SPECIMEN SPECIMEN ------------------------------------------------------------- ------------------- PRESIDENT SECRETARYVariable Life Insurance Policy • December 19th, 2003 • Hancock John Variable Life Account S
Contract Type FiledDecember 19th, 2003 Company
AND MARGARET ROE VARIABLE LIFE INSURANCE POLICY NUMBER XX XXX XXX POLICYVariable Life Insurance Policy • August 9th, 2002 • Separate Account Fp of Equitable Life Assur Soc of the Us
Contract Type FiledAugust 9th, 2002 Company
DRAFT 2Variable Life Insurance Policy • December 31st, 2001 • Separate Account Fp of Equitable Life Assur Soc of the Us
Contract Type FiledDecember 31st, 2001 Company
EXHIBIT 1.(5)(h) [LOGO OF PACIFIC LIFE & APPEARS HERE] Pacific Life Insurance Company 700 Newport Center Drive Newport Beach, CA 92660 LAST SURVIVOR READ YOUR POLICY CAREFULLY. This is a legal contract FLEXIBLE between you, the Owner, and us, Pacific...Variable Life Insurance Policy • July 21st, 2000 • Pacific Select Exec Separate Acct Pacific Life Ins
Contract Type FiledJuly 21st, 2000 Company
Pacific Life Insurance Company . 700 Newport Centre Drive . Newport Beach, CA 92660Variable Life Insurance Policy • July 21st, 2000 • Pacific Select Exec Separate Acct Pacific Life Ins
Contract Type FiledJuly 21st, 2000 Company
DRAFT [PL&A LOGO APPEARS HERE] 700 Newport Center Drive . Newport Beach, CA 92660 FLEXIBLE READ YOUR POLICY CAREFULLY. This is a legal contract between you, the Owner, PREMIUM and us, Pacific Life & Annuity Company, a stock insurance company. We agree...Variable Life Insurance Policy • September 22nd, 1999 • Pacific Select Exec Separate Account of Pacific Life & Annui
Contract Type FiledSeptember 22nd, 1999 Company
DRAFT) [PL&A LOGO APPEARS HERE] 700 Newport Center Drive Newport Beach, CA 92660 FLEXIBLE READ YOUR POLICY CAREFULLY. This is a legal contract between you, the Owner, PREMIUM and us, Pacific Life & Annuity Company, a stock insurance company. We agree...Variable Life Insurance Policy • June 16th, 1999 • Pacific Select Exec Separate Acct of Pm Gp Life Insurance Co
Contract Type FiledJune 16th, 1999 Company
1 Policy Schedule 1,3 Age of Insured 2 Table of Values 10 Assignments 3 Contract 10 Beneficiary 4 Premium 11 Benefits, Payment of 5 The Variable Account 2,6 Cash Value 6 Cash Value of the Policy 3 Claims of Creditors 7 Death Benefit 3 Contestable 8...Variable Life Insurance Policy • May 1st, 1998 • New England Variable Life Separate Account
Contract Type FiledMay 1st, 1998 Company
New England Variable Life Insurance Company Variable Life Policy Name of Insured JOHN ALDEN Policy Number Specimen Plan 30 Payment Variable Life Face Amount $25,000 New England Variable Life Insurance Company Agrees to pay the Death Benefit of this...Variable Life Insurance Policy • April 30th, 1998 • New England Variable Life Separate Account
Contract Type FiledApril 30th, 1998 Company
1 Policy Schedule 1, 4 Age of Insured 2 Tabular Values 14 Assignments 3 Surrender charges 5 Automatic Premium Payment 4 Contract 14 Beneficiary 5 Premiums 15 Benefits, Payment of 6 Unscheduled Payments 4 Claims of Creditors 7 The Variable Account 4...Variable Life Insurance Policy • April 30th, 1998 • New England Variable Life Separate Account
Contract Type FiledApril 30th, 1998 Company
New England Variable Life Insurance Company Variable Life Policy Insured: Policy Number: Face Amount: Plan: New England Variable Life Insurance Company Agrees to pay the Death Benefit of this Policy to the Beneficiary on receipt of proof of the death...Variable Life Insurance Policy • April 24th, 1998 • New England Variable Life Separate Account
Contract Type FiledApril 24th, 1998 Company
THE INSURED RICHARD ROE VARIABLE POLICY OWNER RICHARD ROE LIFE INSURANCE FACE AMOUNT $100,000 POLICY POLICY NUMBER SPECIMEN EQUITABLE VARIABLE LIFE INSURANCE COMPANY [EVLICO LOGO] EQUITABLE VARIABLE LIFE INSURANCE COMPANY A Stock Life Insurance...Variable Life Insurance Policy • December 11th, 1996 • Separate Account I of Equitable Variable Life Insurance Co
Contract Type FiledDecember 11th, 1996 Company
INITIAL EQUITABLE FACE AMOUNT $100,000 VARIABLE LIFE INSURANCE COMPANY [EVLICO LOGO] POLICY NUMBER SPECIMEN EQUITABLE VARIABLE LIFE INSURANCE COMPANY A Stock Life Insurance Company Agrees o To pay the insurance benefits of this policy to the...Variable Life Insurance Policy • December 11th, 1996 • Separate Account I of Equitable Variable Life Insurance Co
Contract Type FiledDecember 11th, 1996 Company
POLICY OWNER RICHARD ROE EQUITABLE VARIABLE LIFE INSURANCE COMPANY INITIAL FACE AMOUNT $100,000 [EVLICO LOGO]Variable Life Insurance Policy • December 11th, 1996 • Separate Account I of Equitable Variable Life Insurance Co
Contract Type FiledDecember 11th, 1996 Company
INSURED PERSON [EQUITABLE VARIABLE LIFE INSURANCE COMPANY LOGO] POLICY OWNER VARIABLE INITIAL LIFE INSURANCE BENEFIT INSURANCE POLICY WE AGREE to pay the Insurance Benefit of this policy to the beneficiary upon receiving proof of the insured person's...Variable Life Insurance Policy • December 11th, 1996 • Separate Account Fp of Equitable Variable Life Insurance Co
Contract Type FiledDecember 11th, 1996 Company
EQUITABLE FACE AMOUNT $100,000 VARIABLE LIFE INSURANCE COMPANY [EVLICO LOGO] POLICY NUMBER SPECIMEN EQUITABLE VARIABLE LIFE INSURANCE COMPANY A Stock Life Insurance Company Agrees o To pay the insurance benefits of this policy to the Beneficiary upon...Variable Life Insurance Policy • December 11th, 1996 • Separate Account I of Equitable Variable Life Insurance Co
Contract Type FiledDecember 11th, 1996 Company
POLICY OWNER RICHARD ROE EQUITABLE VARIABLE LIFE INSURANCE COMPANYVariable Life Insurance Policy • December 11th, 1996 • Separate Account I of Equitable Variable Life Insurance Co
Contract Type FiledDecember 11th, 1996 Company
POLICY OWNER RICHARD ROE EQUITABLE VARIABLE LIFE INSURANCE COMPANYVariable Life Insurance Policy • October 4th, 1996 • Separate Account I of Equitable Variable Life Insurance Co
Contract Type FiledOctober 4th, 1996 Company
THE INSURED RICHARD ROE VARIABLE LIFE INSURANCE POLICY OWNER RICHARD ROE POLICY EQUITABLE FACE AMOUNT $100,000 VARIABLE LIFE INSURANCE COMPANY [EVLICO LOGO] POLICY NUMBER SPECIMENVariable Life Insurance Policy • October 4th, 1996 • Separate Account I of Equitable Variable Life Insurance Co
Contract Type FiledOctober 4th, 1996 Company
SPECIMEN SPECIMENVariable Life Insurance Policy • October 4th, 1996 • Separate Account I of Equitable Variable Life Insurance Co
Contract Type FiledOctober 4th, 1996 Company
SPECIMEN SPECIMENVariable Life Insurance Policy • October 4th, 1996 • Separate Account I of Equitable Variable Life Insurance Co
Contract Type FiledOctober 4th, 1996 Company
FACE AMOUNT $100,000 EQUITABLE VARIABLE LIFE INSURANCE COMPANY [EVLICO LOGO] POLICY NUMBER SPECIMEN EQUITABLE VARIABLE LIFE INSURANCE COMPANY A Stock Life Insurance Company Agrees o To pay the insurance benefits of this policy to the Beneficiary upon...Variable Life Insurance Policy • October 4th, 1996 • Separate Account I of Equitable Variable Life Insurance Co
Contract Type FiledOctober 4th, 1996 Company
POLICY OWNER RICHARD ROE EQUITABLE VARIABLE LIFE INSURANCE COMPANY FACE AMOUNT $100,000 [EVLICO LOGO]Variable Life Insurance Policy • October 4th, 1996 • Separate Account I of Equitable Variable Life Insurance Co
Contract Type FiledOctober 4th, 1996 Company