for preferred plus, 3 years for preferred, 2 years for standard plus and at least 12 months for standard. The most favorable rate classes (and lowest rates) are generally intended for those who can meet strict health/lifestyle criteria. All rates are subject to underwriting qualifications, exam results and personal physician statements. Suicide, incontestability and other limits may apply. Suicide – In the event of the suicide of the insured, while sane or insane, within two years from the date of issue, our liability will be limited to premiums paid. Plan not available in all states. You can return the policy without obligation within 10 days of receipt. Policy descriptions provided here are not a statement of contract. Please refer to policy form for full disclosure of benefits and limitations. Forms and policy provisions may vary by state.

AG Select-a-Term (Form #07007) -10-,12-,15-,16-,17-,18-,19-,20-,21-,22-,23-,24-,25-,26-,27-,28-,29, and 30 year terms. Is a non-participating term life insurance which, depending on initial age and term length, can be written to age 87 . Coverage is renewable to age 95. Minimum issue amount is $250,000. Policy is underwritten by American General Life Insurance Company, Houston, TX 77017. Non-Tobacco means no nicotine use or nicotine substitutes for 5 years for preferred plus, 3 years for preferred, 2 years for standard plus and at least 12 months for standard. The most favorable rate classes (and lowest rates) are generally intended for those who can meet strict health/lifestyle criteria. All rates are subject to underwriting qualifications, exam results and personal physician statements. Suicide, incontestability and other limits may apply. Suicide, incontestability and other limits may apply. Suicide – In the event of the suicide of the insured, while sane or insane, within two years from the date of issue, our liability will be limited to premiums paid. Plan not available in all states. You can return the policy without obligation within 10 days of receipt. Policy descriptions provided here are not a statement of contract. Please refer to policy form for full disclosure of benefits and limitations. Forms and policy provisions may vary by state.

ROP Term (Form# 06001)-, 15- year, 20- year, 30-year is non-participating term life insurance to age 80 with a return of premium provision . Coverage is renewable to age 95. Minimum issue amount is $100, 000. Policy is underwritten by American General Life Companies, Houston, TX 77017. Non-Tobacco means no nicotine or nicotine substitutes use for 5 years for preferred plus, 3 years for preferred, 2 years for standard plus and at least 12 months for standard. The most favorable rate classes (and lowest rates) are generally intended for those who can meet strict health/lifestyle criteria. All rates are subject to underwriting qualifications, exam results and personal physician statements. All premiums with the exception of riders, flat extra and substandard premiums are refunded at the end to the term length. Suicide, incontestability and other limits may apply Suicide, incontestability and other limits may apply. Suicide – In the event of the suicide of the insured, while sane or insane, within two years from the date of issue, our liability will be limited to premiums paid. Plan not available in all states. You can return the policy without obligation within 10 days of receipt. Policy descriptions provided here are not a statement of contract. Please refer to policy form for full disclosure of benefits and limitations. Forms and policy provisions may vary by state.

AG ContinUL Extend – (Form# 05337) A flexible premium adjustable Universal Life policy that can be issued with a No Lapse feature for coverage guaranteed to age 121. Minimum issue amount is $100,000. Policy is underwritten by American General Life Companies, Houston, TX 77017. Non-Tobacco means no nicotine use or nicotine substitutes for 5 years for preferred plus, 3 years for preferred, 2 years for standard plus and at least 12 months for standard. The most favorable rate classes (and lowest rates) are generally intended for those who can meet strict health/lifestyle criteria. All rates are subject to underwriting qualifications, exam results and personal physician statements. Suicide, incontestability and other limits may apply. Suicide – In the event of the suicide of the insured, while sane or insane, within two years from the date of issue, our liability will be limited to premiums paid. Plan not available in all states. You can return the policy without obligation within 10 days of receipt. Policy descriptions provided here are not statements of contract. Please refer to policy form for full disclosure of benefits and limitations. Forms and policy provisions may vary by state.

American General Life Companies: 2727-A Allen Parkway, Houston, TX 77019-2215.

Banner Life Insurance Company: OPTERM

The Banner term life insurance premiums quoted here are based on the information provided for this quote. The quote is based on
the assumption of excellent health and does not take into consideration occupational risks or other avocations. Approval and actual
premiums will be based upon the entire underwriting process, including but not limited to, information provided on the application,
exam results and specific underwriting requirements and criteria.

OPTerm 10 issue ages are 20-75 all classes. OPTerm 15 issue ages are 20-75 all classes. OPTerm 20 issue ages are 20-70 for
non-tobacco classes and 20-65 for tobacco classes. OPTerm 30 issue ages are 20-55 for non-tobacco classes and 20-50 for tobacco
classes. Premium rates vary by coverage amount: $100,000-$249,999, $250,000-$499,999, $500,000-$999,999, $1,000,000 and
above. Premiums quoted include $60 annual policy fee. Premiums are guaranteed to stay level for 10,15, 20 or 30 years, respectively,
and increase annually after initial guarantee period. OPTerm policies can be issued in preferred plus non-tobacco, preferred nontobacco,
standard plus non-tobacco, standard non-tobacco, preferred tobacco and standard tobacco classes. OPTerm 10, 15, 20
and 30 substandard policies can be issued through Table 12, subject to underwriting discretion. Coverage can be renewed to age 95.
Policies can be returned without obligation within 30 days of receipt in most states. Rates as of 08.10.15.

Additional Insurance Riders, form AIR (1-11) and state variations, can provide temporary life insurance coverage for 10, 15 or 20
years after which coverage ceases. Term riders are not available in all states; issue ages vary from base plan. Waiver of Premium
Benefit Rider, policy form #ICC09 WPTR and state variations, is available. A cost-free Accelerated Death Benefit Rider, policy form #
ICC10 ADB and state variations, is included with all policies in states where approved. Children’s Life Insurance Rider, form ICC14-
CLIR and state variations, can provide life insurance coverage on eligible children. Coverage expires at the earlier of the insured
child’s 25th birthday, the base policy insured’s 65th birthday or base policy termination. Forms and policy provisions may vary by state.
Policy descriptions provided here are not a statement of contract. Please refer to the policy forms for full disclosure of all benefits and
limitations.

William Penn Life Insurance Company: OPTERM

Legal & General America life insurance products are underwritten and issued by Banner Life Insurance Company, Urbana, MD and
William Penn Life Insurance Company of New York, Valley Stream, NY. William Penn products are available exclusively in New York.
OPTerm policy form in NY is #OPTN-NY. Two-year contestability and suicide provisions apply. Not for public distribution. For broker
use only.

The William Penn OPTerm life insurance premiums quoted here are based on the information provided for this quote. The quote is
based on the assumption of excellent health and does not take into consideration occupational risks or other avocations. Approval
and actual rates will be based upon the entire underwriting process, including but not limited to, information provided on the
application, exam results and specific underwriting requirements and criteria. Please refer to the policy form for full disclosure of
benefits and limitations

OPTTerm 10, 15, 20 and 30 are term life insurance policies. OPTerm 10 issue ages 20-75 non-tobacco classes; 20-75 tobacco
classes. OPTerm 15 issue ages 20-71 non-tobacco classes; 20-71 tobacco classes. OPTerm 20 issue ages 20-65 for non-tobacco
classes, 20-64 for tobacco classes. OPTerm 30 issue ages 20-51 for non-tobacco classes; 20-50 for tobacco classes. Premium rates
vary by coverage amount: $100,000-$249,999, $250,000-$499,999, $500,000-$999,999, $1,000,000 and above. Premiums quoted
include $60 annual policy fee. Initial premiums remain level for 10, 15, 20 and 30 years respectively. After the initial level term period,
premiums increase annually to age 95. OPTerm 10, 15, 20 and 30 can be issued in preferred plus non-tobacco, preferred nontobacco,
standard plus non-tobacco or standard non-tobacco, preferred tobacco and standard tobacco rates. Substandard policies
can be issued through Table 12, subject to underwriting discretion. Policies can be returned without obligation within 30 days of
receipt. Rates as of 08.10.15.

Additional Insurance Riders, form AIR (1-11), can provide temporary life insurance coverage for 10, 15 or 20 years after which
coverage ceases. Term riders are not available in all states; issue ages vary from base plan. A Waiver of Premium Benefit Rider,
policy form #WPTR, is available. A cost-free Accelerated Death Benefit Rider, policy form #ADB(07-10), is
included with all policies. Policy descriptions provided here are not a statement of contract. Please refer to the
policy forms for full disclosure of all benefits and limitations.

Banner Life Insurance Company: 3275 Ennett Creek Ave., Frederick, MD 21704.

Banner Life Insurance Company: LIFE STEP UL

Legal & General America life insurance products are underwritten and issued by Banner Life Insurance Company, Urbana, MD and
William Penn Life Insurance Company of New York, Valley Stream, NY. Banner products are distributed in 49 states and in DC.
Banner does not solicit business in NY. Policy form #ICC12 UL13 and state variations. Life Step UL is a flexible premium universal
life insurance plan. This product offers a coverage guarantee to maturity at age 121 if the appropriate premium according to policy
terms is paid on time. The policy will not lapse if the coverage guarantee requirement is met. A policy loan however, that exceeds
the cash surrender value will result in a lapse of coverage. Two-year contestability and suicide provisions apply. Not for public
distribution.

The Banner life insurance premiums quoted here are based on the information provided for this quote. The quote is based on the
assumption of excellent health and does not take into consideration occupational risks or other avocations. Approval and actual rates
will be based upon the entire underwriting process, including but not limited to, information provided on the application, exam results
and specific underwriting requirements and criteria.

Life Step UL policies can be issued ages 20-85, in underwriting classifications preferred plus non-tobacco, preferred non-tobacco,
standard plus non-tobacco, standard non-tobacco, preferred tobacco and standard tobacco classes. Substandard policies can be
issued through Table 12, subject to underwriting discretion. Minimum face amount is $50,000. Current cost of insurance rates varies
by underwriting class. Access to account value will result in a surrender charge that is applicable during the first 9 policy years. Partial
surrenders are allowed in approved states. Current interest and cost of insurance charges used to calculate the policy account value
are not guaranteed and may be changed by Banner at any time for any reason, subject to contractual limits. Additional expense
charges will apply. The coverage guarantee amount is used to determine whether or not a policy will lapse and is calculated in a
similar manner as the policy account value, using different charges and interest. The coverage guarantee cost factors are guaranteed
not to change. Rates as of 07.01.14.

A cost-free Accelerated Death Benefit Rider, policy form #ICC10 ADB and state variations, is included with all policies in states where
approved.

Signed illustrations are required for Life Step UL. Policy descriptions provided here are not a statement of contract. Please refer to the
policy forms for full disclosure of all benefits and limitations.

William Penn Life Insurance Company: LIFE STEP UL

Legal & General America life insurance products are underwritten and issued by Banner Life Insurance Company, Urbana, MD and
William Penn Life Insurance Company of New York, Valley Stream, NY. William Penn products are available exclusively in New York.
Policy form #UL13S-NY. Life Step UL is a flexible premium universal life insurance plan. This product offers a coverage guarantee
to maturity at age 121 if the appropriate premium according to policy terms is paid on time. The policy will not lapse if the coverage
guarantee requirement is met. A policy loan however, that exceeds the cash surrender value will result in a lapse of coverage.
Two-year contestability and suicide provisions apply.

The William Penn life insurance premiums quoted here are based on the information provided for this quote. The quote is based on
the assumption of excellent health and does not take into consideration occupational risks or other avocations. Approval and actual
rates will be based upon the entire underwriting process, including but not limited to, information provided on the application, exam
results and specific underwriting requirements and criteria.

Life Step UL policies can be issued ages 20-85, in underwriting classifications preferred plus non-tobacco, preferred non-tobacco,
standard plus non-tobacco, standard non-tobacco, preferred tobacco and standard tobacco classes. Substandard policies can be
issued through Table 12, subject to underwriting discretion. Minimum face amount is $50,000. Current cost of insurance rates varies
by underwriting class. Access to account value will result in a surrender charge that is applicable during the first 9 policy years. Partial
surrenders are not allowed. Current interest and cost of insurance charges used to calculate the policy account value are not guaranteed
and may be changed by William Penn at any time for any reason, subject to contractual limits. Additional expense charges will apply. The
coverage guarantee amount is used to determine whether or not a policy will lapse and is calculated in a similar manner as the policy
account value, using different charges and interest. The coverage guarantee cost factors are guaranteed not to change. Rates as of
08.28.14.

A cost-free Accelerated Death Benefit Rider, policy form #ADB(07-10) is included with all policies.

Genworth Life Insurance Company

Sure Term 10,15, 20 and 30 (Form #GE-1420) is non-participating term life insurance issued to age 80/75/65/50, respectively with some age, sex, class, and state limitations. Coverage is renewable to age 98 (95 in Maryland). Minimum issue amount is $50,000. Policy is underwritten by Genworth Life Insurance Company, Richmond, VA 23230. Non-Tobacco means no nicotine use or nicotine substitutes for 5 years for preferred best, 3 years for preferred, 2 years for select and at least 12 months for standard. The most favorable rate classes (and lowest rates) are generally intended for those who can meet strict health/lifestyle criteria. All rates are subject to underwriting qualifications, exam results and personal physician statements. Suicide, incontestability and other limits may apply. Suicide – If the Insured, while sane or insane dies by suicide, within two years After the Date of Issue, shown in the Schedule, the death proceeds under this Policy will be an amount equal to the premiums paid, less the loan balance as of the date of death. Plan not available in all states. You can return the policy without obligation within 10 days of receipt. Policy descriptions provided here are not a statement of contract. Please refer to policy form for full disclosure of benefits and limitations. Forms and policy provisions may vary by state.

Lifetime FlexPlus- (Form#ULGE02SP)- A flexible premium adjustable Universal Life policy that can be issued with a No Lapse feature for coverage guaranteed for life. Minimum issue amount is $25,000. Policy is underwritten by Genworth Life Insurance Company, Lynchburg, VA. Non-Tobacco means no nicotine use or nicotine substitutes for 5 years for preferred best, 3 years for preferred, 2 years for select and at least 12 months for standard. The most favorable rate classes (and lowest rates) are generally intended for those who can meet strict health/lifestyle criteria. All rates are subject to underwriting qualifications, exam results and personal physician statements. Suicide, incontestability and other limits may apply. Suicide – If the Insured, while sane or insane dies by suicide, within two years after the Date of Issue, shown in the schedule, the death proceeds under this Policy will be an amount equal to the premiums paid, less the loan balance as of the date of death. Policy not available in all states. You can return the policy without obligation within 20 days of receipt. Policy descriptions provided here are not statements of contract. Please refer to policy form for full disclosure of benefits and limitations. Forms and policy provisions may vary by state.

Genworth Life Insurance Company of NY- (Form#AM – 1420)Term 10, 15, 20 and Term 30 are non-participating term life insurance issued to age 70/65/60/50, respectively. Coverage is renewable to age 80. Minimum issue amount is $50,000. Policy is underwritten by Genworth Life Insurance Company, New York, NY 10017. Non-Tobacco means no nicotine use or nicotine substitutes for 5 years for preferred best, 3 years for preferred, 2 years for select and at least 12 months for standard. The most favorable rate classes (and lowest rates) are generally intended for those who can meet strict health/lifestyle criteria. All rates are subject to underwriting qualifications, exam results and personal physician statements. Suicide, incontestability and other limits may apply. Suicide – If the Insured dies by suicide, within two years After the Date of Issue, shown in the Schedule, the death proceeds under this Policy will be an amount equal to the premiums paid as of the date of death. Plan is only available in New York. You can return the policy without obligation within 10 days of receipt. Policy descriptions provided here are not a statement of contract. Please refer to policy form for full disclosure of benefits and limitations. Forms and policy provisions may vary by state.

Genworth Life Insurance Company of NY– Lifetime FlexPlus NY- (Form# ULAML02SP (03)) – A flexible premium adjustable Universal Life policy that can be issued with a No Lapse feature for coverage guaranteed for life. Minimum issue amount is $25,000. Policy is underwritten by Genworth Life Insurance Company of New York , New York, NY. Non-Tobacco means no nicotine use or nicotine substitutes for 5 years for preferred best, 3 years for preferred, 2 years for select and at least 12 months for standard. The most favorable rate classes (and lowest rates) are generally intended for those who can meet strict health/lifestyle criteria. All rates are subject to underwriting qualifications, exam results and personal physician statements. Suicide, incontestability and other limits may apply. Suicide – If the Insured, while sane or insane dies by suicide, within two years after the Date of Issue, shown in the schedule, the death proceeds under this Policy will be an amount equal to the premiums paid, less the loan balance as of the date of death. Plan is only available in New York. You can return the policy without obligation within 20 days of receipt. Policy descriptions provided here are not statements of contract. Please refer to policy form for full disclosure of benefits and limitations. Forms and policy provisions may vary by state.

Genworth Life Insurance Company of NY: 666 Third Avenue, 9th Floor, New York, NY 10017.

Lincoln National Life

Life Elements Term (Form #TRM5060) – – 10-year, Term 15- year, Term 20- year, Term 30-year is non-participating term life insurance to age 80. Coverage is renewable to age 95. Minimum issue amount is $100,000. Policy is underwritten by Lincoln National Life Insurance Company, Fort. Wayne, IN 46801. Non-Tobacco means no nicotine use or nicotine substitutes for 5 years for preferred best and 3 years for preferred. The most favorable rate classes (and lowest rates) are generally intended for those who can meet strict health/lifestyle criteria. All rates are subject to underwriting qualifications, exam results and personal physician statements. Suicide, incontestability and other limits may apply. Suicide – If the Insured commits while sane or insane, within two years from the Issue Date, the liability of the Company under the policy will be limited to all premiums paid. Plan not available in all states. You can return the policy without obligation within 10 days of receipt. Policy descriptions provided here are not a statement of contract. Please refer to policy form for full disclosure of benefits and limitations. Forms and policy provisions may vary by state.

Lincoln Life and Annuity – NY– Life Elements Term (Form #GTO -NY) – GTO Term 10-year, Term 15- year, Term 20- year, Term 30-year is non-participating term life insurance to age 80. Coverage is renewable to age 95. Minimum issue amount is $100,000. Policy is underwritten by Lincoln Life and Annuity Insurance Company, Syracuse, NY 13202. Non-Tobacco means no nicotine use or nicotine substitutes for 5 years for preferred best and 3 years for preferred. The most favorable rate classes (and lowest rates) are generally intended for those who can meet strict health/lifestyle criteria. All rates are subject to underwriting qualifications, exam results and personal physician statements. Suicide incontestability and other limits may apply. Suicide – If the Insured commits while sane or insane, within two years from the Issue Date, the liability of the Company under the policy will be limited to all premiums paid. Plan is only available in New York. You can return the policy without obligation within 10 days of receipt. Policy descriptions provided here are not a statement of contract. Please refer to policy form for full disclosure of benefits and limitations. Forms and policy provisions may vary by state.

Lincoln Life & Annuity of NY: 100 North Greene Street, Greensboro, NC 27401.

Mutual of Omaha

Accidental Death Insurance is underwritten by Mutual of Omaha Insurance Company, 3300 Mutual of Omaha Plaza, Omaha, NE 68175. Policy form 50-AD-23949 or state equivalent (in FL, 50AD Series-23954; in ID, 50AD Series-23991; in NC, 50AD Series-23955; in NY, 50AD Series-23980; in OK, 50AD Series-23972; in OR, 50AD Series-23987; in PA, 50AD Series-23965; in TX, 50AD Series-23952; in WA, 50AD Series-23979) Rider form ONA3M. These policies contain exclusions and limitations. Product features and benefits may not be available in all states. This is a solicitation of insurance. By responding, you are requesting to have a licensed agent/producer contact you to provide additional information.

Protective Life and Annuity – NY

Empire Term Series (Form #PL11312NY), 10 year, 15 year, 20 year, 25 year, and 30 year term is a non-participating term life insurance to age 80, underwritten by Protective Life and Annuity Insurance Co., Birmingham, AL 35202. Minimum issue amount is $100,000. Non-Tobacco means no tobacco use in the last 5 years for super preferred, and 12 months for preferred and standard. The most favorable rate classes (and lowest rates) are generally intended for those who can meet strict health/lifestyle criteria. All rates are subject to underwriting qualifications, exam results and personal physician statements. Suicide, incontestability and other limits may apply. Suicide – If the Insured dies by suicide, within two years from the policy date, The Company liability for the death benefit is limited to the premiums paid. Plan is only available in New York. You can return the policy without obligation within 10 days of receipt. Policy descriptions provided here are not a statement of contract. Please refer to policy form for full disclosure of benefits and limitations. Forms and policy provisions may vary by state.

Protective Life & Annuity: 2801 Highway 280 South, Birmingham, AL 35223.

Pruco Life Insurance Company

Term Essential (Form #IFS-A-073214) 10, 15, 20, 30 years. A non-participating term life insurance to age 95, underwritten by Pruco Life Insurance Company, a division of Prudential Insurance Company of America, Newark, NJ 07102. Minimum issue amount is $100,000. Non-Tobacco means no tobacco use in the last 5 years for preferred best, 3 years for preferred plus, and 12 months for preferred and standard. The most favorable rate classes (and lowest rates) are generally intended for those who can meet strict health/lifestyle criteria. All rates are subject to underwriting qualifications, exam results and personal physician statements. Suicide, incontestability and other limits may apply. Suicide – If the Insured whether sane or insane, dies by suicide within two years from the Issue Date, this contract will end and the Company will return the premiums paid. The contract will provide no further benefit. Plan not available in all states. You can return the policy without obligation within 10 days of receipt. Policy descriptions provided here are not a statement of contract. Please refer to policy form for full disclosure of benefits and limitations. Forms and policy provisions may vary by state.

PruLife ROP 15, 20, 30 years. (Form#PLTIR-2006) Is a non-participating term life insurance to age 95, with a return of premium provision. This Policy is underwritten by Pruco Life Insurance Company, a division of Prudential Insurance Company of America, Newark, NJ 07102. Minimum issue amount is $100,000. Non-Tobacco means no tobacco use in the last 5 years for preferred best, 3 years for preferred plus, and 12 months for preferred and standard. The most favorable rate classes (and lowest rates) are generally intended for those who can meet strict health/lifestyle criteria. All rates are subject to underwriting qualifications, exam results and personal physician statements. Suicide, incontestability and other limits may apply. Suicide – If the Insured whether sane or insane, dies by suicide within two years from the Issue Date, this contract will end and the Company will return the premiums paid. The contract will provide no further benefit. All premiums with the exception of riders, flat extra and substandard premiums are refunded at the end to the term length. Plan not available in all states. You can return the policy without obligation within 10 days of receipt. Policy descriptions provided here are not statements of contract. Please refer to policy form for full disclosure of benefits and limitations. Forms and policy provisions may vary by state.

Prudential Life Insurance Company: 751 Broad Street, 23rd Floor, Newark, NJ 07102.

Transamerica Life Insurance Company

Trendsetter® Super is a term life insurance policy issued by Transamerica Life Insurance Company, Cedar Rapids IA. Policy Forms ICC17 TL24 or TL24. Premiums increase beginning in year 11 for the 10- year policy, in year 16 for the 15-year policy, in year 21 for the 20-year policy, in year 26 for the 25-year policy, and in year 31 for the 30-year policy. Policy forms and numbers may vary, and these policies and riders may not be available in all jurisdictions. Insurance eligibility and premiums are subject to underwriting. In most states, in the event of suicide during the first two policy years, death benefits are limited only to the return of premiums paid.

Not available in New York.

United States Life Insurance Company

Select-a-Term (Form #07007)-10-,12-,15-,16-,17-,18-,19-,20-,21-,22-,23-,24-,25-,26-,27-,28-,29, and 30 year terms. Is a non-participating term life insurance to age 80. Coverage is renewable to age 95. Minimum issue amount is $250,000. Policy is underwritten by United Sates Life Insurance Company, New York, NY 10022. Non-Tobacco means no nicotine use or nicotine substitutes for 5 years for preferred plus, 3 years for preferred, 2 years for standard plus and at least 12 months for standard. The most favorable rate classes (and lowest rates) are generally intended for those who can meet strict health/lifestyle criteria. All rates are subject to underwriting qualifications, exam results and personal physician statements. Suicide, incontestability and other limits may apply. Suicide, incontestability and other limits may apply. Suicide – In the event of the suicide of the insured, within two years from the date of issue, the Company liability will be limited to the premiums paid. Plan is only available in New York. You can return the policy without obligation within 10 days of receipt. Policy descriptions provided here are not a statement of contract. Please refer to policy form for full disclosure of benefits and limitations. Forms and policy provisions may vary by state.

ContinUL Extend – (Form# 05337N) A flexible premium adjustable Universal Life policy that can be issued with a No Lapse feature for coverage guaranteed to age 121. Minimum issue amount is $100,000. Policy is underwritten by the United States Life Insurance Company in the city of New York, NY 10022. Non-Tobacco means no nicotine use or nicotine substitutes for 5 years for preferred plus, 3 years for preferred, 2 years for standard plus and at least 12 months for standard. The most favorable rate classes (and lowest rates) are generally intended for those who can meet strict health/lifestyle criteria. All rates are subject to underwriting qualifications, exam results and personal physician statements. Suicide, incontestability and other limits may apply. Suicide – In the event of the suicide of the insured, while sane or insane, within two years from the date of issue, our liability will be limited to premiums paid. Plan only available in New York. You can return the policy without obligation within 10 days of receipt. Policy descriptions provided here are not statements of contract. Please refer to policy form for full disclosure of benefits and limitations. Forms and policy provisions may vary by state.

United States Life Insurance Company: 3600 Route 66, PO Box 1580, Neptune, NJ 07754-1580.

William Penn Life Insurance Company

William Penn Life Insurance Company of NY, Garden City, NY – The William Penn insurance premiums quoted here are based on the information provided for this quote. The quote is based on the assumption of excellent health and does not take into consideration occupational risks or other avocations. Approval and actual rates will be based upon the entire underwriting process, including but not limited to, information provided on the application, exam results and specific underwriting requirements and criteria. You can return a policy without obligation within 30 day of receipt. Policy descriptions provided here are not a statement of contract. Please refer to the policy form for full disclosure of benefits and limitations. Please contact the brokerage agency responsible for this website to confirm appropriate licenses for your state and contractual authorization to represent William Penn.

Penn Term Series policy form #T-RC-IP/97. Available only in New York. Policy descriptions provided here are not a statement of contract and are not for public distribution. Penn Term 10 issue ages 20-80. Penn Term 15 issue ages 20-75. Penn Term 20 issue ages 20-70 for non-tobacco classes and issues ages 20-65 for tobacco classes. Penn Term 30 issue ages 20-55 for non-tobacco classes and issue ages 20-50 for tobacco classes. Premium rates vary by coverage amount: $100,000-$249,999, $250,000-$999,999, $1 million and above. Premiums quoted include $65 annual policy fee. Initial premiums remain level for 10, 15, 20 and 30 years respectively. After the initial level term period, premiums increase annually to age 95. Penn Term 10, 15, 20 and 30 can be issued in preferred plus non-tobacco, preferred non-tobacco, standard plus non-tobacco, or standard non-tobacco, preferred tobacco and standard tobacco rates. Substandard policies can be issued through Table 12, subject to underwriting discretion. Policies can be returned without obligation within 30 days of receipt. Rates as of 6-15-2010. Two-year contestability and suicide provisions apply. Underwritten and issued by William Penn Life Insurance Company of New York, Garden City, NY.

William Penn Life Insurance Company of NY: 100 Quentin Roosevelt Boulevard, Garden City, NY 11530.

Contact AccuQuote at 800-442-9899 for updated information on your life insurance provider’s life insurance forms.