Common use of PRODUCER’S STATEMENT Clause in Contracts

PRODUCER’S STATEMENT. 1. If replacement, are all policies to be replaced Term policies? 2. Do you intend to deliver the policy face to face? I certify that: • The solicitation or sale did NOT take place on a military base or other Department of Defense (DOD) installation; • I have no knowledge of any factors which may have a negative effect on the proposed insured’s insurability; • I have given the Important Notice About Your Application for Insurance to the proposed insured; Yes No     Yes No • If required by state regulation, I have read the Important Notice Regarding Replacement aloud to the applicant or the applicant did not wish the notice to be read aloud; • If this is for the sale of a variable product: I have provided current copies of the Privacy Notice and the ID Verification Notice to all owner(s) and legal representative(s) and I have offered the client a choice of a paper prospectus or CD and provided the client with their choice; • If this is for the sale of an equity-indexed product: I have provided the owner(s) with the appropriate disclosures; • If this is a replacement: I have discussed the advantages and disadvantages of the replacement with the client and determined that the transaction is appropriate and I have completed the state-required replacement form(s); • I have no other information, other than as previously reported, that the proposed insured has existing life insurance or annuities or that indicates this coverage may replace or change any current insurance or annuity in any company • If I become aware of a change in the health or habits of the proposed insured occurring after the date of the application but before policy delivery, I promise to inform the Company of the change and agree to withhold policy delivery until instructed by the company; • CA: The CA Disclosure Statement was provided to the policyowner in accordance with CA Insurance Code section 789.8;

PRODUCER’S STATEMENT. o 1. Did you see the proposed insured at point-of-sale? o Yes No o o 2. If replacement, are all policies to be replaced Term policies? 2. Do you intend to deliver the policy face to face? I certify that: • The solicitation or sale did NOT take place on a military base or other Department of Defense (DOD) installation; • I have no knowledge of any factors which may have a negative effect on the proposed insured’s 's insurability; • I have given the Important Notice About Your Application for Insurance to the proposed insured; Yes No     Yes No • If required by state regulation, I have read the Important Notice Regarding Replacement aloud to the applicant or the applicant did not wish the notice to be read aloud; • If this is for the sale of a variable product: I have provided the client with a current copies copy of the Privacy Notice and the ID Verification Notice to all owner(s) and legal representative(s) and I have offered the client a choice of a paper prospectus or CD and provided the client with their choice; • If this is for the sale of an equity-indexed product: I have provided the owner(s) with the appropriate disclosuresNotice; • If this is a replacement: I have discussed the advantages and disadvantages of the replacement with the client and determined that the transaction is appropriate and I have completed the state-required replacement form(s); • I have no other information, other than as previously reported, that the proposed insured has existing life insurance or annuities or that indicates this coverage may replace or change any current insurance or annuity in any company • If I become aware of a change in the health or habits of the proposed insured occurring after the date of the application but before policy delivery, I promise to inform the Company of the change and agree to withhold policy delivery until instructed by the company; • CA: The CA Disclosure Statement was provided to the policyowner in accordance with CA Insurance Code section 789.8;

PRODUCER’S STATEMENT. 1. If replacement, are all policies to be replaced Term policies?? o Yes o No 2. Do you intend to deliver the policy face to face? o Yes o No I certify that: • The solicitation or sale did NOT take place on a military base or other Department of Defense (DOD) installation; • I have no knowledge of any factors which may have a negative effect on the proposed insured’s insurability; • I have given the Important Notice About Your Application for Insurance to the proposed insured; Yes No     Yes No • I provided the policyowner with the brochure “What every consumer should know about life insurance” and answered any questions they had about the purchase; • If required by state regulation, I have read the Important Notice Regarding Replacement aloud to the applicant or the applicant did not wish the notice to be read aloud; • If this is for the sale of a variable product: I have provided current copies of the Privacy Notice and the ID Verification Notice to all owner(s) and legal representative(s) and I have offered the client a choice of a paper prospectus or CD and provided the client with their choice; • If this is for the sale of an equity-indexed product: I have provided the owner(s) with the appropriate disclosures; • If this is a replacement: I have discussed the advantages and disadvantages of the replacement with the client and determined that the transaction is appropriate and I have completed the state-required replacement form(s); • I have no other information, other than as previously reported, that the proposed insured has existing life insurance or annuities or that indicates this coverage may replace or change any current insurance or annuity in any company • If I become aware of a change in the health or habits of the proposed insured occurring after the date of the application but before policy delivery, I promise to inform the Company of the change and agree to withhold policy delivery until instructed by the company; • CA: The CA Disclosure Statement was provided to the policyowner in accordance with CA Insurance Code section 789.8;