INSURED --
|
RICHARD W FRANZEN
|
spacer
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AGE 42 MALE
|
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POLICY NUMBER --
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## ### ###
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CLASS OF RISK - STANDARD
(NON-SMOKER DISCOUNT)
|
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POLICY DATE --
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MAY 10, 1996
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DATE OF ISSUE
DATE OF JUNE 19, 1996
|
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OWNER --
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INSURED
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PLAN
|
WHOLE LIFE WITH
OPTION TO PURCHASE PAID-UP ADDITIONS (OPP)
|
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AMOUNT
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FACE AMOUNT
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$100,000.00
|
|
BENEFICIARY
(subject to change)
|
FIRST -- ###### #######, ###### OF INSURED
|
SEE CONTINUATION OF PAGE 2
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{merged below}
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PREMIUM SCHEDULE
PREMIUMS PAYABLE
|
AT ANNUAL
|
INTERVALS AS FOLLOWS
(Premium includes the following amounts for
any supplementary benefits)
|
|
BEGINNING AS OF
MO. DAY YR.
5-10-1996
|
TOTAL
PREMIUM
$1,764.00
|
PAYABLE FOR REMAINDER OF INSURED'S LIFE.
|
THE EXPENSE CHARGE APPLIED TO ALL PAYMENTS MADE UNDER THE OPTION TO
PURCHASE PAID-UP ADDITIONS (OPP) RIDER WILL NOT EXCEED 3%.
THE ANNUAL PREMIUM AMOUNT, WHICH IS BASED ON A STANDARD CLASS OF RISK AND
REFERRED TO IN THE OPTION TO PURCHASE PAID UP ADDITIONS RIDER IS $2,242.00.
THE INTEREST RATE REFERRED TO IN THE BASIS OF COMPUTATION SECTION IS 4.5%
PER YEAR.
POLICY DATA
|
PAGE 2
9550-2
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NEW YORK LIFE INSURANCE COMPANY
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