ULTRA SERIES FUND RULE 22C-2 SHAREHOLDER INFORMATION AGREEMENTCuna Mutual Life Variable Annuity Account • April 27th, 2007
OPTIONAL - COMPLETE ONLY ONE 3A. OWNER-INDIVIDUAL NONQUALIFIED ONLY If other than annuitant/owner. Relationship to Must be at least age 18 (19 in NE & AL, 21 in MS) and no older than age 85 Annuitant ________________________ on the contract issue date.Cuna Mutual Life Variable Annuity Account • April 27th, 2007
