This sample contract is not intended to replace the filed contract, which may differ from this sample policy.November 21st, 2023
FiledNovember 21st, 2023
DISABILITY INCOME INSURANCE POLICYDecember 22nd, 2021
FiledDecember 22nd, 2021This is a non-participating Disability Income Insurance Policy. Standard Insurance Company, a stock life insurance company, issued this policy to the Owner in consideration of the statements made in the application and payment of the premium. A copy of the application is attached to and made part of the policy.