Common Contracts
2 similar Application for Modified Single Payment Variable Life Insurance contracts by Llac Variable Account
1. Plan: / / Single Life 2. / / Single Life w/Last Survivor Benefit Agreement Initial Payment $______________Application for Modified Single Payment Variable Life Insurance • February 28th, 2005 • Llac Variable Account
Exhibit 99.5(a) LIBERTY LIFE ASSURANCE COMPANY OF BOSTON [contract#####] APPLICATION FOR MODIFIED SINGLE PAYMENT VARIABLE LIFE INSURANCE AND CONTRACT INFORMATION 1. Plan: / / Single Life / / Single Life W/Last Survivor Benefit 2. Initial Payment...Application for Modified Single Payment Variable Life Insurance • April 30th, 2004 • Llac Variable Account
