0001017062-03-001487 Sample Contracts

When submitting money (or initial premium) with an application: . it is preferred that the check for the TIA, application, and TIA form all have the same date . if the producer is unable to obtain a check at the time the application is completed, the...

Producer Instructions • July 1st, 2003 • Pacific Select Exec Separate Account of Pacific Life & Annui

• Contract Type
  Producer Instructions
• Filed
  July 1st, 2003
• Company
  Pacific Select Exec Separate Account of Pacific Life & Annui

PACIFIC LIFE & ANNUITY COMPANY LOGO]

Insurance Policy • July 1st, 2003 • Pacific Select Exec Separate Account of Pacific Life & Annui

• Contract Type
  Insurance Policy
• Filed
  July 1st, 2003
• Company
  Pacific Select Exec Separate Account of Pacific Life & Annui

READ YOUR POLICY CAREFULLY. This is a legal contract between you, the Owner, and us, Pacific Life & Annuity Company, a stock insurance company. We agree to pay the benefits of this policy according to its provisions. The consideration for this policy is the application for it, a copy of which is attached, and payment of the premiums.