Insured Policy Number JOHN DOE XX XXX XXX Contract Date Face Amount NOV 15, 198 $25,000-- Premium Period Agency LIFE R-NK 1Pruco Life of New Jersey Variable Insurance Account • April 29th, 1997
WITNESSETH:Selected Broker Agreement • April 29th, 1997 • Pruco Life of New Jersey Variable Insurance Account • New Jersey
EXHIBIT 1.A.(13)(r) Pruco Life Insurance Company of New Jersey Insured Rider for Policy No. This contract is issued as a conversion from an earlier contract. The period we state under Incontestability in this contract will start on the date coverage...Pruco Life of New Jersey Variable Insurance Account • April 29th, 1997
Insured Rider for Policy No.Pruco Life of New Jersey Variable Insurance Account • April 29th, 1997
This contract is no longer in force on a premium paying basis. It is being kept in force as variable reduced paid-up insurance on the Insured's life, as we state under Contract Value Options in the contract.
WITNESSETH:Distribution Agreement • April 29th, 1997 • Pruco Life of New Jersey Variable Insurance Account • New Jersey
Insured Rider for Policy No.Pruco Life of New Jersey Variable Insurance Account • April 29th, 1997
ALTERATION OF TEXT The provision of this policy entitled "Ownership and Control" is replaced at issue by the following: OWNERSHIP AND CONTROL.--Unless we endorse this contract to say otherwise, while the Insured is living and less than 21 years of age...Pruco Life of New Jersey Variable Insurance Account • April 29th, 1997
ENDORSEMENTS (Only we can endorse this contract.)Pruco Life of New Jersey Variable Insurance Account • April 29th, 1997
DEFINITIONS.--We define here some of the words and phrases used all through this contract. We explain others, not defined here, in other parts of the text.
EXHIBIT 1.A.(13)(aa) Pruco Life Insurance Company Pruco Life Insurance Company of New Jersey Insured Rider for Policy No. AUTOMATIC PREMIUM LOAN If this provision is in effect at the end of the days of grace of a premium in default, the premium will...Pruco Life of New Jersey Variable Insurance Account • April 29th, 1997
EXHIBIT 1.A.(13)(y) [ ] Pruco Life Insurance Company [ ] Pruco Life Insurance Company of New Jersey Insured Rider for Policy No. TERMINATION OF BENEFIT We agree that the benefit _____________________________________________________...Pruco Life of New Jersey Variable Insurance Account • April 29th, 1997
EXHIBIT 1.A.(13)(x) Pruco Life Insurance Company of New Jersey Insured Rider for Policy No. TERMINATION OF BENEFIT We agree that the benefit______________________________________________________ _______________________________, will end as of...Pruco Life of New Jersey Variable Insurance Account • April 29th, 1997
3. [ ] Single [ ] Married [ ] Widowed [ ] Separated [ ] Divorced 4. Social Security No. / / -------------------------------------------------------------- --------------------------------------------------------------------- 5a. Occupation(s) 5b....Pruco Life of New Jersey Variable Insurance Account • April 29th, 1997
RIDER ATTACHED TO AND MADE A PART OF THIS CONTRACT ONPruco Life of New Jersey Variable Insurance Account • April 29th, 1997
