Common use of YOUR POLICY CAREFULLY Clause in Contracts

YOUR POLICY CAREFULLY. This is a legal contract between you, the Owner, and us, Pacific Life Insurance Company, a stock insurance company. We agree to pay the benefits of this policy according to its provisions. The consideration for this policy is the application for it, a copy of which is attached, and payment of the premiums. FREE LOOK RIGHT – You may return this policy within 10 days after you receive it. To do so, deliver or mail it to us or to our agent. This policy will then be deemed void from the beginning and we will refund: · any Premium Load deducted from premiums received; plus · any Net Premium allocated to the Fixed Options; plus · the Variable Accumulated Value as of the end of the Valuation Period when we receive the policy; plus · any policy charges and fees deducted from the Variable Accounts. · Death Benefit Payable On The Death Of The Insured While The Policy Is In Force · Net Cash Surrender Value Payable Upon Surrender While The Policy Is In Force · Adjustable Face Amount · Benefits May Vary Based On Investment Experience · Non-Participating POLICY NUMBER: VP99999990 OWNER(S): XXXXXX XXXXXXXX POLICY DATE: MAY 1, 2004 INSURED: XXXXXX XXXXXXXX RISK CLASS: MALE SELECT NONSMOKER AGE ON POLICY DATE: 35 INITIAL FACE AMOUNT: $100,000 NOTE: EVEN IF PLANNED PREMIUMS ARE PAID, IT IS POSSIBLE THAT THE POLICY MAY NOT CONTINUE IN FORCE (THAT IS, IT MAY LAPSE BEFORE THE DEATH OF THE INSURED) DUE TO CHANGES IN INTEREST CREDITED ON THE FIXED OPTIONS, INVESTMENT PERFORMANCE OF THE VARIABLE ACCOUNTS, EXPENSE LOADS, AND COST OF INSURANCE RATES. ADDITIONALLY, LOANS, WITHDRAWALS, AND DEATH BENEFIT OPTION CHANGES WILL AFFECT THE LENGTH OF TIME THE POLICY STAYS IN FORCE. P04SE2 BASIC POLICY: FLEXIBLE PREMIUM VARIABLE LIFE INSURANCE PREMIUMS: PLANNED [ANNUAL] PREMIUM = $ 1,524.60 GUIDELINE SINGLE PREMIUM = 17,278.20 GUIDELINE LEVEL PREMIUM = 1,524.60 7-PAY PREMIUM = 3,915.00 DEATH BENEFIT QUALIFICATION TEST: GUIDELINE PREMIUM TEST (THIS ELECTION IS IRREVOCABLE FOR THE LIFE OF THE CONTRACT) DEATH BENEFIT OPTION: A MINIMUM GUARANTEED INTEREST RATE FOR FIXED OPTIONS: [2.50]% ANNUALLY. ANY EXCESS INTEREST DECLARED BY US WILL BE GUARANTEED FOR ONE YEAR. DIVISOR FOR CALCULATING THE NET AMOUNT AT RISK: [1.002060] PREMIUM LOAD: FOR EACH PREMIUM PAID THERE IS A PREMIUM LOAD THAT CONSISTS OF A SALES LOAD OF 2.50% PLUS A CHARGE OF 2.35% FOR CERTAIN STATE AND LOCAL PREMIUM TAXES PLUS A CHARGE OF 1.50% FOR CERTAIN FEDERAL TAXES. REFER TO CONTRACT FOR DETAILS. ADMINISTRATIVE CHARGE: $7.50 PER MONTH TO AGE 100; $0 THEREAFTER SURRENDER CHARGE FACTOR: $1,436.00 MAXIMUM SURRENDER CHARGE: $630.00 MORTALITY AND EXPENSE RISK FACE AMOUNT CHARGE: $18.90 PER MONTH FOR POLICY YEARS 1 TO 10; $0 THEREAFTER. POLICY NUMBER: VP99999990 OWNER(S): XXXXXX XXXXXXXX POLICY DATE: MAY 1, 2004 INSURED: XXXXXX XXXXXXXX RISK CLASS: MALE SELECT NONSMOKER AGE ON POLICY DATE: 35 INITIAL FACE AMOUNT: $100,000 NOTE: EVEN IF PLANNED PREMIUMS ARE PAID, IT IS POSSIBLE THAT THE POLICY MAY NOT CONTINUE IN FORCE (THAT IS, IT MAY LAPSE BEFORE THE DEATH OF THE INSURED) DUE TO CHANGES IN INTEREST CREDITED ON THE FIXED OPTIONS, INVESTMENT PERFORMANCE OF THE VARIABLE ACCOUNTS, EXPENSE LOADS, AND COST OF INSURANCE RATES. ADDITIONALLY, LOANS, WITHDRAWALS, AND DEATH BENEFIT OPTION CHANGES WILL AFFECT THE LENGTH OF TIME THE POLICY STAYS IN FORCE. P04SE2: BASIC COVERAGE FACE AMOUNT: $100,000.00 AGE AT ISSUE: 35 RISK CLASS: MALE SELECT NONSMOKER COVERED PERSON: XXXXXX XXXXXXXX GUARANTEED MAXIMUM MONTHLY COST OF INSURANCE RATES PER $1000 OF COVERAGE APPLICABLE TO BASIC POLICY COVERING XXXXXX XXXXXXXX. THE RATES BELOW INCLUDE A 5-YEAR GUARANTEE OF OUR CURRENT RATES AS OF THE ISSUE DATE. 35 0.04974 60 1.34998 85 13.73773 36 0.05870 61 1.47355 86 15.02185 37 0.06100 62 1.61341 87 16.35661 38 0.06629 63 1.77217 88 17.73798 39 0.07092 64 1.94909 89 19.17199 40 0.25202 65 2.14342 90 20.67766 41 0.27458 66 2.35100 91 22.28714 42 0.29715 67 2.57276 92 24.06347 43 0.32307 68 2.80882 93 26.11993 44 0.34984 69 3.06532 94 28.81300 45 0.37996 70 3.35367 95 32.81758 46 0.41093 71 3.68199 96 39.64295 47 0.44442 72 4.06029 97 53.06605 48 0.47960 73 4.49620 98 83.33300 49 0.51898 74 4.98352 99 83.33300 50 0.56089 75 5.51331 100 + 0 51 0.61038 76 6.07653 52 0.66577 77 6.66569 53 0.72875 78 7.27588 54 0.80018 79 7.92387 55 0.87672 80 8.63521 56 0.96005 81 9.43078 57 1.04684 82 10.33895 58 1.13962 83 11.37350 59 1.23925 84 12.51385

YOUR POLICY CAREFULLY. This is a legal contract between you, the Owner, and us, Pacific Life Insurance Company, a stock insurance company. We agree to pay the benefits of this policy according to its provisions. The consideration for this policy is the application for it, a copy of which is attached, and payment of the premiums. FREE LOOK RIGHT – You may return this policy within 10 days after you receive it. To do so, deliver or mail it to us or to our agent. This policy will then be deemed void from the beginning and we will refund: · any Premium Load deducted from premiums received; plus · any Net Premium allocated to the Fixed Options; plus · the Variable Accumulated Value as of the end of the Valuation Period when we receive the policy; plus · any policy charges and fees deducted from the Variable Accounts. · Death Benefit Payable On The Death Of The Insured While The Policy Is In Force · Net Cash Surrender Value Payable Upon Surrender While The Policy Is In Force · Adjustable Face Amount · Benefits May Vary Based On Investment Experience · Non-Participating POLICY NUMBER: VP99999990 OWNER(S): XXXXXX XXXXXXXX POLICY DATE: MAY 1, 2004 INSURED: XXXXXX XXXXXXXX RISK CLASS: MALE SELECT NONSMOKER AGE ON POLICY DATE: 35 INITIAL FACE AMOUNT: $100,000 NOTE: EVEN IF PLANNED PREMIUMS ARE PAID, IT IS POSSIBLE THAT THE POLICY MAY NOT CONTINUE IN FORCE (THAT IS, IT MAY LAPSE BEFORE THE DEATH OF THE INSURED) DUE TO CHANGES IN INTEREST CREDITED ON THE FIXED OPTIONS, INVESTMENT PERFORMANCE OF THE VARIABLE ACCOUNTS, EXPENSE LOADS, AND COST OF INSURANCE RATES. ADDITIONALLY, LOANS, WITHDRAWALS, AND DEATH BENEFIT OPTION CHANGES WILL AFFECT THE LENGTH OF TIME THE POLICY STAYS IN FORCE. P04SE2 P04MVP BASIC POLICY: FLEXIBLE PREMIUM VARIABLE LIFE INSURANCE PREMIUMS: PLANNED [ANNUAL] PREMIUM = $ 1,524.60 1,582.70 GUIDELINE SINGLE PREMIUM = 17,278.20 18,104.80 GUIDELINE LEVEL PREMIUM = 1,524.60 1,582.70 7-PAY PREMIUM = 3,915.00 4,022.00 DEATH BENEFIT QUALIFICATION TEST: GUIDELINE PREMIUM TEST (THIS ELECTION IS IRREVOCABLE FOR THE LIFE OF THE CONTRACT) DEATH BENEFIT OPTION: A MINIMUM GUARANTEED INTEREST RATE FOR FIXED OPTIONS: [2.50]% ANNUALLY. ANY EXCESS INTEREST DECLARED BY US WILL BE GUARANTEED FOR ONE YEAR. DIVISOR FOR CALCULATING THE NET AMOUNT AT RISK: [1.002060] PREMIUM LOAD: FOR EACH PREMIUM PAID THERE IS A PREMIUM LOAD THAT CONSISTS OF A SALES LOAD OF 2.503.50% PLUS A CHARGE OF 2.35% FOR CERTAIN STATE AND LOCAL PREMIUM TAXES PLUS A CHARGE OF 1.50% FOR CERTAIN FEDERAL TAXES. REFER TO CONTRACT FOR DETAILS. ADMINISTRATIVE CHARGE: $7.50 PER MONTH TO AGE 100; $0 THEREAFTER SURRENDER CHARGE FACTOR: $1,436.00 MAXIMUM THEREAFTER. INITIAL SURRENDER CHARGE: $630.00 111.00 MORTALITY AND EXPENSE RISK FACE AMOUNT CHARGE: $18.90 19.10 PER MONTH FOR POLICY YEARS 1 TO 10; $0 THEREAFTER. POLICY NUMBER: VP99999990 OWNER(S): XXXXXX XXXXXXXX POLICY DATE: MAY 1, 2004 INSURED: XXXXXX XXXXXXXX RISK CLASS: MALE SELECT NONSMOKER AGE ON POLICY DATE: 35 INITIAL FACE AMOUNT: $100,000 NOTE: EVEN IF PLANNED PREMIUMS ARE PAID, IT IS POSSIBLE THAT THE POLICY MAY NOT CONTINUE IN FORCE (THAT IS, IT MAY LAPSE BEFORE THE DEATH OF THE INSURED) DUE TO CHANGES IN INTEREST CREDITED ON THE FIXED OPTIONS, INVESTMENT PERFORMANCE OF THE VARIABLE ACCOUNTS, EXPENSE LOADS, AND COST OF INSURANCE RATES. ADDITIONALLY, LOANS, WITHDRAWALS, AND DEATH BENEFIT OPTION CHANGES WILL AFFECT THE LENGTH OF TIME THE POLICY STAYS IN FORCE. P04SE2P04MVP: BASIC COVERAGE FACE AMOUNT: $100,000.00 AGE AT ISSUE: 35 RISK CLASS: MALE SELECT NONSMOKER COVERED PERSON: XXXXXX XXXXXXXX R04PNL: NO LAPSE GUARANTEE RIDER GUARANTEE PERIOD = [LIFETIME or XX YEARS or TO AGE YY] NO LAPSE PREMIUM = $[X,XXX.XX] MONTHLY INTEREST RATE FOR ACCUMULATION OF THE NO LAPSE CREDIT IF THE NO LAPSE CREDIT IS POSITIVE: 0.XXXXXX% GUARANTEED MAXIMUM MONTHLY COST OF INSURANCE RATES PER $1000 OF COVERAGE APPLICABLE TO BASIC POLICY COVERING XXXXXX XXXXXXXX. THE RATES BELOW INCLUDE A 5-YEAR GUARANTEE OF OUR CURRENT RATES AS OF THE ISSUE DATE. 35 0.04974 60 1.34998 85 13.73773 36 0.05870 61 1.47355 86 15.02185 37 0.06100 62 1.61341 87 16.35661 38 0.06629 63 1.77217 88 17.73798 39 0.07092 64 1.94909 89 19.17199 40 0.25202 65 2.14342 90 20.67766 41 0.27458 66 2.35100 91 22.28714 42 0.29715 67 2.57276 92 24.06347 43 0.32307 68 2.80882 93 26.11993 44 0.34984 69 3.06532 94 28.81300 45 0.37996 70 3.35367 95 32.81758 46 0.41093 71 3.68199 96 39.64295 47 0.44442 72 4.06029 97 53.06605 48 0.47960 73 4.49620 98 83.33300 49 0.51898 74 4.98352 99 83.33300 50 0.56089 75 5.51331 100 + 0 51 0.61038 76 6.07653 52 0.66577 77 6.66569 53 0.72875 78 7.27588 54 0.80018 79 7.92387 55 0.87672 80 8.63521 56 0.96005 81 9.43078 57 1.04684 82 10.33895 58 1.13962 83 11.37350 59 1.23925 84 12.51385.

YOUR POLICY CAREFULLY. This is a legal contract between you, the Owner, and us, Pacific Life Insurance Company, a stock insurance company. We agree to pay the benefits of this policy according to its provisions. The consideration for this policy is the application for it, a copy of which is attached, and payment of the premiums. FREE LOOK RIGHT – You may return this policy within 10 days after you receive it. To do so, deliver or mail it to us or to our agent. This policy will then be deemed void from the beginning and we will refund: · any Premium Load deducted from refund the premiums received; plus · any Net Premium allocated to the Fixed Options; plus · the Variable Accumulated Value as of the end of the Valuation Period when we receive the policy; plus · any policy charges and fees deducted from the Variable Accountspaid. · • Death Benefit Payable On The Death Of The Insured While The Policy Is In Force · • Net Cash Surrender Value Payable Upon Surrender While The Policy Is In Force · • Adjustable Face Amount · • Benefits May Vary Based On Investment Experience · • Non-Participating POLICY NUMBER: VP99999990 OWNER(S): XXXXXX LXXXXX XXXXXXXX POLICY DATE: MAY 1, 2004 INSURED: XXXXXX LXXXXX XXXXXXXX RISK CLASS: MALE SELECT NONSMOKER AGE ON POLICY DATE: 35 INITIAL FACE AMOUNT: $100,000 50,000 NOTE: EVEN IF PLANNED PREMIUMS ARE PAID, IT IS POSSIBLE THAT THE POLICY MAY NOT CONTINUE IN FORCE (THAT IS, IT MAY LAPSE BEFORE THE DEATH OF THE INSURED) DUE TO CHANGES IN INTEREST CREDITED ON THE FIXED OPTIONS, INVESTMENT PERFORMANCE OF THE VARIABLE ACCOUNTS, EXPENSE LOADSCHARGES, AND COST OF INSURANCE RATES. ADDITIONALLY, LOANS, WITHDRAWALS, AND DEATH BENEFIT OPTION CHANGES WILL MAY AFFECT THE LENGTH OF TIME POLICY VALUES AND HOW LONG THE POLICY STAYS IN FORCE, AND MAY CAUSE THE POLICY TO LAPSE UNLESS ADDITIONAL PREMIUMS ARE PAID. P04SE2 P04SA P BASIC POLICY: FLEXIBLE PREMIUM VARIABLE LIFE INSURANCE PREMIUMS: PLANNED [ANNUAL] PREMIUM = $ 1,524.60 846.70 GUIDELINE SINGLE PREMIUM = 17,278.20 9,995.38 GUIDELINE LEVEL PREMIUM = 1,524.60 846.70 7-PAY PREMIUM = 3,915.00 1,958.12 DEATH BENEFIT QUALIFICATION TEST: GUIDELINE PREMIUM TEST (THIS ELECTION IS IRREVOCABLE FOR THE LIFE OF THE CONTRACT) [or CASH VALUE ACCUMULATION TEST] DEATH BENEFIT OPTION: A MINIMUM GUARANTEED INTEREST RATE FOR FIXED OPTIONS: [2.50]% ANNUALLY. ANY EXCESS INTEREST DECLARED BY US WILL BE GUARANTEED FOR ONE YEAR. DIVISOR FOR CALCULATING THE NET AMOUNT AT RISK: [1.002060] PREMIUM LOAD: FOR EACH PREMIUM PAID THERE IS A PREMIUM LOAD THAT CONSISTS OF A SALES LOAD OF 2.50RATE: 6.35% PLUS A CHARGE OF 2.35% FOR CERTAIN STATE AND LOCAL PREMIUM TAXES PLUS A CHARGE OF 1.50% FOR CERTAIN FEDERAL TAXES. REFER TO CONTRACT FOR DETAILS. ADMINISTRATIVE CHARGE: $7.50 PER MONTH TO AGE 100; $0 THEREAFTER SURRENDER CHARGE FACTOR: $1,436.00 MAXIMUM THEREAFTER. INITIAL SURRENDER CHARGE: $630.00 MORTALITY AND EXPENSE RISK 243.40 FACE AMOUNT CHARGE: $18.90 15.00 PER MONTH FOR POLICY YEARS 1 TO THRU 10; $12.00 TO AGE 100, $0 THEREAFTER. MINIMUM GUARANTEED INTEREST RATE FOR FIXED OPTIONS: 2.50% ANNUALLY (DAILY EQUIVALENT = 0.006765%). DIVISOR FOR CALCULATING THE NET AMOUNT AT RISK: 1.002060 POLICY LOAN INTEREST RATE: 2.75% ANNUALLY POLICY NUMBER: VP99999990 OWNER(S): XXXXXX LXXXXX XXXXXXXX POLICY DATE: MAY 1, 2004 INSURED: XXXXXX LXXXXX XXXXXXXX RISK CLASS: MALE SELECT NONSMOKER AGE ON POLICY DATE: 35 INITIAL FACE AMOUNT: $100,000 50,000 NOTE: EVEN IF PLANNED PREMIUMS ARE PAID, IT IS POSSIBLE THAT THE POLICY MAY NOT CONTINUE IN FORCE (THAT IS, IT MAY LAPSE BEFORE THE DEATH OF THE INSURED) DUE TO CHANGES IN INTEREST CREDITED ON THE FIXED OPTIONS, INVESTMENT PERFORMANCE OF THE VARIABLE ACCOUNTS, EXPENSE LOADSCHARGES, AND COST OF INSURANCE RATES. ADDITIONALLY, LOANS, WITHDRAWALS, AND DEATH BENEFIT OPTION CHANGES WILL MAY AFFECT THE LENGTH OF TIME POLICY VALUES AND HOW LONG THE POLICY STAYS IN FORCE, AND MAY CAUSE THE POLICY TO LAPSE UNLESS ADDITIONAL PREMIUMS ARE PAID. P04SE2P04SA: BASIC COVERAGE FACE AMOUNT: $100,000.00 50,000.00 AGE AT ISSUE: 35 RISK CLASS: MALE SELECT NONSMOKER COVERED PERSON: XXXXXX LXXXXX XXXXXXXX GUARANTEED MAXIMUM MONTHLY COST OF INSURANCE RATES PER $1000 OF COVERAGE APPLICABLE TO BASIC POLICY COVERING XXXXXX LXXXXX XXXXXXXX. THE RATES BELOW INCLUDE A 5-YEAR GUARANTEE OF OUR CURRENT RATES AS OF THE ISSUE DATE. 35 0.04974 60 1.34998 85 13.73773 36 0.05870 0.05370 61 1.47355 86 15.02185 37 0.06100 62 1.61341 87 16.35661 38 0.06629 63 1.77217 88 17.73798 39 0.07092 64 1.94909 89 19.17199 40 0.25202 65 2.14342 90 20.67766 41 0.27458 66 2.35100 91 22.28714 42 0.29715 67 2.57276 92 24.06347 43 0.32307 68 2.80882 93 26.11993 44 0.34984 69 3.06532 94 28.81300 45 0.37996 70 3.35367 95 32.81758 46 0.41093 71 3.68199 96 39.64295 47 0.44442 72 4.06029 97 53.06605 48 0.47960 73 4.49620 98 83.33300 83.33333 49 0.51898 74 4.98352 99 83.33300 83.33333 50 0.56089 75 5.51331 100 + 0 51 0.61038 76 6.07653 52 0.66577 77 6.66569 53 0.72875 78 7.27588 54 0.80018 79 7.92387 55 0.87672 80 8.63521 56 0.96005 81 9.43078 57 1.04684 82 10.33895 58 1.13962 83 11.37350 59 1.23925 84 12.51385

YOUR POLICY CAREFULLY. This is a legal contract between you, the Owner, and us, Pacific Life Insurance & Annuity Company, a stock insurance company. We agree to pay the benefits of this policy according to its provisions. The consideration for this policy is the application for it, a copy of which is attached, and payment of the premiums. FREE LOOK RIGHT – You may return this policy within 10 days after you receive it. To do so, deliver or mail it to us or to our agent. This policy will then be deemed void from the beginning and we will refund: · any Premium Load deducted from premiums received; plus · any Net Premium allocated to the Fixed Options; plus · the Variable Accumulated Value as of the end of the Valuation Period when we receive the policy; plus · any policy charges and fees deducted from the Variable Accounts. · Death Benefit Payable On The Death Of The Insured While The Policy Is In Force · Net Cash Surrender Value Payable Upon Surrender While The Policy Is In Force · Adjustable Face Amount · Benefits May Vary Based On Investment Experience · Non-Participating POLICY NUMBER: VP99999990 OWNER(S): XXXXXX OWNER: LXXXXX XXXXXXXX POLICY DATE: MAY JAN 1, 2004 INSURED: XXXXXX 2007 MXXX XXXXXXXX RISK CLASS: MALE SELECT NONSMOKER AGE ON POLICY DATE: 35 INSURED: LXXXXX XXXXXXXX INITIAL FACE AMOUNT: $100,000 200,000 RISK CLASS: MALE NONSMOKER NOTE: EVEN IF PLANNED PREMIUMS ARE PAID, IT IS POSSIBLE THAT COVERAGE WILL LAPSE IF THE POLICY ACCUMULATED VALUE IS INSUFFICIENT TO PAY THE CHARGES ASSESSED ON A MONTHLY PAYMENT DATE. BECAUSE THE ACCUMULATED VALUE MAY NOT CONTINUE IN FORCE (THAT IS, IT MAY LAPSE BEFORE THE DEATH OF THE INSURED) DUE TO CHANGES IN INTEREST CREDITED BE BASED ON THE FIXED OPTIONS, INVESTMENT PERFORMANCE RESULTS OF THE VARIABLE ACCOUNTS, EXPENSE LOADS, THE PAYMENT OF INITIAL AND COST OF INSURANCE RATES. ADDITIONALLY, LOANS, WITHDRAWALS, AND DEATH BENEFIT OPTION CHANGES WILL AFFECT THE LENGTH OF TIME PLANNED PREMIUMS MAY NOT BE ADEQUATE TO GUARANTEE THAT THE POLICY STAYS WILL REMAIN IN FORCE. P04SE2 IF THE POLICY DOES NOT REMAIN IN FORCE, THERE WILL BE NO DEATH BENEFIT OR ACCUMULATED VALUE. P07SE4-NY (P) 061121b BASIC POLICY: FLEXIBLE PREMIUM VARIABLE UNIVERSAL LIFE INSURANCE PREMIUMS: PLANNED PERIODIC PREMIUM PAYMENT = [ANNUAL$2,000,00] PREMIUM = $ 1,524.60 GUIDELINE SINGLE PREMIUM = 17,278.20 [$32,036.80] GUIDELINE LEVEL PREMIUM = 1,524.60 [$2,890.35] 7-PAY PREMIUM = 3,915.00 [$7,949.42] DEATH BENEFIT QUALIFICATION TEST: [GUIDELINE PREMIUM PREMIUM] TEST (THIS ELECTION IS IRREVOCABLE FOR THE LIFE OF THE CONTRACT) DEATH BENEFIT OPTION: A MINIMUM GUARANTEED INTEREST RATE FOR FIXED OPTIONSMONTHLY DEDUCTION END DATE: POLICY ANNIVERSARY NEAREST THE INSURED’S [100]TH BIRTHDAY MORTALITY TABLE: [2.50]% ANNUALLY1980 CSO, UNISMOKE, ULTIMATE, AGE NEAREST BIRTHDAY, SEX-DISTINCT] [Editor’s Note: If unisex, instead of “SEX-DISTINCT”, use “UNISEX TABLE B (80% MALE AND 20% FEMALE)] INTEREST ON THE FIXED OPTIONS AND ON THE LOAN ACCOUNT IS GUARANTEED TO BE NOT LESS THAN 3.0% ANNUALLY FOR THE FIRST 10 POLICY YEARS AND 3.30% THEREAFTER. ANY EXCESS INTEREST RATE DECLARED BY US AT THE BEGINNING OF EACH POLICY YEAR WILL BE GUARANTEED FOR ONE UNTIL THE END OF THAT YEAR. DIVISOR FOR CALCULATING BEFORE SUCH DECLARATION, EXCESS AMOUNTS ARE NOT GUARANTEED. THERE IS NO EXCESS INTEREST PAID ON THE LOAN ACCOUNT. SUBJECT TO POLICY GUARANTEES, WE HAVE THE RIGHT TO CHANGE THE INTEREST CREDITED TO THE FIXED OPTIONS AND THE COST OF INSURANCE AND OTHER CHARGES DEDUCTED, WHICH MAY REQUIRE MORE PREMIUM TO BE PAID THAN WAS ILLUSTRATED OR THE ACCUMULATED VALUE TO BE LESS THAN WAS ILLUSTRATED. WITHDRAWAL FEE: $25.00 NET AMOUNT AT RISKRISK DIVISOR: [1.002060] PREMIUM LOAD1.002466% SURRENDER CHARGE: FOR EACH PREMIUM PAID THERE IS A SEE POLICY CHARGE SPECIFICATIONS PAGE PREMIUM LOAD RATE AND ADMINISTRATIVE CHARGE: SEE POLICY CHARGE SPECIFICATIONS PAGE COVERAGE CHARGE FOR BASIC COVERAGE: SEE POLICY CHARGE SPECIFICATIONS PAGE COVERAGE CHARGE FOR ABR COVERAGE: SEE POLICY CHARGE SPECIFICATIONS PAGE COVERAGE CHARGE FOR ADDITIONAL COVERAGE: SEE POLICY CHARGE SPECIFICATIONS PAGE POLICY NUMBER: VP99999990 OWNER: LXXXXX XXXXXXXX POLICY DATE: JAN 1, 2007 MXXX XXXXXXXX AGE ON POLICY DATE: 35 INSURED: LXXXXX XXXXXXXX INITIAL FACE AMOUNT: $200,000 RISK CLASS: MALE NONSMOKER NOTE: IT IS POSSIBLE THAT CONSISTS COVERAGE WILL LAPSE IF THE ACCUMULATED VALUE IS INSUFFICIENT TO PAY THE CHARGES ASSESSED ON A MONTHLY PAYMENT DATE. BECAUSE THE ACCUMULATED VALUE MAY BE BASED ON THE INVESTMENT RESULTS OF A SALES THE VARIABLE ACCOUNTS, THE PAYMENT OF INITIAL AND PLANNED PREMIUMS MAY NOT BE ADEQUATE TO GUARANTEE THAT THE POLICY WILL REMAIN IN FORCE. IF THE POLICY DOES NOT REMAIN IN FORCE, THERE WILL BE NO DEATH BENEFIT OR ACCUMULATED VALUE. P07SE4-NY: BASIC COVERAGE FACE AMOUNT $100,000 AGE ON POLICY DATE: 35 RISK CLASS: MALE NONSMOKER COVERED PERSON: LXXXXX XXXXXXXX ADDITIONAL COVERAGE FACE AMOUNT: $50,000 AGE ON POLICY DATE: 35 RISK CLASS: MALE NONSMOKER COVERED PERSON: LXXXXX XXXXXXXX ABR COVERAGE FACE AMOUNT: $50,000 AGE ON POLICY DATE: 35 RISK CLASS: MALE NONSMOKER COVERED PERSON: LXXXXX XXXXXXXX MAXIMUM PREMIUM LOAD OF 2.50RATE: 6.35% PLUS A CHARGE OF 2.35% FOR CERTAIN STATE AND LOCAL PREMIUM TAXES PLUS A CHARGE OF 1.50% FOR CERTAIN FEDERAL TAXES. REFER TO CONTRACT FOR DETAILS. ADMINISTRATIVE CHARGE: $7.50 PER MONTH TO AGE 100; $0 THEREAFTER SURRENDER ASSET CHARGE FACTORRATE: $1,436.00 MAXIMUM SURRENDER CHARGE: $630.00 MORTALITY AND EXPENSE RISK FACE AMOUNT CHARGE: $18.90 PER MONTH FOR POLICY YEARS 1 TO 10; $0 THEREAFTER. POLICY NUMBER: VP99999990 OWNER(S): XXXXXX XXXXXXXX POLICY DATE: MAY 1, 2004 INSURED: XXXXXX XXXXXXXX RISK CLASS: MALE SELECT NONSMOKER AGE ON POLICY DATE: 35 INITIAL FACE AMOUNT: $100,000 NOTE: EVEN IF PLANNED PREMIUMS ARE PAID, IT IS POSSIBLE THAT THE POLICY MAY NOT CONTINUE IN FORCE (THAT IS, IT MAY LAPSE BEFORE THE DEATH OF THE INSURED) DUE TO CHANGES IN INTEREST CREDITED ON THE FIXED OPTIONS, INVESTMENT PERFORMANCE OF THE VARIABLE ACCOUNTS, EXPENSE LOADS, AND COST OF INSURANCE RATES. ADDITIONALLY, LOANS, WITHDRAWALS, AND DEATH BENEFIT OPTION CHANGES WILL AFFECT THE LENGTH OF TIME THE POLICY STAYS IN FORCE. P04SE2: COVERAGE CHARGE — BASIC COVERAGE FACE AMOUNT: $100,000.00 AGE AT ISSUE: 35 RISK CLASS: MALE SELECT NONSMOKER COVERED PERSON: XXXXXX XXXXXXXX GUARANTEED MAXIMUM MONTHLY COST OF INSURANCE RATES PER $1000 1.00 OF COVERAGE APPLICABLE TO BASIC POLICY COVERAGE COVERING XXXXXX LXXXXX XXXXXXXX. THE RATES BELOW INCLUDE A 5-YEAR [5]-YEAR GUARANTEE OF OUR CURRENT RATES AS OF THE ISSUE DATE. 35 0.04974 60 1.34998 85 13.73773 36 0.05870 61 1.47355 86 15.02185 37 0.06100 62 1.61341 87 16.35661 38 0.06629 63 1.77217 88 17.73798 39 0.07092 64 1.94909 89 19.17199 40 0.25202 65 2.14342 90 20.67766 41 0.27458 66 2.35100 91 22.28714 42 0.29715 67 2.57276 92 24.06347 43 0.32307 68 2.80882 93 26.11993 44 0.34984 69 3.06532 94 28.81300 45 0.37996 70 3.35367 95 32.81758 46 0.41093 71 3.68199 96 39.64295 47 0.44442 72 4.06029 97 53.06605 48 0.47960 73 4.49620 98 83.33300 49 0.51898 74 4.98352 99 83.33300 50 0.56089 75 5.51331 100 + 0 51 0.61038 76 6.07653 52 0.66577 77 6.66569 53 0.72875 78 7.27588 54 0.80018 79 7.92387 55 0.87672 80 8.63521 56 0.96005 81 9.43078 57 1.04684 82 10.33895 58 1.13962 83 11.37350 59 1.23925 84 12.51385GUARANTEED MAXIMUM MONTHLY COST OF INSURANCE RATES PER $1.00 OF COVERAGE APPLICABLE TO ABR COVERAGE COVERING LXXXXX XXXXXXXX. THE RATES BELOW INCLUDE A [5]-YEAR GUARANTEE OF OUR CURRENT RATES AS OF THE ISSUE DATE. THE RATES BELOW ARE GUARANTEED MAXIMUM MONTHLY COST OF INSURANCE RATES PER $1.00 OF NET AMOUNT AT RISK APPLICABLE TO THE ADDITIONAL COVERAGE COVERING LXXXXX XXXXXXXX. TABLE OF COVERAGE CHARGES — ABR COVERAGE THE CHARGES BELOW ARE GUARANTEED MAXIMUM MONTHLY COVERAGE CHARGES APPLICABLE TO THE ABR COVERAGE COVERING LXXXXX XXXXXXXX TABLE OF COVERAGE CHARGE — ADDITIONAL COVERAGE THE CHARGES BELOW ARE GUARANTEED MAXIMUM MONTHLY MORTALITY AND EXPENSE RISK COVERAGE CHARGES APPLICABLE TO THE ADDITIONAL COVERAGE COVERING LXXXXX XXXXXXXX.