INSURED: JOHN DOE POLICY NUMBER: 9,000,000 POLICY ISSUE DATE: 09/01/2002 FACE AMOUNT: $50,000.00 ISSUE AGE: 35 DEATH BENEFIT: OPTION A POLICY DATE: 09/01/2002 Provident Mutual Life Insurance Company agrees: To pay the Beneficiary of this Policy the...Life Insurance Policy • August 23rd, 2002 • Provident Mutual Variable Life Separate Account
