Common use of Special Limitations Clause in Contracts

Special Limitations. This Agreement does not guarantee the Company will issue a life insurance policy or any special riders or endorsement thereto. • Fraud or material misrepresentations in the Application(s) or in the answer to the Health Question of this Agreement invalidates this Agreement and the Company’s only liability is for refund of any payment made. • If a Proposed Insured dies by suicide, the Company’s liability under this Agreement is limited to a refund of the payment made. • There is no coverage under this Agreement if the premium check or EFT Authorization in not submitted to the Company and/ or the bank/financial institution does not honor the check or EFT request within 7 days of signing this Agreement. • No one is authorized to waive or modify any of the provisions of this Agreement. I (WE) HAVE RECEIVED A COPY OF AND HAVE READ THIS AGREEMENT AND DECLARE THAT THE ANSWERS ARE TRUE TO THE BEST OF MY (OUR) KNOWLEDGE AND BELIEF. I (WE) UNDERSTAND AND AGREE TO ALL ITS TERMS. / / Signature of Proposed Insured Date (MM/DD/YYYY) / / Signature of Applicant/Owner/Trustee (If other than Proposed Insured) Date (MM/DD/YYYY) (Provide Title if owned by a Trust or a Corporation) / / Signature of Licensed Agent, Financial Planner or Registered Representative Date (MM/DD/YYYY) MGF11613

Special Limitations. This Agreement does not guarantee the Company will issue a life insurance policy or any special riders or endorsement thereto. • Fraud or material misrepresentations in the Application(s) or in the answer to the Health Question of this Agreement invalidates this Agreement and the Company’s only liability is for refund of any payment made. • If a Proposed Insured dies by suicide, the Company’s liability under this Agreement is limited to a refund of the payment made. • There is no coverage under this Agreement if the premium check or EFT Authorization in not submitted to the Company and/ or the bank/financial institution does not honor the check or EFT request within 7 days of signing this Agreement. • No one is authorized to waive or modify any of the provisions of this Agreement. I (WE) HAVE RECEIVED A COPY OF AND HAVE READ THIS AGREEMENT AND DECLARE THAT THE ANSWERS ARE TRUE TO THE BEST OF MY (OUR) KNOWLEDGE AND BELIEF. I (WE) UNDERSTAND AND AGREE TO ALL ITS TERMS. / / Signature of Proposed Insured Date (MM/DD/YYYY) / / Signature of Applicant/Owner/Trustee (If other than Proposed Insured) Date (MM/DD/YYYY) (Provide Title if owned by a Trust or a Corporation) / / Signature of Licensed Agent, Financial Planner or Registered Representative Date (MM/DD/YYYY) MGF11613CMPL

Special Limitations. This Agreement does not guarantee the Company will issue a life insurance policy or any special riders or endorsement thereto. • Fraud or material misrepresentations in the Application(s) or in the answer to the Health Question of this Agreement invalidates this Agreement and the Company’s only liability is for refund of any payment made. • If a Proposed Insured dies by suicide, the Company’s liability under this Agreement is limited to a refund of the payment made. • There is no coverage under this Agreement if the premium check or EFT Authorization in not submitted to the Company and/ or the bank/financial institution does not honor the check or EFT request within 7 days of signing this Agreement. • No one is authorized to waive or modify any of the provisions of this Agreement. I (WE) HAVE RECEIVED A COPY OF AND HAVE READ THIS AGREEMENT AND DECLARE THAT THE ANSWERS ARE TRUE TO THE BEST OF MY (OUR) KNOWLEDGE AND BELIEF. I (WE) UNDERSTAND AND AGREE TO ALL ITS TERMS. / / Signature of Proposed Insured Date (MM/DD/YYYY) / / Signature of Applicant/Owner/Trustee (If other than Proposed Insured) Date (MM/DD/YYYY) (Provide Title if owned by a Trust or a Corporation) / / Signature of Licensed Agent, Financial Planner or Registered Representative Date (MM/DD/YYYY) MGF11613ICC17MGF11613 CMPL

Special Limitations. This Agreement does not guarantee the Company will issue a life insurance policy or any special riders or endorsement thereto. • Fraud or material misrepresentations in the Application(s) or in the answer to the Health Question of this Agreement invalidates this Agreement and the Company’s only liability is for refund of any payment made. • If a Proposed Insured dies by suicide, the Company’s liability under this Agreement is limited to a refund of the payment made. • There is no coverage under this Agreement if the premium check or EFT Authorization in not submitted to the Company and/ or the bank/financial institution does not honor the check or EFT request within 7 days of signing this Agreement. • No one is authorized to waive or modify any of the provisions of this Agreement. Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree. I (WE) HAVE RECEIVED A COPY OF AND HAVE READ THIS AGREEMENT AND DECLARE THAT THE ANSWERS ARE TRUE TO THE BEST OF MY (OUR) KNOWLEDGE AND BELIEF. I (WE) UNDERSTAND AND AGREE TO ALL ITS TERMS. / / Signature of Proposed Insured Date (MM/DD/YYYY) / / Signature of Applicant/Owner/Trustee (If other than Proposed Insured) Date (MM/DD/YYYY) (Provide Title if owned by a Trust or a Corporation) / / Signature of Licensed Agent, Financial Planner or Registered Representative Date (MM/DD/YYYY) MGF11613Florida License Identification Number

Special Limitations. This Agreement does not guarantee the Company will issue a life insurance policy or any special riders or endorsement thereto. • Fraud or material misrepresentations in the Application(s) or in the answer to the Health Question of this Agreement invalidates this Agreement and the Company’s only liability is for refund of any payment made. • If a Proposed Insured dies by suicide, the Company’s liability under this Agreement is limited to a refund of the payment made. • There is no coverage under this Agreement if the premium check or EFT Authorization in not submitted to the Company and/ or the bank/financial institution does not honor the check or EFT request within 7 days of signing this Agreement. • No one is authorized to waive or modify any of the provisions of this Agreement. I (WE) HAVE RECEIVED A COPY OF AND HAVE READ THIS AGREEMENT AND DECLARE THAT THE ANSWERS ARE TRUE TO THE BEST OF MY (OUR) KNOWLEDGE AND BELIEF. I (WE) UNDERSTAND AND AGREE TO ALL ITS TERMS. / / Signature of Proposed Insured Date (MM/DD/YYYY) / / Signature of Applicant/Owner/Trustee (If other than Proposed Insured) Date (MM/DD/YYYY) (Provide Title if owned by a Trust or a Corporation) / / Signature of Licensed Agent, Financial Planner or Registered Representative Date (MM/DD/YYYY) MGF11613ICC17MGF11613 KS