AS FILED WITH THE SEC ON ____________________. REGISTRATION NO. 2-80513
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
----------
FORM S-6
POST-EFFECTIVE AMENDMENT NO. 24
FOR REGISTRATION UNDER THE SECURITIES ACT OF 1933
OF SECURITIES OF UNIT INVESTMENT TRUSTS REGISTERED
ON FORM N-8B-2
----------
PRUCO LIFE
VARIABLE INSURANCE ACCOUNT
(Exact Name of Trust)
PRUCO LIFE INSURANCE COMPANY
(Name of Depositor)
213 WASHINGTON STREET
NEWARK, NEW JERSEY 07102-2992
(800) 437-4016, EXT. 46
(Address and telephone number of principal executive offices)
----------
THOMAS C. CASTANO
ASSISTANT SECRETARY
PRUCO LIFE INSURANCE COMPANY
213 WASHINGTON STREET
NEWARK, NEW JERSEY 07102-2992
(Name and address of agent for service)
Copy to:
JEFFREY C. MARTIN
SHEA & GARDNER
1800 MASSACHUSETTS AVENUE, N.W.
WASHINGTON, D.C. 20036
----------
Variable Life Insurance Contracts--The Registrant has registered an indefinite
amount of securities pursuant to Rule 24f-2 under the Investment Company Act of
1940. The Rule 24f-2 notice for fiscal year 1996 was filed on February 28, 1997.
It is proposed that this filing will become effective (check appropriate space):
|_| immediately upon filing pursuant to paragraph (b) of Rule 485
|X| on May 1, 1997 pursuant to paragraph (b) of Rule 485
(date)
|_| 60 days after filing pursuant to paragraph (a) of Rule 485
|_| on _____________________ pursuant to paragraph (a) of Rule 485
(date)
<PAGE>
CROSS REFERENCE SHEET
(AS REQUIRED BY FORM N-8B-2)
N-8B-2 ITEM NUMBER LOCATION
- ------------------ --------
1. Cover Page
2. Cover Page
3. Not Applicable
4. Sale of the Contract and Sales Commissions
5. Pruco Life Variable Insurance Account
6. Pruco Life Variable Insurance Account
7. Not Applicable
8. Not Applicable
9. Litigation
10. Brief Description of the Contract; Short-Term
Cancellation Right, or "Free Look"; Premiums; Premium
Adjustment; Allocation of Premiums; Transfers; Charges
and Expenses; How a Contract's Death Benefit Will
Vary; How a Contract's Cash Value Will Vary;
Withdrawal of a Portion of a Contract's Net Cash Value;
Surrender of a Contract for its Net Cash Value; When
Proceeds are Paid; Right to Exchange a Contract for a
Fixed-Benefit Whole-Life Policy; Lapse and
Reinstatement; Options on Lapse; Riders; Other General
Contract Provisions; Voting Rights; Substitution of
Series Fund Shares
11. Brief Description of the Contract; Pruco Life Variable
Insurance Account
12. Cover Page; Brief Description of the Contract; The
Prudential Series Fund, Inc.; Sale of the Contract and
Sales Commissions
13. Brief Description of the Contract; The Prudential Series
Fund, Inc.; Charges and Expenses; Sale of the Contract
and Sales Commissions
14. Brief Description of the Contract; Requirements for
Issuance of a Contract
15. Brief Description of the Contract; Allocation of
Premiums; Transfers
16. Brief Description of the Contract; Detailed Information
for Prospective Contract Owners
17. When Proceeds are Paid
18. Pruco Life Variable Insurance Account
19. Reports to Contract Owners
20. Not Applicable
21. Contract Loans
22. Not Applicable
23. Not Applicable
24. Other General Contract Provisions
<PAGE>
N-8B-2 ITEM NUMBER LOCATION
- ------------------ --------
25. Pruco Life Insurance Company
26. Brief Description of the Contract; The Prudential Series
Fund, Inc.; Charges and Expenses
27. Pruco Life Insurance Company; The Prudential Series
Fund, Inc.
28. Pruco Life Insurance Company; Directors and Officers
29. Pruco Life Insurance Company
30. Not Applicable
31. Not Applicable
32. Not Applicable
33. Not Applicable
34. Not Applicable
35. Pruco Life Insurance Company
36. Not Applicable
37. Not Applicable
38. Sale of the Contract and Sales Commissions
39. Sale of the Contract and Sales Commissions
40. Not Applicable
41. Sale of the Contract and Sales Commissions
42. Not Applicable
43. Not Applicable
44. Brief Description of the Contract; The Prudential Series
Fund, Inc.; How a Contract's Death Benefit Will Vary;
How a Contract's Cash Value Will Vary
45. Not Applicable
46. Brief Description of the Contract; Pruco Life Variable
Insurance Account; The Prudential Series Fund, Inc.
47. Pruco Life Variable Insurance Account; The Prudential
Series Fund, Inc.
48. Not Applicable
49. Not Applicable
50. Not Applicable
51. Not Applicable
52. Substitution of Series Fund Shares
53. Tax Treatment of Contract Benefits
54. Not Applicable
55. Not Applicable
56. Not Applicable
57. Not Applicable
58. Not Applicable
<PAGE>
N-8B-2 ITEM NUMBER LOCATION
- ------------------ --------
59. Financial Statements; Financial Statements of Pruco Life
Variable Insurance Account; Consolidated Financial
Statements of Pruco Life Insurance Company and
Subsidiaries
<PAGE>
PART I
INFORMATION REQUIRED IN PROSPECTUS
<PAGE>
PROSPECTUS
MAY 1, 1997
PRUCO LIFE INSURANCE COMPANY
VARIABLE INSURANCE ACCOUNT
VARIABLE
LIFE INSURANCE
CONTRACTS
This prospectus describes a variable life insurance contract (the "Contract")
issued by Pruco Life Insurance Company ("Pruco Life"), a stock life insurance
company that is a wholly-owned subsidiary of The Prudential Insurance Company of
America ("Prudential"). As of January 1, 1992, these Contracts are no longer
available for sale. These Contracts provide whole-life insurance protection.
That is, they provide lifetime insurance coverage, as long as premiums are paid.
They also provide a cash value for the owner if the Contract is terminated
during the insured's lifetime. A Contract's death benefit varies monthly with
the investment performance of the subaccounts of the Pruco Life Variable
Insurance Account (the "Account") to which the owner allocates the net premiums.
Whatever the investment performance, however, it will not cause the death
benefit to be less than a guaranteed minimum amount (generally the face amount
specified in the Contract). The cash value of a Contract generally increases
with the payment of each premium, but it also varies daily with investment
performance. There is no guaranteed minimum cash value.
A Contract's net premiums and earnings on those premiums will be held in one or
more of the investment subaccounts of the Account or, pursuant to a real estate
investment option, in the Pruco Life Variable Contract Real Property Account
(the "Real Property Account"). The assets of each subaccount will be invested in
a corresponding portfolio of The Prudential Series Fund, Inc. (the "Series
Fund"). The attached prospectus for the Series Fund and its statement of
additional information describe the investment objectives of the thirteen
portfolios of the Series Fund in which net premiums under the Contracts may
currently be invested--the MONEY MARKET PORTFOLIO, the DIVERSIFIED BOND
PORTFOLIO, the GOVERNMENT INCOME PORTFOLIO, the CONSERVATIVE BALANCED PORTFOLIO,
the FLEXIBLE MANAGED PORTFOLIO, the HIGH YIELD BOND PORTFOLIO, the STOCK INDEX
PORTFOLIO, the EQUITY INCOME PORTFOLIO, the EQUITY PORTFOLIO, the PRUDENTIAL
JENNISON PORTFOLIO, the SMALL CAPITALIZATION STOCK PORTFOLIO, the GLOBAL
PORTFOLIO, and the NATURAL RESOURCES PORTFOLIO. Other subaccounts and portfolios
may be added in the future. The REAL PROPERTY ACCOUNT, through a partnership,
invests primarily in income-producing real property. The Real Property Account
is described in a prospectus that is attached to this one. This prospectus
describes the Contract generally and the Pruco Life Variable Insurance Account.
THE REPLACEMENT OF LIFE INSURANCE IS GENERALLY NOT IN THE INTEREST OF THE
CUSTOMER. IN MOST CASES, WHEN A CUSTOMER REQUIRES ADDITIONAL COVERAGE, A NEW
POLICY SUPPLEMENTING THE EXISTING POLICY SHOULD BE REQUESTED, THEREBY PROTECTING
THE BENEFITS OF THE ORIGINAL POLICY. IF YOU ARE CONSIDERING REPLACING A POLICY,
YOU SHOULD COMPARE THE BENEFITS AND COSTS OF SUPPLEMENTING YOUR EXISTING POLICY
WITH THE BENEFITS AND COSTS OF PURCHASING THE CONTRACT DESCRIBED IN THIS
PROSPECTUS AND YOU SHOULD CONSULT WITH A QUALIFIED TAX ADVISOR.
PLEASE READ THIS PROSPECTUS AND KEEP IT FOR FUTURE REFERENCE. IT IS ATTACHED TO
A CURRENT PROSPECTUS FOR THE PRUDENTIAL SERIES FUND, INC. AND A CURRENT
PROSPECTUS FOR THE PRUCO LIFE VARIABLE CONTRACT REAL PROPERTY ACCOUNT.
THESE SECURITIES HAVE NOT BEEN APPROVED OR DISAPPROVED BY THE SECURITIES AND
EXCHANGE COMMISSION NOR HAS THE COMMISSION PASSED UPON THE ACCURACY OR ADEQUACY
OF THIS PROSPECTUS. ANY REPRESENTATION TO THE CONTRARY IS A CRIMINAL OFFENSE.
PRUCO LIFE INSURANCE COMPANY
213 Washington Street
Newark, New Jersey 07102-2992
Telephone: (800) 437-4016, Ext. 46
VLI-1 Ed 5-97
Catalog No. 646964K
<PAGE>
PROSPECTUS CONTENTS
PAGE
BRIEF DESCRIPTION OF THE CONTRACT.............................................1
GENERAL INFORMATION ABOUT PRUCO LIFE INSURANCE COMPANY, PRUCO LIFE
VARIABLE INSURANCE ACCOUNT, AND THE VARIABLE INVESTMENT OPTIONS
AVAILABLE UNDER THE CONTRACT...............................................2
PRUCO LIFE INSURANCE COMPANY...............................................2
PRUCO LIFE VARIABLE INSURANCE ACCOUNT......................................2
THE PRUDENTIAL SERIES FUND, INC............................................3
PRUCO LIFE VARIABLE CONTRACT REAL PROPERTY ACCOUNT.........................3
WHICH INVESTMENT OPTION SHOULD BE SELECTED.................................4
DETAILED INFORMATION FOR PROSPECTIVE CONTRACT OWNERS..........................4
REQUIREMENTS FOR ISSUANCE OF A CONTRACT....................................4
PREMIUMS...................................................................5
PREMIUM ADJUSTMENT.........................................................5
ALLOCATION OF PREMIUMS.....................................................6
CHARGES AND EXPENSES.......................................................6
TRANSFERS..................................................................8
HOW A CONTRACT'S DEATH BENEFIT WILL VARY...................................8
HOW A CONTRACT'S CASH VALUE WILL VARY.....................................10
SURRENDER OF A CONTRACT FOR ITS NET CASH VALUE............................12
WITHDRAWAL OF A PORTION OF A CONTRACT'S NET CASH VALUE....................12
WHEN PROCEEDS ARE PAID....................................................12
LIVING NEEDS BENEFIT......................................................13
ILLUSTRATIONS OF CASH VALUES, DEATH BENEFITS, AND ACCUMULATED PREMIUMS....13
CONTRACT LOANS............................................................15
RIGHT TO EXCHANGE A CONTRACT FOR A FIXED-BENEFIT WHOLE-LIFE POLICY........16
SALE OF THE CONTRACT AND SALES COMMISSIONS................................16
TAX TREATMENT OF CONTRACT BENEFITS........................................16
LAPSE AND REINSTATEMENT...................................................18
OPTIONS ON LAPSE..........................................................18
LEGAL CONSIDERATIONS RELATING TO SEX-DISTINCT PREMIUMS AND BENEFITS.......20
OTHER GENERAL CONTRACT PROVISIONS.........................................20
RIDERS....................................................................20
VOTING RIGHTS.............................................................20
SUBSTITUTION OF SERIES FUND SHARES........................................21
REPORTS TO CONTRACT OWNERS................................................21
STATE REGULATION..........................................................21
EXPERTS...................................................................21
LITIGATION................................................................22
ADDITIONAL INFORMATION....................................................22
FINANCIAL STATEMENTS......................................................22
DIRECTORS AND OFFICERS.......................................................23
FINANCIAL STATEMENTS OF PRUCO LIFE VARIABLE INSURANCE ACCOUNT................A1
CONSOLIDATED FINANCIAL STATEMENTS OF PRUCO LIFE INSURANCE COMPANY
AND SUBSIDIARIES..........................................................B1
ADDITIONAL ILLUSTRATIONS OF CASH VALUES, DEATH BENEFITS, AND
ACCUMULATED PREMIUMS.........................................................C1
THIS PROSPECTUS DOES NOT CONSTITUTE AN OFFERING IN ANY JURISDICTION IN WHICH
SUCH OFFERING MAY NOT LAWFULLY BE MADE. NO PERSON IS AUTHORIZED TO MAKE ANY
REPRESENTATIONS IN CONNECTION WITH THIS OFFERING OTHER THAN THOSE CONTAINED IN
THIS PROSPECTUS, THE PROSPECTUS AND STATEMENT OF ADDITIONAL INFORMATION FOR THE
SERIES FUND, AND THE PROSPECTUS FOR THE REAL PROPERTY ACCOUNT.
<PAGE>
BRIEF DESCRIPTION OF THE CONTRACT
This variable life insurance contract (the "Contract") being offered by Pruco
Life Insurance Company ("Pruco Life") is in many respects similar to traditional
"fixed-benefit" whole-life insurance. In other respects it is quite different.
As with fixed-benefit whole-life insurance, the owner pays level premiums for a
Contract that provides lifetime insurance coverage on the named insured. Like
fixed-benefit whole-life insurance, a Contract has a cash value that the owner
may obtain by terminating the Contract. Also like fixed-benefit whole-life
insurance, a variety of optional benefits and riders may be added and may
require an additional premium. Finally, like fixed-benefit whole-life insurance,
the cash value of a Contract during the early years will be substantially lower
than the sum of the premiums paid. Under a fixed-benefit contract, there are a
fixed guaranteed death benefit and a cash value that increases at a guaranteed
rate as additional premiums are paid; in some such contracts, the insurer may
refund some of the premium as a dividend if its experience is better than the
assumptions upon which it made its guarantees. The variable life insurance
Contract described here also has a schedule of cash values and a guaranteed
minimum death benefit. The distinctive feature of this Contract is that the
premiums, after certain deductions are made, are placed in one or more separate
investment subaccounts of Pruco Life's Variable Insurance Account, and the death
benefit and cash value may increase or decrease, depending on the investment
performance of the selected subaccount[s]. There is no minimum cash value. But,
as long as no premium is in default and there is no loan on the Contract, the
death benefit will not be less than a guaranteed minimum amount (the face amount
specified in the Contract, unless the Contract owner has withdrawn part of the
Contract's cash value). See WITHDRAWAL OF A PORTION OF A CONTRACT'S NET CASH
VALUE, page 12. The smallest Contract has a face amount of $25,000. As of
January 1, 1992, these Contracts are no longer available for sale.
The owner of a Contract chooses the subaccount[s] of the Pruco Life Variable
Insurance Account (the "Account") into which the net premiums will be placed. At
present there are thirteen subaccounts, each of which is invested in a
corresponding portfolio of The Prudential Series Fund, Inc. (the "Series Fund"),
a series mutual fund to which The Prudential Insurance Company of America
("Prudential") acts as investment advisor. The MONEY MARKET PORTFOLIO is
invested in short-term debt obligations similar to those purchased by money
market funds; the DIVERSIFIED BOND PORTFOLIO is invested primarily in high
quality medium-term corporate and government debt securities; the GOVERNMENT
INCOME PORTFOLIO is invested primarily in US Government securities including
intermediate and long-term US Treasury securities and debt obligations issued by
agencies of or instrumentalities established, sponsored or guaranteed by the
U.S. Government; the CONSERVATIVE BALANCED PORTFOLIO is invested in a mix of
money market instruments, fixed income securities and common stock in
proportions believed by the investment manager to be appropriate for an investor
who desires diversification of investment who prefers a relatively lower risk of
loss and correspondingly reduced chance of high appreciation; the FLEXIBLE
MANAGED PORTFOLIO is invested in a mix of money market instruments, fixed income
securities and common stocks, in proportions believed by the investment manager
to be appropriate for an investor desiring diversification of investment who is
willing to accept a relatively high level of loss in an effort to achieve
greater appreciation; the HIGH YIELD BOND PORTFOLIO is invested primarily in
high yield fixed-income securities of medium to lower quality, also known as
high risk bonds; the STOCK INDEX PORTFOLIO is invested in common stocks selected
to duplicate the price and yield performance of the Standard & Poor's 500
Composite Stock Price Index; the EQUITY INCOME PORTFOLIO is invested primarily
in common stocks and convertible securities that provide favorable prospects for
investment income returns above those of the Standard & Poor's 500 Stock Index
or the NYSE Composite Index; the EQUITY PORTFOLIO is invested primarily in
common stocks; the PRUDENTIAL JENNISON PORTFOLIO is invested primarily in equity
securities of established companies with above-average growth prospects; the
SMALL CAPITALIZATION STOCK PORTFOLIO is invested in equity securities of
publicly-traded companies with small market capitalization; the GLOBAL PORTFOLIO
is invested primarily in common stocks and common stock equivalents (such as
convertible debt securities) of foreign and domestic issuers; the NATURAL
RESOURCES PORTFOLIO is invested primarily in common stocks and convertible
securities of natural resource companies, and in securities (typically debt
securities or preferred stock) the terms of which are related to the market
value of a natural resource. Further information about the Series Fund
portfolios can be found under THE PRUDENTIAL SERIES FUND, INC. on page 3.
The Contract owner may also invest a portion of his or her net premiums in the
Pruco Life Variable Contract Real Property Account (the "Real Property
Account"), which, through a partnership, invests primarily in income-producing
real property. If a Contract owner elects to invest a portion of his or her net
premiums in the Real Property Account, the assets will be maintained in a
subaccount of the Real Property Account related to the Contract that provides
the mechanism and maintains the records whereby the various Contract charges are
made. The investment objectives of the Real Property Account and the partnership
are described briefly under PRUCO LIFE VARIABLE CONTRACT REAL PROPERTY ACCOUNT
on page 3, 4.
Because the assets that relate to the Contract may be invested in these various
investment options, the Contract offers an opportunity for the cash value to
appreciate more rapidly than it would under comparable fixed-benefit
1
<PAGE>
whole-life insurance. But the owner must accept the risk that if investment
performance is unfavorable the cash value may not appreciate as rapidly and,
indeed, may decrease in value.
Pruco Life deducts certain charges from each premium payment and from the
amounts held in the designated investment options. All these charges, which are
largely designed to cover insurance costs and risks as well as sales and
administrative expenses, are fully described under CHARGES AND EXPENSES on page
6. In brief, and subject to that fuller description, the following charges may
be made: (1) an annual administrative charge of $30 if premiums are paid
annually, $32 if paid semi-annually, $36 if paid quarterly, and $48 if paid
monthly; (2) a one-time first-year administrative charge upon each premium of up
to $5 for each $1,000 of face amount if premiums are paid annually, $2.52 if
paid semi-annually, $1.27 if paid quarterly, and $0.43 if paid monthly; (3)
sales load charges of not more than 30% of the basic premium in the first
Contract year, not more than 10% of the basic premium in the second year, and
not more than 9% of the sum of the basic premiums to be paid in the first 20
years; (4) a premium tax charge of 2% is deducted from each basic premium; (5) a
guaranteed minimum death benefit risk charge of not more than 1.2% of each basic
premium; (6) each month, a charge for anticipated mortality based on the 1980
CSO Tables is deducted; (7) a daily charge equivalent to an annual rate of 0.35%
is deducted from the assets of the subaccounts for mortality and expense risks;
(8) if the Contract includes riders, a deduction from each premium payment will
be made for charges applicable to those riders; and (9) certain fees and
expenses are deducted from the assets of the Series Fund and Real Property
Account. Because of these charges, prospective purchasers should purchase a
Contract only if they intend and have the financial capability to keep it in
force for a substantial period. The death benefit increases or decreases monthly
(but not below the guaranteed minimum amount) depending on the investment
results of the subaccount[s] and/or the Real Property Account in which the
Contract participates. It does not change simply because a premium is paid. The
cash value also changes at a rate that depends upon the investment results, but
these changes take place daily rather than monthly. Each premium payment has the
effect of adding to the cash value. For more detailed information about how the
death benefit and cash value change, see HOW A CONTRACT'S DEATH BENEFIT WILL
VARY, page 8 and HOW A CONTRACT'S CASH VALUE WILL VARY, page 10.
For a limited time, a Contract may be returned for a refund in accordance with
the terms of its "free look" provision. See SHORT-TERM CANCELLATION RIGHT OR
"FREE LOOK", page 4.
Each owner should retain a copy of the Contract document. That document,
together with the attached application, constitutes the entire agreement between
the owner and Pruco Life.
GENERAL INFORMATION ABOUT PRUCO LIFE INSURANCE
COMPANY, PRUCO LIFE VARIABLE INSURANCE ACCOUNT,
AND THE VARIABLE INVESTMENT OPTIONS AVAILABLE
UNDER THE CONTRACT
PRUCO LIFE INSURANCE COMPANY
Pruco Life Insurance Company ("Pruco Life") is a stock life insurance company,
organized in 1971 under the laws of the State of Arizona. It is licensed to sell
life insurance and annuities in the District of Columbia, Guam, and in all
states except New York.
Pruco Life is a wholly-owned subsidiary of Prudential, a mutual insurance
company founded in 1875 under the laws of the State of New Jersey. As of
December 31, 1996, Prudential has invested over $442 million in Pruco Life in
connection with Pruco Life's organization and operation. Prudential intends from
time to time to make additional capital contributions to Pruco Life as needed to
enable it to meet its reserve requirements and expenses in connection with its
business. Prudential is under no obligation to make such contributions and its
assets do not back the benefits payable under the Contract. Pruco Life's
consolidated financial statements begin on page B1 and should be considered only
as bearing upon Pruco Life's ability to meet its obligations under the
Contracts.
PRUCO LIFE VARIABLE INSURANCE ACCOUNT
The Pruco Life Variable Insurance Account (the "Account") was established on
November 10, 1982 under Arizona law as a separate investment account. The
Account meets the definition of a "separate account" under the federal
securities laws. The Account holds assets that are segregated from all of Pruco
Life's other assets.
The obligations to Contract owners and beneficiaries arising under the Contract
are general corporate obligations of Pruco Life. Pruco Life is also the legal
owner of the assets in the Account. Pruco Life will maintain assets in the
Account with a total market value at least equal to the reserve and other
liabilities relating to the variable benefits attributable to the Account. These
assets may not be charged with liabilities which arise from any other business
Pruco Life conducts. In addition to these assets, the Account's assets may
include funds contributed by Pruco Life to commence operation of the Account and
may include accumulations of the charges Pruco Life makes
2
<PAGE>
against the Account. From time to time these additional assets will be
transferred to Pruco Life's general account. Before making any such transfer,
Pruco Life will consider any possible adverse impact the transfer might have on
the Account.
The Account is registered with the Securities and Exchange Commission ("SEC")
under the Investment Company Act of 1940 ("1940 Act") as a unit investment
trust, which is a type of investment company. This does not involve any
supervision by the SEC of the management or investment policies or practices of
the Account. For state law purposes, the Account is treated as a part or
division of Pruco Life. There are currently thirteen subaccounts within the
Account, each of which invests in a single corresponding portfolio of the Series
Fund. Additional subaccounts may be added in the future. The Account's financial
statements begin on page A1.
THE PRUDENTIAL SERIES FUND, INC.
The Prudential Series Fund, Inc. (the "Series Fund") is registered under the
1940 Act as an open-end diversified management investment company. Its shares
are currently sold only to separate accounts of Prudential and certain other
insurers that offer variable life insurance and variable annuity contracts. On
October 31, 1986, the Pruco Life Series Fund, Inc., an open-end, diversified
management investment company which sold its shares only to separate accounts of
Pruco Life and Pruco Life Insurance Company of New Jersey, was merged into the
Series Fund. Prior to that date, the Account invested only in shares of the
Pruco Life Series Fund, Inc. The Account will purchase and redeem shares from
the Series Fund at net asset value. Shares will be redeemed to the extent
necessary for Pruco Life to provide benefits under the Contract and to transfer
assets from one subaccount to another, as requested by Contract owners. Any
dividend or capital gain distribution received from a portfolio of the Series
Fund will be reinvested immediately at net asset value in shares of that
portfolio and retained as assets of the corresponding subaccount.
Prudential is the investment advisor for the assets of each of the portfolios of
the Series Fund. Prudential's principal business address is Prudential Plaza,
Newark, New Jersey 07102-3777. Prudential has a Service Agreement with its
wholly-owned subsidiary The Prudential Investment Corporation ("PIC"), which
provides that, subject to Prudential's supervision, PIC will furnish investment
advisory services in connection with the management of the Series Fund. In
addition, Prudential has entered into a Subadvisory Agreement with its
wholly-owned subsidiary Jennison Associates Capital Corp. ("Jennison"), under
which Jennison furnishes investment advisory services in connection with the
management of the Prudential Jennison Portfolio. Further detail is provided in
the prospectus and statement of additional information for the Series Fund.
Prudential, PIC, and Jennison are registered as investment advisors under the
Investment Advisers Act of 1940.
As an investment advisor, Prudential charges the Series Fund a daily investment
management fee as compensation for its services. In addition to the investment
management fee, each portfolio incurs certain expenses, such as accounting and
custodian fees. See CHARGES AND EXPENSES, page 6.
It is conceivable that in the future it may become disadvantageous for both
variable life insurance and variable annuity contract separate accounts to
invest in the same underlying mutual fund. Although neither the companies which
invest in the Series Fund, nor the Series Fund currently foresees any such
disadvantage, the Series Fund's Board of Directors intends to monitor events in
order to identify any material conflict between variable life insurance and
variable annuity contract owners and to determine what action, if any, should be
taken in response thereto. Material conflicts could result from such things as:
(1) changes in state insurance law; (2) changes in federal income tax law; (3)
changes in the investment management of any portfolio of the Series Fund; or (4)
differences between voting instructions given by variable life insurance and
variable annuity contract owners.
A FULL DESCRIPTION OF THE SERIES FUND, ITS INVESTMENT OBJECTIVES, MANAGEMENT,
POLICIES, AND RESTRICTIONS, ITS EXPENSES, THE RISKS ATTENDANT TO INVESTMENT
THEREIN--INCLUDING ANY RISKS ASSOCIATED WITH INVESTMENT IN THE HIGH YIELD BOND
PORTFOLIO, AND ALL OTHER ASPECTS OF ITS OPERATION IS CONTAINED IN THE ATTACHED
PROSPECTUS FOR THE SERIES FUND AND IN ITS STATEMENT OF ADDITIONAL INFORMATION,
WHICH SHOULD BE READ IN CONJUNCTION WITH THIS PROSPECTUS.
THERE IS NO ASSURANCE THAT THE INVESTMENT OBJECTIVES WILL BE MET.
PRUCO LIFE VARIABLE CONTRACT REAL PROPERTY ACCOUNT
The Pruco Life Variable Contract Real Property Account (the "Real Property
Account") is a separate account of Pruco Life that, through a general
partnership formed by Prudential and two of its subsidiaries, invests primarily
in income-producing real property such as office buildings, shopping centers,
agricultural land, hotels, apartments or industrial properties. It also invests
in mortgage loans and other real estate-related investments, including
sale-leaseback transactions. The objectives of the Real Property Account and the
partnership are to preserve and protect capital, provide for compounding of
income as a result of reinvestment of cash flow from investments, and provide
for increases over time in the amount of such income through appreciation in the
value of assets.
3
<PAGE>
The partnership has entered into an investment management agreement with
Prudential, under which Prudential selects the properties and other investments
held by the partnership. Prudential charges the partnership a daily fee for
investment management which amounts to 1.25% per year of the average daily gross
assets of the partnership.
A FULL DESCRIPTION OF THE REAL PROPERTY ACCOUNT, ITS MANAGEMENT, POLICIES, AND
RESTRICTIONS, ITS CHARGES AND EXPENSES, THE RISKS ATTENDANT TO INVESTMENT
THEREIN, THE PARTNERSHIP'S INVESTMENT OBJECTIVES, AND ALL OTHER ASPECTS OF THE
REAL PROPERTY ACCOUNT'S AND THE PARTNERSHIP'S OPERATIONS IS CONTAINED IN THE
ATTACHED PROSPECTUS FOR THE REAL PROPERTY ACCOUNT, WHICH SHOULD BE READ TOGETHER
WITH THIS PROSPECTUS BY ANY CONTRACT OWNER CONSIDERING THE REAL ESTATE
INVESTMENT OPTION. THERE IS NO ASSURANCE THAT THE INVESTMENT OBJECTIVES WILL BE
MET.
WHICH INVESTMENT OPTION SHOULD BE SELECTED?
A broad objective of the Contract is to provide benefits that will increase in
value if favorable investment results are achieved. Contract owners have a large
number of options as to how the amounts credited to their Contracts will be
invested. Historically, for investments held over relatively long periods, the
investment performance of common stocks has generally been superior to that of
short or long-term debt securities, even though common stocks have been subject
to much more dramatic changes in value over short periods of time. Accordingly,
the Stock Index, Equity Income, Equity, Prudential Jennison, Small
Capitalization Stock, Global, or Natural Resources Portfolios may be desirable
options for Contract owners who are willing to accept such volatility in their
Contract values. Each of these equity portfolios involves somewhat different
investment risks, policies, and programs.
Some Contract owners may prefer the somewhat greater protection against loss of
principal (and reduced chance of high total return) provided by the Government
Income or Diversified Bond Portfolios, while others, who desire even greater
safety of principal, may prefer the Money Market Portfolio, recognizing that the
level of short-term rates may change rather rapidly. Contract owners not
interested in common stocks but willing to take risks and seeking the
possibility of a high total return may prefer the High Yield Bond Portfolio,
recognizing that with higher yielding, lower quality bonds the risks are
greater. Some Contract owners may wish to divide their funds among two or more
of the portfolios. Some may wish to obtain diversification by relying on
Prudential's judgment for an appropriate asset mix by choosing one of the
Balanced Portfolios. The Real Property Account permits a Contract owner to
diversify his or her investment under the Contract to include an interest in a
pool of income-producing real property, and real estate is often considered to
be a hedge against inflation.
Each Contract owner must make his or her own choice that takes into account how
willing he or she is to accept investment risks, the manner in which his or her
other assets are invested, and his or her own predictions about what investment
results are likely to be in the future. Prudential recommends against frequent
transfers among the several options as experience generally indicates that
"market timing" investing, particularly by non-professional investors, is likely
to prove unsuccessful.
DETAILED INFORMATION FOR PROSPECTIVE
CONTRACT OWNERS
REQUIREMENTS FOR ISSUANCE OF A CONTRACT
As of January 1, 1992, these Contracts are no longer available for sale. The
minimum initial guaranteed death benefit that can be applied for is $25,000. The
Contract may generally be issued on insureds below the age of 76. Before issuing
any Contract, Pruco Life requires evidence of insurability which may include a
medical examination. Non-smokers who meet preferred underwriting requirements
are offered the most favorable premium rate. A higher premium is charged if an
extra mortality risk is involved. These are the current underwriting
requirements. The Company reserves the right to change them on a
non-discriminatory basis.
SHORT-TERM CANCELLATION RIGHT OR "FREE LOOK"
Generally, a Contract may be returned for a refund within 10 days after it is
received by the Contract owner, within 45 days after Part I of the application
for insurance is signed or within 10 days after Pruco Life mails or delivers a
Notice of Withdrawal Right, whichever is latest. Some states allow a longer
period of time during which a Contract may be returned for a refund. A refund
can be requested by mailing or delivering the Contract to the representative who
sold it or to the Home Office specified in the Contract. A Contract returned
according to this provision shall be deemed void from the beginning. The
Contract owner will then receive a refund of all premium payments made, plus or
minus any change due to investment experience. However, if applicable law so
requires, the Contract owner who exercises his or her short-term cancellation
right will receive a refund of all premium payments made, with no adjustment for
investment experience.
4
<PAGE>
PREMIUMS
Premiums on the Contract are level, fixed, and payable in advance during the
insured's lifetime on an annual, semi-annual, quarterly or monthly basis. If
paid more often than annually, an extra fee will be charged to compensate Pruco
Life for the additional processing costs (see CHARGES AND EXPENSES, page 6) and
for the loss of interest (computed generally at an annual rate of 8%) incurred
because premiums are paid throughout rather than at the beginning of each
Contract year. The premium amount depends on the Contract's face amount, the
insured's sex (except where unisex rates apply) and age at issue, and the
insured's risk classification. Contract owners who pay premiums other than on a
monthly basis will receive notice that a premium is due about 3 weeks before
each due date. Contract owners who pay premiums monthly will receive each year a
book with twelve coupons that will serve as a reminder. With Pruco Life's
consent, an owner may change the frequency of premium payments.
A Contract owner may elect to have monthly premiums paid automatically under the
"Pru-Matic Premium Plan" by pre-authorized transfers from a bank checking
account. Some Contract owners may also be eligible to have monthly premiums paid
by pre-authorized deductions from an employer's payroll.
The following table shows representative standard and preferred annual premium
amounts for various face amounts:
- -------------- -------------- ------------- -------------- -------------
$25,000 Face $100,000 Face
Amount Amount
-------------- ------------- -------------- -------------
Preferred Standard Preferred Standard
- -------------- -------------- ------------- -------------- -------------
Male, age 25 $270.00 $283.25 $ 990.00 $1,043.00
at issue
- -------------- -------------- ------------- -------------- -------------
Female, age 35 $333.75 $342.75 $1,245.00 $1,281.00
at issue
- -------------- -------------- ------------- -------------- -------------
Male, age 40 $449.00 $484.50 $1,706.00 $1,848.00
at issue
- -------------- -------------- ------------- -------------- -------------
The following table compares annual and monthly premiums for insureds who are
standard risks. Note that in these examples the sum of 12 monthly premiums for a
particular Contract is approximately 105% to 110% of the annual premium for that
Contract.
- -------------- -------------- ------------- -------------- -------------
$25,000 Face $100,000 Face
Amount Amount
-------------- ------------- -------------- -------------
Monthly Annual Monthly Annual
- -------------- -------------- ------------- -------------- -------------
Male, age 25 $26.00 $283.25 $ 92.00 $1,043.00
at issue
- -------------- -------------- ------------- -------------- -------------
Female, age 35 $31.00 $342.75 $112.00 $1,281.00
at issue
- -------------- -------------- ------------- -------------- -------------
Male, age 40 $43.25 $484.50 $161.00 $1,848.00
at issue
- -------------- -------------- ------------- -------------- -------------
There is a grace period of 31 days for each premium except the first one. During
the grace period, the Contract will continue in effect. A Contract will lapse if
a premium has not been paid by the end of the grace period. Upon lapse, the
Contract owner will have several options. These may include continuing the
amount of insurance coverage in effect on the due date of the unpaid premium,
less any Contract debt, for a fixed period, continuing a lesser amount of
insurance for the lifetime of the insured, or surrender of the Contract for its
net cash value. See OPTIONS ON LAPSE, page 18.
PREMIUM ADJUSTMENT
If the insured dies during the grace period before the premium is paid, the
portion of the unpaid premium that covers the period from the due date to the
date of death will be deducted from the death benefit. If the insured
5
<PAGE>
dies while no premium is in default, Pruco Life will increase the death benefit
by the portion of the last premium that covers the period subsequent to the date
of death.
ALLOCATION OF PREMIUMS
Net premium payments--that is, the amount of the premiums less the deductions
described below in items 1 through 5 under Charges and Expenses--will be placed
as of the end of the valuation period when due (not when received) in one or
more subaccounts of the Account and/or the Real Property Account, as directed by
the Contract owner. Any premium payments received prior to the due date will be
held in Pruco Life's general account, and the net premium will not be credited
to the investment option selected by a Contract owner until the due date.
Provided the Contract is not in default, the Contract owner may change the way
in which subsequent premiums are allocated by giving written notice to a Home
Office or by telephoning that Home Office, provided the Contract owner is
enrolled to use the Telephone Transfer System. There is no charge for
reallocating future net premiums. If any portion of a net premium is allocated
to a particular investment option, that portion must be at least 10% on the date
the allocation takes effect. All percentage allocations must be in whole
numbers. For example, 33% can be selected but 331/3% cannot.
CHARGES AND EXPENSES
Every charge made by Pruco Life under the Contract is described below.
1. If premiums are paid annually, there is an annual administrative
charge of $30 for administrative expenses incurred, among other
things, for billing, collecting premiums, processing claims, paying
cash values, making Contract changes, keeping records, and
communicating with Contract owners. If premiums are paid more
frequently, the annual administrative charge will be higher to reflect
the additional expense incurred in collecting and processing more
frequent premiums. The charge will be $32 if premiums are paid
semi-annually, $36 if premiums are paid quarterly, and $48 if premiums
are paid monthly. During 1996, 1995 and 1994, Pruco Life received a
total of approximately $3,627,668, $3,804,569 and $4,001,491,
respectively, in annual administrative charges.
2. There is a charge to compensate Pruco Life for the cost of selling the
Contract. This cost includes sales commissions, advertising, and the
printing of prospectuses and sales literature. This charge is
generally called the "sales load." It is not more than 30% of the
basic premium (defined below) in the first Contract year, not more
than 10% of the basic premium in the second year, and not more than 9%
of the sum of the basic premiums to be paid in the first 20 years.
Also, in any year it is never more than in a prior year. The basic
premium is what the gross annual premium for the Contract, less the
annual administrative charge, would be if the insured were in the
standard rating class and if the Contract had no optional insurance
benefits. During 1996, 1995 and 1994, Pruco Life received a total of
approximately $3,382,821, $3,612,789 and $3,842,076, respectively, in
sales load charges.
3. There is a premium tax charge of 2% of each basic premium. The
applicable statutory tax rules differ from state to state, and in some
states by locality. Pruco Life may collect more or less for this
charge than it actually pays for premium taxes. To the extent that the
2% rate is insufficient to pay taxes in all jurisdictions, the
difference will be borne by Pruco Life. During 1996, 1995 and 1994,
Pruco Life received a total of approximately $678,538, $723,689 and
$769,154, respectively, in charges for payment of state premium taxes.
4. There is a charge of not more than 1.2% of each basic premium to
compensate Pruco Life for the risk that an insured may die at a time
when the death benefit exceeds the benefit that would have been
payable in the absence of a minimum guarantee. During 1996, 1995 and
1994, Pruco Life received a total of approximately $407,123, $434,213
and $461,492, respectively, for this risk charge. When premiums are
paid more frequently than annually, these charges will be deducted
proportionately from each premium payment. If there is an extra
premium for optional insurance benefits or for an extra mortality
risk, or if there is a premium discount because the insured is in the
preferred rating class, the amount allocated to the separate account
will be equal to the amount that would have been allocated if the
insured had been in the standard rating class and there were no
optional insurance benefits.
5. Apart from the deductions from gross premiums just described, the
amounts held in the Account and/or the Real Property Account
attributable to each Contract are subject to a mortality charge and
are reduced once a month to compensate Pruco Life for the anticipated
cost of paying death benefits to the beneficiaries of those persons
who die during that period. The amount of this reduction is based on
the 1980 Commissioner's Standard Ordinary Mortality Table (the "1980
CSO Table").
6. There is also a daily charge to the Account and/or the Real Property
Account for the mortality and expense risks that Pruco Life assumes.
This charge is made daily at an effective annual rate of 0.35% of the
value
6
<PAGE>
of the Account's and/or the Real Property Account's assets. The
mortality risk assumed is that insureds may live for a shorter period
of time than that predicted by the 1980 CSO Table. The expense risk
assumed is that expenses incurred in issuing and administering the
Contracts will be greater than Pruco Life estimated. During 1996, 1995
and 1994, Pruco Life received a total of approximately $1,107,590,
$952,424 and $841,163, respectively, in mortality and expense risk
charges.
7. If the Contract includes riders, a deduction from each premium payment
will be made for charges applicable to those riders.
8. An investment advisory fee is deducted daily from each portfolio at a
rate, on an annualized basis, from 0.35% for the Stock Index Portfolio
to 0.75% for the Global Portfolio. The expenses incurred in conducting
the investment operations of the portfolios (such as custodian fees
and preparation and distribution of annual reports) are paid out of
the portfolio's income.
The total expenses of each portfolio for the year 1996 expressed as a
percentage of the average assets during the year are shown below:
- --------------------------------------------------------------------------------
Other Total
Investment Expenses Expenses
PORTFOLIO Advisory (after expense (after expense
Fee reimbursement)* reimbursement)*
- --------------------------------------------------------------------------------
MONEY MARKET 0.40% 0.00%* 0.40%*
DIVERSIFIED BOND 0.40% 0.00%* 0.40%*
GOVERNMENT INCOME 0.40% 0.06% 0.46%
CONSERVATIVE BALANCED 0.55% 0.00%* 0.40%*
FLEXIBLE MANAGED 0.60% 0.00%* 0.40%*
HIGH YIELD BOND 0.55% 0.08% 0.63%
STOCK INDEX 0.35% 0.05% 0.40%
EQUITY INCOME 0.40% 0.05% 0.45%
EQUITY 0.45% 0.00%* 0.40%*
PRUDENTIAL JENNISON 0.60% 0.06% 0.66%
SMALL CAPITALIZATION STOCK 0.40% 0.16% 0.56%
GLOBAL 0.75% 0.17% 0.92%
NATURAL RESOURCES 0.45% 0.07% 0.52%
- -------------------------- -------------- ------------------ ------------------
Some investment management fees and expenses charged to the Series Fund may be
higher than those that were previously charged to the Pruco Life Series Fund,
Inc. (0.4%), in which the Account previously invested. For the Money Market,
Diversified Bond, Conservative Balanced, Flexible Managed, and Equity
Portfolios, Pruco Life will make daily adjustments that will offset the effect
on Contract owners of any higher investment management fees and expenses charged
against the Series Fund. Without such adjustments the portfolio expenses
indirectly borne by a Contract owner, expressed as a percentage of the average
daily net assets by portfolio, would have been 0.44% for the Money Market
Portfolio, 0.45% for the Diversified Bond Portfolio, 0.59% for the Conservative
Balanced Portfolio, 0.64% for the Flexible Managed Portfolio and 0.50% for the
Equity Portfolio. No such offset will be made with respect to the remaining
portfolios, which had no counterparts in the Pruco Life Series Fund, Inc.
The deductions and charges described above will not be increased by Pruco Life
with respect to any Contract in effect regardless of any changes in longevity or
increases in expenses.
The earnings of the Account are taxed as part of the operations of Pruco Life.
No charge is being made currently to the Account for Company federal income
taxes. Pruco Life will review the question of a charge to the Account for
Company federal income taxes periodically. Such a charge may be made in future
years for any federal income taxes that would be attributable to the Contracts.
Under current laws Pruco Life may incur state and local taxes (in addition to
premium taxes) in several states. At present, these taxes are not significant
and they are not charged against the Contracts or the Account. If there is a
material change in applicable state or local tax laws, the imposition of any
such taxes upon Pruco Life that are attributable to the Account may result in a
corresponding charge against the Account.
More detailed information is contained in the attached prospectus for the Series
Fund and its statement of additional information.
7
<PAGE>
TRANSFERS
Provided no premium is overdue or if the Contract is in force as variable
reduced paid-up insurance (see OPTIONS ON LAPSE, page 18), the owner may, up to
four times in each Contract year, transfer amounts from one subaccount to
another subaccount or to the Real Property Account. Currently, Contract owners
may make additional transfers with our consent. There is no charge. All or a
portion of the amount credited to a subaccount may be transferred. Transfers to
and from the Real Property Account are subject to restrictions described in the
prospectus for that investment option.
Transfers among subaccounts or to the Real Property Account will take effect as
of the end of the valuation period in which a proper transfer request is
received at a Home Office. The "valuation period" means the period of time from
one determination of the value of the amount invested in a subaccount to the
next. Such determinations are made when the net asset values of the portfolios
of the Series Fund are calculated, which is generally at 4:15 p.m. New York City
time on each day during which the New York Stock Exchange is open. The request
may be in terms of dollars, such as a request to transfer $10,000 from one
subaccount to another, or may be in terms of a percentage reallocation among
subaccounts. In the latter case, as with premium reallocations, the percentages
must be in whole numbers. The Contract owner may transfer amounts by proper
written notice to a Home Office or by telephone, provided the Contract owner is
enrolled to use the Telephone Transfer System. Contract owners will
automatically be enrolled to use the Telephone Transfer System unless the
Contract is jointly owned or the Contract owner elects not to have this
privilege. Telephone transfers may not be available on policies that are
assigned, see ASSIGNMENT, page 20, depending on the terms of the assignment.
Pruco Life has adopted procedures designed to ensure that requests by telephone
are genuine. The Company will not be held liable for following telephone
instructions that it reasonably believes to be genuine. Pruco Life cannot
guarantee that owners will be able to get through to complete a telephone
transfer during peak periods such as periods of drastic economic or market
change.
HOW A CONTRACT'S DEATH BENEFIT WILL VARY
Although a Contract's death benefit can never be less than the Contract's
guaranteed minimum amount (assuming no outstanding Contract debt or premium in
default), it will change on the first day of each Contract month after the first
month by an amount that depends on the investment performance of the subaccounts
and/or the Real Property Account in which the Contract participates. The first
Contract month starts on the Contract date. When the first premium is paid with
the application, the Contract date is ordinarily the later of the date of the
application or the date of any medical examination. If the first premium is not
paid with the application, the Contract date is ordinarily 2 or 3 days after the
application is approved by Pruco Life so that it either coincides with or is
prior to the date on which the first premium is paid. For the purpose of
calculating benefits, the initial net premium is deemed to be placed in the
Account on the Contract date. Each succeeding Contract month starts on the same
date in the month as the Contract date. The first day of each Contract month is
called the "Monthly date."
To simplify the following discussion, it is assumed that all of the net premiums
under a Contract have been allocated to a single subaccount. If the value of the
assets relating to the Contract held in the subaccount has increased due to
investment performance during the Contract month at greater than a 4% annual
rate, the Contract's death benefit will increase on the first day of the next
Contract month; if the value of these assets decreases or increases at less than
a 4% annual rate, the death benefit will decrease (but not below the guaranteed
minimum amount). The reason the assets of the subaccount relating to a Contract
must increase from one Monthly date to the next at a rate of more than 4% a year
in order for the death benefit to increase is that Pruco Life, in determining
the premiums for the Contract, has assumed that the value of the assets will
increase due to investment performance at a rate of 4% a year.
The exact amount by which the death benefit changes is determined by an
actuarial computation that is based, among other things, upon the age and sex
(except where unisex rates apply) of the insured, the size of the Contract, and
the number of years it has been in effect, as well as by the investment results
of the subaccount in which the Contract participates. In general, a change in
the dollar value of a subaccount's assets due to investment results will produce
a larger change in the death benefit for a younger insured than for an older
insured and a slightly larger change for a female insured than for a male.
Because the assets relating to a Contract tend to grow as net premiums are paid,
the dollar change in the death benefit will tend to be greater for a Contract
that has been in effect for a long time than for one that has been in effect for
a short time, despite the fact that the insured is older.
Illustrations of how the death benefit for representative Contracts will vary
over extended periods, assuming several different uniform investment results,
are included in tables on pages T1 and T2 and on pages C1 and C2 of this
prospectus. The examples set forth below illustrate death benefits. These
examples also assume a total Series Fund expense ratio of 0.51% (taking into
account the offsets described under CHARGES AND EXPENSES on page 6).
8
<PAGE>
The following two examples show, for the same Contracts, how the death benefit
will vary over a selected year for two hypothetical investment results that are
different from those shown in the tables and thus provide additional
comparisons.
Example No. 1. Contract with $50,000 guaranteed death benefit and annual
premiums in effect for 18 years, during which the value of the assets in the
subaccount increased due to investment performance at a uniform rate of 7.14%
per year. In the 19th year the value of the assets increase at a uniform rate of
8.14%. (These percentages correspond to gross annual investment returns in the
corresponding Series Fund portfolio of 8% and 9% per year, respectively.)
------------- ------------- --------------
DEATH BENEFIT DEATH BENEFIT
INSURED END OF YEAR 18END OF YEAR 19
------------- ------------- --------------
Male, age 25 $59,406 $60,878
at issue
------------- ------------- --------------
Male, age 40 $60,533 $62,149
at issue
------------- ------------- --------------
Example No. 2. Same assumptions as in Example No. 1 except that the value of the
assets increases by 1.14% in the 19th year. (This percentage corresponds to a
gross annual investment return in the corresponding Series Fund portfolio of
2%.)
------------- ------------- --------------
DEATH BENEFIT DEATH BENEFIT
INSURED END OF YEAR 18END OF YEAR 19
------------- ------------- --------------
Male, age 25 $59,406 $58,390
at issue
------------- ------------- --------------
Male, age 40 $60,533 $59,417
at issue
------------- ------------- --------------
In these examples the changes are slightly greater for the Contract issued on
the older insured because the premiums for a $50,000 Contract issued at age 40
are greater than those for one issued at age 25, and the dollar amount of the
increase resulting from a 7.14% compounded return upon the assets in the Account
relating to the Contract on the older insured is therefore larger. The changes
in the death benefit are greater even though the increase or decrease in the
death benefit resulting from a $1 change in the assets relating to the Contract
is greater for a younger insured.
Example No. 3. This example and the one following provide information for a
Contract with an $800 annual premium, in effect for 18 years, during which the
value of the assets in the subaccount increased due to investment performance at
a uniform rate of 7.14% per year. In the 19th year the value of the assets
increases at a uniform rate of 8.14%. (These percentages correspond to gross
annual investment returns in the corresponding Series Fund portfolio of 8% and
9% per year, respectively.)
-------------- ------------- -------------- -------------
GUARANTEED Death Benefit Death Benefit
INSURED DEATH BENEFIT End of Year 18 End of Year 19
-------------- ------------- -------------- -------------
Male, age 25 $76,012 $90,312 $92,548
at issue
-------------- ------------- -------------- -------------
Male, age 40 $42,354 $51,277 $52,646
at issue
-------------- ------------- -------------- -------------
Example No. 4. Same assumptions as Example No. 3 except that the value of the
assets increases by 1.14% in the 19th year. (This percentage corresponds to a
gross annual investment return in the corresponding Series Fund portfolio of
2%.)
9
<PAGE>
-------------- ------------- -------------- -------------
GUARANTEED Death Benefit Death Benefit
INSURED DEATH BENEFIT End of Year 18 End of Year 19
-------------- ------------- -------------- -------------
Male, age 25 $76,012 $90,312 $88,767
at issue
-------------- ------------- -------------- -------------
Male, age 40 $42,354 $51,277 $50,332
at issue
-------------- ------------- -------------- -------------
These examples show how the same investment results affect the death benefit
more significantly for a younger insured.
If the assets in the subaccount in which the Contract participates have earned
less than 4%, and the death benefit accordingly equals the guaranteed minimum
amount, Pruco Life will keep a record of what the death benefit would have been
had there not been a guaranteed minimum. If later investment results are
favorable, that is if the value of the assets in the subaccount later increases
at a rate greater than 4% a year, the death benefit will not become more than
the guaranteed minimum amount until the earlier unfavorable investment results
have been offset. For example, suppose for the first 3 years the value of the
assets in the subaccount increases due to investment performance at only a rate
of 2% per year. The death benefit will nevertheless remain at the guaranteed
minimum amount. If the value of the assets increases at a rate of 8% in the
fourth year, this might not be enough to offset the earlier unfavorable
investment results. If so, the death benefit will not increase.
For further information, see the tables on pages T1 and T2. They show for
various insureds how a Contract's death benefit and cash value will change if
the gross investment return in the selected Series Fund portfolio[s] is 0%, 4%
or 8%. In addition, the tables on pages C1 and C2 show, for various insureds,
how a Contract's death benefit and cash value will change if the gross
investment return is 0%, 6% or 12%. The registration statement of the Account on
file with the SEC contains a full and precise description of how the death
benefit and cash value of a Contract are determined.
HOW A CONTRACT'S CASH VALUE WILL VARY
A variable life insurance Contract has a net cash value which the owner may get
by surrender of the Contract while the insured is living. Unlike traditional
fixed-benefit whole-life insurance, however, a Contract's cash value is not
known in advance even if it is assumed that premiums are paid when due, because
it varies daily with the investment performance of the subaccount[s] and/or the
Real Property Account in which the Contract participates.
A Contract's value upon surrender is its "net cash value," which is the cash
value less any outstanding Contract debt. See CONTRACT LOANS, page 15. The
following discussion of cash values assumes that there is no Contract debt, that
no premium is in default, and that the net premiums have all been allocated to a
single subaccount.
During the early months of the first Contract year, the cash value will be very
small or zero because of the charges made in connection with issuance of the
Contract. On the Contract date the cash value is equal to the first net premium,
unless, as may be the case throughout the first Contract year, there are unpaid
issue charge installments which reduce the cash value. Thereafter, the cash
value on every Monthly date will be equal to the cash value on the preceding
Monthly date increased or decreased by the change in the value of the assets
relating to the Contract, less the amount Pruco Life needs to provide for the
death benefit for the period between the two dates. If a premium is due and paid
on a Monthly date, the cash value on that date is further increased by the
amount of the net premium. The cash value between Monthly dates is computed in a
similar way.
While the death benefit increases if the value of the assets in the subaccount
increases at a rate of more than 4% a year, the investment performance needed to
produce an increase in the cash value cannot be stated in advance. It is
different for insureds of different age and sex (except where unisex rates
apply) at issue. It is also different for Contracts on comparable insureds if
those Contracts have been in effect for different lengths of time. Moreover, the
crediting of the net premium on the due date (even if it has not yet been paid)
does not result in any change in the death benefit, while the cash value is
assumed to increase by exactly the amount of the net premium. But if the net
premium is not paid before the end of the grace period, or if the Contract is
surrendered before then, the cash value is adjusted downward to take into
account the failure to pay the premium on the due date.
The tables on pages T1 and T2 and on pages C1 and C2 of this prospectus
illustrate what the cash values would be for representative Contracts over
extended periods, assuming uniform investment results, together with information
about the aggregate premiums paid under these Contracts. The examples set forth
below assume a total Series Fund expense ratio of 0.51% (taking into account the
offsets described under CHARGES AND EXPENSES on page 6).
10
<PAGE>
The following two examples show, for the same Contracts, how the cash values
will vary over a selected year for two hypothetical investment results that are
different from those shown in the tables.
Example No. 1. Contract with $50,000 guaranteed death benefit and annual
premiums in effect for 18 years, during which the value of the assets in the
subaccount increased due to investment performance at a uniform rate of 7.14%
per year. In the 19th year the value of the assets increases at a uniform rate
of 8.14%. (These percentages correspond to gross annual investment returns in
the corresponding Series Fund portfolio of 8% and 9% per year, respectively.)
------------- ------------- --------------
Cash Value Cash Value
INSURED End of Year 18End of Year 19
------------- ------------- --------------
Male, age 25 $11,836 $13,089
at issue
------------- ------------- --------------
Male, age 40 $20,070 $22,046
at issue
------------- ------------- --------------
Example No. 2. Same assumptions as in Example No. 1 except that the value of the
assets increases by 1.14% in the 19th year. (This percentage corresponds to a
gross annual investment return in the corresponding Series Fund portfolio of
2%.)
------------- ------------- --------------
Cash Value Cash Value
INSURED End of Year 18End of Year 19
------------- ------------- --------------
Male, age 25 $11,836 $12,238
at issue
------------- ------------- --------------
Male, age 40 $20,070 $20,607
at issue
------------- ------------- --------------
The changes are greater for the older insured because the premiums (and hence
the assets in the Account relating to the Contract on that insured) are greater
and the same rate of increase therefore produces a greater dollar amount.
Example No. 3. This example and the one following provide information for a
Contract with an $800 annual premium, in effect for 18 years, during which time
the value of the assets in the subaccount increased due to investment
performance at a uniform rate of 7.14% per year. In the 19th year the value of
the assets increases at a uniform rate of 8.14%. (These percentages correspond
to gross annual investment returns in the corresponding Series Fund portfolio of
8% and 9% per year, respectively.)
------------- ------------- --------------
Cash Value Cash Value
INSURED End of Year 18End of Year 19
------------- ------------- --------------
Male, age 25 $17,994 $19,899
at issue
------------- ------------- --------------
Male, age 40 $17,001 $18,675
at issue
------------- ------------- --------------
Example No. 4. Same assumptions as in Example No. 3 except that the value of the
assets increases by 1.14% in the 19th year. (This percentage corresponds to a
gross annual investment return in the corresponding Series Fund portfolio of
2%.)
11
<PAGE>
------------- ------------- --------------
Cash Value Cash Value
INSURED End of Year 18End of Year 19
------------- ------------- --------------
Male, age 25 $17,994 $18,605
at issue
------------- ------------- --------------
Male, age 40 $17,001 $17,456
at issue
------------- ------------- --------------
The last two examples might be compared with Examples No. 3 and 4 on pages 9 and
10. Note that while the same premium results in a larger death benefit for the
younger insured, the cash values for the younger and older insureds are quite
similar. Note also that while the death benefit decreases if the investment
return is 1.14% per year, the cash value increases.
Because a substantial part of each premium is used to provide life insurance
protection, the cash values cannot meaningfully be compared with the amounts
that would have been available had the gross premiums been invested without
obtaining life insurance protection.
SURRENDER OF A CONTRACT FOR ITS NET CASH VALUE
A Contract may be surrendered in whole or in part for its net cash value while
the insured is living. Surrendering a Contract in part involves splitting the
Contract into two Contracts. One is surrendered for its net cash value; the
other is continued in force on the same terms as the original Contract except
that premiums and values will be appropriately reduced. The Contract continued
must have a face amount of at least $25,000, and its premium will be based on
the new face amount. Surrender of all or part of a Contract may have tax
consequences. See TAX TREATMENT OF CONTRACT BENEFITS, page 16.
To surrender a Contract in whole or in part, the owner must deliver or mail it,
together with a written request in a form that meets Pruco Life's needs, to a
Home Office. The net cash value of a surrendered Contract will be determined as
of the valuation period such notice is received in a Home Office.
WITHDRAWAL OF A PORTION OF A CONTRACT'S NET CASH VALUE
Pruco Life will permit a Contract owner to withdraw a portion of the Contract's
net cash value (generally that resulting from investment performance in excess
of 4% a year) without surrendering the Contract, provided that the death benefit
is reduced by the amount of paid-up whole life insurance that the cash value
withdrawn would have purchased for that Contract owner, and that the guaranteed
minimum death benefit is reduced so that the difference between the death
benefit and the guaranteed minimum death benefit is the same percentage of cash
value after the withdrawal as before. The right to withdraw such excess net cash
value may be usefully compared with a partial surrender. As noted above, a
partial surrender essentially involves splitting an existing Contract into two
Contracts and surrendering one for its net cash value; the death benefit, the
guaranteed minimum death benefit, and the cash value of the continuing Contract
will all be proportionately reduced and a new lower scheduled premium will
henceforth be payable. If a Contract owner elects to withdraw excess cash value,
the scheduled premium is not reduced. The cash value is, of course, reduced by
exactly the amount of the withdrawal. Both the death benefit and the guaranteed
minimum death benefit are also reduced but by a lesser amount than they would be
under a partial surrender. It is important to note, however, that a death
benefit decrease may under certain circumstances cause the Contract to become a
Modified Endowment Contract. For a brief discussion of the potential tax
consequences of a Contract owner's withdrawal of the excess cash value, see TAX
TREATMENT OF CONTRACT BENEFITS, page 16.
Upon request, Pruco Life will tell a Contract owner the amount of the net cash
value that may be withdrawn in this manner and the amount of the corresponding
reductions in the death benefit and guaranteed minimum death benefit for that or
any lesser amount of cash value withdrawn. A Contract owner is able to exercise
the right to withdraw a portion of the Contract's cash value either on an
isolated or occasional basis or automatically every year, to the extent
investment performance warrants, for the purpose of applying partial cash value
withdrawals toward the payment of premiums on the Contract. To exercise this
right, a Contract owner must deliver or mail a written request in a form that
meets Pruco Life's needs to a Home Office.
WHEN PROCEEDS ARE PAID
Pruco Life will generally pay any death benefit, cash value or loan proceeds
within 7 days after receipt at a Home Office of all the documents required for
such a payment. Other than the death benefit, which is determined as of the date
of death, the amount will be determined as of the end of the valuation period in
which the necessary documents are received at a Home Office. However, Pruco Life
may delay payment of proceeds from the
12
<PAGE>
subaccount[s] and the variable portion of the death benefit due under the
Contract if the disposal or valuation of the Account's assets is not reasonably
practicable because the New York Stock Exchange is closed for other than a
regular holiday or weekend, trading is restricted by the SEC or the SEC declares
that an emergency exists.
With respect to a Contract in force as extended term or fixed reduced paid-up
insurance, Pruco Life expects to pay any cash value promptly upon request.
However, Pruco Life has the right to delay payment of such cash value for up to
6 months (or a shorter period if required by applicable law). Pruco Life will
pay interest of at least 3% a year if it delays such a payment for 30 days or
more (or a shorter period if required by applicable law).
LIVING NEEDS BENEFIT
Contract applicants may elect to add the LIVING NEEDS BENEFIT(sm) to their
Contracts at issue. The benefit may vary state-by-state. It can generally be
added only to Contracts of $50,000 or more or when the aggregate face amounts of
the insured's eligible contracts equal $50,000 or more.
Subject to state regulatory approval, the LIVING NEEDS BENEFIT allows the
Contract owner to elect to receive an accelerated payment of all or part of the
Contract's death benefit, adjusted to reflect current value, at a time when
certain special needs exist. The adjusted death benefit will always be less than
the death benefit, but will generally be greater than the Contract's cash
surrender value. One or both of the following options may be available. A Pruco
Life representative should be consulted as to whether additional options may be
available.
Terminal Illness Option. This option is available if the insured is diagnosed as
terminally ill with a life expectancy of 6 months or less. When satisfactory
evidence is provided, Pruco Life will provide an accelerated payment of the
portion of the death benefit selected by the Contract owner as a LIVING NEEDS
BENEFIT. The Contract owner may (1) elect to receive the benefit in a single sum
or (2) receive equal monthly payments for 6 months. If the insured dies before
all of the payments have been made, the present value of the remaining payments
will be paid to the beneficiary designated in the Living Needs Benefit claim
form in a single sum.
Nursing Home Option. This option is available after the insured has been
confined to an eligible nursing home for 6 months or more. When satisfactory
evidence is provided, including certification by a licensed physician, that the
insured is expected to remain in the nursing home until death, Pruco Life will
provide an accelerated payment of the portion of the death benefit selected by
the Contract owner as a LIVING NEEDS BENEFIT. The Contract owner may (1) elect
to receive the benefits in a single sum or (2) receive equal monthly payments
for a specified number of years (not more than 10 nor less than 2), depending
upon the age of the insured. If the insured dies before all of the payments have
been made, the present value of the remaining payments will be paid to the
beneficiary designated in the Living Needs Benefit claim form in a single sum.
All or part of the Contract's death benefit may be accelerated under the LIVING
NEEDS BENEFIT. If the benefit is only partially accelerated, a death benefit of
at least $25,000 must remain under the Contract. Pruco Life reserves the right
to determine the minimum amount that may be accelerated.
The LIVING NEEDS BENEFIT is available only to the extent regulatory approval has
been obtained. If desired by a Contract owner, the benefit must be requested on
the Contract's application. There is no charge for adding the benefit to the
Contract. However, an administrative charge (not to exceed $150) will be made at
the time the LIVING NEEDS BENEFIT is paid.
No benefit will be payable if the Contract owner is required to elect it in
order to meet the claims of creditors or to obtain a government benefit. Pruco
Life can furnish details about the amount of LIVING NEEDS BENEFIT that is
available to an eligible Contract owner under a particular Contract, and the
adjusted premium payments that would be in effect if less than the entire death
benefit is accelerated.
The Contract owner should consider whether adding this settlement option is
appropriate in his or her given situation. Adding the LIVING NEEDS BENEFIT to
the Contract has no adverse consequences; however, electing to use it could.
With the exception of certain business-related policies, the recently enacted
Health Insurance Portability and Accountability Act of 1996 excludes from income
the LIVING NEEDS BENEFIT if the insured is terminally ill or chronically ill as
defined by the tax law (although the exclusion in the latter case may be
limited). Contract owners should consult a qualified tax advisor before electing
to receive this benefit. Receipt of a LIVING NEEDS BENEFIT payment may also
affect a Contract owner's eligibility for certain government benefits or
entitlements.
ILLUSTRATIONS OF CASH VALUES, DEATH BENEFITS, AND ACCUMULATED PREMIUMS
The following tables have been prepared to help show how values under the
Contract change with investment performance of the Account. The tables assume
that no portion of the Contract's cash value is allocated to the Real Property
Account. The tables illustrate how cash values and death benefits of Contracts
with a given premium and face amount issued on an insured of a given age would
vary over time if the return on the assets held
13
<PAGE>
in the selected Series Fund portfolios were a uniform, gross, after-tax, annual
rate of 0%, 4% or 8%. The death benefits and cash values would be different from
those shown if the returns averaged 0%, 4%, and 8% but fluctuated over and under
those averages throughout the years.
The amounts shown for the death benefit and cash value as of each Contract year
reflect the fact that the net investment return on the assets held in the
subaccounts is lower than the gross, after-tax return of the portfolios. This is
because the tables assume a total Series Fund expense ratio of 0.51% (taking
into account the offsets described under CHARGES AND EXPENSES on page 6), and
also reflect a daily mortality and expense risk charge to the Account equal to
an effective annual charge of 0.35%. The actual fees and expenses of the
portfolios associated with a particular Contract may be more or less than 0.51%
and will depend on which subaccounts are selected. Based on the above
assumptions, gross annual rates of return of 0%, 4%, and 8% correspond to
approximate net annual rates of return of -0.86%, 3.14%, and 7.14%.
The tables reflect the fact that no charges for federal or state income taxes
are currently made against the Account. If such a charge is made in the future,
it will take a higher gross rate of return to produce after-tax returns of 0%,
4% or 8% than it does now.
The second column of each table shows what results would be achieved if an
amount equal to the total annual premium were invested to earn 4% interest
compounded annually.
Upon request, Pruco Life will furnish a comparable illustration based on the
proposed insured's age and sex (except where unisex rates apply) and on the face
amount or premium amount requested. Such an illustration will assume that the
insured is a standard (or, on request, a preferred) risk and that the premium
will be paid on an annual basis.
Additional illustrations that assume the gross annual investment return is 0%,
6%, and 12% can be found on pages C1 and C2. These percentages correspond to
approximate net annual rates of return of -0.86%, 5.14%, and 11.14%,
respectively.
14
<PAGE>
ILLUSTRATIONS
-------------
VARIABLE LIFE INSURANCE CONTRACT
MALE ISSUE AGE 25
$50,000 GUARANTEED DEATH BENEFIT
$536.50 ANNUAL PREMIUM FOR STANDARD UNDERWRITING RISK (1)
<TABLE>
<CAPTION>
DEATH BENEFIT (2) CASH VALUE (2)
---------------------------------------------- ----------------------------------------------
ASSUMING HYPOTHETICAL GROSS (AND NET) ASSUMING HYPOTHETICAL GROSS (AND NET)
PREMIUMS ANNUAL INVESTMENT RETURN OF ANNUAL INVESTMENT RETURN OF
END OF ACCUMULATED ---------------------------------------------- ----------------------------------------------
POLICY AT 4% INTEREST 0% GROSS 4% GROSS 8% GROSS 0% GROSS 4% GROSS 8% GROSS
YEAR PER YEAR (-0.86% NET) (3.14% NET) (7.14% NET) (-0.86% NET) (3.14% NET) (7.14% NET)
---------- -------------- -------------- -------------- -------------- -------------- -------------- --------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 $ 558 $50,000 $50,000 $ 50,012 $ 22 $ 25 $ 28
2 $ 1,138 $50,000 $50,000 $ 50,080 $ 376 $ 396 $ 416
3 $ 1,742 $50,000 $50,000 $ 50,207 $ 729 $ 781 $ 834
4 $ 2,369 $50,000 $50,000 $ 50,392 $1,080 $ 1,178 $ 1,282
5 $ 3,022 $50,000 $50,000 $ 50,637 $1,437 $ 1,597 $ 1,771
6 $ 3,701 $50,000 $50,000 $ 50,942 $1,790 $ 2,028 $ 2,294
7 $ 4,407 $50,000 $50,000 $ 51,307 $2,139 $ 2,471 $ 2,852
8 $ 5,141 $50,000 $50,000 $ 51,734 $2,484 $ 2,926 $ 3,446
9 $ 5,905 $50,000 $50,000 $ 52,222 $2,824 $ 3,392 $ 4,080
10 $ 6,699 $50,000 $50,000 $ 52,771 $3,159 $ 3,870 $ 4,754
15 $11,172 $50,000 $50,000 $ 56,445 $4,727 $ 6,408 $ 8,796
20 $16,615 $50,000 $50,000 $ 61,704 $6,082 $ 9,154 $14,163
25 $23,237 $50,000 $50,000 $ 68,621 $7,214 $12,080 $21,229
30 $31,293 $50,000 $50,000 $ 77,318 $8,098 $15,128 $30,418
40 (AGE 65) $53,020 $50,000 $50,000 $100,739 $9,005 $21,150 $56,847
</TABLE>
(1) IF PREMIUMS ARE PAID MORE FREQUENTLY THAN ANNUALLY, THE PAYMENTS WOULD BE
$274.50 SEMI-ANNUALLY, $139.50 QUARTERLY OR $48 MONTHLY. THE DEATH BENEFITS
AND CASH VALUES WOULD BE SLIGHTLY DIFFERENT FOR A CONTRACT WITH MORE
FREQUENT PREMIUM PAYMENTS.
(2) ASSUMES NO CONTRACT LOAN HAS BEEN MADE.
THE HYPOTHETICAL INVESTMENT RATES OF RETURN SHOWN ABOVE AND ELSEWHERE IN THIS
PROSPECTUS ARE ILLUSTRATIVE ONLY AND SHOULD NOT BE DEEMED A REPRESENTATION OF
PAST OR FUTURE INVESTMENT RATES OF RETURN. ACTUAL RATES OF RETURN MAY BE MORE OR
LESS THAN THOSE SHOWN AND WILL DEPEND ON A NUMBER OF FACTORS INCLUDING THE
INVESTMENT ALLOCATIONS MADE BY AN OWNER, PREVAILING INTEREST RATES, AND RATES OF
INFLATION. THE DEATH BENEFIT AND CASH VALUE FOR A CONTRACT WOULD BE DIFFERENT
FROM THOSE SHOWN IF THE ACTUAL RATES OF RETURN AVERAGED 0%, 4%, AND 8% OVER A
PERIOD OF YEARS BUT ALSO FLUCTUATED ABOVE OR BELOW THOSE AVERAGES FOR INDIVIDUAL
CONTRACT YEARS. NO REPRESENTATIONS CAN BE MADE BY PRUCO LIFE OF NEW JERSEY OR
THE SERIES FUND THAT THESE HYPOTHETICAL RATES OF RETURN CAN BE ACHIEVED FOR ANY
ONE YEAR OR SUSTAINED OVER ANY PERIOD OF TIME.
T1
<PAGE>
VARIABLE LIFE INSURANCE CONTRACT
MALE ISSUE AGE 40
$50,000 GUARANTEED DEATH BENEFIT
$939 ANNUAL PREMIUM FOR STANDARD UNDERWRITING RISK (1)
<TABLE>
<CAPTION>
DEATH BENEFIT (2) CASH VALUE (2)
---------------------------------------------- ----------------------------------------------
ASSUMING HYPOTHETICAL GROSS (AND NET) ASSUMING HYPOTHETICAL GROSS (AND NET)
PREMIUMS ANNUAL INVESTMENT RETURN OF ANNUAL INVESTMENT RETURN OF
END OF ACCUMULATED ---------------------------------------------- ----------------------------------------------
POLICY AT 4% INTEREST 0% GROSS 4% GROSS 8% GROSS 0% GROSS 4% GROSS 8% GROSS
YEAR PER YEAR (-0.86% NET) (3.14% NET) (7.14% NET) (-0.86% NET) (3.14% NET) (7.14% NET)
---------- -------------- -------------- -------------- -------------- -------------- -------------- --------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 $ 977 $50,000 $50,000 $50,029 $ 197 $ 208 $ 219
2 $ 1,992 $50,000 $50,000 $50,120 $ 815 $ 863 $ 912
3 $ 3,048 $50,000 $50,000 $50,273 $ 1,417 $ 1,527 $ 1,642
4 $ 4,147 $50,000 $50,000 $50,488 $ 2,001 $ 2,198 $ 2,410
5 $ 5,289 $50,000 $50,000 $50,770 $ 2,641 $ 2,953 $ 3,296
6 $ 6,477 $50,000 $50,000 $51,120 $ 3,263 $ 3,718 $ 4,231
7 $ 7,713 $50,000 $50,000 $51,536 $ 3,868 $ 4,494 $ 5,217
8 $ 8,998 $50,000 $50,000 $52,019 $ 4,456 $ 5,280 $ 6,257
9 $10,335 $50,000 $50,000 $52,568 $ 5,026 $ 6,076 $ 7,353
10 $11,725 $50,000 $50,000 $53,184 $ 5,579 $ 6,881 $ 8,507
15 $19,554 $50,000 $50,000 $57,270 $ 8,039 $10,994 $15,222
20 $29,080 $50,000 $50,000 $63,054 $ 9,949 $15,145 $23,694
25 (AGE 65) $40,670 $50,000 $50,000 $70,607 $11,302 $19,214 $34,245
</TABLE>
(1) IF PREMIUMS ARE PAID MORE FREQUENTLY THAN ANNUALLY, THE PAYMENTS WOULD BE
$479.50 SEMI-ANNUALLY, $243 QUARTERLY OR $82.50 MONTHLY. THE DEATH BENEFITS
AND CASH VALUES WOULD BE SLIGHTLY DIFFERENT FOR A CONTRACT WITH MORE
FREQUENT PREMIUM PAYMENTS.
(2) ASSUMES NO CONTRACT LOAN HAS BEEN MADE.
THE HYPOTHETICAL INVESTMENT RATES OF RETURN SHOWN ABOVE AND ELSEWHERE IN THIS
PROSPECTUS ARE ILLUSTRATIVE ONLY AND SHOULD NOT BE DEEMED A REPRESENTATION OF
PAST OR FUTURE INVESTMENT RATES OF RETURN. ACTUAL RATES OF RETURN MAY BE MORE OR
LESS THAN THOSE SHOWN AND WILL DEPEND ON A NUMBER OF FACTORS INCLUDING THE
INVESTMENT ALLOCATIONS MADE BY AN OWNER, PREVAILING INTEREST RATES, AND RATES OF
INFLATION. THE DEATH BENEFIT AND CASH VALUE FOR A CONTRACT WOULD BE DIFFERENT
FROM THOSE SHOWN IF THE ACTUAL RATES OF RETURN AVERAGED 0%, 4%, AND 8% OVER A
PERIOD OF YEARS BUT ALSO FLUCTUATED ABOVE OR BELOW THOSE AVERAGES FOR INDIVIDUAL
CONTRACT YEARS. NO REPRESENTATIONS CAN BE MADE BY PRUCO LIFE OF NEW JERSEY OR
THE SERIES FUND THAT THESE HYPOTHETICAL RATES OF RETURN CAN BE ACHIEVED FOR ANY
ONE YEAR OR SUSTAINED OVER ANY PERIOD OF TIME.
T2
<PAGE>
CONTRACT LOANS
After the first Contract year, the owner may borrow from Pruco Life using the
Contract as the only security for the loan. During the first Contract year, no
loans are permitted. Except as provided in the following paragraph, after the
first Contract year a Contract owner may borrow up to 75% of the Contract's cash
value. The minimum amount that may be borrowed at any one time is $500, unless
the loan is used to pay premiums on the Contract. The owner who is paying
premiums other than monthly may elect in advance to have Pruco Life
automatically make a loan against the Contract, if the net cash value is large
enough, in order to pay a premium that has not been paid at the end of a grace
period. In some states this automatic premium loan may be available to owners
who pay premiums monthly.
Under one of the loan provisions available under this Contract, interest on a
loan accrues daily at a fixed effective annual rate of 5.5% (6% for Contracts
issued to Texas residents). However, if a Contract owner so desires, and if
Pruco Life has received any required approvals from the regulatory officials in
the state or other jurisdiction in which the Contract is to be issued, the
Contract owner may elect at the time of issuance of the Contract to have a
different loan provision in the Contract under which the interest rate will vary
from time to time. Under this variable loan interest rate provision, a Contract
owner may borrow up to 90% of the Contract's cash value after the first Contract
year.
If an owner elects the variable loan interest rate provision, interest on any
loan will accrue daily at an effective annual rate Pruco Life determines at the
start of each Contract year (instead of at the fixed 5.5% rate). This interest
rate will not exceed the greatest of: (1) the "Published Monthly Average" for
the calendar month ending 2 months before the calendar month of the Contract
anniversary; (2) 5%, which is the assumed rate of return for the Contract plus
1%; and (3) any rate required by law in the state of issue of the Contract. The
"Published Monthly Average" means Moody's Corporate Bond Yield Average--Monthly
Average Corporates, as published by Moody's Investors Service, Inc. or any
successor to that service, or if that average is no longer published, a
substantially similar average established by the insurance regulator where the
Contract is issued. For example, the Published Monthly Average in 1996 ranged
from 7.10% to 8.00%.
Interest payments on any loan are due at the end of each Contract year. If
interest is not paid when due, it is added to the amount of the loan. If the sum
of all outstanding loans plus accrued interest exceeds what the net cash value
would be if there were no Contract debt, Pruco Life will notify the Contract
owner of its intent to terminate the Contract in 31 days, within which time the
owner may repay all or enough of the loan to obtain a positive net cash value
and thus keep the Contract in force. If you fail to keep the Contract in force,
the amount of unpaid Contract debt will be treated as a distribution which may
be taxable. See TAX TREATMENT OF CONTRACT BENEFITS -- Pre-Death Distributions,
page 17, and LAPSE AND REINSTATEMENT, page 18.
When a loan is made, an amount equal to the loan proceeds will be transferred
out of the Account and the Real Property Account, as applicable. The reduction
will generally be made in the same proportions as the value in each subaccount
and Real Property Account bears to the total value of the Contract. While a
fixed-rate loan is outstanding, the amount that was so transferred will be
credited with the assumed investment return of 4% rather than with the actual
rate of return of the subaccount[s] and/or the Real Property Account. While a
loan made pursuant to the variable loan interest rate provision is outstanding,
the amount that was so transferred will be credited with a rate which is 1% less
than the loan interest rate for the Contract year (instead of 4%), rather than
with the actual rate of return of the subaccount[s] and/or the Real Property
Account.
A loan will not affect the amount of the premiums due. Should the death benefit
become payable while a loan is outstanding, or should the Contract be
surrendered, the amount of the Contract debt will be deducted from the death
benefit or the cash value otherwise payable.
A loan will have a permanent effect on a Contract's death benefit and cash value
because the investment results of the subaccount[s] and/or the Real Property
Account will apply only to the amount remaining in the subaccount[s] and/or the
Real Property Account. The longer the loan is outstanding, the greater the
effect is likely to be. The effect could be favorable or unfavorable. If
investment results are favorable while the loan is outstanding, the death
benefit and cash value will not increase as rapidly as they would have if no
loan had been made. If investment results are unfavorable, the death benefit and
the cash value will not be as adversely affected as they would have been had no
loan been made. Of course, a loan that is repaid will not have any effect upon
the guaranteed minimum death benefit.
The tax treatment of Contract loans depends upon whether the Contract is
classified as a Modified Endowment Contract for federal tax purposes. See TAX
TREATMENT OF CONTRACT BENEFITS, page 16.
Consider the Contract issued on a 25 year old insured illustrated in the table
on page T1 with an 8% gross investment return. Assume a $2,500 (5.5%) fixed-rate
loan was made at the end of Contract year 8 and repaid at the end of Contract
year 9. Upon repayment, the death benefit would be $51,911.08 and the cash value
$4,002.72. These amounts are lower than the death benefit and cash value shown
on that page for the end of
15
<PAGE>
Contract year 9 because the loan amount was credited with the 4% assumed
investment return rather than the 8% gross rate of return for the selected
subaccounts.
RIGHT TO EXCHANGE A CONTRACT FOR A FIXED-BENEFIT WHOLE-LIFE POLICY
At any time during the first 24 months after a Contract is issued, so long as no
premium due remains unpaid, the owner may exchange it for a fixed benefit
whole-life policy on the insured's life. No evidence of insurability will be
required to make an exchange. The new policy's death benefit will be the same as
the guaranteed minimum amount of the Contract. The new policy will also have the
same issue date and risk classification for the insured as the Contract, but it
will be issued by Prudential and will be a participating (potentially
dividend-paying) policy. Premiums for the new policy will be based on
Prudential's rates in effect on the original issue date for the same class of
risk which are currently higher than premiums under the Contract. The new
policy's cash value will be the same as it would have been had the new policy
been purchased at the outset. There will be an equitable cash adjustment on the
exchange equal to the difference between the premiums on the new policy and the
premiums on the Contract for the period between the Contract date and the date
of the exchange, reduced by the amount, if any, by which the cash value of the
Contract on the date of the exchange exceeds what the cash value would have been
had the subaccounts and/or the Real Property Account in which the Contract
participated uniformly earned the assumed investment return of 4%. A further
adjustment will be made for any differences in premiums for any optional
benefits carried over to the new policy.
The exchange will be effective when Pruco Life receives a written request in a
form that meets its needs, and receives the Contract and payment of any
adjustment due on the exchange. Any outstanding Contract debt must be repaid on
or before the effective date of the exchange.
The Contract owner may also exchange the Contract for a fixed-benefit life
insurance policy according to procedures meeting applicable state insurance law
requirements if the Series Fund or one of its portfolios has a material change
in its investment policy. Pruco Life, in conjunction with the Arizona Director
of Insurance, will determine if a change in investment policy is material. The
Contract owner will be able to exchange within 60 days of receipt of notice of
such a material change or of the effective date of the change, whichever is
later. Upon such an exchange, there will be a cash adjustment based on any
difference in net cash value between the Contract and the new policy.
SALE OF THE CONTRACT AND SALES COMMISSIONS
Pruco Securities Corporation ("Prusec"), an indirect wholly-owned subsidiary of
Prudential, acts as the principal underwriter of the Contract. Prusec, organized
in 1971 under New Jersey law, is registered as a broker and dealer under the
Securities Exchange Act of 1934 and is a member of the National Association of
Securities Dealers, Inc. Prusec's principal business address is 213 Washington
Street, Newark, New Jersey, 07102-2992. The Contract is sold by registered
representatives of Prusec who are also authorized by state insurance departments
to do so. The Contract may also be sold through other broker-dealers authorized
by Prusec and applicable law to do so. Registered representatives of such other
broker-dealers may be paid on a different basis than described below. Where the
insured is less than 58 years of age, the representative will generally receive
a commission of no more than 50% of the premiums for the first year, no more
than 11% of the premiums for the second, third, and fourth years, no more than
3% of the premiums for the fifth through tenth years, and no more than 2% of the
premiums thereafter. For insureds over 58 years of age, the commission will be
lower. The representative may be required to return all or part of the first
year commission if the Contract is not continued through the second year.
Representatives with less than 3 years of service may be paid on a different
basis. Representatives who meet certain productivity, profitability and
persistency standards with regard to the sale of the Contract will be eligible
for additional compensation.
Sales expenses in any year are not equal to the deduction for sales load in that
year. Pruco Life expects to recover its total sales expenses over the periods
the Contracts are in effect. To the extent that the sales charges are
insufficient to cover total sales expenses, the sales expenses will be recovered
from Pruco Life's surplus, which may include the amounts derived from the risk
charge and the mortality and expense risk charge, described in items 5 and 7
under CHARGES AND EXPENSES, page 6.
TAX TREATMENT OF CONTRACT BENEFITS
Each prospective purchaser is urged to consult a qualified tax advisor. The
following discussion is not intended as tax advice, and it is not a complete
statement of what the effect of federal income taxes will be under all
circumstances. Rather, it provides information about how Pruco Life believes the
current tax laws apply in the most commonly occurring circumstances. There is no
guarantee, however, that the current federal income tax laws and regulations or
interpretations will not change.
16
<PAGE>
Treatment as Life Insurance. The Contract will be treated as "life insurance,"
as long as it satisfies certain definitional tests set forth in Sections 7702 of
the Internal Revenue Code (the "Code") and as long as the underlying investments
for the Contract satisfy diversification requirements. (See DIVIDENDS,
DISTRIBUTIONS, AND TAXES in the attached prospectus for the Series Fund.)
Pruco Life believes that the Contract meets these definitional and
diversification requirements and accordingly will be treated as life insurance
for tax purposes. This means that: (1) except as noted below, the Contract owner
should not be taxed on any part of the Contract's cash value, including
additions attributable to interest, dividends or appreciation until amounts are
distributed under the Contract; and (2) the death benefit should be excludible
from the gross income of the beneficiary under Section 101(a) of the Code.
However, Section 7702 of the Code which defines life insurance for tax purposes
gives the Secretary of the Treasury authority to prescribe regulations to carry
out the purposes of the Section. In this regard, proposed regulations governing
mortality charges were issued in 1991 and proposed regulations relating to the
definition of life insurance were issued in 1992. None of these proposed
regulations has yet been finalized. Additional regulations under Section 7702
may also be promulgated in the future. Moreover, in connection with the issuance
of temporary regulations under Section 817(h), the Treasury Department announced
that such regulations do not provide guidance concerning the extent to which
Contract owners may direct their investments to particular divisions of a
separate account. Such guidance will be included in regulations or rulings under
Section 817(d) relating to the definition of a variable contract.
Pruco Life intends to comply with final regulations issued under sections 7702
and 817. Therefore, it reserves the right to make such changes as it deems
necessary to assure that the Contract continues to qualify as life insurance for
tax purposes. Any such changes will apply uniformly to affected Contract owners
and will be made only after advance written notice to affected Contract owners.
Pre-Death Distributions. The taxation of pre-death distributions depends on
whether the Contract is classified as a Modified Endowment Contract. The
following discussion first deals with distributions under Contracts not so
classified, and then with Modified Endowment Contracts.
1. A surrender or lapse of the Contract may have tax consequences. Upon
surrender, the owner will not be taxed on the net cash value except for the
amount, if any, that exceeds the gross premiums paid less the untaxed
portion of any prior withdrawals. The amount of any unpaid Contract debt
will, upon surrender or lapse, be added to the net cash value and treated,
for this purpose, as if it had been received. Any loss incurred upon
surrender is generally not deductible. The tax consequences of a surrender
may differ if the proceeds are received under any income payment settlement
option.
A withdrawal (or partial surrender) generally is not taxable unless it
exceeds total premiums paid to the date of withdrawal less the untaxed
portion of any prior withdrawals. However, under certain limited
circumstances, in the first 15 Contract years all or a portion of a
withdrawal may be taxable if the Contract's cash value exceeds the total
premiums paid less the untaxed portions of any prior withdrawals, even if
total withdrawals do not exceed total premiums paid to date.
Extra premiums for optional benefits and riders generally do not count in
computing gross premiums paid, which in turn determines the extent to which
a withdrawal might be taxed.
Loans received under the Contract will ordinarily be treated as
indebtedness of the owner and will not be considered to be distributions
subject to tax.
2. Some of the above rules are changed if the Contract is classified as a
Modified Endowment Contract under Section 7702A of the Code. In general,
this Contract should not become a Modified Endowment Contract. However,
certain actions may cause the Contract to become a Modified Endowment
Contract. These actions may include partial surrenders or withdrawals, the
deletion of certain riders or the selection of certain options upon the
lapse of the Contract. Contract owners contemplating any of these steps
should first consult a qualified tax advisor and their Pruco Life
representative.
If the Contract is classified as a Modified Endowment Contract, then
pre-death distributions, including loans and withdrawals, are includible in
income to the extent that the Contract's cash value prior to surrender
charges exceeds the gross premiums paid for the Contract increased by the
amount of any loans previously includible in income and reduced by any
untaxed amounts previously received other than the amount of any loans
excludible from income. These rules may also apply to pre-death
distributions, including loans, made during the 2 year period prior to the
Contract becoming a Modified Endowment Contract.
In addition, pre-death distributions from such Contracts (including full
surrenders) will be subject to a penalty of 10 per cent of the amount
includible in income unless the amount is distributed on or after age 59
1/2, on account of the taxpayer's disability or as a life annuity. It is
presently unclear how the penalty tax provisions apply to Contracts owned
by nonnatural persons such as corporations.
17
<PAGE>
Under certain circumstances, Modified Endowment Contracts issued during any
calendar year will be treated as a single contract for purposes of applying
the above rules.
Withholding. The taxable portion of any amounts received under the Contract will
be subject to withholding to meet federal income tax obligations if the Contract
owner fails to elect that no taxes be withheld or in certain other
circumstances. Contract owners who do not provide a social security number or
other taxpayer identification number will not be permitted to elect out of
withholding. All recipients may be subject to penalties under the estimated tax
payment rules if withholding and estimated tax payments are not sufficient.
Other Tax Considerations. Transfer of the Contract to a new owner or assignment
of the Contract may have tax consequences depending on the circumstances. In the
case of a transfer of the Contract for a valuable consideration, the death
benefit may be subject to federal income taxes under Section 101(a)(2) of the
Code. In addition, a transfer of the Contract to or the designation of a
beneficiary who is either 37 1/2 years younger than the Contract owner or a
grandchild of the Contract owner may have Generation Skipping Transfer tax
consequences under Section 2601 of the Code.
In certain circumstances, deductions for interest paid or accrued on Contract
debt or on other loans that are incurred or continued to purchase or carry the
Contract may be denied under Section 163 of the Code as personal interest or
under Section 264 of the Code. Contract owners should consult a tax advisor
regarding the application of these provisions to their circumstances.
Business-owned life insurance is subject to additional rules. Section 264(a)(1)
of the Code generally precludes business Contract owners from deducting premium
payments. The recently enacted Health Insurance Portability and Accountability
Act of 1996 generally disallows tax deductions for interest on Contract debt on
a business- owned insurance policy effective (with certain transitional rules)
for interest paid or accrued after October 13, 1995. An exception permits the
deduction of interest on policy loans on Contracts for up to 20 key persons. The
interest deduction for Contract debt on such loans is limited to a prescribed
interest rate and a maximum aggregate loan amount of $50,000 per key insured
person. The Code also imposes an indirect tax upon additions to the Contract's
cash value or the receipt of death benefits under business-owned life insurance
policies under certain circumstances by way of the corporate alternative minimum
tax.
The individual situation of each Contract owner or beneficiary will determine
the federal estate taxes and the state and local estate, inheritance and other
taxes due if the owner or insured dies.
LAPSE AND REINSTATEMENT
This Contract ensures that as long as premiums are paid, insurance protection
remains in effect. However, if a premium is not paid on or before each due date,
or within the 31 day grace period after each due date, the Contract will lapse.
A Contract that lapses with an outstanding Contract loan may have tax
consequences. See TAX TREATMENT OF CONTRACT BENEFITS on page 16.
A Contract that has lapsed may be reinstated within 3 years after the date of
default unless the Contract has been surrendered for its cash value. To
reinstate a lapsed Contract, Pruco Life requires renewed evidence of
insurability, and submission of certain payments due under the Contract.
If a Contract does lapse, it may still provide some benefits. Those benefits are
described below under OPTIONS ON LAPSE.
OPTIONS ON LAPSE
If a Contract lapses because the premium has not been paid before the end of the
grace period, some life insurance coverage may continue in effect or the owner
may choose to surrender the Contract for its net cash value. A lapse of a
Contract with a Contract loan may have tax consequences. See TAX TREATMENT OF
CONTRACT BENEFITS, page 16.
1. Extended Term Insurance. With one exception explained below, if the owner
does not communicate at all with Pruco Life, life insurance coverage will
continue for a length of time that depends on the net cash value on the due date
of the first unpaid premium, the amount of insurance, and the age and sex
(except where unisex rates apply) of the insured. The insurance amount will be
what it would have been on the due date of the unpaid premium, taking into
account any Contract debt on that date. The amount will not change while the
insurance stays in force. This benefit is known as extended term insurance. The
owner will be told in writing how long the insurance will be in effect. Extended
term insurance has a cash value but no loan value.
Contracts issued on the lives of certain insureds in high risk rating classes
will include a statement that extended term insurance will not be provided. In
that case, variable reduced paid-up insurance (as described in item 3 below)
will be the automatic benefit provided on lapse for Contracts issued in
jurisdictions where required approvals have been obtained from regulatory
authorities. Such approvals have been received in all jurisdictions except the
18
<PAGE>
District of Columbia and Texas. The automatic benefit provided on lapse for
these insureds under Contracts issued in these two remaining jurisdictions will
be fixed reduced paid-up insurance (as described in item 2 below) until such
time as approvals for variable reduced paid-up insurance are obtained.
2. Fixed Reduced Paid-Up Insurance. The owner may choose to have insurance
coverage provided for the lifetime of the insured. The amount will be lower than
what extended term insurance would provide. This is known as fixed reduced
paid-up insurance. The insurance amount will depend on the net cash value on the
due date of the first premium in default, and the age and sex (except where
unisex rates apply) of the insured. The amount will not change thereafter unless
a loan is taken against the fixed reduced paid-up insurance. Pruco Life will, if
asked, tell the owner what the amount will be. Apart from the case described
above in which fixed reduced paid-up insurance is the automatic benefit provided
on lapse, the owner who wants fixed reduced paid-up insurance must ask for it in
writing, in a form that meets Pruco Life's needs, within 3 months of the due
date of the first unpaid premium. Fixed reduced paid-up insurance has a cash
value and a loan value. Acquisition of reduced paid-up insurance within the
first 7 Contract years may result in the Contract becoming a Modified Endowment
Contract. See TAX TREATMENT OF CONTRACT BENEFITS, page 16.
3. Variable Reduced Paid-Up Insurance. Variable reduced paid-up insurance
provides insurance coverage for the lifetime of the insured. The initial
insurance amount will depend upon the net cash value on the due date of the
first premium in default and the age and sex (except where unisex rates apply)
of the insured. This will be a new guaranteed minimum death benefit. Aside from
this guarantee, the cash value and the amount of insurance will vary with
investment performance in the same manner as a Contract in force on a premium
paying basis (see HOW A CONTRACT'S DEATH BENEFIT WILL VARY, page 8 and HOW A
CONTRACT'S CASH VALUE WILL VARY, page 10). Variable reduced paid-up insurance
has a loan privilege identical to that available on premium paying Contracts
(see CONTRACT LOANS, page 15). The availability of variable reduced paid-up
insurance is subject to the receipt of required state regulatory approvals.
Acquisition of reduced paid-up insurance within the first 7 Contract years may
result in the Contract becoming a Modified Endowment Contract. See TAX TREATMENT
OF CONTRACT BENEFITS, page 16.
As explained in item 1 above, variable reduced paid-up insurance is the
automatic benefit on lapse for Contracts issued on certain insureds in those
jurisdictions where regulatory approval has been obtained for such insurance.
Owners of other Contracts who want variable reduced paid-up insurance must ask
for it in writing, in a form that meets Pruco Life's needs, within 3 months of
the date of default; it will be available to such owners only if the initial
amount of variable reduced paid-up insurance would be at least $5,000. This
minimum is not applicable to Contracts for which variable reduced paid-up
insurance is the automatic benefit upon lapse.
4. Payment of Net Cash Value. The owner can receive the net cash value by
surrendering the Contract and making a written request in a form that meets
Pruco Life's needs. If Pruco Life receives the request within the days of grace
of a premium in default, the net cash value will be the net cash value as of the
due date of that premium, adjusted for any loan made or repaid during the days
of grace, plus or minus an amount that depends upon the investment performance
between the due date and the date Pruco Life receives the request. Whether the
net cash value as of the due date of the unpaid premium is increased or
decreased by subsequent investment performance depends upon whether or not the
assets relating to the Contract have increased at more than 4% a year. If Pruco
Life receives the request after the grace period expires, the net cash value
will be the net value of any extended term insurance then in force, or the net
value of any reduced paid-up insurance then in force (either fixed or variable),
less any Contract debt. Surrender of the Contract may have tax consequences. See
TAX TREATMENT OF CONTRACT BENEFITS, page 16.
The following table shows, the cash value, extended term insurance, and both
fixed and variable reduced paid-up insurance for two representative Contracts,
each with a guaranteed death benefit of $50,000, which lapse at the end of 8
years after a uniform gross annual investment return of 8%. The tables assume a
total Series Fund expense ratio of 0.51% (taking into account the offsets
described under CHARGES AND EXPENSES on page 6).
---------------- --------------- --------------- ---------------
Extended Reduced
INSURED Cash Value Term Insurance Paid-Up Insurance
---------------- --------------- --------------- ---------------
Male, age 25 $3,446 $51,734 $14,387
at issue for 19.82 years for life
---------------- --------------- --------------- ---------------
Male, age 40 $6,257 $52,019 $16,180
at issue for 12.72 years for life
---------------- --------------- --------------- ---------------
19
<PAGE>
LEGAL CONSIDERATIONS RELATING TO SEX-DISTINCT PREMIUMS AND BENEFITS
The Contract generally employs mortality tables that distinguish between males
and females. Thus, premiums and benefits under Contracts issued on males and
females of the same age will generally differ. However, in those states that
have adopted regulations prohibiting sex-distinct insurance rates, premiums and
cost of insurance charges will be based on male mortality tables whether the
insured is male or female. In addition, employers and employee organizations
considering purchase of a Contract should consult their legal advisors to
determine whether purchase of a Contract based on sex-distinct actuarial tables
is consistent with Title VII of the Civil Rights Act of 1964 or other applicable
law. Pruco Life may offer the Contract with unisex mortality rates to such
prospective purchasers.
OTHER GENERAL CONTRACT PROVISIONS
BENEFICIARY. The beneficiary is designated and named in the application by the
Contract owner. Thereafter, the owner may change the beneficiary, provided it is
in accordance with the terms of the Contract. Should the insured die with no
surviving beneficiary, the insured's estate will become the beneficiary.
INCONTESTABILITY. After the Contract has been in force during the insured's
lifetime for 2 years from the Contract date, Pruco Life will not contest its
liability under the Contract in accordance with its terms.
MISSTATEMENT OF AGE OR SEX. If the insured's stated age or sex (except where
unisex rates apply) or both are incorrect in the Contract, Pruco Life will
adjust the benefits payable, as required by law, to reflect what the premium
would have purchased for the correct age and sex.
SUICIDE EXCLUSION. Generally, if the insured, whether sane or insane, dies by
suicide within 2 years from the Contract date, Pruco Life will pay no more under
the Contract than the sum of the premiums paid.
ASSIGNMENT. This Contract may not be assigned if such assignment would violate
any federal, state or local law or regulation. Pruco Life assumes no
responsibility for the validity or sufficiency of any assignment, and it will
not be obligated to comply with any assignment unless it has received a copy at
one of its Home Offices.
SETTLEMENT OPTIONS. The Contract grants to most owners, or to the beneficiary, a
wide variety of optional ways of receiving Contract proceeds, other than in a
lump sum. Any Pruco Life representative authorized to sell this Contract can
explain these options upon request.
RIDERS
The Contract owner may be able to obtain extra fixed benefits, which may require
an additional premium. These benefits will be described in what is known as a
"rider" to the Contract. For example, one benefit pays an additional amount if
the insured dies in an accident. Others waive certain premiums if the insured is
disabled within the meaning of the provision (or, in the case of a Contract
issued on an insured under the age of 15, if the applicant dies or becomes
disabled within the meaning of the provision). Others pay an additional amount
if the insured dies within a stated number of years after issue; similar
benefits may be available if the insured's spouse or child should die. The
amounts of these benefits are fully guaranteed at issue; they do not depend on
the performance of the Account. Certain restrictions may apply; they are clearly
described in the applicable rider. Any Pruco Life representative authorized to
sell the Contract can explain these extra benefits further. Samples of the
provisions are available from Pruco Life upon written request.
VOTING RIGHTS
As stated above, all of the assets held in the subaccounts of the Account will
be invested in shares of the corresponding portfolios of the Series Fund. Pruco
Life is the legal owner of those shares and as such has the right to vote on any
matter voted on at Series Fund shareholders meetings. However, Pruco Life will,
as required by law, vote the shares of the Series Fund at any regular and
special shareholders meetings it is required to hold in accordance with voting
instructions received from Contract owners. The Series Fund will not hold annual
shareholders meetings when not required to do so under Maryland law or the
Investment Company Act of 1940. Series Fund shares for which no timely
instructions from Contract owners are received, and any shares attributable to
general account investments of Pruco Life will be voted in the same proportion
as shares in the respective portfolios for which instructions are received.
Should the applicable federal securities laws or regulations, or their current
interpretation, change so as to permit Pruco Life to vote shares of the Series
Fund in its own right, it may elect to do so.
Matters on which Contract owners may give voting instructions include the
following: (1) election of the Board of Directors of the Series Fund; (2)
ratification of the independent accountant of the Series Fund; (3) approval of
the investment advisory agreement for a portfolio of the Series Fund
corresponding to the Contract owner's selected subaccount[s]; (4) any change in
the fundamental investment policy of a portfolio corresponding to the Contract
20
<PAGE>
owner's selected subaccount[s]; and (5) any other matter requiring a vote of the
shareholders of the Series Fund. With respect to approval of the investment
advisory agreement or any change in a portfolio's fundamental investment policy,
Contract owners participating in such portfolios will vote separately on the
matter, pursuant to the requirements of Rule 18f-2 under the 1940 Act.
The number of Series Fund shares for which instructions may be given by a
Contract owner is determined by dividing the portion of the value of the
Contract derived from participation in a subaccount, by the value of one share
in the corresponding portfolio of the Series Fund. The number of votes for which
each Contract owner may give Pruco Life instructions will be determined as of
the record date chosen by the Board of Directors of the Series Fund. Pruco Life
will furnish Contract owners with proper forms and proxies to enable them to
give these instructions. Pruco Life reserves the right to modify the manner in
which the weight to be given voting instructions is calculated where such a
change is necessary to comply with current federal regulations or
interpretations of those regulations.
Pruco Life may, if required by state insurance regulations, disregard voting
instructions if such instructions would require shares to be voted so as to
cause a change in the sub-classification or investment objectives of one or more
of the Series Fund's portfolios, or to approve or disapprove an investment
advisory contract for the Series Fund. In addition, Pruco Life itself may
disregard voting instructions that would require changes in the investment
policy or investment advisor of one or more of the Series Fund's portfolios,
provided that Pruco Life reasonably disapproves such changes in accordance with
applicable federal regulations. If Pruco Life does disregard voting
instructions, it will advise Contract owners of that action and its reasons for
such action in the next annual or semi-annual report to Contract owners.
SUBSTITUTION OF SERIES FUND SHARES
Although Pruco Life believes it to be unlikely, it is possible that in the
judgment of its management, one or more of the portfolios of the Series Fund may
become unsuitable for investment by Contract owners because of investment policy
changes, tax law changes or the unavailability of shares for investment. In that
event, Pruco Life may seek to substitute the shares of another portfolio or of
an entirely different mutual fund. Before this can be done, the approval of the
SEC, and possibly one or more state insurance departments, will be required.
Contract owners will be notified of such substitution.
REPORTS TO CONTRACT OWNERS
Once each Contract year (except where the Contract is in force as fixed extended
term insurance or fixed reduced paid-up insurance), Contract owners will be sent
statements that provide certain information pertinent to their own Contract.
These statements detail values and transactions made and specific Contract data
that apply only to each particular Contract. On request, a Contract owner will
be sent a current statement in a form similar to that of the annual statement
described above, but Pruco Life may limit the number of such requests or impose
a reasonable charge if such requests are made too frequently.
Contract owners will also be sent annual and semi-annual reports of the Series
Fund showing the financial condition of the portfolios and the investments held
in each.
STATE REGULATION
Pruco Life is subject to regulation and supervision by the Department of
Insurance of the State of Arizona, which periodically examines its operations
and financial condition. It is also subject to the insurance laws and
regulations of all jurisdictions in which it is authorized to do business.
Pruco Life is required to submit annual statements of its operations, including
financial statements, to the insurance departments of the various jurisdictions
in which it does business to determine solvency and compliance with local
insurance laws and regulations.
In addition to the annual statements referred to above, Pruco Life is required
to file with Arizona and other jurisdictions a separate statement with respect
to the operations of all its variable contract accounts, in a form promulgated
by the National Association of Insurance Commissioners.
EXPERTS
The financial statements included in this prospectus for the year ended December
31, 1996 have been audited by Price Waterhouse LLP, independent accountants, as
stated in their reports appearing herein, and are included in reliance upon the
reports of such firm given upon their authority as experts in accounting and
auditing. Price Waterhouse LLP's principal business address is 1177 Avenue of
the Americas, New York, New York 10036.
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<PAGE>
The financial statements included in this prospectus for years ended December
31, 1995 and December 31, 1994, have been audited by Deloitte & Touche LLP,
independent auditors, as stated in their reports appearing herein, and are
included in reliance upon the reports of such firm given upon their authority as
experts in accounting and auditing. Deloitte & Touche LLP's principal business
address is Two Hilton Court, Parsippany, New Jersey 07054- 0319.
On March 12, 1996, Deloitte & Touche LLP was dismissed as the independent
accountants of Pruco Life. There have been no disagreements with Deloitte &
Touche LLP on any matter of accounting principles or practices, financial
statement disclosure or auditing scope or procedure which, if not resolved to
the satisfaction of the accountant, would have caused them to make reference to
the matter in their reports.
Actuarial matters included in this prospectus have been examined by Nancy D.
Davis, FSA, MAAA, Vice President and Actuary of Prudential whose opinion is
filed as an exhibit to the registration statement.
LITIGATION
Several actions have been brought against Pruco Life alleging that Pruco Life
and its agents engaged in improper life insurance sales practices. Prudential
has agreed to indemnify Pruco Life for losses, if any, resulting from such
litigation. No other significant litigation is being brought against Pruco Life
that would have a material effect on its financial position.
ADDITIONAL INFORMATION
A registration statement has been filed with the SEC under the Securities Act of
1933, relating to the offering described in this prospectus. This prospectus
does not include all of the information set forth in the registration statement.
Certain portions have been omitted pursuant to the rules and regulations of the
SEC. The omitted information may, however, be obtained from the SEC's principal
office in Washington, D.C., upon payment of a prescribed fee.
Further information may also be obtained from Pruco Life's office. The address
and telephone number are set forth on the cover of this prospectus.
FINANCIAL STATEMENTS
The consolidated financial statements of Pruco Life and subsidiaries included
herein should be distinguished from the financial statements of the Account, and
should be considered only as bearing upon the ability of Pruco Life to meet its
obligations under the Contracts.
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<PAGE>
DIRECTORS AND OFFICERS
The directors and major officers of Pruco Life, listed with their principal
occupations during the past 5 years, are shown below.
DIRECTORS OF PRUCO LIFE
WILLIAM M. BETHKE, Director. -- President, Prudential Capital Markets Group
since 1992.
IRA J. KLEINMAN, Director. -- Executive Vice President, Prudential International
Insurance Group since 1997; 1995 to 1997: Chief Marketing and Product
Development Officer, Prudential Individual Insurance Group; 1993 to 1995:
President, Prudential Select; Prior to 1993: Senior Vice President of
Prudential.
MENDEL A. MELZER, Director. -- Chief Investment Officer, Mutual Funds and
Annuities, Prudential Investments since 1996; 1995 to 1996: Chief Financial
Officer of the Money Management Group of Prudential; 1993 to 1995: Senior Vice
President and Chief Financial Officer of Prudential Preferred Financial
Services; Prior to 1993: Managing Director, Prudential Investment Corporation.
ESTHER H. MILNES, President and Director. -- Vice President and Actuary,
Prudential Individual Insurance Group since 1996; 1993 to 1996: Senior Vice
President and Chief Actuary, Prudential Insurance and Financial Services; Prior
to 1993: Vice President and Associate Actuary of Prudential.
I. EDWARD PRICE, Vice Chairman and Director. -- Senior Vice President and
Actuary, Prudential Individual Insurance Group since 1995; 1994 to 1995: Chief
Executive Officer, Prudential International Insurance; 1993 to 1994: President,
Prudential International Insurance; Prior to 1993: Senior Vice President and
Company Actuary of Prudential.
KIYOFUMI SAKAGUCHI, Director. -- President, Prudential International Insurance
Group since 1995; 1994 to 1995: Chairman and Chief Executive Officer, The
Prudential Life Insurance Co., Ltd.; Prior to 1994: President and Chief
Executive Officer, Asia Pacific Region-Prudential International Insurance, and
President, The Prudential Life Insurance Co., Ltd.
WILLIAM F. YELVERTON, Chairman and Director. --Chief Executive Officer,
Prudential Individual Insurance Group since 1995; Prior to 1995: Chief Executive
Officer, New York Life Worldwide.
OFFICERS WHO ARE NOT DIRECTORS
SUSAN L. BLOUNT, Secretary.--Vice President and Secretary of Prudential since
1995; Prior to 1995: Assistant General Counsel for Prudential Residential
Services Company.
C. EDWARD CHAPLIN, Treasurer. -- Vice President and Treasurer of Prudential
since 1995; 1993 to 1995: Managing Director and Assistant Treasurer of
Prudential; 1992 to 1993: Vice President and Assistant Treasurer, Banking and
Cash Management for Prudential.
LINDA S. DOUGHERTY, Vice President, Comptroller and Chief Accounting Officer. --
Vice President and Comptroller, Prudential Individual Insurance Group since
1997; Prior to 1997: Vice President, Accounting, Prudential.
JAMES C. DROZANOWSKI, Senior Vice President. -- Vice President and Operations
Executive, Prudential Individual Insurance Group since 1996; 1995 to 1996:
President and Chief Executive Officer of Chase Manhattan Bank; 1993 to 1995:
Vice President, North America Customer Services, Chase Manhattan Bank; Prior to
1993: Operations Executive, Global Securities Services, Chase Manhattan Bank.
CLIFFORD E. KIRSCH, Chief Legal Officer. -- Chief Counsel, Variable Products,
Law Department of Prudential since 1995; 1994 to 1995: Associate General Counsel
with Paine Webber; Prior to 1994: Assistant Director in the Division of
Investment Management with the Securities and Exchange Commission.
FRANK P. MARINO, Senior Vice President. -- Vice President, Policyowner Relations
Department, Prudential Individual Insurance Group since 1996; Prior to 1996:
Senior Vice President, Prudential Mutual Fund Services.
MARIO A. MOSSE, Senior Vice President. -- Vice President, Annuity Services,
Prudential Investments since 1996; Prior to 1996: Vice President, Chase
Manhattan Bank.
SHIRLEY H. SHAO, Senior Vice President and Chief Actuary. -- Vice President and
Associate Actuary, Prudential.
KAREN L. SHAPIRO, Senior Vice President. -- Vice President, Prudential
Individual Insurance Group since 1996; Vice President and Associate General
Counsel, Prudential Securities Incorporated 1993 to 1996; Prior to 1993: Senior
Associate with Shaw, Pittman, Potts and Trowbridge.
The business address of all directors and officers of Pruco Life is 213
Washington Street, Newark, New Jersey 07102-2992.
* SUBSIDIARY OF PRUDENTIAL
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<PAGE>
FINANCIAL STATEMENTS OF
PRUCO LIFE VARIABLE INSURANCE ACCOUNT
STATEMENTS OF NET ASSETS
December 31, 1996
<TABLE>
<CAPTION>
SUBACCOUNTS
------------------------------------------------------------------------------
MONEY DIVERSIFIED FLEXIBLE CONSERVATIVE
MARKET BOND EQUITY MANAGED BALANCED
-------------- -------------- -------------- -------------- --------------
<S> <C> <C> <C> <C> <C>
ASSETS
Investment in shares of The Prudential Series
Fund, Inc. Portfolios at net asset value [Note
3]............................................ $ 15,891,052 $ 21,602,400 $ 124,430,793 $ 117,789,879 $ 38,561,554
-------------- -------------- -------------- -------------- --------------
NET ASSETS, representing:
Equity of Contract owners....................... $ 15,884,609 $ 21,596,796 $ 124,397,981 $ 117,711,154 $ 38,535,298
Equity of Pruco Life Insurance Company.......... 6,443 5,604 32,812 78,725 26,256
-------------- -------------- -------------- -------------- --------------
$ 15,891,052 $ 21,602,400 $ 124,430,793 $ 117,789,879 $ 38,561,554
-------------- -------------- -------------- -------------- --------------
-------------- -------------- -------------- -------------- --------------
Number of Contract owner units outstanding...... 6,918,745.338 6,274,180.531 19,041,712.036 25,083,512.242 10,043,263.234
-------------- -------------- -------------- -------------- --------------
-------------- -------------- -------------- -------------- --------------
Unit Value...................................... $ 2.29588 $ 3.44217 $ 6.53292 $ 4.69277 $ 3.83693
-------------- -------------- -------------- -------------- --------------
-------------- -------------- -------------- -------------- --------------
</TABLE>
STATEMENTS OF OPERATIONS
For the year ended December 31, 1996
<TABLE>
<CAPTION>
SUBACCOUNTS
------------------------------------------------------------------------------
MONEY DIVERSIFIED FLEXIBLE CONSERVATIVE
MARKET BOND EQUITY MANAGED BALANCED
-------------- -------------- -------------- -------------- --------------
<S> <C> <C> <C> <C> <C>
INVESTMENT INCOME
Dividend distributions received................. $ 808,417 $ 1,365,153 $ 2,829,543 $ 3,436,833 $ 1,504,600
EXPENSES
Charges to Contract owners for assuming
mortality risk and expense risk [Note 4A]..... 55,366 73,783 401,534 387,082 126,668
Reimbursement for excess expenses [Note 4B]..... (6,730) (10,368) (126,451) (279,063) (72,650)
-------------- -------------- -------------- -------------- --------------
NET EXPENSES...................................... 48,636 63,415 275,083 108,019 54,018
-------------- -------------- -------------- -------------- --------------
NET INVESTMENT INCOME (LOSS)...................... 759,781 1,301,738 2,554,460 3,328,814 1,450,582
-------------- -------------- -------------- -------------- --------------
NET REALIZED AND UNREALIZED GAIN (LOSS)
ON INVESTMENTS
Capital gains distributions received............ 0 0 11,007,423 11,065,352 2,350,211
Realized gain (loss) on shares redeemed
[average cost basis].......................... 0 43,347 1,192,928 549,342 104,292
Net unrealized gain (loss) on investments....... 0 (485,901) 4,650,911 (803,121) 402,663
-------------- -------------- -------------- -------------- --------------
NET GAIN (LOSS) ON INVESTMENTS.................... 0 (442,554) 16,851,262 10,811,573 2,857,166
-------------- -------------- -------------- -------------- --------------
NET INCREASE IN NET ASSETS
RESULTING FROM OPERATIONS....................... $ 759,781 $ 859,184 $ 19,405,722 $ 14,140,387 $ 4,307,748
-------------- -------------- -------------- -------------- --------------
-------------- -------------- -------------- -------------- --------------
</TABLE>
SEE NOTES TO FINANCIAL STATEMENTS ON PAGES A9 THROUGH A12.
A1
<PAGE>
<TABLE>
<CAPTION>
SUBACCOUNTS (CONTINUED)
------------------------------------------------------------------------------
HIGH
YIELD STOCK EQUITY NATURAL
BOND INDEX INCOME RESOURCES GLOBAL
-------------- -------------- -------------- -------------- --------------
<S> <C> <C> <C> <C> <C>
ASSETS
Investment in shares of The Prudential Series
Fund, Inc. Portfolios at net asset value [Note
3] $ 2,027,185 $ 6,115,303 $ 2,945,977 $ 2,151,631 $ 917,409
-------------- -------------- -------------- -------------- --------------
NET ASSETS, representing:
Equity of Contract owners $ 2,023,292 $ 6,109,277 $ 2,939,997 $ 2,149,468 $ 908,942
Equity of Pruco Life Insurance Company 3,893 6,026 5,980 2,163 8,467
-------------- -------------- -------------- -------------- --------------
$ 2,027,185 $ 6,115,303 $ 2,945,977 $ 2,151,631 $ 917,409
-------------- -------------- -------------- -------------- --------------
-------------- -------------- -------------- -------------- --------------
Number of Contract owner units outstanding 907,647.673 1,944,118.875 900,240.772 703,672.946 679,689.521
-------------- -------------- -------------- -------------- --------------
-------------- -------------- -------------- -------------- --------------
Unit Value $ 2.22916 $ 3.14244 $ 3.26579 $ 3.05464 $ 1.33729
-------------- -------------- -------------- -------------- --------------
-------------- -------------- -------------- -------------- --------------
<CAPTION>
SMALL
GOVERNMENT PRUDENTIAL CAPITALIZATION
INCOME JENNISON STOCK
-------------- -------------- --------------
<S> <C> <C> <C>
ASSETS
Investment in shares of The Prudential Series
Fund, Inc. Portfolios at net asset value [Note
3] $ 498,731 $ 561,660 $ 383,127
-------------- -------------- --------------
NET ASSETS, representing:
Equity of Contract owners $ 498,929 $ 548,029 $ 381,283
Equity of Pruco Life Insurance Company (198) 13,631 1,844
-------------- -------------- --------------
$ 498,731 $ 561,660 $ 383,127
-------------- -------------- --------------
-------------- -------------- --------------
Number of Contract owner units outstanding 269,355.958 383,857.076 266,965.892
-------------- -------------- --------------
-------------- -------------- --------------
Unit Value $ 1.85230 $ 1.42769 $ 1.42821
-------------- -------------- --------------
-------------- -------------- --------------
</TABLE>
<TABLE>
<CAPTION>
SUBACCOUNTS (CONTINUED)
--------------------------------------------------------------
HIGH
YIELD STOCK EQUITY NATURAL
BOND INDEX INCOME RESOURCES
-------------- -------------- -------------- --------------
<S> <C> <C> <C> <C>
INVESTMENT INCOME
Dividend distributions received $ 193,067 $ 99,546 $ 91,474 $ 12,990
EXPENSES
Charges to Contract owners for assuming
mortality risk and expense risk [Note 4A] 6,864 18,542 8,941 6,608
Reimbursement for excess expenses [Note 4B] 0 0 0 0
-------------- -------------- -------------- --------------
NET EXPENSES 6,864 18,542 8,941 6,608
-------------- -------------- -------------- --------------
NET INVESTMENT INCOME (LOSS) 186,203 81,004 82,533 6,382
-------------- -------------- -------------- --------------
NET REALIZED AND UNREALIZED GAIN (LOSS)
ON INVESTMENTS
Capital gains distributions received 0 69,432 92,133 249,205
Realized gain (loss) on shares redeemed
[average cost basis] (255) 26,711 10,132 25,407
Net unrealized gain (loss) on investments 15,911 891,077 325,992 196,158
-------------- -------------- -------------- --------------
NET GAIN (LOSS) ON INVESTMENTS 15,656 987,220 428,257 470,770
-------------- -------------- -------------- --------------
NET INCREASE IN NET ASSETS
RESULTING FROM OPERATIONS $ 201,859 $ 1,068,224 $ 510,790 $ 477,152
-------------- -------------- -------------- --------------
-------------- -------------- -------------- --------------
<CAPTION>
SMALL
GOVERNMENT PRUDENTIAL CAPITALIZATION
GLOBAL INCOME JENNISON STOCK
-------------- -------------- -------------- --------------
<S> <C> <C> <C> <C>
INVESTMENT INCOME
Dividend distributions received $ 19,171 $ 31,327 $ 860 $ 1,994
EXPENSES
Charges to Contract owners for assuming
mortality risk and expense risk [Note 4A] 2,518 1,671 1,066 703
Reimbursement for excess expenses [Note 4B] 0 0 0 0
-------------- -------------- -------------- --------------
NET EXPENSES 2,518 1,671 1,066 703
-------------- -------------- -------------- --------------
NET INVESTMENT INCOME (LOSS) 16,653 29,656 (206) 1,291
-------------- -------------- -------------- --------------
NET REALIZED AND UNREALIZED GAIN (LOSS)
ON INVESTMENTS
Capital gains distributions received 13,744 0 0 6,557
Realized gain (loss) on shares redeemed
[average cost basis] 3,662 520 635 344
Net unrealized gain (loss) on investments 96,458 (19,539) 40,175 28,167
-------------- -------------- -------------- --------------
NET GAIN (LOSS) ON INVESTMENTS 113,864 (19,019) 40,810 35,068
-------------- -------------- -------------- --------------
NET INCREASE IN NET ASSETS
RESULTING FROM OPERATIONS $ 130,517 $ 10,637 $ 40,604 $ 36,359
-------------- -------------- -------------- --------------
-------------- -------------- -------------- --------------
</TABLE>
SEE NOTES TO FINANCIAL STATEMENTS ON PAGES A9 THROUGH A12.
A2
<PAGE>
FINANCIAL STATEMENTS OF
PRUCO LIFE VARIABLE INSURANCE ACCOUNT
STATEMENTS OF CHANGES IN NET ASSETS
For the years ended December 31, 1996, 1995 and 1994
<TABLE>
<CAPTION>
SUBACCOUNTS
----------------------------------------------------------------------------------------------
MONEY DIVERSIFIED
MARKET BOND
---------------------------------------------- ----------------------------------------------
1996 1995 1994 1996 1995 1994
-------------- -------------- -------------- -------------- -------------- --------------
<S> <C> <C> <C> <C> <C> <C>
OPERATIONS:
Net investment income (loss)..... $ 759,781 $ 836,141 $ 559,929 $ 1,301,738 $ 1,300,825 $ 1,112,882
Capital gains distributions
received....................... 0 0 0 0 46,988 40,866
Realized gain (loss) on shares
redeemed
[average cost basis]........... 0 0 0 43,347 25,897 8,522
Net unrealized gain (loss) on
investments.................... 0 0 0 (485,901) 2,288,395 (1,825,278)
-------------- -------------- -------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM OPERATIONS........ 759,781 836,141 559,929 859,184 3,662,105 (663,008)
-------------- -------------- -------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM PREMIUM PAYMENTS
AND OTHER OPERATING TRANSFERS
[NOTE 6]......................... (774,685) (251,391) (470,898) (747,162) (215,375) (238,081)
-------------- -------------- -------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM EQUITY TRANSFERS
[NOTE 7]......................... (40,679) 13,580 (40,960) (1,424) (15,824) (12,282)
-------------- -------------- -------------- -------------- -------------- --------------
TOTAL INCREASE (DECREASE) IN NET
ASSETS........................... (55,583) 598,330 48,071 110,598 3,430,906 (913,371)
NET ASSETS:
Beginning of year................ 15,946,635 15,348,305 15,300,234 21,491,802 18,060,896 18,974,267
-------------- -------------- -------------- -------------- -------------- --------------
End of year...................... $ 15,891,052 $ 15,946,635 $ 15,348,305 $ 21,602,400 $ 21,491,802 $ 18,060,896
-------------- -------------- -------------- -------------- -------------- --------------
-------------- -------------- -------------- -------------- -------------- --------------
</TABLE>
SEE NOTES TO FINANCIAL STATEMENTS ON PAGES A9 THROUGH A12.
A3
<PAGE>
<TABLE>
<CAPTION>
SUBACCOUNTS (CONTINUED)
--------------------------------------------------------------
FLEXIBLE
EQUITY MANAGED
---------------------------------------------- --------------
1996 1995 1994 1996
-------------- -------------- -------------- --------------
<S> <C> <C> <C> <C>
OPERATIONS:
Net investment income (loss) $ 2,554,460 $ 1,821,687 $ 1,683,712 $ 3,328,814
Capital gains distributions
received 11,007,423 3,775,598 3,446,147 11,065,352
Realized gain (loss) on shares
redeemed
[average cost basis] 1,192,928 592,148 270,343 549,342
Net unrealized gain (loss) on
investments 4,650,911 19,423,426 (3,314,767) (803,121)
-------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM OPERATIONS 19,405,722 25,612,859 2,085,435 14,140,387
-------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM PREMIUM PAYMENTS
AND OTHER OPERATING TRANSFERS
[NOTE 6] (2,590,623) (966,669) 191,542 (1,978,785)
-------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM EQUITY TRANSFERS
[NOTE 7] (9,294) 1,701 (99,540) 24,234
-------------- -------------- -------------- --------------
TOTAL INCREASE (DECREASE) IN NET
ASSETS 16,805,805 24,647,891 2,177,437 12,185,836
NET ASSETS:
Beginning of year 107,624,988 82,977,097 80,799,660 105,604,043
-------------- -------------- -------------- --------------
End of year $ 124,430,793 $ 107,624,988 $ 82,977,097 $ 117,789,879
-------------- -------------- -------------- --------------
-------------- -------------- -------------- --------------
<CAPTION>
CONSERVATIVE
BALANCED
----------------------------------------------
1995 1994 1996 1995 1994
-------------- -------------- -------------- -------------- --------------
<S> <C> <C> <C> <C> <C>
OPERATIONS:
Net investment income (loss) $ 3,006,879 $ 2,308,550 $ 1,450,582 $ 1,301,886 $ 955,348
Capital gains distributions
received 4,387,819 2,439,446 2,350,211 1,170,397 306,877
Realized gain (loss) on shares
redeemed
[average cost basis] 234,407 57,114 104,292 31,524 8,992
Net unrealized gain (loss) on
investments 12,905,968 (7,638,295) 402,663 2,509,581 (1,583,036)
-------------- -------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM OPERATIONS 20,535,073 (2,833,185) 4,307,748 5,013,388 (311,819)
-------------- -------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM PREMIUM PAYMENTS
AND OTHER OPERATING TRANSFERS
[NOTE 6] (777,608) 1,830,761 (204,807) 374,732 1,302,374
-------------- -------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM EQUITY TRANSFERS
[NOTE 7] (110,202) (126,969) (70,175) 9,314 (63,244)
-------------- -------------- -------------- -------------- --------------
TOTAL INCREASE (DECREASE) IN NET
ASSETS 19,647,263 (1,129,393) 4,032,766 5,397,434 927,311
NET ASSETS:
Beginning of year 85,956,780 87,086,173 34,528,788 29,131,354 28,204,043
-------------- -------------- -------------- -------------- --------------
End of year $ 105,604,043 $ 85,956,780 $ 38,561,554 $ 34,528,788 $ 29,131,354
-------------- -------------- -------------- -------------- --------------
-------------- -------------- -------------- -------------- --------------
</TABLE>
SEE NOTES TO FINANCIAL STATEMENTS ON PAGES A9 THROUGH A12.
A4
<PAGE>
FINANCIAL STATEMENTS OF
PRUCO LIFE VARIABLE INSURANCE ACCOUNT
STATEMENTS OF CHANGES IN NET ASSETS
For the years ended December 31, 1996, 1995 and 1994
<TABLE>
<CAPTION>
SUBACCOUNTS
----------------------------------------------------------------------------------------------
HIGH
YIELD STOCK
BOND INDEX
---------------------------------------------- ----------------------------------------------
1996 1995 1994 1996 1995 1994
-------------- -------------- -------------- -------------- -------------- --------------
<S> <C> <C> <C> <C> <C> <C>
OPERATIONS:
Net investment income (loss).... $ 186,203 $ 175,531 $ 154,127 $ 81,004 $ 70,991 $ 64,000
Capital gains distributions
received...................... 0 0 0 69,432 32,489 4,568
Realized gain (loss) on shares
redeemed
[average cost basis].......... (255) (933) 2,079 26,711 16,334 13,026
Net unrealized gain (loss) on
investments................... 15,911 95,010 (205,610) 891,077 1,052,064 (58,977)
-------------- -------------- -------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM OPERATIONS....... 201,859 269,608 (49,404) 1,068,224 1,171,878 22,617
-------------- -------------- -------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM PREMIUM PAYMENTS
AND OTHER OPERATING TRANSFERS
[NOTE 6]........................ (8,482) (24,810) (3,900) 494,766 291,051 182,827
-------------- -------------- -------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM EQUITY TRANSFERS
[NOTE 7]........................ (655) (217) (3,448) (16,223) (9,754) 7,658
-------------- -------------- -------------- -------------- -------------- --------------
TOTAL INCREASE (DECREASE) IN NET
ASSETS.......................... 192,722 244,581 (56,752) 1,546,767 1,453,175 213,102
NET ASSETS:
Beginning of year............... 1,834,463 1,589,882 1,646,634 4,568,536 3,115,361 2,902,259
-------------- -------------- -------------- -------------- -------------- --------------
End of year..................... $ 2,027,185 $ 1,834,463 $ 1,589,882 $ 6,115,303 $ 4,568,536 $ 3,115,361
-------------- -------------- -------------- -------------- -------------- --------------
-------------- -------------- -------------- -------------- -------------- --------------
</TABLE>
SEE NOTES TO FINANCIAL STATEMENTS ON PAGES A9 THROUGH A12.
A5
<PAGE>
<TABLE>
<CAPTION>
SUBACCOUNTS (CONTINUED)
--------------------------------------------------------------
EQUITY NATURAL
INCOME RESOURCES
---------------------------------------------- --------------
1996 1995 1994 1996
-------------- -------------- -------------- --------------
<S> <C> <C> <C> <C>
OPERATIONS:
Net investment income (loss) $ 82,533 $ 73,400 $ 51,821 $ 6,382
Capital gains distributions
received 92,133 96,854 85,670 249,205
Realized gain (loss) on shares
redeemed
[average cost basis] 10,132 7,871 4,284 25,407
Net unrealized gain (loss) on
investments 325,992 203,709 (130,972) 196,158
-------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM OPERATIONS 510,790 381,834 10,803 477,152
-------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM PREMIUM PAYMENTS
AND OTHER OPERATING TRANSFERS
[NOTE 6] 129,405 239,675 418,737 147,039
-------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM EQUITY TRANSFERS
[NOTE 7] (14,464) 18,454 (25,455) (14,433)
-------------- -------------- -------------- --------------
TOTAL INCREASE (DECREASE) IN NET
ASSETS 625,731 639,963 404,085 609,758
NET ASSETS:
Beginning of year 2,320,246 1,680,283 1,276,198 1,541,873
-------------- -------------- -------------- --------------
End of year $ 2,945,977 $ 2,320,246 $ 1,680,283 $ 2,151,631
-------------- -------------- -------------- --------------
-------------- -------------- -------------- --------------
<CAPTION>
GLOBAL*
----------------------------------------------
1995 1994 1996 1995 1994
-------------- -------------- -------------- -------------- --------------
<S> <C> <C> <C> <C> <C>
OPERATIONS:
Net investment income (loss) $ 12,839 $ 7,326 $ 16,653 $ 6,731 $ 131
Capital gains distributions
received 69,644 22,870 13,744 10,665 99
Realized gain (loss) on shares
redeemed
[average cost basis] 2,181 11,808 3,662 823 0
Net unrealized gain (loss) on
investments 233,804 (94,709) 96,458 53,463 (15,549)
-------------- -------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM OPERATIONS 318,468 (52,705) 130,517 71,682 (15,319)
-------------- -------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM PREMIUM PAYMENTS
AND OTHER OPERATING TRANSFERS
[NOTE 6] 80,100 186,135 225,265 161,379 340,684
-------------- -------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM EQUITY TRANSFERS
[NOTE 7] 13,605 (31,173) (18,747) 12,250 9,698
-------------- -------------- -------------- -------------- --------------
TOTAL INCREASE (DECREASE) IN NET
ASSETS 412,173 102,257 337,035 245,311 335,063
NET ASSETS:
Beginning of year 1,129,700 1,027,443 580,374 335,063 0
-------------- -------------- -------------- -------------- --------------
End of year $ 1,541,873 $ 1,129,700 $ 917,409 $ 580,374 $ 335,063
-------------- -------------- -------------- -------------- --------------
-------------- -------------- -------------- -------------- --------------
*Commenced
Business
on 5/1/94
</TABLE>
SEE NOTES TO FINANCIAL STATEMENTS ON PAGES A9 THROUGH A12.
A6
<PAGE>
FINANCIAL STATEMENTS OF
PRUCO LIFE VARIABLE INSURANCE ACCOUNT
STATEMENTS OF CHANGES IN NET ASSETS
For the years ended December 31, 1996, 1995 and 1994
<TABLE>
<CAPTION>
SUBACCOUNTS
------------------------------------------------------------------------------
GOVERNMENT PRUDENTIAL
INCOME JENNISON**
---------------------------------------------- ------------------------------
1996 1995 1994 1996 1995
-------------- -------------- -------------- -------------- --------------
<S> <C> <C> <C> <C> <C> <C>
OPERATIONS:
Net investment income (loss)...... $ 29,656 $ 27,273 $ 26,190 $ (206) $ (74)
Capital gains distributions
received........................ 0 0 0 0 0
Realized gain (loss) on shares
redeemed
[average cost basis]............ 520 8,064 397 635 506
Net unrealized gain (loss) on
investments..................... (19,539) 43,870 (49,148) 40,175 3,478
-------------- -------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM OPERATIONS......... 10,637 79,207 (22,561) 40,604 3,910
-------------- -------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM PREMIUM PAYMENTS
AND OTHER OPERATING TRANSFERS
[NOTE 6].......................... 22,080 2,911 12,783 423,154 77,699
-------------- -------------- -------------- -------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM EQUITY TRANSFERS
[NOTE 7].......................... (2,408) (38,380) 26,654 7,912 8,381
-------------- -------------- -------------- -------------- --------------
TOTAL INCREASE (DECREASE) IN NET
ASSETS............................ 30,309 43,738 16,876 471,670 89,990
NET ASSETS:
Beginning of year................. 468,422 424,684 407,808 89,990 0
-------------- -------------- -------------- -------------- --------------
End of year....................... $ 498,731 $ 468,422 $ 424,684 $ 561,660 $ 89,990
-------------- -------------- -------------- -------------- --------------
-------------- -------------- -------------- -------------- --------------
**Commenced
Business
on 5/1/95
</TABLE>
SEE NOTES TO FINANCIAL STATEMENTS ON PAGES A9 THROUGH A12.
A7
<PAGE>
<TABLE>
<CAPTION>
SUBACCOUNTS (CONTINUED)
------------------------------
SMALL
CAPITALIZATION
STOCK**
------------------------------
1996 1995
-------------- --------------
<S> <C> <C>
OPERATIONS:
Net investment income (loss) $ 1,291 $ 147
Capital gains distributions
received 6,557 628
Realized gain (loss) on shares
redeemed
[average cost basis] 344 60
Net unrealized gain (loss) on
investments 28,167 3,161
-------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM OPERATIONS 36,359 3,996
-------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM PREMIUM PAYMENTS
AND OTHER OPERATING TRANSFERS
[NOTE 6] 280,751 60,180
-------------- --------------
NET INCREASE (DECREASE) IN NET
ASSETS
RESULTING FROM EQUITY TRANSFERS
[NOTE 7] (7,047) 8,888
-------------- --------------
TOTAL INCREASE (DECREASE) IN NET
ASSETS 310,063 73,064
NET ASSETS:
Beginning of year 73,064 0
-------------- --------------
End of year $ 383,127 $ 73,064
-------------- --------------
-------------- --------------
**Commenced
Business
on 5/1/95
</TABLE>
SEE NOTES TO FINANCIAL STATEMENTS ON PAGES A9 THROUGH A12.
A8
<PAGE>
NOTES TO FINANCIAL STATEMENTS OF
PRUCO LIFE VARIABLE INSURANCE ACCOUNT
FOR THE YEAR ENDED DECEMBER 31, 1996
NOTE 1: GENERAL
Pruco Life Variable Insurance Account (the "Account") was established on
November 10, 1982 under Arizona law as a separate investment account of Pruco
Life Insurance Company ("Pruco Life") which is a wholly-owned subsidiary of The
Prudential Insurance Company of America ("Prudential"). The assets of the
Account are segregated from Pruco Life's other assets.
The Account is registered under the Investment Company Act of 1940, as amended,
as a unit investment trust. There are thirteen subaccounts within the Account,
each of which invests only in a corresponding portfolio of The Prudential Series
Fund, Inc. (the "Series Fund"). The Series Fund is a diversified open-end
management investment company, and is managed by Prudential.
New sales of the product which invests in the Account were discontinued as of
January 1, 1992. However, premium payments made by current Contract owners will
continue to be received by the Account.
NOTE 2: SIGNIFICANT ACCOUNTING POLICIES
The accompanying financial statements are prepared in conformity with generally
accepted accounting principles (GAAP). The preparation of the financial
statements in conformity with GAAP requires management to make estimates and
assumptions that affect the reported amounts and disclosures. Actual results
could differ from those estimates.
Investments--The investments in shares of the Series Fund are stated at the net
asset value of the respective portfolio.
Security Transactions--Realized gains and losses on security transactions are
reported on an average cost basis. Purchase and sale transactions are recorded
as of the trade date of the security being purchased or sold.
Distributions Received--Dividend and capital gain distributions received are
reinvested in additional shares of the Series Fund and are recorded on
ex-dividend date.
Equity of Pruco Life Insurance Company--Pruco Life maintains a position in the
Account for the purpose of administering activity in the Account. The activity
includes unit transactions, fund share transactions, and expense processing.
Pruco Life monitors the balance daily and transfers funds based upon anticipated
activity. At times, Pruco Life may owe an amount to the Account, which is
reflected in Pruco Life's equity as a negative balance. The position does not
have an effect on the Contract owner's account or the related unit value.
A9
<PAGE>
NOTE 3: INVESTMENT INFORMATION FOR THE PRUDENTIAL SERIES FUND, INC. PORTFOLIOS
The net asset value per share for each portfolio of the Series Fund, the number
of shares of each portfolio held by the subaccounts of the Account and the
aggregate cost of investments in such shares at December 31, 1996 were as
follows:
<TABLE>
<CAPTION>
PORTFOLIOS
----------------------------------------------------------------------------
MONEY DIVERSIFIED FLEXIBLE CONSERVATIVE
MARKET BOND EQUITY MANAGED BALANCED
------------- ------------- ------------- -------------- ---------------
<S> <C> <C> <C> <C> <C>
Number of shares: 1,589,105 1,952,242 4,614,549 6,622,011 2,485,107
Net asset value per
share: $ 10.00000 $ 11.06543 $ 26.96489 $ 17.78763 $ 15.51706
Cost: $ 15,891,052 $ 20,698,690 $ 83,795,041 $ 100,217,089 $ 34,388,928
</TABLE>
<TABLE>
<CAPTION>
PORTFOLIOS (CONTINUED)
-----------------------------------------------------------
HIGH
YIELD STOCK EQUITY NATURAL
BOND INDEX INCOME RESOURCES
------------- ------------- ------------- --------------
<S> <C> <C> <C> <C>
Number of shares: 257,666 257,544 159,158 108,858
Net asset value per
share: $ 7.86749 $ 23.74471 $ 18.50982 $ 19.76541
Cost: $ 2,045,825 $ 3,741,497 $ 2,396,229 $ 1,656,733
<CAPTION>
PORTFOLIOS (CONTINUED)
-----------------------------------------------------------
SMALL
GOVERNMENT PRUDENTIAL CAPITALIZATION
GLOBAL INCOME JENNISON STOCK
------------- ------------- ------------- --------------
<S> <C> <C> <C> <C>
Number of shares: 51,382 44,446 39,213 27,779
Net asset value per
share: $ 17.85474 $ 11.22109 $ 14.32319 $ 13.79187
Cost: $ 783,038 $ 504,460 $ 518,007 $ 351,798
</TABLE>
NOTE 4: CHARGES AND EXPENSES
A. Mortality Risk and Expense Risk Charges
The mortality risk and expense risk charges at an effective annual rate of
0.35% are applied daily against the net assets representing equity of
Contract owners held in each subaccount. Mortality risk is that Contract
holders may not live as long as estimated and expense risk is that the cost
of issuing and administering the policies may exceed the estimated expenses.
For 1996, the amount of these charges paid to Pruco Life was $1,091,346.
B. Expense Reimbursement
Pursuant to a prior merger agreement, the Account is reimbursed by Pruco
Life for expenses in excess of 0.40% of the average daily net assets
incurred by the Money Market, Diversified Bond, Equity, Flexible Managed and
the Conservative Balanced Portfolios of the Series Fund. For 1996, the
amount of these reimbursements totaled $495,262.
C. Cost of Insurance Charges
Contract holder contributions are applied to the Account net of the
following charges: administrative charges, death benefit risk charges,
premium taxes, and sales loads. During 1996, Pruco Life received from
Contract holders $3,555,115, $398,981, $664,967, and $3,315,165
respectively, for these charges.
NOTE 5: TAXES
Pruco life is taxed as a "life insurance company" under the Internal Revenue
Code and the operations of the Account form a part of and are taxed with those
of Pruco Life. Under current federal law, no federal income taxes are payable by
the Account. As such, no provision for tax liability has been recorded.
A10
<PAGE>
NOTE 6: NET INCREASE (DECREASE) IN NET ASSETS RESULTING FROM PREMIUM PAYMENTS
AND OTHER OPERATING TRANSFERS
Contract owner activity in the subaccounts of the Account, for the year ended
December 31, 1996, was as follows:
<TABLE>
<CAPTION>
SUBACCOUNTS
--------------------------------------------------------------------------------
MONEY DIVERSIFIED FLEXIBLE CONSERVATIVE
MARKET BOND EQUITY MANAGED BALANCED
-------------- -------------- --------------- --------------- --------------
<S> <C> <C> <C> <C> <C>
Contract Owner
Contributions,
net: $ 2,310,544 $ 2,461,240 $ 11,801,616 $ 12,193,253 $ 4,769,122
Contract Owner
Redemptions: $ (2,340,261) $ (2,648,324) $ (15,118,025) $ (13,435,028) $ (4,644,506)
Net Transfers
from(to) other
subaccounts: $ (744,968) $ (560,078) $ 725,786 $ (737,010) $ (329,423)
</TABLE>
<TABLE>
<CAPTION>
SUBACCOUNTS (CONTINUED)
----------------------------------------------------------------
HIGH
YIELD STOCK EQUITY NATURAL
BOND INDEX INCOME RESOURCES
-------------- -------------- --------------- ---------------
<S> <C> <C> <C> <C>
Contract Owner
Contributions, net: $ 376,657 $ 789,040 $ 449,444 $ 310,549
Contract Owner
Redemptions: $ (374,644) $ (837,091) $ (468,159) $ (373,597)
Net Transfers from(to)
other subaccounts: $ (10,495) $ 542,817 $ 148,120 $ 210,087
<CAPTION>
SUBACCOUNTS (CONTINUED)
----------------------------------------------------------------
SMALL
GOVERNMENT PRUDENTIAL CAPITALIZATION
GLOBAL INCOME JENNISON STOCK
-------------- -------------- --------------- ---------------
<S> <C> <C> <C> <C>
Contract Owner
Contributions, net: $ 136,096 $ 96,161 $ 83,478 $ 39,137
Contract Owner
Redemptions: $ (108,356) $ (73,763) $ (85,323) $ (35,804)
Net Transfers from(to)
other subaccounts: $ 197,525 $ (318) $ 424,999 $ 277,418
</TABLE>
NOTE 7: NET INCREASE (DECREASE) IN NET ASSETS RESULTING FROM EQUITY TRANSFERS
The increase (decrease) in net assets resulting from equity transfers represents
the net contributions (withdrawals) of Pruco Life to the Account.
NOTE 8: UNIT ACTIVITY
Transactions in units (including transfers among subaccounts), for the year
ended December 31, 1996, were as follows:
<TABLE>
<CAPTION>
SUBACCOUNTS
---------------------------------------------------------------------------------------------
MONEY DIVERSIFIED FLEXIBLE CONSERVATIVE
MARKET BOND EQUITY MANAGED BALANCED
----------------- ----------------- ----------------- ----------------- -----------------
<S> <C> <C> <C> <C> <C>
Contract Owner
Contributions: 1,030,442.209 746,053.428 2,115,422.788 2,801,879.413 1,329,879.254
Contract Owner
Redemptions: (1,377,953.802) (972,541.044) (2,545,555.957) (3,253,817.888) (1,387,010.702)
</TABLE>
<TABLE>
<CAPTION>
SUBACCOUNTS (CONTINUED)
--------------------------------------------------------------------------
HIGH
YIELD STOCK EQUITY NATURAL
BOND INDEX INCOME RESOURCES
----------------- ----------------- ----------------- -----------------
<S> <C> <C> <C> <C>
Contract Owner
Contributions: 178,674.418 473,039.375 207,203.812 185,741.755
Contract Owner
Redemptions: (181,912.311) (295,729.538) (161,396.371) (133,534.069)
<CAPTION>
SUBACCOUNTS (CONTINUED)
--------------------------------------------------------------------------
SMALL
GOVERNMENT PRUDENTIAL CAPITALIZATION
GLOBAL INCOME JENNISON STOCK
----------------- ----------------- ----------------- -----------------
<S> <C> <C> <C> <C>
Contract Owner
Contributions: 272,484.637 53,827.127 380,827.375 240,646.185
Contract Owner
Redemptions: (88,899.804) (40,948.295) (61,380.639) (26,691.754)
</TABLE>
A11
<PAGE>
NOTE 9: PURCHASES AND SALES OF INVESTMENTS
The aggregate costs of purchases and proceeds from sales of investments in the
Series Fund, Inc. were as follows:
<TABLE>
<CAPTION>
PORTFOLIOS
--------------------------------------------------------------------------------
MONEY DIVERSIFIED FLEXIBLE CONSERVATIVE
MARKET BOND EQUITY MANAGED BALANCED
-------------- -------------- --------------- --------------- --------------
<S> <C> <C> <C> <C> <C>
For the year ended
December 31, 1996
Purchases......... $ 91,000 $ 76,000 $ 391,000 $ 614,000 $ 419,000
Sales............. $ (955,000) $ (888,000) $ (3,266,000) $ (2,720,000) $ (748,000)
</TABLE>
<TABLE>
<CAPTION>
PORTFOLIOS (CONTINUED)
----------------------------------------------------------------
HIGH
YIELD STOCK EQUITY NATURAL
BOND INDEX INCOME RESOURCES
-------------- -------------- --------------- ---------------
<S> <C> <C> <C> <C>
For the year ended
December 31, 1996
Purchases........... $ 108,000 $ 534,000 $ 177,000 $ 212,000
Sales............... $ (124,000) $ (74,000) $ (71,000) $ (86,000)
<CAPTION>
PORTFOLIOS (CONTINUED)
----------------------------------------------------------------
SMALL
GOVERNMENT PRUDENTIAL CAPITALIZATION
GLOBAL INCOME JENNISON STOCK
-------------- -------------- --------------- ---------------
<S> <C> <C> <C> <C>
For the year ended
December 31, 1996
Purchases........... $ 234,000 $ 52,000 $ 441,000 $ 278,000
Sales............... $ (30,000) $ (34,000) $ (11,000) $ (5,000)
</TABLE>
A12
<PAGE>
REPORT OF INDEPENDENT ACCOUNTANTS
To the Contract Owners of
Pruco Life Variable Insurance Account
and the Board of Directors of
Pruco Life Insurance Company
In our opinion, the accompanying statements of net assets and the related
statements of operations and of changes in net assets present fairly, in all
material respects, the financial position of Money Market Subaccount,
Diversified Bond Subaccount, Equity Subaccount, Flexible Managed Subaccount,
Conservative Balanced Subaccount, High Yield Bond Subaccount, Stock Index
Subaccount, Equity Income Subaccount, Natural Resources Subaccount, Global
Subaccount, Government Income Subaccount, Prudential Jennison Subaccount and
Small Capitalization Stock Subaccount of Pruco Life Variable Insurance Account
at December 31, 1996, and the results of each of their operations and the
changes in each of their net assets for the year then ended, in conformity with
generally accepted accounting principles. These financial statements are the
responsibility of Pruco Life Insurance Company's management; our responsibility
is to express an opinion on these financial statements based on our audits. We
conducted our audits of these financial statements in accordance with generally
accepted auditing standards which require that we plan and perform the audit to
obtain reasonable assurance about whether the financial statements are free of
material misstatement. An audit includes examining, on a test basis, evidence
supporting the amounts and disclosures in the financial statements, assessing
the accounting principles used and significant estimates made by management, and
evaluating the overall financial statement presentation. We believe that our
audits, which included confirmation of shares owned in The Prudential Series
Fund, Inc. at December 31, 1996, provide a reasonable basis for the opinion
expressed above.
Price Waterhouse LLP
New York, New York
March 31, 1997
A13
<PAGE>
INDEPENDENT AUDITORS' REPORT
To the Contract Owners of
Pruco Life Variable Insurance
Account and the Board of Directors
of Pruco Life Insurance Company
Newark, New Jersey
We have audited the accompanying statements of changes in net assets of Pruco
Life Variable Insurance Account of Pruco Life Insurance Company (comprising,
respectively, the Money Market, Diversified Bond, Equity, Flexible Managed,
Conservative Balanced, High Yield Bond, Stock Index, Equity Income, Natural
Resources, Global, Government Income, Prudential Jennison, and Small
Capitalization Stock subaccounts) for the periods presented for each of the two
years ended December 31, 1995. These financial statements are the responsibility
of the Company's management. Our responsibility is to express an opinion on
these financial statements based on our audits.
We conducted our audits in accordance with generally accepted auditing
standards. Those standards require that we plan and perform the audit to obtain
reasonable assurance about whether the financial statements are free of material
misstatement. An audit includes examining, on a test basis, evidence supporting
the amounts and disclosures in the financial statements. An audit also includes
assessing the accounting principles used and significant estimates made by
management, as well as evaluating the overall financial statement presentation.
We believe that our audits provide a reasonable basis for our opinion.
In our opinion, such financial statements present fairly, in all material
respects, the changes in net assets of each of the respective subaccounts
constituting the Pruco Life Variable Insurance Account for the respective stated
periods in conformity with generally accepted accounting principles.
Deloitte & Touche LLP
Parsippany, New Jersey
February 15, 1996
A14
<PAGE>
<TABLE>
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF FINANCIAL POSITION
<CAPTION>
DECEMBER 31,
1996 1995
----------- ------------
(000'S)
ASSETS
<S> <C> <C>
Fixed maturities
Held to maturity $ 405,731 $ 437,727
Available for sale 2,236,817 2,144,854
Equity securities 3,748 4,036
Mortgage loans 46,915 64,464
Investment real estate - 4,059
Policy loans 639,782 569,273
Other long term investments 4,528 4,159
Short term investments 169,830 228,016
----------- ------------
Total invested assets 3,507,351 3,456,588
----------- ------------
Cash 73,766 41,435
Deferred policy acquisition costs 633,159 566,976
Premiums due 9,084 6,367
Accrued investment income 62,110 59,862
Receivable from affiliates 1,901 8,275
Federal income tax receivable 7,191 6,375
Reinsurance recoverable on unpaid losses 27,014 27,914
Other assets 20,000 12,578
Separate Account assets 5,336,851 4,285,268
----------- ------------
TOTAL ASSETS $9,678,427 $8,471,638
=========== ============
LIABILITIES AND STOCKHOLDER'S EQUITY
Liabilities
Future policy benefits and other policyholders'
liabilities $ 557,351 $ 501,200
Policyholders' account balances 2,188,862 2,218,330
Deferred federal income tax payable 148,960 141,048
Payable to affiliate 51,729 41,584
Other liabilities 55,090 37,387
Separate Account liabilities 5,277,454 4,263,896
----------- ------------
Total Liabilities 8,279,446 7,203,445
----------- ------------
Contingencies - Note 9
Stockholder's Equity
Common Stock, $10 par value;
1,000,000 shares, authorized;
250,000 shares, issued and outstanding at
December 31, 1996 and 1995 2,500 2,500
Paid-in-capital 439,582 439,582
Net unrealized investment gains (less deferred
income tax) 12,402 30,836
Retained earnings 944,497 795,275
----------- ------------
Total Stockholder's Equity 1,398,981 1,268,193
----------- ------------
TOTAL LIABILITIES AND
STOCKHOLDER'S EQUITY $9,678,427 $8,471,638
=========== ============
</TABLE>
SEE NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
B-1
<PAGE>
<TABLE>
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS
<CAPTION>
YEAR ENDED
DECEMBER 31,
1996 1995 1994
-----------------------------------
(000'S)
REVENUES
<S> <C> <C> <C>
Premiums $ 51,525 $ 42,089 $ 22,689
Policy charges and fee income 324,976 319,012 308,753
Net investment income 247,328 246,618 241,132
Realized investment gains (losses) 10,835 13,200 (41,074)
Other income 20,818 26,986 13,259
-----------------------------------
Total Revenues 655,482 647,905 544,759
-----------------------------------
BENEFITS AND EXPENSES
Policyholders' benefits 186,873 153,987 121,949
Interest credited to policyholders' account
balances 118,246 126,926 113,711
Other operating costs and expenses 122,006 134,790 179,173
-----------------------------------
Total Benefits and Expenses 427,125 415,703 414,833
-----------------------------------
Income before income tax provision 228,357 232,202 129,926
-----------------------------------
Income tax provision 79,135 79,558 48,031
-----------------------------------
NET INCOME $ 149,222 $ 152,644 $ 81,895
===================================
</TABLE>
SEE NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
B-2
<PAGE>
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF STOCKHOLDER'S EQUITY
<TABLE>
<CAPTION>
YEAR ENDED
DECEMBER 31,
1996 1995 1994
-----------------------------------
(000'S)
Common Stock
<S> <C> <C> <C>
Balance, beginning of year $ 2,500 $ 2,500 $ 2,500
Issued during year - - -
-----------------------------------
Balance, end of year 2,500 2,500 2,500
-----------------------------------
Paid in Capital
Balance, beginning of year 439,582 439,582 439,582
Paid in during year - - -
-----------------------------------
Balance, end of year 439,582 439,582 439,582
-----------------------------------
Net Unrealized Investment Gains (Losses)
(Less Deferred Income Tax)
Balance, beginning of year 30,836 (1,349) -
Adoption of SFAS 115 - (39,762) -
Net change in unrealized investment
gains (losses) (18,434) 71,947 (1,349)
-----------------------------------
Balance, end of year 12,402 30,836 (1,349)
-----------------------------------
RETAINED EARNINGS
Balance, beginning of year 795,275 642,631 560,736
Net income 149,222 152,644 81,895
-----------------------------------
Balance, end of year 944,497 795,275 642,631
-----------------------------------
TOTAL STOCKHOLDER'S EQUITY $1,398,981 $1,268,193 $1,083,364
===================================
</TABLE>
SEE NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
B-3
<PAGE>
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
<TABLE>
<CAPTION>
YEAR ENDED
DECEMBER 31,
1996 1995 1994
------------------------------------------
(000'S)
CASH FLOWS FROM OPERATING ACTIVITIES:
<S> <C> <C> <C>
Net income $ 149,222 $ 152,644 $ 81,895
Adjustments to reconcile net income to net cash from
operating activities:
Increase in future policy benefits and other policyholders'
liabilities 56,151 22,877 31,932
General account policy fee income (50,286) (56,637) (48,401)
Interest credited to policyholders' account balances 118,246 126,926 113,711
Net decrease (increase) in Separate Accounts (38,025) (3,520) (4,121)
Net realized investment (gains) losses (10,835) (13,200) 41,074
Amortization and other non-cash items 26,709 (8,106) 6,228
Change in:
Accrued investment income (2,248) (480) (2,597)
Premiums due (2,717) (1,957) (1,374)
Receivable from affiliates 6,374 (758) (637)
Note receivable from affiliate -- -- 50,000
Deferred policy acquisition costs (66,183) 31,318 34,124
Federal income tax receivable (816) 12,031 (28,908)
Other assets (6,522) (12,689) (11,121)
Payable to affiliate 10,145 11,327 (24,029)
Deferred federal income tax payable 7,912 30,779 --
Other liabilities 17,703 (61,306) (5,293)
-----------------------------------------
Cash Flows From Operating Activities 214,830 229,249 232,483
-----------------------------------------
CASH FLOWS FROM INVESTING ACTIVITIES:
Proceeds from the sale/maturity of:
Fixed maturities:
Held to maturity 138,127 144,898 2,710,423
Available for sale 3,886,254 1,886,687 --
Equity securities 7,527 5,557 1,910
Mortgage loans 19,226 7,395 10,821
Other long term investments 288 1,559 607
Investment real estate 4,488 2,926 8,677
Payments for the purchase of:
Fixed maturities:
Held to maturity (114,494) (135,092) (2,561,082)
Available for sale (4,008,810) (1,741,139) --
Equity securities (4,697) (4,279) (2,436)
Mortgage loans -- -- (35,276)
Other long term investments (657) (1,674) (1,584)
Policy loans (70,509) (75,411) (73,591)
Net proceeds (payments) of short term investments 58,186 (36,482) 9,845
-----------------------------------------
Cash Flows From Investing Activities (85,071) 54,945 68,314
-----------------------------------------
CASH FLOWS FROM FINANCING ACTIVITIES:
Policyholders' account balances:
Deposits 536,370 95,039 114,105
Withdrawals (net of transfers to/from separate accounts) (633,798) (365,578) (387,793)
-----------------------------------------
Cash Flows From Financing Activities (97,428) (270,539) (273,688)
-----------------------------------------
Net increase in Cash 32,331 13,655 27,109
Cash, beginning of year 41,435 27,780 671
-----------------------------------------
CASH, END OF YEAR $ 73,766 $ 41,435 $ 27,780
=========================================
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION
Income taxes paid $ 61,760 $ 53,107 $ 56,089
=========================================
</TABLE>
SEE NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS
B-4
<PAGE>
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS OF
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
DECEMBER 31, 1996, 1995, AND 1994
1. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES AND PRINCIPLES
A. Principles of Consolidation
The accompanying consolidated financial statements include the accounts of
Pruco Life Insurance Company (Pruco Life), a stock life insurance company,
and its subsidiaries (collectively, the Company). Pruco Life is a
wholly-owned subsidiary of The Prudential Insurance Company of America
(Prudential), a mutual life insurance company. The Company markets
individual life insurance and deferred annuities primarily through
Prudential's sales force in the United States, and in Taiwan. All
significant intercompany balances and transactions have been eliminated in
consolidation.
B. Basis of Presentation
The Financial Accounting Standards Board (FASB) issued Interpretation No. 40
"Applicability of Generally Accepted Accounting Principles to Mutual Life
Insurance and Other Enterprises", as amended by Statement of Financial
Accounting Standards (SFAS) No. 120 "Accounting and Reporting by Mutual Life
Insurance Enterprises and by Insurance Enterprises for Certain Long-Duration
Participating Contracts", effective for fiscal years beginning after
December 15, 1995. Financial statements of mutual life insurance companies,
and their wholly owned stock life insurance subsidiaries, for periods
beginning after December 15, 1995 which are prepared on the basis of
statutory accounting practices will no longer be characterized as in
conformity with generally accepted accounting principles (GAAP). As a
result, the Company has prepared its 1996 consolidated financial statements
in accordance with all applicable GAAP pronouncements. The 1995 and 1994
consolidated financial statements, which were previously prepared on the
statutory basis of accounting, have been restated in accordance with GAAP.
The cumulative effect of adopting GAAP as of January 1, 1994 was an increase
in retained earnings of $378.3 million. See Note 7 for a reconciliation of
the Company's surplus and net income determined in accordance with statutory
accounting practices with equity and net income determined on a GAAP basis.
On January 1, 1995, the Company adopted SFAS 115, "Accounting for Certain
Investments in Debt and Equity Securities," which expanded the use of fair
value accounting for those securities that a company does not have positive
intent and ability to hold to maturity. Implementation of this statement
decreased stockholder's equity by $39.8 million net of deferred income tax
benefit of $21.4 million. In 1994 prior to the adoption of SFAS 115, all
fixed maturities were carried at amortized cost.
C. Investments
Fixed Maturities - Securities held to maturity are those that the Company
has the positive intent and ability to hold to maturity and are principally
reported at amortized cost. Amortized cost is adjusted to estimated fair
value for impairments which are deemed to be other than temporary.
Where the Company may not have the positive intent to hold fixed maturities
until maturity, the securities are classified as "Available for Sale." These
securities are reported at market value based principally on their quoted
market prices. The associated unrealized gains and losses, net of income
taxes and deferred policy acquisition costs, are included as a component of
equity or if deemed to be other than temporary, are included as a realized
loss.
Equity Securities consist primarily of common and preferred stocks.
Marketable equity securities are reported at market value based principally
on their quoted market prices. Cost basis of the equity securities is $3.9
million and $5.3 million as of December 31, 1996 and 1995, respectively. The
associated unrealized gains and losses are included as a component of
equity.
Mortgage Loans and Policy Loans are stated primarily at unpaid principal
balances, net of unamortized discounts. Interest income is recognized as net
investment income earned.
B-5
<PAGE>
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS OF
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
DECEMBER 31, 1996, 1995, AND 1994
Investment Real Estate acquired through foreclosure during 1994 was sold in
1996 for $4.5 million.
Other Long Term Investments, which consist of limited partnerships, are
valued at the aggregate net equity in the partnerships. Certain investments
in this category were non-income producing at December 31, 1995. These
investments were $.3 million at December 31, 1995. There were no non-income
producing investments at December 31, 1996 and 1994.
Partnership and joint venture interests in which the Company does not have
control and a majority economic interest are reported on the equity basis of
accounting. Non real estate related interests of $4.5 million and $4.1
million are included in other long term investments, at December 31, 1996
and 1995, respectively. The Company's share of net income from such entities
was $1.4 million, $.3 million, and $1.9 million for the years ended December
31, 1996, 1995, and 1994, respectively, and is reported in net investment
income.
Realized investment gains and losses are reported based on specific
identification of the investments sold.
Short-term investments are fixed maturities that mature within one year, and
are reported at estimated fair value.
D. Revenue Recognition and Related Expenses
Universal life contracts are long duration life insurance contracts that
involve significant mortality and morbidity risk with both fixed and
guaranteed terms. Investment contracts are long duration contracts that do
not subject the insurance enterprise to risks arising from policyholder
mortality or morbidity. Amounts received as payments for these contracts are
reported as deposits to policyholders' account balances. Revenues from these
contracts consist primarily of amounts assessed during the period against
policyholders' account balances for mortality charges, policy administration
fees and surrender charges. Policy benefits and claims that are charged to
expenses include benefit claims incurred in the period in excess of related
policyholders' account balances.
Premiums, policy benefits and claims from traditional life and annuity
policies, generally are recognized in operations when due.
E. Deferred Policy Acquisition Costs
Acquisition costs consist of commissions and other costs which vary with and
are primarily related to the production or acquisition of new business.
Acquisition costs related to universal life products and investment-type
contracts are deferred and amortized in proportion to total estimated gross
profits arising principally from investment results, mortality, expense
margins and surrender charges based on historical and anticipated future
experience. Amortization of deferred policy acquisition costs was $9.3
million, $54.4 million, and $76.0 million for the years ended December 31,
1996, 1995, and 1994, respectively. Deferred policy acquisition costs are
analyzed to determine if they are recoverable from future income, including
investment income. If such costs are determined to be unrecoverable, they
are expensed at the time of determination. The effect on the deferred policy
acquisition asset that would result from realization of unrealized
investment gains (losses) is recognized with an offset to unrealized
investment gains (losses) in consolidated stockholder's equity.
B-6
<PAGE>
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS OF
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
DECEMBER 31, 1996, 1995, AND 1994
F. Future Policy Benefits and Policyholders' Account Balances
Benefit reserve liabilities for payout annuities such as matured deferred
annuities and supplementary contracts represent the present values of
estimated future benefits payments and related expenses. Present values for
these contracts are computed using interest rates ranging from 6.5% to 11%.
The mortality assumption for these contracts is the 83 IAM tables. Reserves
for supplementary benefits are stated at interest rates that vary from 4% to
6.5% using mortality and morbidity assumptions either from company
experience or various actuarial tables.
When liabilities for future policy benefits plus the present value of
expected future gross deposits are insufficient to provide expected future
policy benefits and expenses, unrecoverable deferred policy acquisition
costs are written off and thereafter, if required, a premium deficiency
reserve is established as a charge to income.
Policyholders' account balances for universal life and investment-type
contracts are equal to the policy account values. The policy account values
represent an accumulation of gross deposits plus interest credited less
expense and mortality charges and withdrawals.
Interest crediting rates on life insurance products range from 3.35% to 7%.
G. Separate Accounts
Separate Accounts represent funds for which investment income and investment
gains and losses accrue directly to, and investment risk is borne by, the
policyholders, with the exception of the Pruco Life Modified Guaranteed
Annuity Account. The Pruco Life Modified Guaranteed Annuity Account is a
non-unitized separate account, which funds the Modified Guaranteed Annuity
Contract and the Market Value Adjustment Annuity Contract. Owners of the
Pruco Life Modified Guaranteed Annuity and the Market Value Adjustment
Annuity Contracts do not participate in the investment gain or loss from
assets relating to such accounts. Such gain or loss is borne, in total, by
the Company.
All Separate Account assets are carried at market value. Deposits to all
Separate Accounts are reported as increases in Separate Account liabilities,
which equal the Separate Account policy account fund values. Charges
assessed against Policyholders' account balances for mortality, policy
administration and surrender charges are included in policy charges and fee
income. Mortality and expense risk charges are applied against the
Policyholders' account balance. The Separate Account assets are legally
segregated and are not subject to claims that arise out of any other
business of the Company.
H. Estimates
The preparation of financial statements requires management to make
estimates and assumptions that affect the reported amounts of assets and
liabilities and disclosure of contingent assets and liabilities at the date
of the financial statements and the reported amounts of revenues and
expenses during the reporting period. Actual results could differ from those
estimates.
B-7
<PAGE>
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS OF
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
DECEMBER 31, 1996, 1995, AND 1994
2. FIXED MATURITIES
Gross unrealized gains and losses for securities classified as Held to Maturity
and Available for Sale, by major security type, are as follows:
<TABLE>
<CAPTION>
DECEMBER 31, 1996
- ---------------------------------------------------------------------------------------------------
Gross Gross
Amortized Unrealized Unrealized Fair
(000's) Cost Gains Losses Value
- ---------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C>
Held to Maturity
U.S. Treasury securities and
obligations of U.S. government
corporations and agencies $ - $ - $ - $ -
Foreign government bonds - - - -
Corporate securities 405,731 10,947 576 416,102
Mortgage-backed securities - - - -
Other fixed maturities - - - -
- ---------------------------------------------------------------------------------------------------
Total $ 405,731 $ 10,947 $ 576 $ 416,102
- ---------------------------------------------------------------------------------------------------
<CAPTION>
DECEMBER 31, 1996
- ---------------------------------------------------------------------------------------------------
Gross Gross
Amortized Unrealized Unrealized Fair
(000's) Cost Gains Losses Value
- ---------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C>
Available For Sale
U.S. Treasury securities and
obligations of U.S. government
corporations and agencies $ 32,055 $ 30 $ 174 $ 31,911
Foreign government bonds 90,447 857 205 91,099
Corporate securities 2,087,250 30,365 4,206 2,113,409
Mortgage-backed securities 398 - - 398
Other fixed maturities - - - -
- ---------------------------------------------------------------------------------------------------
Total $ 2,210,150 $ 31,252 $ 4,585 $ 2,236,817
- ---------------------------------------------------------------------------------------------------
</TABLE>
B-8
<PAGE>
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS OF
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
DECEMBER 31, 1996, 1995, AND 1994
<TABLE>
<CAPTION>
DECEMBER 31, 1995
- ---------------------------------------------------------------------------------------------------
Gross Gross
Amortized Unrealized Unrealized Fair
(000's) Cost Gains Losses Value
- ---------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C>
Held to Maturity
U.S. Treasury securities and
obligations of U.S. government
corporations and agencies $ - $ - $ - $ -
Foreign government bonds - - - -
Corporate securities 437,727 18,629 1,805 454,551
Mortgage-backed securities - - - -
Other fixed maturities - - - -
- ---------------------------------------------------------------------------------------------------
Total $ 437,727 $ 18,629 $ 1,805 $ 454,551
- ---------------------------------------------------------------------------------------------------
<CAPTION>
DECEMBER 31, 1995
- ---------------------------------------------------------------------------------------------------
Gross Gross
Amortized Unrealized Unrealized Fair
(000's) Cost Gains Losses Value
- ---------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C>
Available For Sale
U.S. Treasury securities and
obligations of U.S. government
corporations and agencies $ 324,854 $ 6,830 $ 61 $ 331,623
Foreign government bonds 73,042 3,055 - 76,097
Corporate securities 1,507,248 54,545 2,168 1,559,625
Mortgage-backed securities 169,190 8,717 398 177,509
Other fixed maturities - - - -
- ---------------------------------------------------------------------------------------------------
Total $ 2,074,334 $ 73,147 $ 2,627 $ 2,144,854
- ---------------------------------------------------------------------------------------------------
</TABLE>
B-9
<PAGE>
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS OF
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
DECEMBER 31, 1996, 1995, AND 1994
The amortized cost and estimated fair value of fixed maturities at December 31,
1996, categorized by contractual maturity, are shown below. Actual maturities
will differ from contractual maturities because borrowers may prepay obligations
with or without call or prepayment penalties.
DECEMBER 31, 1996
- ------------------------------------------------------------------------------
Estimated
Amortized Fair
(000's) Cost Value
- ------------------------------------------------------------------------------
Held to Maturity
Due in one year or less $ 28,653 $ 28,762
Due after one year through five years 156,013 158,183
Due after five years through ten years 194,765 202,766
Due after ten years 26,300 26,391
Mortgage-backed securities -- --
- ------------------------------------------------------------------------------
Total $ 405,731 $ 416,102
- ------------------------------------------------------------------------------
DECEMBER 31, 1996
- ------------------------------------------------------------------------------
Estimated
Amortized Fair
(000's) Cost Value
- ------------------------------------------------------------------------------
Available For Sale
Due in one year or less $ 130,400 $ 131,301
Due after one year through five years 1,561,854 1,578,979
Due after five years through ten years 398,090 404,920
Due after ten years 119,408 121,219
Mortgage-backed securities 398 398
- ------------------------------------------------------------------------------
Total $2,210,150 $2,236,817
- ------------------------------------------------------------------------------
Proceeds from the sale of fixed maturities during 1996, 1995, and 1994 were $3.8
billion, $1.8 billion, and $2.6 billion, respectively. Gross gains of $28.7
million, $28.8 million, and $16.8 million and gross losses of $19.7 million,
$17.5 million, and $49.8 million were realized on those sales during 1996, 1995,
and 1994, respectively.
B-10
<PAGE>
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS OF
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
DECEMBER 31, 1996, 1995, AND 1994
<TABLE>
<CAPTION>
3. Net Investment Income YEAR ENDED
DECEMBER 31,
1996 1995 1994
-------------------------------------------
(000'S)
<S> <C> <C> <C>
Net investment income consists of:
Gross investment income
Fixed maturities
Held to maturity $ 33,419 $ 33,458 $ 196,909
Available for sale 152,445 160,740 --
Equity securities 44 104 14
Mortgage loans 5,669 7,757 4,041
Investment real estate 613 647 2,146
Policy loans 33,449 29,775 25,692
Short term investments 16,780 15,092 12,676
Other 9,438 3,949 5,075
-------------------------------------------
251,857 251,522 246,553
Investment expenses (4,529) (4,904) (5,421)
===========================================
Net investment income $ 247,328 $ 246,618 $ 241,132
===========================================
4. Investment Gains (Losses)
<CAPTION>
YEAR ENDED
DECEMBER 31,
1996 1995 1994
-------------------------------------------
(000'S)
<S> <C> <C> <C>
Realized investment gains (losses)
Fixed maturities - Available for sale $ 9,036 $ 11,359 $ (38,180)
Equity securities 781 2,020 503
Mortgage loans 1,677 (90) (4,581)
Investment real estate 487 (99) 1,184
Other (1,146) 10 --
-------------------------------------------
Realized investment gains (losses) $ 10,835 $ 13,200 $ (41,074)
===========================================
<CAPTION>
YEAR ENDED
DECEMBER 31,
1996 1995 1994
-------------------------------------------
(000'S)
<S> <C> <C> <C>
Net unrealized investment gains
(losses), beginning of period $ 30,836 $ (1,349) $ --
Net unrealized investment gains (losses)
Fixed maturities - Available for sale (43,853) 131,712 --
Equity securities 1,403 827 (2,108)
-------------------------------------------
(42,450) 132,539 (2,108)
Deferred income tax benefit (provision) 15,398 (47,714) 759
Deferred policy acquisition costs
(net of deferred income taxes) 8,618 (12,878) --
-------------------------------------------
Net change in unrealized
investment gains (losses) (18,434) 71,947 (1,349)
Adoption of SFAS 115 -- (39,762) --
-------------------------------------------
Net unrealized investment gains
(losses), end of period $ 12,402 $ 30,836 (1,349)
===========================================
</TABLE>
B-11
<PAGE>
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS OF
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
DECEMBER 31, 1996, 1995, AND 1994
5. Fair Value Information
The fair value amounts have been determined by the Company using available
information and reasonable valuation methodologies. Considerable judgment is
applied, as necessary, in interpreting data to develop the estimates of fair
value. Accordingly, the estimates presented may not be realized in a current
market exchange. The use of different market assumptions and/or estimation
methodologies could have a material effect on the estimated fair values.
The following methods and assumptions were used in calculating the fair values.
Fixed Maturities - Fair values for fixed maturities, other than private
placement securities, are based on quoted market prices or estimates from
independent pricing services. Fair values for private placement securities are
estimated using a discounted cash flow model which considers the current market
spreads between the U.S. Treasury yield curve and corporate bond yield curve
adjusted for the type of issue, its current quality and its remaining average
life.
Equity Securities - Fair value is based on quoted market prices.
Mortgage Loans - The fair value of the mortgage loan portfolio is primarily
based upon the present value of the scheduled cash flows discounted at the
appropriate U.S. Treasury rate, adjusted for the current market spread for a
similar quality mortgage.
Policy Loans - The estimated fair value is calculated using a discounted cash
flow model based upon current U.S. Treasury rates and historical loan
repayments.
Policyholders' Account Balances - Fair values for policyholders' account
balances are equal to the policy account values.
Short-term Investments - Fair values for short-term investments are based on
quoted market prices or estimates from independent pricing services.
The following table discloses the carrying amounts and estimated fair values of
the Company's financial instruments at December 31, 1996 and 1995:
<TABLE>
<CAPTION>
1996 1995
CARRYING VALUE FAIR VALUE CARRYING VALUE FAIR VALUE
-------------- ---------- -------------- ----------
(000'S)
<S> <C> <C> <C> <C>
Financial Assets:
Fixed maturities:
Held to maturity $ 405,731 $ 416,102 $ 437,727 $ 454,551
Available for sale 2,236,817 2,236,817 2,144,854 2,144,854
Mortgage loans 46,915 46,692 64,464 63,635
Policy loans 639,782 623,218 569,273 577,975
Equity securities 3,748 3,748 4,036 4,036
Short-term investments 169,830 169,830 228,016 228,016
Financial Liabilities:
Policyholders'
account balances $ 2,188,862 $ 2,188,862 $ 2,218,330 $ 2,218,330
</TABLE>
B-12
<PAGE>
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS OF
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
DECEMBER 31, 1996, 1995, AND 1994
6. Income Taxes
The Company is a member of a group of affiliated companies which join in filing
a consolidated federal income tax return in addition to separate company state
and local tax returns. The Internal Revenue Code limits the amount of nonlife
insurance losses that may offset life insurance company taxable income.
Companies operating outside the United States are taxed under applicable foreign
statutes.
Pursuant to the tax allocation arrangement, total federal income tax expense is
determined on a separate company basis. Members with losses record tax benefits
to the extent such losses are recognized in the consolidated federal tax
provision. The Company has a net receivable from Prudential of $7.2 million and
$6.4 million as of December 31, 1996 and 1995, respectively.
Deferred income taxes are generally recognized when assets and liabilities have
different values for financial statement and tax reporting purposes.
The components of income taxes are as follows:
YEAR ENDED
DECEMBER 31,
1996 1995 1994
-------------------------------------
(000'S)
Current income tax provision:
Federal income tax $ 59,489 $ 65,131 $ 59,641
State and local income tax 703 1,876 3,036
Foreign income tax 4 7 7
-------------------------------------
Total current income tax 60,196 67,014 62,684
Deferred income tax provision
(benefit):
Federal income tax 18,413 12,196 (14,246)
State and local income tax 526 348 (407)
-------------------------------------
Total deferred income tax 18,939 12,544 (14,653)
-------------------------------------
Total income tax provision $ 79,135 $ 79,558 $ 48,031
=====================================
The income tax provision is different from the amount computed using the
expected federal income tax rate of 35% for the following reasons:
YEAR ENDED
DECEMBER 31,
1996 1995 1994
-------------------------------------
(000'S)
Expected federal income tax expense $ 79,926 $ 81,271 $ 45,474
State income taxes 1,229 2,224 2,629
Other (2,020) (3,937) (72)
=====================================
Total income tax provision $ 79,135 $ 79,558 $ 48,031
=====================================
B-13
<PAGE>
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS OF
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
DECEMBER 31, 1996, 1995, AND 1994
The components of net deferred income taxes payable are as follows:
YEAR ENDED
DECEMBER 31,
1996 1995
------------------------------
(000'S)
Deferred Income Tax Assets
Insurance liabilities $ 38,532 $ 40,732
Other -- --
------------------------------
Total deferred income tax assets $ 38,532 $ 40,732
==============================
Deferred Income Tax Liabilities
Deferred acquisition costs $ 173,785 $ 153,526
Net investment gains 12,502 28,157
Other 1,205 97
------------------------------
Total deferred income tax liabilities 187,492 181,780
------------------------------
Deferred federal income tax payable $ 148,960 $ 141,048
==============================
The Internal Revenue Service (the "Service") has completed examinations of the
consolidated federal income tax returns through 1989. The Service is examining
the years 1990 through 1992. Discussions are being held with the Service with
respect to proposed adjustments. However, management believes there are adequate
defenses against, or sufficient reserves to provide for, such adjustments.
B-14
<PAGE>
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS OF
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
DECEMBER 31, 1996, 1995, AND 1994
7. Stockholder's Equity Reconciliation
The reconciliation of statutory net income to GAAP net income, and statutory
surplus to GAAP equity as of December 31, 1996, 1995, and 1994 are as
follows:
<TABLE>
<CAPTION>
1996 1995 1994
---------------------------------------------------------
(000'S)
<S> <C> <C> <C>
Statutory net income $ 73,847 $ 157,751 $ 52,955
Deferred acquisition costs 48,862 (6,103) (34,124)
Deferred premium 1,295 (743) 1,122
Insurance liabilities 10,211 22,890 31,780
Income taxes (7,780) (27,669) 42,755
Interest maintenance reserve 365 5,480 (24,704)
Separate accounts and other 22,422 1,038 12,111
---------------------------------------------------------
GAAP net income $ 149,222 $ 152,644 $ 81,895
=========================================================
Statutory surplus $ 901,645 $ 829,022 $ 676,087
Investment valuation 26,678 70,776 -
Deferred acquisition costs 633,159 566,976 598,294
Deferred premium (11,859) (13,154) (12,412)
Insurance liabilities (124,781) (153,995) (71,076)
Income taxes (124,823) (128,070) (82,167)
Asset valuation reserve and interest
maintenance reserve 68,733 64,551 23,690
Other 30,229 32,087 (49,052)
---------------------------------------------------------
GAAP stockholder's equity $ 1,398,981 $ 1,268,193 $ 1,083,364
=========================================================
</TABLE>
The New York State Insurance Department ("Department") recognizes only
statutory accounting for determining and reporting the financial condition
and results of operations of an insurance company, for determining its
solvency under the New York Insurance Law, and for determining whether its
financial condition warrants the payment of a dividend to its stockholders.
No consideration is given by the Department to financial statements prepared
in accordance with generally accepted accounting principles in making such
determinations.
B-15
<PAGE>
NOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS OF
PRUCO LIFE INSURANCE COMPANY AND SUBSIDIARIES
DECEMBER 31, 1996, 1995, AND 1994
8. Related Party Transactions
A. Service Agreements
The Company, Prudential, and Pruco Securities Corporation, an indirect
wholly-owned subsidiary of Prudential, operate under service and lease
agreements whereby services of officers and employees, supplies, use of
equipment and office space are provided. The net cost of these services
allocated to the Company were $102 million, $98 million and $78 million for
the years ended December 31, 1996, 1995, and 1994, respectively.
B. Pension Plans
The Company is a wholly-owned subsidiary of Prudential which sponsors
several defined benefit pension plans that cover substantially all of its
employees. Benefits are generally based on career average earnings and
credited length of service. Prudential's funding policy is to contribute
annually the amount necessary to satisfy the Internal Revenue Service
contribution guidelines.
No pension expense for contributions to the plan was allocated to the
Company in 1996, 1995, or 1994 because the plan was subject to the full
funding limitation under the Internal Revenue Code.
C. Postretirement Life and Health Benefits
Prudential also sponsors certain life insurance and health care benefits for
its retired employees. Substantially all employees may become eligible to
receive a benefit if they retire after age 55 with at least 10 years of
service. Prudential elected to amortize its obligation over twenty years. A
provision for contributions to the postretirement fund is included in the
net cost of services allocated to the Company discussed above for the years
ended December 31, 1996, 1995, and 1994.
D. Reinsurance
The Company currently has three reinsurance agreements in place with
Prudential (the reinsurer). Specifically: reinsurance Group Annuity
Contract, whereby the reinsurer, in consideration for a single premium
payment by the Company, provides reinsurance equal to 100% of all payments
due under the contract, and two yearly renewable term agreements in which
the Company may offer and the reinsurer may accept reinsurance on any life
in excess of the Company's maximum limit of retention. The Company is not
relieved of its primary obligation to the policyholder as a result of these
reinsurance transactions. These agreements had no material effect on net
income for the years ended December 31, 1996, 1995, and 1994.
9. Contingencies
Several actions have been brought against the Company on behalf of those
persons who purchased life insurance policies based on complaints about
sales practices engaged in by Prudential, the Company and agents appointed
by Prudential and the Company. Prudential has agreed to indemnify the
Company for any and all losses resulting from such litigation.
10. Dividends
The Company is subject to Arizona law which limits the amount of dividends
that insurance companies can pay to stockholders. The maximum dividend which
may be paid in any twelve month period without notification or approval is
limited to the lesser of 10% of surplus as of December 31 of the preceding
year or the net gain from operations of the preceding calendar year. Cash
dividends may only be paid out of surplus derived from realized net profits.
Based on these limitations and the Company's surplus position at December
31, 1996, the Company would be permitted a maximum of $48 million in
dividend distribution in 1997, all of which could be paid in cash, without
approval from The State of Arizona Department of Insurance.
B-16
<PAGE>
REPORT OF INDEPENDENT ACCOUNTANTS
To the Board of Directors of
Pruco Life Insurance Company
In our opinion, the accompanying consolidated statement of financial position
and the related consolidated statements of operations, of stockholder's equity
and of cash flows present fairly, in all material respects, the financial
position of Pruco Life Insurance Company and its subsidiaries at December 31,
1996, and the results of their operations and their cash flows for the year in
conformity with generally accepted accounting principles. These financial
statements are the responsibility of the Company's management; our
responsibility is to express an opinion on these financial statements based on
our audit. We conducted our audit of these statements in accordance with
generally accepted auditing standards which require that we plan and perform the
audit to obtain reasonable assurance about whether the financial statements are
free of material misstatement. An audit includes examining, on a test basis,
evidence supporting the amounts and disclosures in the financial statements,
assessing the accounting principles used and significant estimates made by
management, and evaluating the overall financial statement presentation. We
believe that our audit provides a reasonable basis for the opinion expressed
above.
/s/ PRICE WATERHOUSE LLP
- --------------------------
PRICE WATERHOUSE LLP
New York, New York
March 21, 1997
B-17
<PAGE>
INDEPENDENT AUDITORS' REPORT
To The Board of Directors of
Pruco Life Insurance Company
Newark, New Jersey
We have audited the accompanying consolidated statement of financial position of
Pruco Life Insurance Company and subsidiaries as of December 31, 1995, and the
related consolidated statements of operations, stockholder's equity and cash
flows for the years ended December 31, 1995 and 1994. These financial statements
are the responsibility of the Company's management. Our responsibility is to
express an opinion on the financial statements based on our audits.
We conducted our audits in accordance with generally accepted auditing
standards. Those standards require that we plan and perform the audit to obtain
reasonable assurance about whether the financial statements are free of material
misstatement. An audit includes examining, on a test basis, evidence supporting
the amounts and disclosures in the financial statements. An audit also includes
assessing the accounting principles used and significant estimates made by
management, as well as evaluating the overall financial statement presentation.
We believe that our audits provide a reasonable basis for our opinion.
In our opinion, the accompanying financial statements presents fairly, in all
material respects, the consolidated financial position of Pruco Life Insurance
Company and subsidiaries as of December 31, 1995, and the consolidated results
of operations and cash flows for the years ended December 31, 1995 and 1994 in
conformity with generally accepted accounting principles.
As discussed in Note 1 to the consolidated financial statements, the Company has
retroactively adopted all applicable generally accepted accounting principles
relating to stock life insurance subsidiaries of mutual life insurance companies
and has changed, as of January 1, 1995, the method of accounting for fixed
maturity investments.
/s/ DELOITTE & TOUCHE LLP
Parsippany, N.J.
December 19, 1996
B-18
<PAGE>
ADDITIONAL ILLUSTRATIONS OF
CASH VALUES, DEATH BENEFITS, AND ACCUMULATED PREMIUMS
-----------------------------------------------------
VARIABLE LIFE INSURANCE CONTRACT
MALE ISSUE AGE 25
$50,000 GUARANTEED DEATH BENEFIT
$536.50 ANNUAL PREMIUM FOR STANDARD UNDERWRITING RISK (1)
<TABLE>
<CAPTION>
DEATH BENEFIT (2) CASH VALUE (2)
---------------------------------------------- ----------------------------------------------
ASSUMING HYPOTHETICAL GROSS (AND NET) ASSUMING HYPOTHETICAL GROSS (AND NET)
PREMIUMS ANNUAL INVESTMENT RETURN OF ANNUAL INVESTMENT RETURN OF
END OF ACCUMULATED ---------------------------------------------- ----------------------------------------------
POLICY AT 4% INTEREST 0% GROSS 6% GROSS 12% GROSS 0% GROSS 6% GROSS 12% GROSS
YEAR PER YEAR (-0.86% NET) (5.14% NET) (11.14% NET) (-0.86% NET) (5.14% NET) (11.14% NET)
---------- -------------- -------------- -------------- -------------- -------------- -------------- --------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 $ 558 $50,000 $50,004 $ 50,026 $ 22 $ 26 $ 31
2 $ 1,138 $50,000 $50,029 $ 50,184 $ 376 $ 406 $ 437
3 $ 1,742 $50,000 $50,074 $ 50,479 $ 729 $ 807 $ 889
4 $ 2,369 $50,000 $50,140 $ 50,918 $1,080 $ 1,229 $ 1,392
5 $ 3,022 $50,000 $50,226 $ 51,511 $1,437 $ 1,682 $ 1,961
6 $ 3,701 $50,000 $50,332 $ 52,265 $1,790 $ 2,157 $ 2,590
7 $ 4,407 $50,000 $50,458 $ 53,187 $2,139 $ 2,655 $ 3,287
8 $ 5,141 $50,000 $50,604 $ 54,287 $2,484 $ 3,176 $ 4,058
9 $ 5,905 $50,000 $50,768 $ 55,571 $2,824 $ 3,720 $ 4,909
10 $ 6,699 $50,000 $50,952 $ 57,049 $3,159 $ 4,288 $ 5,849
15 $11,172 $50,000 $52,137 $ 67,720 $4,727 $ 7,498 $ 12,195
20 $16,615 $50,000 $53,734 $ 85,043 $6,082 $11,351 $ 22,400
25 $23,237 $50,000 $55,706 $111,201 $7,214 $15,928 $ 38,707
30 $31,293 $50,000 $58,021 $149,321 $8,098 $21,280 $ 64,512
40 (AGE 65) $53,020 $50,000 $63,592 $280,879 $9,005 $34,192 $166,707
</TABLE>
(1) IF PREMIUMS ARE PAID MORE FREQUENTLY THAN ANNUALLY, THE PAYMENTS WOULD BE
$274.50 SEMI-ANNUALLY, $139.50 QUARTERLY OR $48 MONTHLY. THE DEATH BENEFITS
AND CASH VALUES WOULD BE SLIGHTLY DIFFERENT FOR A CONTRACT WITH MORE
FREQUENT PREMIUM PAYMENTS.
(2) ASSUMES NO CONTRACT LOAN HAS BEEN MADE.
THE HYPOTHETICAL INVESTMENT RATES OF RETURN SHOWN ABOVE AND ELSEWHERE IN THIS
PROSPECTUS ARE ILLUSTRATIVE ONLY AND SHOULD NOT BE DEEMED A REPRESENTATION OF
PAST OR FUTURE INVESTMENT RATES OF RETURN. ACTUAL RATES OF RETURN MAY BE MORE OR
LESS THAN THOSE SHOWN AND WILL DEPEND ON A NUMBER OF FACTORS INCLUDING THE
INVESTMENT ALLOCATIONS MADE BY AN OWNER, PREVAILING INTEREST RATES, AND RATES OF
INFLATION. THE DEATH BENEFIT AND CASH VALUE FOR A CONTRACT WOULD BE DIFFERENT
FROM THOSE SHOWN IF THE ACTUAL RATES OF RETURN AVERAGED 0%, 6%, AND 12% OVER A
PERIOD OF YEARS BUT ALSO FLUCTUATED ABOVE OR BELOW THOSE AVERAGES FOR INDIVIDUAL
CONTRACT YEARS. NO REPRESENTATIONS CAN BE MADE BY PRUCO LIFE OF NEW JERSEY OR
THE SERIES FUND THAT THESE HYPOTHETICAL RATES OF RETURN CAN BE ACHIEVED FOR ANY
ONE YEAR OR SUSTAINED OVER ANY PERIOD OF TIME.
C1
<PAGE>
VARIABLE LIFE INSURANCE CONTRACT
MALE ISSUE AGE 40
$50,000 GUARANTEED DEATH BENEFIT
$939 ANNUAL PREMIUM FOR STANDARD UNDERWRITING RISK (1)
<TABLE>
<CAPTION>
DEATH BENEFIT (2) CASH VALUE (2)
---------------------------------------------- ----------------------------------------------
ASSUMING HYPOTHETICAL GROSS (AND NET) ASSUMING HYPOTHETICAL GROSS (AND NET)
PREMIUMS ANNUAL INVESTMENT RETURN OF ANNUAL INVESTMENT RETURN OF
END OF ACCUMULATED ---------------------------------------------- ----------------------------------------------
POLICY AT 4% INTEREST 0% GROSS 6% GROSS 12% GROSS 0% GROSS 6% GROSS 12% GROSS
YEAR PER YEAR (-0.86% NET) (5.14% NET) (11.14% NET) (-0.86% NET) (5.14% NET) (11.14% NET)
---------- -------------- -------------- -------------- -------------- -------------- -------------- --------------
<S> <C> <C> <C> <C> <C> <C> <C>
1 $ 977 $50,000 $50,010 $ 50,065 $ 197 $ 214 $ 231
2 $ 1,992 $50,000 $50,043 $ 50,276 $ 815 $ 887 $ 962
3 $ 3,048 $50,000 $50,098 $ 50,635 $ 1,417 $ 1,584 $ 1,762
4 $ 4,147 $50,000 $50,174 $ 51,149 $ 2,001 $ 2,302 $ 2,636
5 $ 5,289 $50,000 $50,273 $ 51,836 $ 2,641 $ 3,121 $ 3,672
6 $ 6,477 $50,000 $50,395 $ 52,703 $ 3,263 $ 3,967 $ 4,807
7 $ 7,713 $50,000 $50,538 $ 53,759 $ 3,868 $ 4,843 $ 6,051
8 $ 8,998 $50,000 $50,702 $ 55,009 $ 4,456 $ 5,747 $ 7,413
9 $10,335 $50,000 $50,887 $ 56,464 $ 5,026 $ 6,683 $ 8,905
10 $11,725 $50,000 $51,092 $ 58,133 $ 5,579 $ 7,649 $10,539
15 $19,554 $50,000 $52,405 $ 70,077 $ 8,039 $12,918 $21,286
20 $29,080 $50,000 $54,155 $ 89,296 $ 9,949 $18,885 $37,877
25 (AGE 65) $40,670 $50,000 $56,297 $118,168 $11,302 $25,518 $63,250
</TABLE>
(1) IF PREMIUMS ARE PAID MORE FREQUENTLY THAN ANNUALLY, THE PAYMENTS WOULD BE
$479.50 SEMI-ANNUALLY, $243 QUARTERLY OR $82.50 MONTHLY. THE DEATH BENEFITS
AND CASH VALUES WOULD BE SLIGHTLY DIFFERENT FOR A CONTRACT WITH MORE
FREQUENT PREMIUM PAYMENTS.
(2) ASSUMES NO CONTRACT LOAN HAS BEEN MADE.
THE HYPOTHETICAL INVESTMENT RATES OF RETURN SHOWN ABOVE AND ELSEWHERE IN THIS
PROSPECTUS ARE ILLUSTRATIVE ONLY AND SHOULD NOT BE DEEMED A REPRESENTATION OF
PAST OR FUTURE INVESTMENT RATES OF RETURN. ACTUAL RATES OF RETURN MAY BE MORE OR
LESS THAN THOSE SHOWN AND WILL DEPEND ON A NUMBER OF FACTORS INCLUDING THE
INVESTMENT ALLOCATIONS MADE BY AN OWNER, PREVAILING INTEREST RATES, AND RATES OF
INFLATION. THE DEATH BENEFIT AND CASH VALUE FOR A CONTRACT WOULD BE DIFFERENT
FROM THOSE SHOWN IF THE ACTUAL RATES OF RETURN AVERAGED 0%, 6%, AND 12% OVER A
PERIOD OF YEARS BUT ALSO FLUCTUATED ABOVE OR BELOW THOSE AVERAGES FOR INDIVIDUAL
CONTRACT YEARS. NO REPRESENTATIONS CAN BE MADE BY PRUCO LIFE OF NEW JERSEY OR
THE SERIES FUND THAT THESE HYPOTHETICAL RATES OF RETURN CAN BE ACHIEVED FOR ANY
ONE YEAR OR SUSTAINED OVER ANY PERIOD OF TIME.
C2
<PAGE>
VARIABLE
LIFE INSURANCE
CONTRACTS
[LOGO] Prudential
PRUCO LIFE INSURANCE COMPANY
213 Washington Street, Newark, NJ 07102-2992
Telephone 800 437-4016, Extension 46
A Subsidiary of
The Prudential Insurance Company of America
<PAGE>
PART II
OTHER INFORMATION
<PAGE>
UNDERTAKING TO FILE REPORTS
Subject to the terms and conditions of Section 15(d) of the Securities Exchange
Act of 1934, the undersigned Registrant hereby undertakes to file with the
Securities and Exchange Commission such supplementary and periodic information,
documents, and reports as may be prescribed by any rule or regulation of the
Commission heretofore or hereafter duly adopted pursuant to authority conferred
in that section.
REPRESENTATION WITH RESPECT TO CHARGES
Pruco Life Insurance Company represents that the fees and charges deducted under
the variable life insurance contracts registered by this registration statement,
in the aggregate, are reasonable in relation to the services rendered, the
expenses expected to be incurred, and the risks assumed by Pruco Life Insurance
Company.
UNDERTAKING WITH RESPECT TO INDEMNIFICATION
Prudential Directors' and Officers' Liability and Corporation Reimbursement
Insurance program, purchased by Prudential from Aetna Casualty & Surety Company,
CNA Insurance Companies, Lloyds of London, Great American Insurance Company,
Reliance Insurance Company, Corporate Officers & Directors Assurance Ltd.,
A.C.E. Insurance Company, Ltd., XL Insurance Company, Ltd., and Zurich-American
Insurance Company, provides reimbursement for "Loss" (as defined in the
policies) which the Company pays as indemnification to its directors or officers
resulting from any claim for any actual or alleged act, error, misstatement,
misleading statement, omission, or breach of duty by persons in the discharge of
their duties in their capacities as directors or officers of Prudential, any of
its subsidiaries, or certain investment companies affiliated with Prudential.
Coverage is also provided to the individual directors or officers for such Loss,
for which they shall not be indemnified. Loss essentially is the legal liability
on claims against a director or officer, including adjudicated damages,
settlements and reasonable and necessary legal fees and expenses incurred in
defense of adjudicatory proceedings and appeals therefrom. Loss does not include
punitive or exemplary damages or the multiplied portion of any multiplied damage
award, criminal or civil fines or penalties imposed by law, taxes or wages, or
matters which are uninsurable under the law pursuant to which the policies are
construed.
There are a number of exclusions from coverage. Among the matters excluded are
Losses arising as the result of (1) claims brought about or contributed to by
the criminal, dishonest or fraudulent acts or omissions or the willful violation
of any law by a director or officer, (2) claims based on or attributable to
directors or officers gaining personal profit or advantage to which they were
not legally entitled, and (3) claims arising from actual or alleged performance
of, or failure to perform, services as, or in any capacity similar to, an
investment adviser, investment banker, underwriter, broker or dealer, as those
terms are defined in the Securities Act of 1933, the Securities Exchange Act of
1934, the Investment Advisers Act of 1940, the Investment Company Act of 1940,
any rules or regulations thereunder, or any similar federal, state or local
statute, rule or regulation.
The limit of coverage under the program for both individual and corporate
reimbursement coverage is $150,000,000. The retention for corporate
reimbursement coverage is $10,000,000 per loss.
The relevant provisions of New Jersey law permitting or requiring
indemnification, New Jersey being the state of organization of Prudential, can
be found in Section 14A:3-5 of the New Jersey Statutes Annotated. The relevant
provisions of Arizona law permitting or requiring indemnification, Arizona being
the state of organization of Pruco Life, can be found in Section 10-005 of the
Arizona Statutes Annotated. The text of Prudential's by-law 26, which relates to
indemnification of officers and directors, is incorporated by reference to
Exhibit 1.A.(6)(b) of Post-Effective Amendment No. 1 to Form S-6, Registration
No. 33-61079, filed April 25, 1996, on behalf of The Prudential Variable
Appreciable Account. The text of Pruco Life's by-laws, Article VIII, which
relates to indemnification of officers and directors, is incorporated by
reference to Exhibit (8)(ii) to this Registration Statement.
Insofar as indemnification for liabilities arising under the Securities Act of
1933 may be permitted to directors, officers and controlling persons of the
Registrant pursuant to the foregoing provisions or otherwise, the Registrant has
been advised that in the opinion of the Securities and Exchange Commission such
indemnification is against public policy as expressed in the Act and is,
therefore, unenforceable. In the event that a claim for indemnification against
such liabilities (other than the payment by the Registrant of expenses incurred
or paid by a director, officer or controlling person of the Registrant in the
successful defense of any action, suit or proceeding) is asserted by such
director, officer or controlling person in connection with the securities being
registered, the Registrant will, unless in the opinion of its counsel the matter
has been settled by controlling precedent, submit to a court of appropriate
jurisdiction the question whether such indemnification by it is against public
policy as expressed in the Act and will be governed by the final adjudication of
such issue.
II-1
<PAGE>
CONTENTS OF REGISTRATION STATEMENT
This Registration Statement comprises the following papers and documents:
The facing sheet.
Cross-reference to items required by Form N-8B-2.
The prospectus consisting of 63 pages.
The undertaking to file reports.
The representation with respect to charges.
The undertaking with respect to indemnification.
The signatures.
Written consents of the following persons:
1. Deloitte & Touche LLP, independent auditors.
2. Price Waterhouse LLP, independent accountants.
3. Clifford E. Kirsch, Esq.
4. Nancy D. Davis, FSA, MAAA
The following exhibits:
1. The following exhibits correspond to those required by paragraph A of
the instructions as to exhibits in Form N-8B-2:
A. (1) Resolution of Board of Directors of Pruco Life Insurance
Company establishing the Pruco Life Variable Insurance
Account. (Note 1)
(2) Not Applicable.
(3) Distributing Contracts:
(a) Distribution Agreement between Pruco Securities
Corporation and Pruco Life Insurance Company, as
amended June 1, 1984. (Note 1)
(b) Proposed form of Agreement between Pruco Securities
Corporation and independent brokers with respect to the
Sale of the Contracts. (Note 1)
(c) Schedules of Sales Commissions. (Note 1)
(4) Not Applicable.
(5) (a) Variable Life Insurance Contract. (Note 1)
(b) Illustrative Tabular Cash Values. (Note 1)
(c) Copy of Colorado and North Dakota VL-83 Endorsement to
the Variable Life Insurance Contract. (Note 1)
(d) Copy of the Oklahoma VL-83 Endorsement to the Variable
Life Insurance Contract. (Note 1)
(e) Copy of South Carolina VL-83 Endorsement to the
Variable Life Insurance Contract. (Note 1)
(f) Copy of Alternate Copy face page for Pennsylvania and
Maryland to the Variable Life Insurance Contract. (Note
1)
(g) Copy of Illinois Notice PLI 3 to the Variable Life
Insurance Contract. (Note 1)
(h) Copy of North Carolina Endorsement PLI 16 to the
Variable Life Insurance Contract. (Note 1)
(i) Copy of North Carolina Endorsement PLI 17 to the
Variable Life Insurance Contract. (Note 1)
(j) Copy of Missouri Endorsement PLI 18 to the Variable
Life Insurance Contract. (Note 1)
(k) Copy of Texas Endorsement PLI 21 to the Variable Life
Insurance Contract. (Note 1)
(l) Copy of Florida Endorsement PLI 35 to the Variable Life
Insurance Contract. (Note 1)
(m) Copy of Rhode Island Endorsement PLI-47 to the Variable
Life Insurance Contract. (Note 1)
(n) Copy of Maryland Endorsement PLI 48 to the Variable
Life Insurance Contract.
II-2
<PAGE>
(Note 1)
(o) Copy of Minnesota Endorsement PLI 50 to the Variable
Life Insurance Contract. (Note 1)
(p) Copy of Endorsement PLI 28 to the Variable Life
Insurance Contract used in all states except New York
and New Jersey. (Note 1)
(q) Copy of Endorsement PLI 73 to the Variable Life
Insurance Contract used in all states except New York
and New Jersey. (Note 1)
(r) Copy of Pennsylvania Endorsement PLI 86 to the Variable
Life Insurance Contract. (Note 1)
(s) Copy of Texas Endorsement PLI 90 to the Variable Life
Insurance Contract. (Note 1)
(t) Copy of Iowa Endorsement PLI 97 to the Variable Life
Insurance Contract. (Note 1)
(u) Copy of Endorsement PLI 99 to the Variable Life
Insurance Contract used in all states except New York
and New Jersey. (Note 1)
(v) Copy of Virginia jacket to the Variable Life Insurance
Contract. (Note 1)
(w) Copy of page 9 to the Variable Life Insurance
Contract--Virginia Issues. (Note 1)
(x) Copy of page 11 to the Variable Life Insurance
Contract--West Virginia Issues. (Note 1)
(y) Copy of page 13 to the Variable Life Insurance
Contract--Virginia Issues. (Note 1)
(z) Copy of page 13 to the Variable Life Insurance Contract
for use with variable loan interest rate
provision--Kentucky Issues. (Note 1)
(aa) Copy of Endorsement PLI 25 to the Variable Life
Insurance Contract for use in all states except New
York and New Jersey. (Note 1)
(bb) Copy of Endorsement PLI 104 to the Variable Life
Insurance Contract for use in Pennsylvania. (Note 1)
(cc) Copy of Endorsement PLI 134 to the Variable Life
Insurance Contract for use in all states except New
York and New Jersey. (Note 1)
(dd) Notice of Consumer Information for use in Illinois.
(Note 1)
(ee) Complaint Procedure Notice for use in Texas. (Note 1)
(ff) Certification of right to convert Variable Life
Insurance Contract for use in Pennsylvania. (Note 1)
(gg) Copy of Endorsement PLI 168-85 to the Variable Life
Insurance Contract for use in all states except New
York and New Jersey (Note 1)
(6) (a) Articles of Incorporation of Pruco Life Insurance
Company, as amended October 19, 1993. (Note 4)
(b) By-laws of Pruco Life Insurance Company, as amended
June 18, 1996. (Note 5)
(7) Not Applicable.
(8) Not Applicable.
(9) Not Applicable.
(10) (a) Application Form for Variable Life Insurance Contract.
(Note 1)
(b) Supplement to the Application for Variable Life
Insurance Contract. (Note 1)
(c) Application Form for Variable Life Insurance
Contract--Maryland issues. (Note 1)
(d) Application Form for Variable Life Insurance
Contract--Connecticut issues. (Note 1)
(e) Application Form for Variable Life Insurance
Contract--Missouri issues. (Note 1)
(f) Application Form for Variable Life Insurance
Contracts--Pennsylvania and South Carolina issues.
(Note 1)
(11) Form of Notice of Withdrawal Right. (Note 1)
(12) Memorandum describing Pruco Life's issuance, transfer, and
redemption procedures for the Contracts pursuant to Rule
6e-2(b) (12)(ii) and method of computing cash adjustment
upon exercise of right to exchange for fixed-benefit
insurance pursuant to Rule 6e-2(b)(13) (v)(B). (Note 1)
(13) Available Contract Riders.
(a) Rider for Insured's Waiver of Premium Benefit. (Note 1)
(b) Rider for Insured's Accidental Death Benefit. (Note 1)
(c) Rider for Term Insurance Benefit on Life of
Insured-Decreasing Amount. (Note 1)
(d) Rider for Option to Purchase Additional Insurance on
Life of Insured. (Note 1)
(e) Rider for Interim Term Insurance Benefit. (Note 1)
(f) Rider for Term Insurance Benefit on Life of Insured
Spouse-Decreasing Amount. (Note 1)
II-3
<PAGE>
(g) Rider for Level Term Insurance Benefit on Dependent
Children. (Note 1)
(h) Rider for Impaired Eyesight. (Note 1)
(i) Rider for Insured's Waiver of Premium Benefit. (Note 1)
(j) Rider for Insured's Accidental Death Benefit. (Note 1)
(k) Rider for Aviation Risk Exclusion. (Note 1)
(l) Rider for Aviation Risk Exclusion. (Note 1)
(m) Rider for Military Aviation Risk Exclusion. (Note 1)
(n) Rider for Military Aviation Risk Exclusion. (Note 1)
(o) Rider for Level Term Insurance Benefit on Dependent
Children. (Note 1)
(p) Rider for Insured's Waiver of Premium Benefit. (Note 1)
(q) Rider for Insured's Waiver of Premium Benefit. (Note 1)
(r) Rider for Insured's Accidental Death Benefit. (Note 1)
(s) Rider for Insured's Accidental Death Benefit. (Note 1)
(t) Rider for Insured's Accidental Death Benefit. (Note 1)
(u) Rider for Level Term Insurance Benefit on Dependent
Children. (Note 1)
(v) Rider for Level Term Insurance Benefit on Dependent
Children. (Note 1)
(w) Rider for Reduced Paid-Up Insurance. (Note 1)
(x) Rider for Exempting Child from Reinstatement. (Note 1)
(y) Rider Defining Incontestable Period. (Note 1)
(z) Rider for Modification of Insured's Waiver of Premium
Benefit Provision. (Note 1)
(aa) Rider for Termination of Benefit. (Note 1)
(bb) Rider for Aviation Risk Exclusion. (Note 1)
(cc) Rider for Military Aviation Risk Exclusion. (Note 1)
(dd) Rider for War Risk Exclusion. (Note 1)
(ee) Rider Defining Incontestable Period. (Note 1)
(ff) Rider for Suicide Provision. (Note 1)
(gg) Rider Defining Incontestable Period. (Note 1)
(hh) Rider for Aviation Risk Exclusion. (Note 1)
(ii) Rider for Military Aviation Risk Exclusion. (Note 1)
(jj) Rider for Level Term Benefit on Dependent Children.
(Note 1)
(kk) Rider for Insured's Waiver of Premium Benefit. (Note 1)
(ll) Rider for Insured's Accidental Death Benefit. (Note 1)
(mm) Rider for Ownership and Control. (Note 1)
(nn) Rider for Ownership and Control. (Note 1)
(oo) Rider for Applicant's Waiver of Premium Benefit. (Note
1)
(pp) Rider for Applicant's Waiver of Premium Benefit. (Note
1)
(qq) Rider for Applicant's Waiver of Premium Benefit. (Note
1)
(rr) Rider for Applicant's Waiver of Premium Benefit. (Note
1)
(ss) Rider for Applicant's Waiver of Premium Benefit. (Note
1)
(tt) Rider for Applicant's Waiver of Premium Benefit. (Note
1)
(uu) Rider for Level Term Benefit on Insured for use in West
Virginia. (Note 1)
(vv) Rider for Level Term Benefit on Insured for use in all
states except West Virginia. (Note 1)
(ww) Rider permitting Special Premium Remittance Plan for
use in all states except New York, New Jersey, and
Pennsylvania. (Note 1)
(xx) Rider for Variable Loan Interest Rate for use in all
states except New York, New Jersey, and Michigan. (Note
1)
(yy) Rider for Variable Loan Interest Rate for use in
Michigan. (Note 1)
(zz) Rider permitting Special Premium Remittance Plan for
use in Pennsylvania. (Note 1)
(aaa) Rider for Decreasing Term Insurance Benefit for use in
West Virginia. (Note 1)
(bbb) Rider for Decreasing Term Insurance Benefit for use in
all states except New York, New Jersey and West
Virginia. (Note 1)
(ccc) Rider for Decreasing Term Insurance Benefit on life of
Insured Spouse for use in all states except New York,
New Jersey, South Carolina and West Virginia. (Note 1)
(ddd) Rider for Decreasing Term Insurance Benefit on life of
Insured Spouse for use in South Carolina. (Note 1)
(eee) Rider for Decreasing Term Insurance Benefit on life of
Insured Spouse for use in West Virginia. (Note 1)
II-4
<PAGE>
(fff) Rider for Variable Loan Interest Rate for use in
Michigan. (Note 1)
(ggg) Rider for Variable Loan Interest Rate for use in South
Carolina. (Note 1)
(hhh) Rider for Variable Loan Interest Rate for use in all
states except New York, New Jersey, Michigan and South
Carolina. (Note 1)
(iii) Rider providing Options on Lapse for use in all states
except New York and New Jersey. (Note 1)
(jjj) Rider for Variable Reduced Paid-Up Insurance for use
in all states except New York and New Jersey. (Note 1)
(kkk) Living Needs Benefit Rider for use in Florida. (Note
4)
(lll) Living Needs Benefit Rider for use in all approved
jurisdictions except Florida. (Note 4)
2. See Exhibit 1.A.(5).
3. Opinion and Consent of Clifford E. Kirsch, Esq. as to the legality of the
securities being registered. (Note 1)
4. None.
5. Not Applicable.
6. Opinion and Consent of Nancy D. Davis, FSA, MAAA, as to actuarial matters
pertaining to the securities being registered. (Note 1)
7. Powers of Attorney.
(a) William M. Bethke, Ira J. Kleinman, Mendel A. Melzer, Esther H.
Milnes, I. Edward Price, William F. Yelverton (Note 2)
(b) Linda S. Dougherty (Note 5)
(c) Kiyofumi Sakaguchi (Note 3)
27. Financial Data Schedule (Note 1)
(Note 1) Filed herewith.
(Note 2) Incorporated by reference to Form 10-K, Registration No. 33-08698,
filed March 31, 1997 on behalf of the Pruco Life Variable Contract
Real Property Account.
(Note 3) Incorporated by reference to Post-Effective Amendment No. 8 to Form
S-6, Registration No. 33-49994, filed on or about April 25, 1997 on
behalf of the Pruco Life PRUvider Variable Appreciable Account.
(Note 4) Incorporated by reference to Form S-6, Registration No. 333-07451,
filed July 2, 1996 on behalf of the Pruco Life Variable Appreciable
Account.
(Note 5) Incorporated by reference to Post-Effective Amendment No. 3 to Form
S-1, Registration No. 33- 86780, filed April 9, 1997 on behalf of the
Pruco Life Variable Contract Real Property Account.
II-5
<PAGE>
SIGNATURES
Pursuant to the requirements of the Securities Act of 1933, the Registrant, the
Pruco Life Variable Insurance Account, certifies that this Amendment is filed
solely for one or more of the purposes specified in Rule 485(b)(1) under the
Securities Act of 1933 and that no material event requiring disclosure in the
prospectus, other than one listed in Rule 485(b)(1), has occurred since the
effective date of the most recent Post-Effective Amendment to the Registration
Statement which included a prospectus and has duly caused this Registration
Statement to be signed on its behalf by the undersigned thereunto duly
authorized and its seal hereunto affixed and attested, all in the city of Newark
and the State of New Jersey, on this 25th day of April, 1997.
(Seal) PRUCO LIFE VARIABLE INSURANCE ACCOUNT
(Registrant)
By: PRUCO LIFE INSURANCE COMPANY
(Depositor)
Attest: /s/ Thomas C. Castano By: /s/ Esther H. Milnes
--------------------- --------------------
Thomas C. Castano Esther H. Milnes
Assistant Secretary President
Pursuant to the requirements of the Securities Act of 1933, this Post-Effective
Amendment No. 24 to the Registration Statement has been signed below by the
following persons in the capacities indicated on this 25th day of April, 1997.
SIGNATURE AND TITLE
/s/ *
- ----------------------------------------
Esther H. Milnes
President and Director
/s/ *
- ----------------------------------------
Linda S. Dougherty
Chief Accounting Officer and Comptroller
/s/ * *By: /s/ Thomas C. Castano
- ---------------------------------------- -------------------------
William M. Bethke Thomas C. Castano
Director (Attorney-in-Fact)
/s/ *
- ----------------------------------------
Ira J. Kleinman
Director
/s/ *
- ----------------------------------------
Mendel A. Melzer
Director
/s/ *
- ----------------------------------------
I. Edward Price
Director
/s/ *
- ----------------------------------------
Kiyofumi Sakaguchi
Director
/s/ *
- ----------------------------------------
William F. Yelverton
Director
II-6
<PAGE>
EXHIBIT INDEX
99.C.1(a) Consent of Deloitte & Touche LLP, independent Page II-11
auditors.
99.C.1(b) Consent of Price Waterhouse LLP, independent Page II-12
accountants.
1.A.(1) Resolution of Board of Directors of Pruco Life Page II-13
Insurance Company establishing the Pruco Life
Variable Insurance Account.
1.A.(3)(a) Distribution Agreement between Pruco Page II-21
Securities Corporation and Pruco Life
Insurance Company, as amended June 1, 1984.
(b) Proposed form of Agreement between Pruco Page II-31
Securities Corporation and independent brokers
with respect to the Sale of the Contracts.
(c) Schedules of Sales Commissions. Page II-40
1.A.(5)(a) Variable Life Insurance Contract. Page II-43
(b) Illustrative Tabular Cash Values. Page II-71
(c) Copy of Colorado and North Dakota VL-83 Page II-81
Endorsement to the Variable Life Insurance
Contract.
(d) Copy of the Oklahoma VL-83 Endorsement to the Page II-83
Variable Life Insurance Contract.
(e) Copy of South Carolina VL-83 Endorsement to Page II-85
the Variable Life Insurance Contract.
(f) Copy of Alternate Copy face page for Page II-87
Pennsylvania and Maryland to the Variable Life
Insurance Contract.
(g) Copy of Illinois Notice PLI 3 to the Variable Page II-91
Life Insurance Contract.
(h) Copy of North Carolina Endorsement PLI 16 to Page II-92
the Variable Life Insurance Contract.
(i) Copy of North Carolina Endorsement PLI 17 to Page II-93
the Variable Life Insurance Contract.
(j) Copy of Missouri Endorsement PLI 18 to the Page II-94
Variable Life Insurance Contract.
(k) Copy of Texas Endorsement PLI 21 to the Page II-95
Variable Life Insurance Contract.
(l) Copy of Florida Endorsement PLI 35 to the Page II-96
Variable Life Insurance Contract.
(m) Copy of Rhode Island Endorsement PLI-47 to the Page II-97
Variable Life Insurance Contract.
(n) Copy of Maryland Endorsement PLI 48 to the Page II-98
Variable Life Insurance Contract.
(o) Copy of Minnesota Endorsement PLI 50 to the Page II-99
Variable Life Insurance Contract.
(p) Copy of Endorsement PLI 28 to the Variable Page II-100
Life Insurance Contract used in all states
except New York and New Jersey.
(q) Copy of Endorsement PLI 73 to the Variable Page II-101
Life Insurance Contract used in all states
except New York and New Jersey.
(r) Copy of Pennsylvania Endorsement PLI 86 to the Page II-102
Variable Life Insurance Contract.
(s) Copy of Texas Endorsement PLI 90 to the Page II-103
Variable Life Insurance Contract.
(t) Copy of Iowa Endorsement PLI 97 to the Page II-105
Variable Life Insurance Contract.
(u) Copy of Endorsement PLI 99 to the Variable Page II-106
Life Insurance Contract used in all states
except New York and New Jersey. Page II-107
(v) Copy of Virginia jacket to the Variable Life
Insurance
II-7
<PAGE>
Contract.
(w) Copy of page 9 to the Variable Life Insurance Page II-108
Contract--Virginia Issues.
(x) Copy of page 11 to the Variable Life Insurance Page II-109
Contract--West Virginia Issues.
(y) Copy of page 13 to the Variable Life Insurance Page II-110
Contract--Virginia Issues.
(z) Copy of page 13 to the Variable Life Insurance Page II-111
Contract for use with variable loan interest
rate provision--Kentucky Issues.
(aa) Copy of Endorsement PLI 25 to the Variable Page II-112
Life Insurance Contract for use in all states
except New York and New Jersey.
(bb) Copy of Endorsement PLI 104 to the Variable Page II-113
Life Insurance Contract for use in
Pennsylvania.
(cc) Copy of Endorsement PLI 134 to the Variable Page II-114
Life Insurance Contract for use in all states
except New York and New Jersey.
(dd) Notice of Consumer Information for use in Page II-115
Illinois.
(ee) Complaint Procedure Notice for use in Texas. Page II-116
(ff) Certification of right to convert Variable Page II-117
Life Insurance Contract for use in
Pennsylvania.
(gg) Copy of Endorsement PLI 168-85 to the Variable Page II-118
Life Insurance Contract for use in all states
except New York and New Jersey.
1.A.(10)(a) Application Form for Variable Life Insurance Page II-120
Contract.
(b) Supplement to the Application for Variable Page II-123
Life Insurance Contract.
(c) Application Form for Variable Life Insurance Page II-124
Contract--Maryland issues.
(d) Application Form for Variable Life Insurance Page II-129
Contract--Connecticut issues.
(e) Application Form for Variable Life Insurance Page II-135
Contract--Missouri issues.
(f) Application Form for Variable Life Insurance Page II-141
Contracts--Pennsylvania and South Carolina
issues.
1.A.(11) Form of Notice of Withdrawal Right. Page II-147
1.A.(12) Memorandum describing Pruco Life's issuance, Page II-149
transfer, and redemption procedures for the
Contracts pursuant to Rule 6e-2(b) (12)(ii)
and method of computing cash adjustment upon
exercise of right to exchange for
fixed-benefit insurance pursuant to Rule
6e-2(b)(13) (v)(B).
1.A.(13)(a) Rider for Insured's Waiver of Premium Benefit. Page II-166
(b) Rider for Insured's Accidental Death Benefit. Page II-168
(c) Rider for Term Insurance Benefit on Life of Page II-169
Insured-Decreasing Amount.
(d) Rider for Option to Purchase Additional Page II-172
Insurance on Life of Insured.
(e) Rider for Interim Term Insurance Benefit. Page II-175
(f) Rider for Term Insurance Benefit on Life of Page II-176
Insured Spouse-Decreasing Amount.
(g) Rider for Level Term Insurance Benefit on Page II-180
Dependent Children.
(h) Rider for Impaired Eyesight. Page II-183
(i) Rider for Insured's Waiver of Premium Benefit. Page II-184
(j) Rider for Insured's Accidental Death Benefit. Page II-186
(k) Rider for Aviation Risk Exclusion. Page II-187
II-8
<PAGE>
(l) Rider for Aviation Risk Exclusion. Page II-188
(m) Rider for Military Aviation Risk Exclusion. Page II-189
(n) Rider for Military Aviation Risk Exclusion. Page II-190
(o) Rider for Level Term Insurance Benefit on Page II-191
Dependent Children.
(p) Rider for Insured's Waiver of Premium Benefit. Page II-193
(q) Rider for Insured's Waiver of Premium Benefit. Page II-195
(r) Rider for Insured's Accidental Death Benefit. Page II-197
(s) Rider for Insured's Accidental Death Benefit. Page II-198
(t) Rider for Insured's Accidental Death Benefit. Page II-199
(u) Rider for Level Term Insurance Benefit on Page II-190
Dependent Children.
(v) Rider for Level Term Insurance Benefit on Page II-191
Dependent Children.
(w) Rider for Reduced Paid-Up Insurance. Page II-202
(x) Rider for Exempting Child from Reinstatement. Page II-203
(y) Rider Defining Incontestable Period. Page II-204
(z) Rider for Modification of Insured's Waiver of Page II-205
Premium Benefit Provision.
(aa) Rider for Termination of Benefit. Page II-206
(bb) Rider for Aviation Risk Exclusion. Page II-207
(cc) Rider for Military Aviation Risk Exclusion. Page II-208
(dd) Rider for War Risk Exclusion. Page II-209
(ee) Rider Defining Incontestable Period. Page II-210
(ff) Rider for Suicide Provision. Page II-211
(gg) Rider Defining Incontestable Period. Page II-212
(hh) Rider for Aviation Risk Exclusion. Page II-213
(ii) Rider for Military Aviation Risk Exclusion. Page II-214
(jj) Rider for Level Term Benefit on Dependent Page II-215
Children.
(kk) Rider for Insured's Waiver of Premium Benefit. Page II-216
(ll) Rider for Insured's Accidental Death Benefit. Page II-218
(mm) Rider for Ownership and Control. Page II-219
(nn) Rider for Ownership and Control. Page II-220
(oo) Rider for Applicant's Waiver of Premium Page II-221
Benefit.
(pp) Rider for Applicant's Waiver of Premium Page II-223
Benefit.
(qq) Rider for Applicant's Waiver of Premium Page II-225
Benefit.
(rr) Rider for Applicant's Waiver of Premium Page II-227
Benefit.
(ss) Rider for Applicant's Waiver of Premium Page II-229
Benefit.
(tt) Rider for Applicant's Waiver of Premium Page II-231
Benefit.
(uu) Rider for Level Term Benefit on Insured for Page II-233
use in West Virginia.
(vv) Rider for Level Term Benefit on Insured for Page II-235
use in all states except West Virginia.
(ww) Rider permitting Special Premium Remittance Page II-236
Plan for use in all states except New York,
New Jersey, and Pennsylvania.
(xx) Rider for Variable Loan Interest Rate for use Page II-237
in all states except New York, New Jersey, and
Michigan.
(yy) Rider for Variable Loan Interest Rate for use Page II-239
in Michigan.
(zz) Rider permitting Special Premium Remittance Page II-241
Plan for use in Pennsylvania.
(aaa) Rider for Decreasing Term Insurance Benefit Page II-242
for use in West Virginia.
(bbb) Rider for Decreasing Term Insurance Benefit Page II-246
for use in all states except New York, New
Jersey and West Virginia.
(ccc) Rider for Decreasing Term Insurance Benefit on Page II-250
life of Insured Spouse for use in all states
except New York, New Jersey, South Carolina
and West Virginia.
(ddd) Rider for Decreasing Term Insurance Benefit on Page II-256
life of Insured Spouse for use in South
Carolina.
(eee) Rider for Decreasing Term Insurance Benefit on Page II-262
life of Insured Spouse for use in West
Virginia.
(fff) Rider for Variable Loan Interest Rate for use Page II-268
in Michigan.
II-9
<PAGE>
(ggg) Rider for Variable Loan Interest Rate for use Page II-270
in South Carolina.
(hhh) Rider for Variable Loan Interest Rate for use Page II-272
in all states except New York, New Jersey,
Michigan and South Carolina.
(iii) Rider providing Options on Lapse for use in Page II-274
all states except New York and New Jersey.
(jjj) Rider for Variable Reduced Paid-Up Insurance Page II-276
for use in all states except New York and New
Jersey.
3. Opinion and Consent of Clifford E. Kirsch, Page II-277
Esq., as to the legality of the securities
being registered.
6. Opinion and Consent of Nancy D. Davis, FSA, Page II-278
MAAA, as to actuarial matters pertaining to
the securities being registered.
27. Financial Data Schedule. Page II-279
II-10
INDEPENDENT AUDITORS' CONSENT
We consent to the use in this Post-Effective Amendment No. 24 to Registration
Statement No. 2-80513 on Form S-6 of Pruco Life Variable Insurance Account of
Pruco Life Insurance Company of our report dated February 15, 1996, relating to
the financial statements of Pruco Life Variable Insurance Account, and of our
report dated December 19, 1996, relating to the consolidated financial
statements of Pruco Life Insurance Company and subsidiaries appearing in the
Prospectus, which is part of such Registration Statement, and to the reference
to us under the heading "Experts" in such Prospectus.
/S/ Deloitte & Touche LLP
Parsippany, New Jersey
April 25, 1997
II-11
CONSENT OF INDEPENDENT ACCOUNTANTS
We hereby consent to the use in the Prospectus constituting part of this
Post-Effective Amendment No. 24 to the registration statement on Form S-6 (the
"Registration Statement") of our report dated March 31, 1997, relating to the
financial statements of Pruco Life Variable Insurance Account, which appears in
such Prospectus.
We also consent to the use in the Prospectus constituting part of this
Registration Statement of our report dated March 21, 1997, relating to the
consolidated financial statements of Pruco Life Insurance Company and
Subsidiaries, which appears in such Prospectus.
We also consent to the reference to us under the heading "Experts" in the
Prospectus.
/s/ PRICE WATERHOUSE LLP
1177 Avenue of the Americas
New York, New York 10036
April 24, 1997
II-12
EXHIBIT 1.A.(1)
ISABELLE L. KIRCHNER
Vice President and Secretary
The PRUDENTIAL [LOGO]
The Prudential Insurance Company of America
Prudential Plaza, Newark, NJ 07101
201-877-7770
October 29, 1987
I hereby certify that the following is a true copy of an extract from the
minutes of a meetinq of the Finance Committee of the Board of Directors of The
Prudential Insurance Company of America held on August 11, 1987, at which
meeting a quorum was present and that said minute has not since been altered or
rescinded:
Senior Vice President Hill reviewed with the Committee the desirability of
establishing two new separate accounts:
a. The Prudential Variable Life Insurance Account, and
b. The Prudential Variable Appreciable Account
After discussion, the Committee, on motion, duly made and seconded, adopted
the following resolutions:
II-13
<PAGE>
(a) RESOLVED, subject to the approval of the Commissioner of Insurance in
the State of New Jersey and to such conditions as said Commissioner may impose,
pursuant to Section 17B:28-7 of the Revised Statutes of New Jersey, the Company
hereby establishes a new commingled Variable Contract Account, to be designated
initially as "The Prudential Variable Life Insurance Account" (hereinafter
referred to as the "Account") and to be used for contracts under which values
or payments, or portions thereof, vary to reflect the investment results of said
Account; and
FURTHER RESOLVED, that the Company shall receive and hold in the Account
amounts arising from (i) purchase payments received pursuant to certain variable
life insurance contracts ("Variable Contracts") of the Company sold as part of
its Variable Life Insurance Program ("Program") and (ii) such other assets of
the Company as the proper officers of the Company may deem prudent and
appropriate to have invested in the same manner as the assets applicable to its
reserve liability under Variable Contracts funded in the Account, and such
amounts, together with the dividends, interest and gains produced thereby shall
be invested and reinvested, subject to the rights of the holders of such
Variable Contracts, in shares of The Prudential Series Fund, Inc., an open-end
diversified management investment company of
II-14
<PAGE>
the series type, at the net asset value of such shares at the time of
acguisition; and
FURTHER RESOLVED, that the Account shall be registered as an investment
company under the Investment Company Act of 1940, and that the proper officers
of the Company be and they hereby are authorized to sign and file, or cause to
be filed with the Securities and Exchange Commission, a registration statement,
on behalf of the Account, as registrant, under the Investment Company Act of
1940 ("Investment Company Act Registration") and to sign and file, or cause to
be filed, an exemption application, including any amendments thereto, seeking an
order under Section 6(c) of the Investment Company Act of 1940, which shall
grant such exemptions from the provisions of that Act as may be necessary or
desirable ("Exemption Application"); and
FURTHER RESOLVED, that the proper officers of the Company be and they
hereby are authorized to sign and file, or cause to be filed, with the
Securities and Exchange Cormnission on behalf of the Company as issuer, a
registration statement, including the financial statements and schedules,
exhibits and form of prospectus required as a part thereof, for the registration
under the Securities Act of 1933 of the offering and sale of the Variable
Contracts, to the extent they represent participating interests in the Account
("Securities Act Registration"), and to pay the registration fees required in
connection therewith; and
II-15
<PAGE>
FURTHER RESOLVED, that the proper officers of the Company are authorized
and directed to sign and file, or cause to be filed, such amendment or
amendments of such Investment Company Act Registration, Exemption Application
and Securities Act Registration as they may find necessary or desirable from
time to time; and
FURTHER RESOLVED, that the signature of any director or officer required by
law to affix his signature to any such Investment Company Act Registration,
Exemption Application and Securities Act Registration, or to any amendment
thereof, may be affixed by said director or officer personally, or by an
attorney in fact duly constituted in writing by said director or officer to sign
his name thereto; and
FURTHER RESOLVED, that the Secretary of the Company is appointed agent of
the Company to receive any and all notices and communications from the
Securities and Exchange Commission relating to such Investment Company Act
Registration, Exemption Application, and Securities Act Registration and any and
all amendments thereof; and
FURTHER RESOLVED, that the proper officers of the Company be and they
hereby are authorized, in the name and on behalf of the Company, to execute and
deliver such corporate documents and certificates and to take such further
action as may be necessary
II-16
<PAGE>
or desirable, including but not limited to the payment of applicable fees and
compliance with such laws and regulations of the several states as may be
applicable to the Company's Program, in order to effectuate the purposes of the
foregoing resolutions or any of them.
(b) RESOLVED, subject to the approval of the Commissioner of Insurance in
the State of New Jersey and to such conditions as said Commissioner may impose,
pursuant to Section 17B:28-7 of the Revised Statutes of New Jersey, the Company
hereby establishes a new commingled Variable Contract Account, to be designated
initially as "The Prudential Variable Appreciable Account" (hereinafter referred
to as the "Account") and to be used for contracts under which values or
payments, or portions thereof, vary to reflect the investment results of said
Account; and
FURTHER RESOLVED, that the Company shall receive and hold in the Account
amounts arising from (i) purchase payments received pursuant to certain Variable
Appreciable Life Insurance Contracts ("Variable Contracts") of the Company sold
as part of its Variable Appreciable Life Insurance Program ("Program") and (ii)
such other assets of the Company as the proper officers of the Company may deem
prudent and appropriate to have invested in the same manner as the assets
applicable to its reserve liability
II-17
<PAGE>
under Variable Contracts funded in the Account, and such amounts, together with
the dividends, interest and gains produced thereby shall be invested and
reinvested, subject to the rights of the holders of such Variable Contracts, in
shares of The Prudential Series Fund, Inc., an open-end diversified management
investment company of the series type, at the net asset value of such shares at
the time of acquisition; and
FURTHER RESOLVED, that the Account shall be registered as an investment
company under the Investment Company Act of 1940, and that the proper officers
of the Company be and they hereby are authorized to sign and file, or cause to
be filed with the Securities and Exchange Commission, a registration statement,
on behalf of the Account, as registrant, under the Investment Company Act of
1940 ("Investment Company Act Registration") and to sign and file, or cause to
be filed, an exemption application, including any amendments thereto, seeking an
order under Section 6(c) of the Investment Company Act of 1940, which shall
grant such exemptions from the provisions of that Act as may be necessary or
desirable ("Exemption Application"); and
FURTHER RESOLVED, that the proper officers of the Company be and they
hereby are authorized to sign and file, or cause to be filed, with the
Securities and Exchange Commission on behalf of the Company as issuer, a
registration statement, including the financial statements and schedules,
exhibits and form of prospectus required as a part thereof, for the registration
under
II-18
<PAGE>
the Securities Act of 1933 of the offering and sale of the variable Contracts,
to the extent they represent participating interests in the Account ("Securities
Act Registration"),and to pay the registration fees required in connection
therewith; and
FURTHER RESOLVED, that the proper officers of the Company are authorized
and directed to sign and file, or cause to be filed, such amendment or
amendments of such Investment Company Act Registration, Exemption Application
and Securities Act Registration as they may find necessary or desirable from
time to time; and
FURTHER RESOLVED, that the signature of any director or officer required by
law to affix his signature to any such Investment Company Act Registration,
Exemption Application and Securities Act Registration, or to any amendment
thereof, may be affixed by said director or officer personally, or by an
attorney in fact duly constituted in writing by said director or officer to sign
his name thereto; and
FURTHER RESOLVED, that the Secretary of the Company is appointed agent of
the Company to receive any and all notices and communications from the
Securities and Exchange Commission relating to such Investment Company Act
Registration, Exemption Application, and Securities Act Registration and any and
all amendments thereof; and
II-19
<PAGE>
FURTHER RESOLVED, that the proper officers of the Company be and they
hereby are authorized, in the name and on behalf of the Company, to execute and
deliver such corporate documents and certificates and to take such further
action as may be necessary or desirable, including but not limited to the
payment of applicable fees and compliance with such laws and regulations of the
several states as may be applicable to the Company's Program, in order to
effectuate the purposes of the foregoing resolutions or any of them.
Secretary
The Prudential Insurance Company
of America
October 29, 1987
II-20
EXHIBIT 1A(3)(a)
Amended Distribution Agreement
AGREEMENT made this 1st day of June, 1964, by and between Pruco Life
Insurance Company, an Arizona corporation ("Company") , on its own behalf and on
behalf of the Pruco Life Variable Insurance Account ("Account") and Pruco
Securities Corporation, a New Jersey corporation("Distributor")
WITNESSETH:
WHEREAS, the Company has established and maintains the Account, a separate
investment account, pursuant to the laws of Arizona for the purpose of selling
variable life insurance contracts ("Contracts"), to commence after the
effectiveness of the Registration Statement filed with the Securities and
Exchange Commission on Form S-6 pursuant to the Securities Act of 1933, as
amended (the "1933 Act"); and
WHEREAS, The Account is registered as a unit investment trust under the
Investment Company Act of 1940 (the "1940 Act"); and
WHEREAS, Distributor is registered as a broker-dealer under the Securities
Exchange Act of 1934 (the "Securities Exchange Act") and is a member of the
National Association of Securities Dealers, Inc. ("NASD") ; and
II-21
<PAGE>
WHEREAS, the Company and the Distributor wish to enter into an agreement to
have the Distributor act as the Company's principal underwriter for the sale of
the Contracts through the Account;
NOW, THEREFORE, the parties agree as follows:
1. Appointment of the Distributor
The Company agrees that during the term of this agreement it will take all
action which is required to cause the Contracts to comply as an insurance
product and a registered security with all applicable federal and state laws and
regulations. The Company appoints the Distributor and the Distributor agrees to
act as the principal underwriter for the sale of Contracts to the public, during
the term of this Agreement, in each state and other jurisdictions in which such
Contracts may lawfully be sold. Distributor shall offer the Contracts for sale
and distribution at premium rates set by the Company. Applications for the
Contracts shall be solicited only by representatives duly and appropriately
licensed or otherwise qualified for the sale of such Contracts in each state or
other jurisdiction. Company shall undertake to appoint Distributor's qualified
representatives as life insurance agents of Company. Completed applications for
Contracts shall be transmitted directly to the Company or acceptance
II-22
<PAGE>
or rejection in accordance with underwriting rules established by the Company.
Initial premium payments under the Contracts shall be made by check payable to
the Company and shall be held at all times by Distributor or its representatives
in a fiduciary capacity and remitted promptly to the Company. Anything in this
Agreement to the contrary notwithstanding, the Company retains the ultimate
right to control the sale of the Contracts and to appoint and discharge life
insurance agents of the Company. The Distributor shall be held to the exercise
of reasonable care in carrying out the provisions of this Agreement.
2. Sales Agreements
Distributor is hereby authorized to enter into separate written agreements,
on such terms and conditions as Distributor may determine not inconsistent with
this Agreement, with one or more organizations which agree to participate in the
distribution of Contracts. Such organization (hereafter "Dealer") shall be both
registered as a broker/dealer under the Securities Exchange Act and a member of
NASD. Dealer and its agents or representatives soliciting applications for
Contracts shall be duly and appropriately licensed, registered or otherwise
qualified for the sale of such Contracts (and the riders and other policies
offered in connection therewith) under the insurance laws and any applicable
blue-sky; laws of each
II-23
<PAGE>
state or other jurisdiction in which the Company is licensed to sell the
Contracts.
Distributor shall have the responsibility for ensuring that Dealer
supervises its representatives. Dealer shall assume any legal responsibilities
of Company for the acts, commissions or defalcations of such representatives
insofar as they relate to the sale of the Contracts. Applications for Contracts
solicited by such Dealer through its agents or representatives shall be
transmitted directly to the Company, and if received by Distributor, shall be
forwarded to Company. All premium payments under the Contracts shall be made by
check to Company and, if received by the Distributor, shall be held at all times
in a fiduciary capacity and remitted promptly to Company.
3. Life Insurance Agents
Company shall be responsible for insuring that Dealers are duly qualified,
under the insurance laws of the applicable jurisdictions, to sell the Contracts.
4. Suitability
Company wishes to ensure that Contracts sold by Distributor will be issued
to purchasers for whom the Contract will be suitable. Distributor shall take
II-24
<PAGE>
reasonable steps to ensure that the various representatives appointed by it
shall not make recommendations to an applicant to purchase a Contract in the
absence of reasonable grounds to believe that the purchase of the Contract is
suitable for such applicant. While not limited to the following, a determination
of suitability shall be based on information furnished to a representative after
reasonable inquiry of such applicant concerning the applicant's insurance and
investment objectives, financial situation and needs, and the likelihood that
the applicant will continue to make the premium payments contemplated by the
Contract.
5. Promotion Materials
Company shall have the responsibility for furnishing to Distributor and its
representatives sales promotion materials and individual sales proposals related
to the sale of the Contracts. Distributor shall not use any such materials that
have not been approved by Company.
6. Compensation
Company shall arrange for the payment of commissions directly to those
registered representatives of Distributor who are entitled thereto in connection
with the sale of the Contracts on behalf of Distributor, in the amounts and on
II-25
<PAGE>
such terms and conditions as Company and Distributor shall determine; provided
that such terms, conditions and commissions shall be as are set forth in or as
are not inconsistent with a Prospectus included as part of the Registration
Statement for the Contracts and effective under the 1933 Act.
Company shall arrange for the payment of commissions directly to those
Dealers who sell Contracts under agreements entered into pursuant to paragraph
2. hereof, in amounts as may be agreed to among the parties and specified in
such written agreements.
Company shall reimburse Distributor for the costs and expenses incurred by
Distributor in furnishing or obtaining the services, materials and supplies
required by the terms of this Agreement in the initial sales efforts and the
continuing obligations hereunder.
7. Records
Distributor shall have the responsibility for maintaining the records of
representatives licensed, registered and otherwise qualified to sell the
Contracts. Distributor shall maintain such other records as are required of it
by applicable laws and regulations. The books, accounts and records of Company,
the Account and
II-26
<PAGE>
Distributor shall be maintained so as to clearly and accurately disclose the
nature and details of the transactions. All records maintained by the
Distributor in connection with this Agreement shall be the property of the
Company and shall be returned to the Company upon termination of this Agreement
free from any claims or retention of rights by the Distributor. The Distributor
shall keep confidential any information obtained pursuant to this Agreement and
shall disclose such information only if the Company has authorized such
disclosure, or if such disclosure is expressly required by applicable federal or
state regulatory authorities.
8. Investigation and Proceeding
(a) Distributor and Company agree to cooperate fully in any insurance
regulatory investigation or proceeding or judicial proceeding arising in
connection with the Contracts distributed under this Agreement. Distributor and
Company further agree to cooperate fully in any securities regulatory
investigation or proceeding or judicial proceeding with respect to Company,
Distributor, their affiliates and their agents or representatives to the extent
that such investigation or proceeding is in connection with Contracts
distributed under this Agreement. The Distributor shall furnish applicable
federal and state regulatory authorities with any information or reports in
connection
II-27
<PAGE>
with its services under this Agreement which such authorities may request in
order to ascertain whether the Company's operations are being conducted in a
manner consistent with any applicable law or regulation.
(b) In the case of a substantive customer complaint, Distributor and
Company will cooperate in investigating such complaint and any response to such
complaint will be sent to the other party to this Agreement for approval not
less than five business days prior to its being sent to the customer or
regulatory authority, except that if a more prompt response is required, the
proposed response shall be communicated by telephone or telegraph.
9. Termination
This Agreement shall terminate automatically upon its assignment without
the prior written consent of both parties. This Agreement may be terminated at
any time by either party on 60 days' written notice to the other party, without
the payment of any penalty. Upon termination of this Agreement all
authorizations, rights and obligations shall cease except the obligation to
settle accounts hereunder, including commissions on premiums subsequently
received for Contracts in effect at the time of termination, and the agreements
contained in paragraph 8. hereof.
II-28
<PAGE>
10. Regulation
This Agreement shall be subject to the provisions of the 1940 Act and the
Securities Exchange Act and the rules, regulations, and rulings thereunder and
of the applicable rules and regulations of the NASD, from time to time in
effect, and the terms hereof shall be interpreted and construed in accordance
therewith.
11. Severability
If any provision of this Agreement shall be held or made invalid by a court
decision, statute, rule or otherwise, the remainder of this Agreement shall not
be affected thereby.
12. Applicable Law
This Agreement shall be construed and enforced in accordance with and
governed by the laws of the State of Arizona.
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be
duly executed as of the day and year first above written.
II-29
<PAGE>
PRUCO LIFE INSURANCE COMPANY
By /s/ DONALD G. SOUTHWELL
----------------------------
PRESIDENT
PRUCO SECURITIES CORPORATION
By /s/ GEORGE E. HARTZ, JR.
----------------------------
PRESIDENT
II-30
Exhibit 1A(3)(b)
SELECTED BROKER AGREEMENT
Agreement dated _________, 1983, by and between Pruco Securities
Corporation (Distributor), a New Jersey corporation1 and _________________
(Broker), a ___________ corporation.
WITNESSETH:
In consideration or the mutual promises contained herein, the parties
hereto agree as follows:
A. Definitions
(1) Contracts -- The variable life insurance contracts which Pruco Life
Insurance Company (Company), an Arizona corporation, proposes to issue
and for which Distributor has been appointed the principal underwriter
pursuant to a Distribution Agreement, a copy of which has been
furnished to Broker.
(2) Pruco Life Variable Insurance Account, or the Account -- The separate
account established and maintained by Company pursuant to the laws or
Arizona to fund the benefits under the Contracts.
(3) Pruco Life Series Fund, Inc., or the Fund -- An open-end management
investment company registered under the 1940 Act shares of which are
sold to the Account in connection with the sale of the Contracts.
(4) Registration Statement -- The registration statements and amendments
thereto relating to the Contracts, the Account, and the Fund,
including financial statements and all exhibits.
II-31
<PAGE>
-2-
(5) Prospectus -- The prospectuses included within the registration
statements referred to herein.
(6) 1933 Act -- The Securities Act of 1933, as amended.
(7) 1934 Act -- The Securities Exchange Act of 1934, as amended.
(8) SEC -- The Securities and Exchange Commission.
B. Agreements or Distributor
(1) Pursuant to the authority delegated to it by Company, Distributor
hereby authorizes Broker during the term or this Agreement to solicit
applications for Contracts from eligible persons provided that there
is an effective Registration Statement relating to such Contracts and
provided further that Broker has been notified by Distributor that the
Contracts are qualified for sale under all applicable securities and
insurance laws of the state or jurisdiction in which the application
will be solicited. In connection with the solicitation of applications
for Contracts, Broker is hereby authorized to offer riders that are
available with the Contracts in accordance with instructions furnished
by Distributor or Company.
(2) Distributor, during the term or this Agreement, will notify Broker of
the issuance by the SEC of any stop order with respect to the
Registration Statement or any amendments thereto or the initiation of
any proceedings for that purpose or for any other purpose relating to
the registration and/or offering of the Contracts and of any other
action or circumstance that may prevent the lawful sale of the
Contracts in any state or jurisdiction.
II-32
<PAGE>
-3-
(3) During the term of this Agreement, Distributor shall advise Broker of
any amendment to the Registration Statement or any amendment or
supplement to any Prospectus.
C. Agreements of Broker
(1) It is understood and agreed that Broker is a registered broker/dealer
under the 1934 Act and a member of the National Association of
Securities Dealers, Inc. and that the agents or representatives of
Broker who will be soliciting applications for the Contracts also will
be duly registered representatives of Broker.
(2) Commencing at such time as Distributor and Broker shall agree upon,
Broker agrees to use its best efforts to find purchasers for the
Contracts acceptable to Company. In meeting its obligation to use its
best efforts to solicit applications for Contracts, Broker shall1
during the term of this Agreement, engage in the following activities:
(a) Continuously utilize training, sales and promotional materials
which have been approved by Company;
(b) Establish and implement reasonable procedures for periodic
inspection and supervision of sales practices of its agents or
representatives and submit periodic reports to Distributor as may
be requested on the results of such inspections and the
compliance with such procedures.
(c) Broker shall take reasonable steps to ensure that the various
representatives appointed by it shall not make
II-33
<PAGE>
-4-
recommendations to an applicant to purchase a Contract in the
absence of reasonable grounds to believe that the purchase of the
Contract is suitable for such applicant. While not limited to the
following, a determination or suitability shall be based on
information furnished to a representative after reasonable
inquiry of such applicant concerning the applicant's insurance
and investment objectives, financial situation and needs, and the
likelihood that the applicant will continue to make the premium
payments contemplated by the Contract.
(3) All payments for Contracts collected by agents or representatives of
Broker shall be remitted promptly in full together with such
applications, forms and any other required documentation to an office
of the Company designated by Distributor. Checks or money orders in
payment of initial premiums shall be drawn to the order of "Pruco Life
Insurance Company." Broker acknowledges that Distributor or Company
shall have the unconditional right to reject, in whole or in part, any
application for the Contract. In the event Company or Distributor
rejects an application, Company immediately will return all payments
directly to the purchaser and Broker will be notified of such action.
In the event that any purchaser of a Contract elects to return such
Contract pursuant to Rule 6e-2(b)(13)(viii) of the 1940 Act, any
premium paid will be refunded to the purchaser and Broker will be
notified of such action.
II-34
<PAGE>
-5-
(4) Broker shall act as an independent contractor, and nothing herein
contained shall constitute Broker, its agents or representatives, or
any employees thereof as employees of Company or Distributor in
connection with the solicitation of applications for Contracts.
Broker, its agents or representatives, and its employees shall not
hold themselves out to be employees of Company or Distributor in this
connection or in any dealings with the public.
(5) Broker agrees that any material it develops, approves or uses for
sales, training, explanatory or other purposes in connection with the
solicitation of applications for Contracts hereunder (other than
generic advertising materials which do not make specific reference to
the Contracts) will not be used without the prior written consent of
Distributor and, where appropriate, the endorsement of Company to be
obtained by Distributor.
(6) Solicitation and other activities by Broker shall be undertaken only
in accordance with applicable laws and regulations. No agent or
representative of Broker shall so1icit applications for the Contracts
until duly licensed and appointed by Company as a life insurance and
variable contract broker or agent of Company in the appropriate states
or other jurisdictions. Broker shall ensure that such agents or
representatives fulfill any training requirements necessary to be
licensed. Broker understands and acknowledges that neither it nor its
agents or representatives is authorized by Distributor or Company to
give any information or make any representation in connection with
this Agreement or the offering of the Contract other than those
contained in the
II-35
<PAGE>
-6-
Prospectus or other solicitation material authorized in writing by
Distributor or Company.
(7) Broker shall not have authority on behalf of Distributor or Company
to: make, alter or discharge any Contract or other form; waive any
forfeiture, extend the time of paying any premium; receive any monies
or premiums due, or to become due, to Company, except as set forth in
Section C(3) of this Agreement. Broker shall not expend, nor contract
for the expenditure of the funds of Distributor, nor shall Broker
possess or exercise any authority on behalf of Distributor other than
that expressly conferred on Broker by this Agreement.
D. Compensation
(1) Pursuant to the Distribution Agreement between Distributor and
Company, Distributor shall cause Company to arrange for the payment of
commissions to Broker as compensation for the sale of each Contract
sold by an agent or representative of Broker. The amount of such
compensation shall be based on a schedule to be determined by
agreement of Company, Distributor and Broker. Company shall identify
to Broker with each such payment of the agent; or representative of
Broker who solicited each Contract covered by the payment.
(2) Neither Broker nor any of its agents or representatives shall have any
right to withhold or deduct any part of any premium it shall receive
for purposes of payment of commission or otherwise. Neither Broker nor
any of its agents or representatives shall have an interest in any
compensation paid by Company to Distributor,
II-36
<PAGE>
-7-
now or hereafter, in connection with the sale of any Contracts
hereunder.
E. Complaints and Investigations
(1) Broker and Distributor jointly agree to cooperate fully in any
insurance regulatory investigation or proceeding or judicial
proceeding arising in connection with the Contracts marketed under
this Agreement. Broker and Distributor further agree to cooperate
fully in any securities regulatory investigation or proceeding or
judicial proceeding with respect to Broker, Distributor, their
affiliates and their agents or representatives to the extent that such
investigation or proceeding is in connection with Contracts marketed
under this Agreement.
F. Term of Agreement
(1) This Agreement shall continue in force for one year from its effective
date and thereafter shall automatically be renewed every year for a
further one year period; provided that either party may unilaterally
terminate this Agreement upon thirty (30) days written notice to the
other party of its intention to do so.
(2) Upon termination of this Agreement, all authorizations, rights and
obligations shall cease except (a) the agreements contained in Section
E hereof; (b) the indemnity set forth in Section G hereof; and (c) the
obligations to settle accounts hereunder, including payments on
premiums subsequently received for Contracts in effect at the time of
termination or issued pursuant to applications received by Broker
prior to termination.
II-37
<PAGE>
-8-
G. Indemnity
(1) Distributor agrees to indemnify and hold harmless Broker and each
officer or director or Broker against any losses, claims, damages or
liabilities, joint or several, to which Broker or such officer or
director become subject, under the 1933 Act or otherwise, insofar as
such losses, claims, damages or liabilities (or actions in respect
thereof) arise out of or are based upon any untrue statement or
alleged untrue statement of a material fact, required to be stated
therein or necessary to make the statements therein not misleading,
contained in any Registration Statement or any post-effective
amendment thereof or in the Prospectus or any amendment or supplement
to the Prospectus.
(2) Broker agrees to indemnify and hold harmless Company and Distributor
and each of their current and former directors and officers and each
person if any, who controls or has controlled Company or Distributor
within the meaning of the 1933 Act or the 1934 Act, against any
losses, claims, damages or liabilities to which Company or Distributor
and any such director or officer or controlling person may become
subject, under the 1933 Act or otherwise, insofar as such losses,
claims, damages or liabilities (or actions in respect thereof) arise
out of or are based upon:
(a) Any unauthorized use of sales materials or any verbal or written
misrepresentations or any unlawful sales practices concerning the
Contracts by Brokers; or
(b) Claims by agents or representatives or employees of Broker for
commissions, service fees, development
II-38
<PAGE>
-9-
allowances or other compensation or remuneration of any type;
(c) The failure of Broker, its officers, employees, or agents to
comply with the provisions of this Agreement;
and Broker will reimburse Company and Distributor and any director or
officer or controlling person of either for any legal or other
expenses reasonably incurred by Company; Distributor, such director or
controlling person in connection with investigating or defending any
such loss, claims, damage, liability or action. This indemnity
agreement will be in addition to any liability which Dealer may
otherwise have.
H. Assignability
This Agreement shall not be assigned by either party without the written
consent of the other.
I. Governing Law
This Agreement shall be governed by and construed in accordance with the
laws of the State of New Jersey.
In Witness Whereof, the parties hereto have caused this Agreement to be
duly executed as of the day and year first above written.
PRUCO SECURITIES CORPORATION
(Distributor)
By
-------------------------
(Broker)
By
-------------------------
II-39
EXHIBIT 1A(3)(C)
COMMISSION SCHEDULE FOR
VARIABLE LIFE INSURANCE CONTRACTS
I. DISTRICT AGENCIES
A. First Year Commissions on Contracts Issued on the Following Insureds:
Commission as Percentage
Insured of Premiums
------- ------------------------
Male Under Age 58 or Female Under Age 61 ........... 50%
Male, Age 58-67, or Female, Age 61-70 .............. 45
Male, Age 68-72, or Female, Age 71-75 .............. 40
Male, Age 73-75 .................................... 35
B. Commissions on Renewal Premiums in Contract Years Two Through Four:
<TABLE>
<CAPTION>
Commission as Percentage
Insured of Premiums
------- ------------------------
<S> <C>
Male Under Age 73 and all Females .......... 11%, if Contract's Face
Amount is less than $50,000;
10%, if Contract's Face Amount
is $50,000 or more
Male, Age 73-75 ............................ 10%, if Contract's Face Amount
is less than $50,000; 9% if
Contract's Face Amount is
$50,000 or more
</TABLE>
C. On Renewal Premiums in Contract Years Five Through Ten, A Commission
of 3% Will Be Paid. In Subsequent Years, A Commission of 2% Will Be
Paid.
II. ORDINARY AGENCIES
A. First Year Commissions Are the Same as Those Stated Above for District
Agencies
II-40
<PAGE>
-2-
B. Renewal Premiums on Contracts Sold Through Ordinary Agencies Depend On
the Classification of the Selling Agent
1. For Agents in categories T (Career agent - TAP), W (Career
agent-temporary TAP), and Y (Career agent-temporary), the following
commission schedule on renewal premiums applies:
<TABLE>
<CAPTION>
Commission as Percentage
Insured of Premiums
------- ------------------------
<S> <C>
Male Under Age 73 and all Females ......... 12% in Contract Years Two
through Four; 3% in Contract
Years Five through Ten
Male, Age 73-75 ........................... 11% in Contract Years Two
through Four; 3% in Contract
Years Five through Ten
</TABLE>
2. For Agents in categories A (Asst. Mgr. or Assoc. Mgr., 65 Series),
B (Broker), G (Part-time Special Agent), K (Retired Full-Time Agent), M
(Manager), N (Full-Time Career Special Agent pre-65 contract), P (Fart-Time
Special Agent, after 1-1-48), 5 (Surplus Broker), and U (Manager), the
Commission rate on renewal premiums is 5% for Contract Years Two Through
Ten.
3. For Agents in Categories F (Asst. Mgr. or Assoc. Mgr., pre-65), E
(Full-Time Agents, 1SF), V (Full-Time Career Agents, 1SF), and N (Agent
Emeritus), the following commission schedule on renewal premiums applies:
<TABLE>
<CAPTION>
Commission as Percentage
Insured of Premiums
------- ------------------------
<S> <C>
Male Under Age 73 and all Females ......... 10% in Contract Years Two
Through Four; 3% in Contract
Years Five Through Ten
Male, Age 73-75 ........................... 9% in Contract Years Two
Through Four; 3% in Contract
Years Five Through Ten
</TABLE>
II-41
<PAGE>
-3-
4. For Agents in Category X (Retired Full-Time Agent), the commission
rate on renewal premiums is 9% for Contract years Two Through Five.
III. The registered representatives of Prudential-Bache Securities Inc. will be
paid the following commissions on contracts they sell: 35% of the first
year premiums, 5% of the second, third, and fourth year premiums, and
2-1/2% of the fifth year premiums.
IV. In the event a Contract lapses or is surrendered within the first two
Contract years, a portion or all of the first year commission may be
subject to recapture by the Pruco Life Insurance Company. If the Contract
lapses at the end of year one, 30% of the commission is subject to
recapture. A higher percentage of the first year commission may be
recaptured on earlier lapses. A lower and decreasing portion of the first
year commission is subject to recapture throughout the second Contract
year.
II-42
EXHIBIT 1.A(5)(a)
Prudential Pruco Life Insurance Company
Phoenix, Arizona
A Stock Company subsidiary of
The Prudential Insurance Company of America
- -------------------------------------------------------------------------------
Insured Policy Number
JOHN DOE XX XXX XXX Contract Date
Face Amount NOV 15, 198
$25,000--
Premium Period
Agency LIFE
R-NK 1
- -------------------------------------------------------------------------------
We will pay the beneficiary the proceeds of this contract promptly if we receive
due proof that the Insured died. We make this promise subject to all the
provisions of the contract.
The Death Benefit will be the insurance amount plus the amount of any extra
benefit if no premium is in default and if there is no contract debt. During the
first contract month, the insurance amount is the face amount we show above.
After that, it depends on the payment of premiums and on investment results. The
insurance amount may increase or decrease for any month as we state under
Insurance Provisions on page 8. But it will not be less than the face amount if
no premium is in default.
The net cash value may increase or decrease daily depending on the investment
experience of the separate account. There is no guaranteed minimum.
Premiums are fixed as to amount. They will not vary with investment results.
Please read this contract with care. A guide to its contents is on the last
page. A summary is on page 2. If there is ever a question about it, or if there
is a claim, just see one of our representatives or get in touch with one of our
offices.
Right to Cancel Contract.--You may return this contract to us within (1) 10 days
after you get it, or (2) 45 days after Part 1 of the application was signed, or
(3)10 days after we mail the Notice of Withdrawal Right, whichever is latest.
All you have to do is take the contract or mail it to one of our offices or to
the representative who sold it to you. It will be canceled from the start and we
will give back your money promptly.
Signed for Pruco Life Insurance Company,
an Arizona Corporation.
/s/ [SPECIMEN] /s/ [SPECIMEN]
Secretary President
Variable Life Insurance Policy. Insurance payable only upon death. Fixed
premiums payable during Insured's lifetime. Benefits reflect investment results.
Guaranteed minimum death benefit if premiums duly paid and no contract debt.
Nonparticipating.
VL--83
II-43
<PAGE>
CONTRACT SUMMARY
We offer this summary to help you understand this contract. We do not intend
that it change any of the provisions of the contract.
This is a contract of life insurance. Premiums are to be paid throughout the
Insured's lifetime. The insurance amount and the net cash value will vary with
the investment performance of those subaccounts of the Pruco Life Variable
Insurance Account that you select. But, except as we state in the next sentence,
the insurance amount will never be less than the face amount. If a premium is
not paid before its days of grace are over, the contract may end or it may stay
in force with reduced benefits. If either occurs, you may be able to reinstate
it.
Proceeds is a word we use to mean the amount we would pay if we were to settle
the contract in one sum. To compute the proceeds that may arise from the
Insured's death, we start with a basic amount. We may adjust that amount if
there is a loan, a premium in default, or a premium paid (but not waived under a
waiver of premium benefit, if any) for a period past the date of death. The
table on page 19 tells you how we adjust the basic amount. If you surrender the
contract, the proceeds will be the net cash value. We describe it under Cash
Value Option on page 11.
Proceeds often are not taken in one sum. For instance, on surrender, you may be
able to put proceeds under a settlement option to provide retirement income or
for some other purpose. Also, for all or part of the proceeds that arise from
the Insured's death, you may be able to choose a manner of payment to fit the
beneficiary's expected needs. If the Insured dies, and a manner of payment has
not been chosen, the beneficiary may be able to choose one. We will pay interest
under Option 3 from the date of death on any proceeds to which no other manner
of payment applies. This will be automatic as we state on page 18. There is no
need to ask for it.
You and we may agree on a change in the ownership of this contract. Also, unless
we endorse it to say otherwise, the contract gives you these rights, among
others:
o You may change the beneficiary under it.
o You may change the allocation of future net premiums among the subaccounts.
o You may transfer amounts among subaccounts.
o You may borrow on it up to its loan value.
o You may surrender it for its net cash value.
The contract, as issued, may or may not have extra benefits that we call
Supplementary Benefits. If it does, we list them under Supplementary Benefits on
the Contract Data page(s) and describe them after page 18. The contract may or
may not have other extra benefits. If it does, we add them by rider. Any extra
benefit ends as soon as any premium is in default past its days of grace, unless
the form that describes it states otherwise.
(Contract Summary Continued on Page 191
II-44
<PAGE>
CONTRACT DATA
INSURED'S SEX AND ISSUE AGE M-35
RATING CLASS STANDARD
INSURED JOHN DOE XX XXX XXX POLICY NUMBER
NOV 15, 1982 CONTRACT DATE
FACE AMOUNT $25,000--
PREMIUM PERIOD LIFE
AGENCY R-NK 1
BENEFICIARY CLASS 1 MARY DOE, WIFE
CLASS 2 ROBERT DOE, SON
LIST OF SUPPLEMENTARY BENEFITS
***** NONE *****
CONTRACT DATA CONTINUED ON NEXT PAGE
PAGE 3 (83) [LOGO]
II-45
<PAGE>
POLICY NO. XX XXX XXX
CONTRACT DATA CONTINUED
SCHEDULE OF PREMIUMS
DUE DATES OF CONTRACT PREMIUMS OCCUR ON THE CONTRACT DATE AND AT INTERVALS OF 6
MONTHS AFTER THAT DATE.
CONTRACT PREMIUMS ARE $208.00 EACH
DURING THE FIRST CONTRACT YEAR. EACH CONTRACT PREMIUM ALSO INCLUDES AN ISSUE
CHARGE INSTALMENT OF $63.00.
***** END OF SCHEDULE *****
TABLE OF NET PREMIUMS
WE USE NET PREMIUMS TO COMPUTE CASH VALUES FOR THIS CONTRACT (SEE PAGE 11). A
NET PREMIUM APPLIES TO EACH DATE FOR WHICH A CONTRACT PREMIUM APPLIES. THE NET
PREMIUMS THAT APPLY TO THIS CONTRACT ARE:
DURING CONTRACT YEAR NET PREMIUM
1 $863.75 EACH
2-4 $164.75 EACH
5-20 $173.75 EACH
21 AND LATER $174.75 EACH
***** END OF TABLE *****
CONTRACT DATA CONTINUED ON NEXT PAGE
PAGE 3A (83)
II-46
<PAGE>
POLICY NO. XX XXX XXX
CONTRACT DATA CONTINUED
LIST OF SUBACCOUNTS AND PORTFOLIOS
EACH SUBACCOUNT OF THE PRUCO LIFE VARIABLE INSURANCE ACCOUNT INVESTS IN A
SPECIFIC PORTFOLIO OF THE FUND WE SHOW BELOW. WE ALSO SHOW THE SUBACCOUNTS AND
THE PORTFOLIOS THEY INVEST IN.
IF WE CONSENT, YOU MAY ALSO ALLOCATE ALL OR PART OF YOUR INVESTED PREMIUM AMOUNT
TO, OR TRANSFER AMOUNTS INTO OR OUT OF, THE REAL ESTATE VLI SUB-ACCOUNT OF THE
PRUCO LIFE REAL PROPERTY ACCOUNT.
FUND:
-----
PRUCO LIFE SERIES FUND, INC.
SUBACCOUNT PORTFOLIO
---------- ---------
MONEY MARKET MONEY MARKET
BOND BOND
COMMON STOCK COMMON STOCK
INITIAL ALLOCATION OF NET PREMIUMS
MONEY MARKET SUBACCOUNT 40%
BOND SUBACCOUNT 20%
COMMON STOCK SUBACCOUNT 40%
***** END OF LIST *****
SERVICE OFFICE -- PLEASE DIRECT ANY COMMUNICATIONS ABOUT THIS CONTRACT TO:
PRUCO LIFE INSURANCE COMPANY, P.O. BOX XXXX, CITY, STATE XXXXX.
PAGE 3B (83)
II-47
<PAGE>
VL M--35 POLICY NO. XX XXX XXX
TABULAR CASH VALUES
WE EXPLAIN THIS TABLE UNDER TABULAR VALUES. NET CASH VALUES MAY BE MORE OR LESS
THAN AMOUNTS SHOWN (SEE CASH VALUE OPTION).
END OF END OF
CONTRACT CASH CONTRACT CASH ATTAINED CASH
YEAR VALUE YEAR VALUE AGE VALUE
1 $ 76.00 11 $3,393.00 60 $ 9,379.00
2 360.00 12 3,774.25 62 10,319.50
3 651.75 13 4,163.75 65 11,738.00
4 951.00 14 4,562.00
5 1,276.00 15 4,968.25
6 1,608.75 16 5,382.50
7 1,949.50 17 5,804.00
8 2,298.25 18 6,231.75
9 2,655.00 19 6,665.00
10 3,020.00 20 7,103.50
[LOGO]
PAGE 4 (VL-83)
II-48
<PAGE>
POLICY NO. XX XXX XXX
TABLE OF NET SINGLE PREMIUMS
FOR $1 OF VARIABLE INSURANCE AMOUNT OR REDUCED PAID-UP AMOUNT
THESE NET SINGLE PREMIUMS APPLY ON THE CONTRACT ANNIVERSARY WHEN THE INSURED'S
ATTAINED AGE IS AS SHOWN. TO CALCULATE VALUES AT OTHER TIMES WE CONSIDER THE
TIME ELAPSED SINCE THE LAST CONTRACT ANNIVERSARY.
NET NET NET
ATTAINED SINGLE ATTAINED SINGLE ATTAINED SINGLE
AGE PREMIUM AGE PREMIUM AGE PREMIUM
35 $.25596 60 $.54046 85 $ .85064
36 .26455 61 .55426 86 .85911
37 .27340 62 .56813 87 .86718
38 .28250 63 .58205 88 .87496
39 .29185 64 .59597 89 .88256
40 .30144 65 .60986 90 .89014
41 .31126 66 .62371 91 .89787
42 .32131 67 .63752 92 .90599
43 .33161 68 .65130 93 .91476
44 .34214 69 .66506 94 .92440
45 .35292 70 .67876 95 .93510
46 .36393 71 .69237 96 .94681
47 .37518 72 .70579 97 .95911
48 .36669 73 .71895 98 .97113
49 .39844 74 .73177 99 .98021
50 .41045 75 .74420 100 1.00000
51 .42268 76 .75623
52 .43513 77 .76791
53 .44776 78 .77929
54 .46057 79 .79043
55 .47352 80 .80134
56 .48661 81 .81199
57 .49985 82 .82233
58 .51324 83 .83226
59 .52678 84 .84170
[LOGO]
PAGE 4A (VL-83-M)
II-49
<PAGE>
ENDORSEMENTS
(Only we can endorse this contract.)
GENERAL PROVISIONS
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.
We, Our, Us and Company.--Pruco Life Insurance Company, an Arizona Corporation.
You and Your.--The owner of the contract.
Insured.--The person named as the Insured on the first page. He or she need not
be the owner.
Example: Suppose we issue a contract on the life of your spouse. You applied for
it and named no one else as owner. Your spouse is the Insured and you are the
owner.
SEC.--The Securities and Exchange Commission.
Issue Date.--The contract date.
Monthly Date.--The date on which we compute variable insurance amounts. It
occurs on the contract date and on the same day as the contract date in each
later month.
Example: If the contract date is March 9, 1986, the Monthly Dates are each March
9, April 9, May 9 and so on.
Anniversary or Contract Anniversary.--The same day and month as the contract
date in each later year.
Example: If the contract date is March 9, 1986, the first anniversary is March
9, 1987. The second is March 9, 1988, and so on.
Contract Year.--A year that starts on the contract date or on an anniversary.
Example: If the contract date is March 9, 1986, the first contract year starts
then and ends on March 8, 1987. The second starts on March 9, 1987 and ends on
March 8, 1988, and so on.
Contract Month.--A month that starts on a Monthly Date.
Example: If March 9, 1986 is a Monthly Date, a contract month starts then and
ends on April 8, 1986. The next contract month starts on April 9, 1986 and ends
on May 8, 1986, and so on.
Attained Age.--The Insured's attained age at any time is the issue age plus the
length of time since the contract date. You will find the issue age near the top
of page 3.
The Contract.--This policy and the application, a copy of which is attached,
form the whole contract. We assume that all statements in the application were
made to the best of the knowledge and belief of the person(s) who made them; in
the absence of fraud they are deemed to be representations and not warranties.
We relied on those statements when we issued the contract. We will not use any
statement, unless made in the application, to try to void the contract or to
deny a claim.
Contract Modifications.--Only a Company officer may agree to modify this
contract, and then only in writing.
Non-participating.--This contract will not share in our profits or surplus
earnings. We will pay no dividends on it.
Service Office.--This is the office that will service this contract. Its mailing
address is the one we show on the Contract Data page, unless we notify you of
another one.
Ownership and Control.--Unless we endorse this contract to say otherwise: (1)
the owner of the contract is the Insured; and (2) while the Insured is living
the owner alone is entitled to (a) any contract benefit and value, and (b) the
exercise of any right and privilege granted by the contract or by us.
Suicide Exclusion.--If the Insured, whether sane or insane, dies by suicide
within two years from the issue date, we will pay no more under this contract
than the sum of the premiums paid.
Currency.--Any money we pay, or that is paid to us, must be in United States
currency. Any amount we owe will be payable at our Service Office.
(Continued on Next Page)
Page 5 (VL--83)
II-50
<PAGE>
GENERAL PROVISIONS (Continued)
Misstatement of Age or Sex.--If the Insured's stated age or sex or both are not
correct, we will change each benefit and any amount to be paid to what the
premium would have bought for the correct age and sex.
The Schedule of Premiums may show that premiums change or stop on a certain
date. We may have used that date because the Insured would attain a certain age
on that date. If we find that the issue age was wrong, we will correct that
date.
Incontestability.--Except for non-payment of premium, we will not contest this
contract after it has been in force during the Insured's lifetime for two years
from the issue date.
Assignment.--We will not be deemed to know of an assignment unless we receive
it, or a copy of it, at our Service Office. We are not obliged to see that an
assignment is valid or sufficient.
Annual Report.--Each year we will send you a report. It will show: (1) the
insurance amount; (2) the net cash value; (3) the amount of net cash value in
each subaccount; and (4) any contract debt and the interest on the debt for the
prior year. The report will, of course, include any other data that may be
currently required where this contract is delivered. No report will be sent if
this contract is being continued under any contract value options provision.
Payment of Death Claim.--If we settle this contract in one sum as a death claim,
we will usually pay the proceeds within 7 days after we receive at our Service
Office proof of death and any other information we need to pay the claim. But we
have the right to defer paying any portion of the proceeds equal to the variable
insurance amount if (1) the New York Stock Exchange is closed; or (2) the SEC
requires that trading be restricted or declares an emergency; or (3) the SEC
lets us defer payment to protect our contract owners.
BENEFICIARY
You may designate or change a beneficiary. Your request must be in writing and
in a form that meets our needs. It will take effect only when we file it at our
Service Office; this will be after you send the contract to us to be endorsed,
if we ask you to do so. Then any previous beneficiary's interest will end as of
the date of the request. It will end then even if the Insured is not living when
we file the request. Any beneficiary's interest is subject to the rights of any
assignee of whom we know.
When a beneficiary is designated, any relationship shown is to the Insured,
unless otherwise stated. To show priority, we may use numbered classes, so that
the class with first priority is called class 1, the class with next priority is
called class 2, and so on. When we use numbered classes, these statements apply
to beneficiaries unless the form states otherwise:
1. One who survives the Insured will have the right to be paid only if no one in
a prior class survives the Insured.
2. One who has the right to be paid will be the only one paid if no one else in
the same class survives the Insured.
3. Two or more in the same class who have the right to be paid will be paid in
equal shares.
4. If none survives the Insured, we will pay in one sum to the Insured's estate.
Example: Suppose the class 1 beneficiary is Jane and the class 2 beneficiaries
are Paul and John. We owe Jane the proceeds if she is living at the Insured's
death. We owe Paul and John the proceeds if they are living then but Jane is
not. But if only one of them is living, we owe him the proceeds. If none of them
is living we owe the Insured's estate.
Beneficiaries who do not have a right to be paid under these terms may still
have a right to be paid under the Automatic Mode of Settlement.
Before we make a payment, we have the right to decide what proof we need of the
identity, age or any other facts about any persons designated as beneficiaries.
If beneficiaries are not designated by name and we make payment(s) based on that
proof, we will not have to make the payment(s) again.
Page 6 (VL--83)
II-51
<PAGE>
PREMIUM PAYMENT AND REINSTATEMENT
Payment of Premiums.--The Schedule of Premiums shows the amounts of the
premiums, how often and when they must be paid. We tell you below how you may be
able to have them fall due either more or less often. Due dates occur only while
the Insured is living. The premium period, which we show on the first page,
starts on the contract date. Each premium is to be paid by its due date. It may
be paid at our Service Office or to any of our authorized representatives. If we
are asked to do so, we will give a signed receipt. A premium is in default if it
is not paid when it is due.
Change of Frequency.--You may ask us in writing to have premiums fall due either
more or less often. If we agree, we will make the change and tell you what the
new premiums are and when they are due. The more often premiums are due, the
larger the total amount that will have to be paid for a contract year.
Grace Period.--We grant 31 days of grace for paying each premium except the
first one. If a premium has not been paid by its due date, the contract will
stay in force during its days of grace. If a premium has not been paid when its
days of grace are over, the contract will end and have no value, except as we
state under Contract Value Options. If a premium is paid during the grace
period, all benefits will be the same as they would have been if the premium had
been paid on its due date.
Premium Adjustment.--The Insured might die while no premium is in default. If
so, we will make an adjustment so that the proceeds will include that part of
the last premium paid which is more than was needed to pay premiums through the
date of death. Or the Insured might die in the days of grace of a premium in
default. If so, the amount needed to pay premiums through the date of death is
due us. We will make an adjustment so that the proceeds will not include that
amount.
Example. Suppose the contract date is in 1986. An annual premium of $400 due in
1988 is paid. The Insured dies nine months later. The proceeds will include
about $100 from the premium, since $300 was enough to pay premiums through the
date of death. The proceeds could include slightly more or less than $100 since
some months have more days than others.
This contract might have an extra benefit that insures someone other than the
Insured. And there might be a claim under that benefit while the Insured is
living and in the days of grace of a premium in default. In this case, we will
subtract any premium in default when we settle the claim.
Reinstatement.--You may reinstate this contract after the days of grace of a
premium in default. All these conditions must be met:
1. Premium payment must not be in default more than three years.
2. You must not have surrendered the contract to us for its net cash value.
3. You must give us any facts we need to satisfy us that the Insured is
insurable for the contract.
4. We must be paid the larger of amounts (a) and (b), where (a) is equal to the
total of all premiums in arrears with compound interest at 6% a year, and (b) is
equal to the total premiums in arrears for any extra benefits with compound
interest at 6% a year, plus 110% of the difference between the net cash value
that would apply upon reinstatement and the net cash value that applied just
before reinstatement. When we compute the net cash value upon reinstatement, we
assume that each premium was paid when due and was allocated to subaccounts in
accord with your most recent request. We also assume that any loan continued to
bear interest, which was not paid when due, thus reducing the investment base in
accord with the Loans provision.
5. Any contract debt must be restored or paid back with interest to date at
5-1/2% a year. If that debt with interest would exceed the loan value of the
reinstated contract, the excess must be paid to us before reinstatement.
Example: Suppose a premium due May 1st is not paid on time. The contract will
stay in force until June 1st whether the premium is paid or not. If the premium
is not paid by June 1st, you must meet all the above conditions if you want to
reinstate the contract.
After reinstatement, the contract will have the same investment base and the
same insurance amount as if no premium had been in default. We explain
investment base on page 9 and insurance amount on page 8.
Page 7 (VL--83)
II-52
<PAGE>
INSURANCE PROVISIONS
Insurance Amount.--The insurance amount on any date is equal to the sum of the
face amount, which we show on the first page, and the variable insurance amount
for that date, if it is more than zero.
Variable Insurance Amount.--The variable insurance amount is zero on the
contract date. On any Monthly Date after the contract date, it is equal to the
sum of (a) what it was on the prior Monthly Date, and (b) the variable
adjustment amount for the current Monthly Date. It can be less than, equal to.
or more than zero. On any date other than a Monthly Date, it is equal to what it
was on the prior Monthly Date.
Variable Adjustment Amount.--The variable adjustment amount for any Monthly Date
is equal to (a) divided by (b), where (a) is the excess investment return for
the contract month ending just before the Monthly Date, and (b) is the net
single premium at the Insured's attained age on the Monthly Date.
We show the net single premiums on the Contract Data page(s); we explain excess
investment return on page 9. If the excess investment return for a contract
month is less than zero, the variable adjustment amount for the next Monthly
Date will be less than zero.
SEPARATE ACCOUNT
The Account.--The word account, where we use it in this contract without
qualification, means the Pruco Life Variable Insurance Account. This is a unit
investment trust registered with the SEC under the Investment Company Act of
1940. It is also subject to the laws of Arizona. We own the assets of the
account; we keep them separate from the assets of our general investment
account. We established the account to support variable life insurance
contracts. But we do not use it to support this contract if the contract is
being continued under any contract value options provision.
Subaccounts.--The account has several subaccounts. We list them on the Contract
Data page(s). You determine, using percentages, how net premiums will be
allocated among the subaccounts. You may choose to allocate nothing to a
particular subaccount. But any allocation you make must be at least 10%; you may
not choose a fractional percent.
Example: You may choose a percentage of 0, or 100, or 10, 11, 12 and so on, up
to 90. But you may not choose a percentage of 1 through 9, or 91 through 99, or
any other percent that is not a whole number.
The allocation of net premiums that took effect on the contract date is shown on
the Contract Data page(s). You may change the allocation for future net premiums
at any time if all due premiums have been paid. To do so, you must notify us in
writing and in a form that meets our needs. The change will take effect on the
first premium due date on or after the date we receive your notice at our
Service Office.
A premium might be due when the investment base is less than zero. In that case,
if we receive that premium, we will first use as much of the net premium as we
need to increase the assets in each subaccount to which amounts are allocated to
zero. We will then allocate any remainder of the net premium in accord with your
most recent request.
The Fund.--The word fund, where we use it in this contract without
qualification, means the one we identify under the heading Fund on the Contract
Data page(s). The fund is registered with the SEC under the Investment Company
Act of 1940 as an open-end diversified management investment company. The fund
has several portfolios; there is a portfolio that corresponds to each of the
subaccounts of the account. We also list these portfolios on the Contract Data
page(s).
Account Investments.--We use the assets of the account to buy shares in the
fund. Each subaccount is invested in a corresponding specific portfolio. Income
and realized and unrealized gains and losses from assets in each subaccount are
credited to, or charged against, the subaccount. This is without regard to
income, gains, or losses in our other investment accounts.
We will determine the value of the assets in the account at the end of each
business day. When we use the term business day, we mean a day when the New York
Stock Exchange is open for trading. We might need to know the value of an asset
on a day that is not a business day or on which trading in that asset does not
take place. In this case, we will use the value of that asset as of the end of
the last prior business day on which trading took place.
Example: If we need to know the value of an asset on a Sunday, we will normally
use the value of the asset as of the end of business on Friday.
We will always keep assets in the account with a total value at least equal to
the amount of the investment bases under contracts like this one. To the extent
those assets do not exceed this amount, we use them only to support those
contracts; we do not use those assets to support any other business we conduct.
We may use any excess over this amount in any way we choose.
(Continued on Next Page)
Page 8 (VL--83)
II-53
<PAGE>
SEPARATE ACCOUNT (Continued)
Change in Investment Policy.--A portfolio of the fund might make a material
change in its investment policy. In that case, we will send you a notice of the
change. Within 60 days after you receive the notice, or within 60 days after the
effective date of the change, if later, you may exchange this contract for a new
contract of fixed benefit insurance on the Insured's life. The conditions for
exchange, and the specifications for the new contract, are described under
Exchange of Contract on page 14.
Change of Fund.--A portfolio might, in our judgment, become unsuitable for
investment by a subaccount. This might happen because of a change in investment
policy, or a change in the laws or regulations, or because the shares are no
longer available for investment, or for some other reason. If that occurs, we
have the right to substitute another portfolio of the fund, or to invest in a
fund other than the one we show on the Contract Data page(s). But we would first
seek approval from the SEC and, where required, the insurance regulator where
this contract is delivered.
INVESTMENT BASE AND RETURN ON INVESTMENT
Investment Base.--The investment base for this contract is the amount we use to
compute the excess investment return and the variable insurance amount. The
investment base is allocated among the subaccounts. The amount of the investment
base and its allocation to subaccounts depend on (1) how you choose to allocate
net premiums; (2) whether or not you transfer amounts among subaccounts, as we
discuss below; (3) the investment performance of the subaccounts to which
amounts are allocated or transferred; and (4) whether or not you take any loan.
The investment base exists only if the contract is in force with no premium in
default past its days of grace.
Base on Monthly Date.--On a Monthly Date, the investment base is equal to the
sum of these three items:
1. the net cash value on the Monthly Date (we explain net cash value under
Contract Value Options);
2. on any loan, the interest we have charged that is not yet due and that we
have not yet added to the loan (we explain these terms under Loans); and
3. during the first contract year, the issue charge instalments due during the
rest of the year (we show this charge on the Contract Data page(s).
Base on Other Dates.--On a date other than a Monthly Date, the investment base
is equal to:
1. what it was on the prior Monthly Date; plus
2. any increase due to investment results in the value of the subaccounts to
which amounts are allocated; minus
3. any decrease due to investment results in the value of the subaccounts to
which amounts are allocated; minus
4. a charge against the investment base at a rate of not more than .0009572% a
day (.35% a year) for mortality and expense risks that we assume; minus
5. any amount charged against the investment base for federal or state income
taxes; minus
6. any loan you made since the prior Monthly Date; plus
7. any loan principal you paid back since the prior Monthly Date.
Assumed Rate of Return.--The assumed rate of return is an effective rate of 4% a
year. This is the same as .01074598% a day compounded daily. We use this daily
rate when we make computations for less than a whole year.
Excess Investment Return.--The excess investment return for any period is equal
to:
1. the investment base at the end of the period; minus
2. what the investment base would have been at the end of the period if: (a) the
value of the assets in the subaccounts to which amounts are allocated had earned
interest at a rate equal to the assumed rate of return during the period; and
(b) we had made no charge for the mortality and expense risks described in item
4 under Base on Other Dates, or for federal or state income taxes.
The excess investment return can be less than, equal to, or more than zero. If a
premium was paid and accepted under the terms of this contract, then for the
purpose of computing the excess investment return it will be deemed to have been
paid as of its due date.
Transfers Among Subaccounts.--You may transfer amounts among subaccounts as
often as four times in a contract year, if all due premiums have been paid. To
do so, you must notify us in writing and in a form that meets our needs. The
transfer will take effect on the date we receive your notice at our Service
Office.
Page 9 (VL--83)
II-54
<PAGE>
ENDORSEMENTS
(Only we can endorse this contract.)
II-55
<PAGE>
CONTRACT VALUE OPTIONS
(NONFORFEITURE BENEFITS ARE DESCRIBED HERE)
Benefit After the Grace Period.--If a premium is in default past its days of
grace and if the net cash value (which we describe under Cash Value Option) is
more than zero, we will use that value to keep the contract in force as one of
two kinds of insurance. One kind is extended insurance. The other is reduced
paid-up insurance. We describe both below. You will find under Automatic Benefit
which kind it will be. Any extra benefit(s) will, of course, end as soon as a
premium is in default past its days of grace unless the form that describes it
states otherwise.
Extended Insurance.--This will be term insurance on the Insured's life. We will
pay the amount of term insurance if the Insured dies in the term we describe
below. Before the end of the term there will be cash values but no loan value.
The amount of term insurance will be equal to the insurance amount on the due
date of the premium in default, minus any contract debt. The amount of the
insurance will not vary. The term is a period of time that will start on the due
date of the premium in default. The length of the term will be what is provided
when we use the net cash value as a net single premium for extended term
insurance. The length of the term will depend on the net cash value, the amount
of insurance, the Insured's issue age and sex, and on the length of time since
the contract date. (The net single premiums that we refer to here are not those
we show on the Contract Data page(s). The ones we show there are used to compute
the variable insurance amount.)
Example: Suppose the face amount is $50,000. On the day a premium is due, the
variable insurance amount is $5,740. There is contract debt of $1,300. If the
premium due is not paid at the end of its days of grace, the amount of term
insurance will be $53,840. This comes from the insurance amount of $55,140 (the
face amount of $50,000 plus the variable insurance amount $5,140) minus the
$1,300 contract debt. The term insurance will last as long as the net cash value
will provide it.
There may be extra days of term insurance. This will occur if, on the due date
of the premium in default, the term of extended insurance provided by the net
cash value does not exceed 90 days, or the number of days for which premiums
have been paid, if less. The number of extra days will be (1) 90, or the number
of days for which premiums have been paid, if less, minus (2) the number of days
of extended insurance that would be provided by the net cash value, if there
were no contract debt. The extra days, if any, start on the day after the last
day of term insurance provided by the net cash value, if any. If there is no
such term insurance, they start on the due date of the premium in default. The
term insurance for the extra days has no cash value. There will be no extra days
if you replace the extended insurance with reduced paid-up insurance or you
surrender the contract before the extra days start.
Reduced Paid-up Insurance.--This will be paid-up life insurance on the Insured's
life. We will pay the amount of this insurance when the Insured dies. There will
be cash values and loan values.
The amount of this insurance will be what is provided when we use the net cash
value at the net single premium rate. This rate depends on the Insured's issue
age and sex and on the length of time since the contract date. The amount of
this insurance will not vary.
Computations.--We will make all computations for either of these benefits as of
the due date of the premium in default. But we will consider any loan you take
Out or pay back in the days of grace of that premium.
Automatic Benefit.--When a premium is in default past its days of grace, the
contract will stay in force as extended insurance. But it will stay in force as
reduced paid-up insurance if we issued the contract in a rating class for which
we do not provide extended insurance. In this case, the phrase No Extended
Insurance is in the Rating Class on page 3.
Optional Benefit.--You may choose to replace any extended insurance that has a
cash value by reduced paid-up insurance. To make this choice, you must do so in
writing to us and in a form that meets our needs, not more than three months
after the due date of the premium in default. You must also send the contract to
us to be endorsed.
Cash Value Option.--You may surrender this contract for its net cash value, if
this value is more than zero. If this value is less than zero, the proceeds on
surrender will be equal to zero. To do so, you must ask us in writing and in a
form that meets our needs. You must also send the contract to us. Here is how we
will compute the net cash value:
1. On a Monthly Date if no premium is in default: The net cash value on a
Monthly Date will be equal to (a) the tabular cash value on that date; plus (b)
the net single premium at the Insured's then attained age for the variable
insurance amount that applies on that date; minus (c) if that date is a premium
due date, and the premium has not
(Continued on Next Page)
Page 11 (VL--83)
II-56
<PAGE>
CONTRACT VALUE OPTIONS (Continued)
been paid, the net premium that applies on that date; minus (d) any contract
debt; minus (e) in the first contract year, any issue charge instalments that
have not yet been paid. The amount of (b) will be less than zero if the variable
insurance amount is less than zero.
2. On any other date if no premium is in default: The net cash value on a date
other than a Monthly Date will be equal to (a) the tabular cash value on that
date; plus (b) the net single premium at the Insured's then attained age for the
variable insurance amount that applies on that date; plus (c) the excess
investment return since the last Monthly Date; minus (d) any contract debt;
minus (e) in the first contract year, any issue charge instalments that have not
yet been paid. The amount of (b) will be less than zero if the variable
insurance amount is less than zero.
3. During the days of grace of a premium in default: The net cash value on any
date will be the net cash value as of the due date of the first unpaid premium
plus the excess investment return since that due date. But we will adjust this
value for any loan you took out or paid back since that due date.
4. After the days of grace of a premium in default: The net cash value as of any
date will be the net value on that date of any extended insurance benefits then
in force. Or it will be the net value on that date of any reduced paid-up
insurance benefits then in force, less any contract debt. However, within 30
days after an anniversary, the net cash value will not be less than it was on
that anniversary. We will, of course, adjust it for any loan you took out or
paid back since that anniversary.
If the due date of a paid premium is on or after the date a contract value
option takes effect, we will pay that premium to you in cash.
If all due premiums have been paid, or during the days of grace of a premium in
default, we will usually pay any cash value within 7 days after we receive your
request and the contract at our Service Office. But we have the right to defer
payment if (1) the New York Stock Exchange is closed; or (2) the SEC requires
that trading be restricted or declares an emergency; or (3) the SEC lets us
defer payments to protect our contract owners.
If a premium is in default past its days of grace, we have the right to postpone
paying a cash value for up to six months. If we do so for more than 30 days, we
will pay interest at the rate of 3% a year.
Tabular Values.--In the table on page 4 we show tabular values at the ends of
contract years. The tabular value at the beginning of the first contract year is
the net premium then due. If we need to compute tabular values at some time
during a contract year, we will count the time since the start of the year and
any premiums paid for the year. We will let you know the tabular values for
other durations if you ask for them.
ENDORSEMENTS
(Only we can endorse this contract.)
Page 12 (VL--83) Printed in U.S.A.
II-57
<PAGE>
LOANS
Loan Requirements.--On or after the first contract anniversary, you may borrow
from us on the contract. All these conditions must be met:
1. The Insured must be living.
2. The contract must be in force other than as extended insurance.
3. The contract debt will not be more than the loan value. (We explain these
phrases below.)
4. As sole security for the loan, you must assign the contract to us in a form
that meets our needs.
5. Except when used to pay premiums on this contract, the amount you borrow at
any one time must be at least $500.
If there is already contract debt when you borrow from us, we will add the new
amount you borrow to that debt.
Contract Debt.--Contract debt at any time means the loan on the contract plus
the interest we have charged that is not yet due and that we have not yet added
to the loan.
Loan Value.--During the first contract year the loan value is zero. After the
first contract year, it is 75% of the sum of the net cash value and any existing
contract debt.
If the difference between the loan value and any existing contract debt is $500
or more, you may borrow any amount from $500 up to that difference. If the
difference is less than $500, you may not borrow any amount unless it is to pay
premiums on this contract.
Example 1: Suppose the net cash value is $8,000. You borrowed $1,500 a few
months ago. Suppose also that now there is interest of $40 charged but not yet
due. The contract debt is now $1,540, which is made up of the $1,500 loan and
the $40 interest.
Example 2: Suppose, in example 1, you want to borrow all that you can. The loan
value is $7,155; to compute it we add the net cash value ($8,000) to the
contract debt ($1,540) and take 75% of the sum. We will lend you $5,615 which is
the difference between the $7,155 loan value and the $1,540 contract debt. This
will increase the contract debt to $7,155. We will add the new amount borrowed
to the existing loan and will charge interest on it, too.
There are three exceptions to the above definition of loan value. The first is
that in the days of grace of a premium in default, the loan value is what it was
on the due date of that premium, plus 75% of the excess investment return since
that date. The second is that if the contract is in force as reduced paid-up
insurance we use anniversaries and not premium due dates to find the loan value
since there are no more of those due dates. The third is that if the contract is
in force as reduced paid-up insurance, the loan value is the amount that would
grow with interest to equal the net single premium on the next anniversary.
Interest Charge.--We will charge interest daily on any loan. The loan interest
rate is 5 1/2% a year. Interest is due on each contract anniversary, or when the
loan is paid back if that comes first. If interest is not paid when due, it will
become part of the loan. Then we will start to charge interest on it, too.
Example 3: Suppose the contract date is in 1987. Six months before the
anniversary in 1996 you borrow $1,000 out of a $4,000 loan value. Three months
later, but still three months before the anniversary, we will have charged about
$13.75 interest. This amount will be a few cents more or less than $13.75 since
some months have more days than others. The interest will not be due until the
anniversary unless the loan is paid back sooner. The loan will still be $1,000.
The contract debt will be $1,013.75, since contract debt includes interest
charged but not yet due. On the anniversary in 1996 we will have charged about
$27.50 interest. The interest will then be due.
Example 4: Suppose the $27.50 interest in example 3 is paid on the anniversary.
The loan and contract debt will each become $1,000 right after the payment.
Example 5: Suppose the $27.50 interest in example 3 is not paid on the
anniversary. The interest will become part of the loan, and we will begin to
charge interest on it, too. The loan and contract debt will each become
$1,027.50.
Repayment.--All or part of any contract debt may be paid back at any time while
the Insured is living. But if there is contract debt at the end of the last day
of grace of a premium in default, it may be paid back only if the contract is
reinstated. When we settle the contract, any contract debt is due us. We will
make an adjustment so that the proceeds will not include the amount of that
debt.
(Continued on Next Page)
Page 13 (VL--83)
II-58
<PAGE>
LOANS (Continued)
Effect of a Loan.--When you take a loan, we will reduce the investment base by
the amount you borrow. We will also reduce the investment base by interest that
becomes part of the loan because it is not paid when due. When you repay part or
all of a loan we will increase the investment base by the amount you repay. We
will not increase the investment base by interest that is paid before we make it
part of the loan. We will allocate loans and repayments among the subaccounts in
proportion to the investment base in each subaccount as of the date of the loan
or repayment. Only the amount of the investment base will reflect the investment
results of the subaccounts. Since the amount you borrow is removed from the
investment base, a loan will have a permanent effect on the death benefit and
net cash value of this contract. The longer the loan is outstanding, the greater
this effect is likely to be.
Example 6: Suppose the contract's investment base is $15,000 and that $10,000 is
in subaccount A and $5,000 is in subaccount B. If you make a $9,000 loan we will
reduce the amount in subaccount A by $6,000 and the amount in subaccount B by
$3,000.
Suppose that sometime later, when the investment base in each of the two
subaccounts is the same, you choose to repay the $9,000 loan. We will add $4,500
to the amount in each subaccount.
Excess Contract Debt.--If contract debt ever becomes equal to or more than what
the net cash value would be if there were no contract debt, all the contract's
benefits will end 31 days after we mail a notice to you and any assignee of whom
we know. Also, we may send a notice to the Insured's last known address. In the
notice we will state the amount that, if paid to us, will reduce the contract
debt enough to keep the contract's benefits from ending for a limited time.
Payment of Loan.--We will usually make a loan within 7 days after we receive
your request at our Service Office. But we have the right to defer making the
loan if (1) the New York Stock Exchange is closed; or (2) the SEC requires that
trading be restricted or declares an emergency; or (3) the SEC lets us defer
payments to protect our contract owners. If the contract is in force as reduced
paid-up insurance, we have the right to defer making a loan for up to 8 months.
ENDORSEMENTS (Only we can endorse this contract.)
Page 13a (VL--83)
II-59
<PAGE>
EXCHANGE OF CONTRACT
Right to Exchange.--Before the second anniversary you may exchange this contract
for a new contract of fixed benefit insurance on the Insured's life. You will
not have to prove to us that the Insured is insurable. Also, you may make such
an exchange at any time if there is a material change in the investment policy
of a portfolio (see Change in Investment Policy on page 9). When we use the
phrase new contract we mean the contract for which this contract may be
exchanged.
Conditions.--Your right to make this exchange is subject to all these
conditions: (1) You must ask for the exchange in writing and in a form that
meets our needs. (2) You must surrender the contract to us. (3) We must have
your request and the contract at our Service Office while the contract is in
force with no premium in default past its days of grace. (4) You must pay back
any contract debt under this contract.
Exchange Date.--The exchange date will be the later of: (1) the date we receive
the contract and your request at our Service Office; and (2) the date we receive
the payment, if any, required for the exchange. The new contract will take
effect on the exchange date only if the Insured is then living. If the new
contract takes effect, this contract will end just before the exchange date.
Contract Specifications.--The new contract will be on the Life Paid Up at Age 85
plan (Life Paid Up at Age 65 plan if the issue age for this contract is less
than age 15) issued by The Prudential Insurance Company of America. The new
contract will have a face amount equal to the face amount of this one. It will
have the same contract date and issue age as this contract and be in the same
rating class.
This contract might include an extra benefit. And a similar kind of benefit
might have been regularly offered in contracts like the new one on the date the
extra benefit took effect in this contract. In that case, if you ask for it in
your request for the exchange, that similar kind of benefit will be put in the
new contract. When we use the phrase contracts like the new one, we mean
contracts that were, on the contract date of this contract, regularly issued on
the same plan as the new one and for the same rating class, amount, issue age
and sex.
The amount of any accidental death benefit included in the new contract in
accord with this provision will be the same as the amount of the accidental
death benefit in this contract.
If a benefit for waiving premiums is included in the new contract in accord with
this provision, any premiums to be waived under the new contract for a
disability that began before the exchange date must be at the frequency that was
in effect for this contract when the disability started. But premiums will not
be waived under the new contract unless it has a benefit for waiving premiums in
the event of disability. This will be so even if we have waived premiums under
this contract.
There may be a cash adjustment on exchange. If the exchange is made before the
second anniversary, the adjustment will be based on any difference in premiums
between this contract and the new one for those benefits carried over to the new
contract. If the exchange is made on or after the second anniversary, the
adjustment will be based on any difference in net cash values between this
contract and the new one. For this purpose the net cash value of the new
contract is what the proceeds of the new contract would be if it were
surrendered immediately after the exchange. The adjustment may be either a
charge or an allowance.
We will determine the charge or allowance as of the date we receive this
contract and your written request for the exchange at our Service Office.
Other Exchanges.--You may be able to have this contract changed to another plan
of life insurance either with us or with an affiliate of ours other than in
accord with the requirements for exchange that we state above. But any change
may be made only if we consent and will be subject to conditions and charges
that are then determined.
Page 14 (VL--83)
II-60
<PAGE>
ENDORSEMENTS
(Only we can endorse this contract.)
Page 14a (VL--83) Printed In U.S.A.
II-61
<PAGE>
SETTLEMENT OPTIONS
Payee Defined.--In these provisions and under the Automatic Mode of Settlement,
the word Payee means a person who has a right to receive a settlement under the
contract. Such a person may be the Insured, the owner, a beneficiary, or a
contingent payee.
Choosing an Option.--While the Insured is living you may choose, or change the
choice of, an option for all or part of the proceeds that may arise from the
Insured's death. The requirements are the same as those to designate or change a
beneficiary. We describe them under Beneficiary.
A Payee may choose an option for all or part of any proceeds or residue that
becomes payable to him or her in one sum. We describe residue later on this
page.
In some cases, you or another Payee will need our consent to choose an option.
We describe these cases under Conditions.
Options Described.--Here are the options we offer. We may also consent to other
arrangements.
Option 1 (Instalments for a Fixed Period).--We will make equal payments for up
to 25 years based on the Option 1 Table. The payments will include interest at
an effective rate of 3-1/2% a year. We may credit more interest. If and while we
do so, the payments will be larger.
Option 2 (LIfe Income).--We will make equal monthly payments for as long as the
person on whose life the settlement is based lives, with payments certain for
the period chosen. The choices are either ten years (10-Year Certain) or until
the sum of the payments equals the amount put under this option (Instalment
Refund). The amount of each payment will be based on the Option 2 Table and on
the sex and age, on the due date of the first payment, of the person on whose
life the settlement is based. But if a choice is made more than two years after
the Insured's death, we may use the Option 2 payment rates in individual annuity
contracts or life insurance contracts we regularly issue, based on United States
currency, on the due date of the first payment. On request, we will quote the
payment rates in contracts we then issue. We must have proof of the date of
birth of the person on whose life the settlement is based. If on the due date of
the first payment under this option, we have declared a higher payment rate
under the option, we will base the payments on that higher rate.
Option 3 (Interest Payment).--We will hold an amount at interest. We will pay
interest at an effective rate of at least 3% a year ($30.00 annually. $14.89
semi-annually, $7.42 quarterly or $2.47 monthly per $1,000). We may pay more
interest.
Option 4 (Instalments of a Fixed Amount).--We will make equal annual,
semi-annual, quarterly or monthly payments if they total at least $90 a year for
each $1,000 put under this option. We will credit the unpaid balance with
interest at an effective rate of at least 3-1/2% a year. We may credit more
interest. If we do so, the balance will be larger. The final payment will be any
balance equal to or less than one payment.
First Payment Due Date.--Unless a different date is stated when the option is
chosen: (1) the first payment for Option 3 will be due at the end of the chosen
payment interval; and (2) the first payment for any of the other options will be
due on the date the option takes effect.
Residue Described.--For Options 1 and 2, residue on any date means the then
present value of any unpaid payments certain. We will compute it at an effective
interest rate of 3 1/2% a year. But we will use the interest rate we used to
compute the actual Option 2 payments if they were not based on the table in this
contract.
For Options 3 and 4, residue on any date means any unpaid balance with interest
to that date.
For Option 2, residue does not include the value of any payments that may become
due after the certain period.
(Continued on Next Page)
Page 15 (VL--83)
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<PAGE>
SETTLEMENT OPTIONS (Continued)
OPTION 1 TABLE
----------------------------
MINIMUM AMOUNT OF
MONTHLY PAYMENT FOR
EACH $1,000, THE FIRST
PAYABLE IMMEDIATELY
----------------------------
Number of Monthly
Years Payment
----------------------------
1 $84.65
2 43.05
3 29.19
4 22.27
5 18.12
6 15.35
7 13.38
8 11.90
9 10.75
10 9.83
11 9.09
12 8.46
13 7.94
14 7.49
15 7.10
16 6.76
17 6.47
18 6.20
19 5.97
20 5.75
21 5.56
22 5.39
23 5.24
24 5.09
25 4.96
----------------------------
Multiply the monthly amount
by 2.989 for quarterly,
5.952 for semi-annual or
11.804 for annual.
----------------------------
<TABLE>
<CAPTION>
OPTION 2 TABLE
- -------------------------------------------------------------------------------------
MINIMUM AMOUNT OF MONTHLY PAYMENT FOR EACH $1,000, THE FIRST PAYABLE IMMEDIATELY
- -------------------------------------------------------------------------------------
KIND OF LIFE INCOME KIND OF LIFE INCOME
----------------------------- -----------------------------
10-Year Instalment 10-Year Instalment
AGE Certain Refund AGE Certain Refund
LAST ----------------------------- LAST -----------------------------
BIRTHDAY Male Female Male Female BIRTHDAY Male Female Male Female
- -------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
10 $3.18 $3.11 $3.17 $3.10 45 $4.06 $3.82 $3.99 $3.78
and under 46 4.12 3.86 4.03 3.81
11 3.19 3.12 3.18 3.11 47 4.17 3.90 4.08 3.85
12 3.20 3.13 3.19 3.12 48 4.23 3.94 4.13 3.90
13 3.21 3.14 3.20 3.13 49 4.28 3.99 4.18 3.94
14 3.22 3.15 3.21 3.14
50 4.35 4.04 4.24 3.98
15 3.24 3.16 3.23 3.15 51 4.41 4.09 4.29 4.03
16 3.25 3.17 3.24 3.16 52 4.48 4.15 4.35 4.08
17 3.27 3.19 3.25 3.18 53 4.55 4.21 4.41 4.13
18 3.28 3.20 3.27 3.19 54 4.62 4.27 4.48 4.19
19 3.30 3.21 3.28 3.20
55 4.70 4.33 4.55 4.24
20 3.31 3.22 3.30 3.21 56 4.78 4.40 4.62 4.30
21 3.33 3.24 3.32 3.23 57 4.86 4.47 4.69 4.37
22 3.35 3.25 3.33 3.24 58 4.95 4.54 4.77 4.43
23 3.36 3.26 3.35 3.25 59 5.05 4.62 4.86 4.50
24 3.38 3.28 3.37 3.27
60 5.15 4.71 4.94 4.58
25 3.40 3.30 3.39 3.29 61 5.25 4.79 5.03 4.66
26 3.42 3.31 3.41 3.30 62 5.36 4.89 5.13 4.74
27 3.45 3.33 3.43 3.32 63 5.48 4.98 5.23 4.82
28 3.47 3.35 3.45 3.34 64 5.60 5.09 5.34 4.92
29 3.49 3.37 3.47 3.35
65 5.73 5.20 5.45 5.01
30 3.52 3.39 3.49 3.37 66 5.87 5.31 5.57 5.11
31 3.54 3.41 3.52 3.39 67 6.01 5.43 5.70 5.22
32 3.57 3.43 3.54 3.41 68 6.15 5.56 5.83 5.34
33 3.60 3.45 3.57 3.44 69 6.30 5.70 5.97 5.46
34 3.63 3.47 3.60 3.46
70 6.46 5.84 6.11 5.58
35 3.66 3.50 3.63 3.48 71 6.62 5.99 6.27 5.72
36 3.69 3.52 3.66 3.50 72 6.79 6.15 6.43 5.86
37 3.72 3.55 3.69 3.53 73 6.96 6.31 6.60 6.01
38 3.76 3.58 3.72 3.56 74 7.13 6.49 6.78 8.18
39 3.80 3.61 3.75 3.58
75 7.30 6.67 6.97 6.35
40 3.84 3.64 3.79 3.61 76 7.48 6.85 7.17 6.53
41 3.88 3.67 3.82 3.64 77 7.66 7.04 7.38 6.72
42 3.92 3.70 3.86 3.67 78 7.83 7.24 7.60 6.93
43 3.97 3.74 3.90 3.71 79 8.00 7.44 7.83 7.15
44 4.01 3.78 3.94 3.74
80 8.17 7.64 8.07 7.38
and over
- -------------------------------------------------------------------------------------
</TABLE>
(Continued on Next Page)
Page 16 (VL--83)
II-63
<PAGE>
SETTLEMENT OPTIONS (Continued)
Withdrawal of Residue.--Unless otherwise stated when the option is chosen: (1)
under Options 1 end 2 the residue may be withdrawn: and (2) under Options 3 and
4 all, or any part not less than $100, of the residue may be withdrawn. If an
Option 3 residue is reduced to less than $1,000, we have the right to pay it in
one sum. Under Option 2, withdrawal of the residue will not affect any payments
that may become due after the certain period; the value of those payments cannot
be withdrawn. Instead, the payments will start again if they were based on the
life of a person who lives past the certain period.
Designating Contingent Payee(s).--A Payee under an option has the right, unless
otherwise stated, to name or change a contingent payee to receive any residue at
that Payee's death. This may be done only if (1) the Payee has the full right to
withdraw the residue; or (2) the residue would otherwise have been payable to
that Payee's estate at death.
A Payee who has this right may choose, or change the choice of, an option for
all or part of the residue. In some cases, the Payee will need our consent to
choose or change an option. We describe these cases under Conditions.
Any request to exercise any of these rights must be in writing and in a form
that meets our needs. It will take effect only when we file it at our Service
Office. Then the interest of anyone who is being removed will end as of the date
of the request, even if the Payee who made the request is not living when we
file it.
Changing Options.--A Payee under Option 1, 3 or 4 may choose another option for
any sum that the Payee could withdraw on the date the chosen option is to start.
That date may be before the date the Payee makes the choice only if we consent.
In some cases, the Payee will need our consent to choose or change an option. We
describe these cases next.
Conditions.--Under any of these conditions, our consent is needed for an option
to be used for any person:
1. The person is not a natural person who will be paid in his or her own right.
2. The person will be paid as assignee.
3. The amount to be held for the person under Option 3 is less than $1,000. But
we will hold any amount for at least one year in accord with the Automatic Mode
of Settlement.
4. Each payment to the person under the option would be less than $20.
5. The option is for residue arising other than at (a) the Insured's death, or
(b) the death of the beneficiary who was entitled to be paid as of the date of
the Insured's death.
6. The option is for proceeds that arise other than from the Insured's death,
and we are settling with an owner or any other person who is not the Insured.
Death of Payee.--If a Payee under an option dies and if no other distribution is
shown, we will pay any residue under that option in one sum to the Payee's
estate.
ENDORSEMENTS
(Only we can endorse this contract.)
Page 17 (VL--83)
II-64
<PAGE>
AUTOMATIC MODE OF SETTLEMENT
Applicability.--These provisions apply to proceeds arising from the Insured's
death and payable in one sum to a Payee who is a beneficiary. They do not apply
to any periodic payment.
Interest on Proceeds.--We will hold the proceeds at interest under Option 3 of
the Settlement Options provision. The Payee may withdraw the residue. We will
pay it promptly on request. We will pay interest annually unless we agree to pay
it more often. We have the right to pay the residue in one sum after one year if
(1) the Payee is not a natural person who will be paid in his or her own right:
(2) the Payee will be paid as assignee; or (3) the original amount we hold under
Option 3 for the Payee is less than $1,000.
Settlement at Payee's Death.--If the Payee dies and leaves an Option 3 residue,
we will honor any contingent payee provision then in effect. If there is none,
here is what we will do. We will look to the beneficiary designation of the
contract; we will see what other beneficiary(ies), if any, would have been
entitled to the portion of the proceeds that produced the Option 3 residue if
the insured had not died until immediately after the Payee died. Then we will
pay the residue in one sum to such other beneficiary(ies). in accord with that
designation. But if, as stated in that designation, payment would be due the
estate of someone else, we will instead pay the estate of the Payee.
Example: Suppose the class I beneficiary is Jane and the class 2 beneficiaries
are Paul and John. Jane was living when the Insured died. Jane later died
without having chosen an option or naming someone other than Paul and John as
contingent payee. If Paul and John are living at Jane's death we owe them the
residue. If only one of them is living then, and if the contract called for
payment to the survivor of them, we owe him the residue. If neither of them is
living then, we owe Jane's estate.
Spendthrift and Creditor.--A beneficiary or contingent payee may not, at or
after the Insured's death, assign. transfer, or encumber any benefit payable. To
the extent allowed by law, the benefits will not be subject to the claims of any
creditor of any beneficiary or contingent payee.
ENDORSEMENTS
(Only we can endorse this contract.)
Page 18 (VL--83)
II-65
<PAGE>
<TABLE>
<CAPTION>
<S> <C>
- ----------------------------------------------------===============================================================================
Part 1 Application to No.
[ ] The Prudential Insurance Company of America XX XXX XXX
[X] Pruco Life Insurance Company--A Subsidiary of The Prudential Insurance Company of America
- -----------------------------------------------------------------------------------------------------------------------------------
1a. Proposed Insured's name--first, initial, last (Print) 1b. Sex 2a. Date of birth 2b. Age 2c. Place of birth
M F Mo. Day Yr.
JOHN DOE [X] [ ] 6 17 47 35 (NAME OF STATE)
- -----------------------------------------------------------------------------------------------------------------------------------
3. [ ] Single [X] Married [ ] Widowed [ ] Separated [ ] Divorced 4. Occupation(s)
- -----------------------------------------------------------------------------------------------------------------------------------
5. Address for mail No. Street City State Zip
15 BLANK STREET (NAME OF CITY) (NAME OF STATE) XXXXX
- -----------------------------------------------------------------------------------------------------------------------------------
6a. Kind of policy 6b. Initial amount 7. Accidental death coverage
VARIABLE LIFE $25,000 initial amount $
- -----------------------------------------------------------------------------------------------------------------------------------
8. Beneficiary: (Include name, age and relationship.) 9. List all life insurance on proposed Insured. If NONE, so state.)
a. Primary (Class 1): b. Contingent (Class 2) if any: Company Initial Yr. Kind Medical
MARY DOE, 35 ROBERT DOE, 10 amt. issued (Indiv., Group) Yes No
SPOUSE SON NONE [ ] [ ]
____________________________________________________ _______________________________________________________________________
[ ] [ ]
(For insurance payable upon death of (1) the Insured, _______________________________________________________________________
and (2) an insured child after the death of the [ ] [ ]
Insured if there is no insured spouse.) _______________________________________________________________________
[ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
10. Other person(s) proposed for coverage including the Applicant for Applicant's Waiver of Premium benefit (AWP)
Relationship to Date of birth Total life insurance
Name--first, initial, last Sex proposed Insured Mo. Day Yr. Age Place of birth in all companies
a. Spouse $
___________________________________________________________________________________________________________________________________
b. $
___________________________________________________________________________________________________________________________________
c. $
___________________________________________________________________________________________________________________________________
d. $
___________________________________________________________________________________________________________________________________
e. $
___________________________________________________________________________________________________________________________________
f. $
- -----------------------------------------------------------------------------------------------------------------------------------
11. Supplementary benefits: a. For proposed Insured b. For spouse, children, Applicant for AWP
Type and duration of benefit Amount Type and duration of benefit Amount
$ $
___________________________________________________________________________________________________________________________________
$ $
___________________________________________________________________________________________________________________________________
$ $
___________________________________________________________________________________________________________________________________
[ ] Option to Purchase Additional Ins. $ [ ] Applicant's Waiver of Premium benefit
- -----------------------------------------------------------------------------------------------------------------------------------
12. State any special request.
- -----------------------------------------------------------------------------------------------------------------------------------
13. Will this insurance replace or change any existing insurance or annuity in any company on any person named Yes No
in 1a or 10? If "Yes", give their names, name of company, plan, amount and policy numbers. [ ] [X]
- -----------------------------------------------------------------------------------------------------------------------------------
14. Is anyone applying for, or trying to reinstate, life or health insurance on any person named in 1a or 10 in Yes No
this or any company? If "Yes", give amount, details and company. [ ] [X]
- -----------------------------------------------------------------------------------------------------------------------------------
15. Does any person named in 1a or 10 plan to live or travel outside the United States and Canada within the next Yes No
12 months? If "Yes", give details. [ ] [X]
- -----------------------------------------------------------------------------------------------------------------------------------
16. Has any person named in 1a or 10 operated or had any duties aboard an aircraft, glider, balloon, or like Yes No
device, within the last 2 years, or does any such person have any plans to do so in the future? If "Yes", [ ] [X]
complete Aviation Questionnaire.
- -----------------------------------------------------------------------------------------------------------------------------------
17. Has any person named in 1a or 10, within the last 12 months: Yes No
a. been treated by a doctor for or had a known heart attack, stroke or cancer other than of the skin? ............ [ ] [X]
b. had an electrocardiogram for any physical complaint, or taken medication for high blood pressure? ............. [ ] [X]
- -----------------------------------------------------------------------------------------------------------------------------------
18. Premium payable [ ] Ann. [X] Semi-Ann. [ ] Quar. [ ] Mon. [ ] Pay. Budg. [ ] Pru-Matic [ ] Gov't. Allot.
- -----------------------------------------------------------------------------------------------------------------------------------
19. Amount paid $208.00 [ ] None (Must be "None" if either 17a or 17b is answered "Yes".)
- -----------------------------------------------------------------------------------------------------------------------------------
20. Is a medical examination to be made on Yes No
a. the proposed Insured?.......................................................................................... [ ] [X]
b. spouse (if proposed for coverage)? ............................................................................ [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
21. If 20a or 20b is "Yes", is it agreed that no insurance will take effect on anyone proposed for coverage until Yes No
the person(s) indicated in 20 have been examined, even if 19 shows that an amount has been paid? ................. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
22. Changes made by the Company
- -----------------------------------------------------------------------------------------------------------------------------------
ORD 84376-82 Page 1 (Continued on page 2)
</TABLE>
II-66
<PAGE>
<TABLE>
<CAPTION>
<S> <C>
- -----------------------------------------------------------------------------------------------------------------------------------
Continuation of Part 1 of Application
Complete on all persons named in 1a and 10 if any one of them can have insurance on a non-medical basis.
- -----------------------------------------------------------------------------------------------------------------------------------
23. Height and weight of:
a. Proposed Insured Ht. 5'10" Wt. 160 lbs b. Spouse Ht.________ Wt.________ c. Applicant for AWP Ht.________ Wt.________
Has the weight changed more than 10 pounds in the past year? Yes [ ] No [ ] If "Yes", give details in 30.
- -----------------------------------------------------------------------------------------------------------------------------------
24. Has the proposed insured or spouse ever smoked? a. Proposed Insured Yes [ ] No [ ] b. Spouse Yes [ ] No [ ]
If "Yes", give date(s) last smoked: Cigarettes Cigars Pipe
Proposed Insured Mo.______ Yr. ______ Mo.______ Yr. ______ Mo.______ Yr. ______
Spouse Mo.______ Yr. ______ Mo.______ Yr. ______ Mo.______ Yr. ______
- -----------------------------------------------------------------------------------------------------------------------------------
25. When was a doctor last consulted by: a. Proposed Insured? b. Spouse? c. Applicant for AWP?
Mo. 6 Yr. 82 Mo.______ Yr. ______ Mo.______ Yr. ______
- -----------------------------------------------------------------------------------------------------------------------------------
26. Is any person to be covered now being treated or taking medicine for any condition or disease ................. Yes [ ] No [X]
- -----------------------------------------------------------------------------------------------------------------------------------
27. Has any person to be covered ever:
Yes No
a. had any surgery or been advised to have surgery and has not done so?............................................... [ ] [X]
b. been in a hospital, sanitarium or other institution for observation, rest, diagnosis or treatment ................. [ ] [X]
c. regularly used or is any such person now using, barbiturates or amphetamines, marijuana or other hallucinatory
drugs, or heroin, opiates or other narcotics, except as prescribed by a doctor? ................................... [ ] [X]
d. been treated or counseled for alcoholism? ......................................................................... [ ] [X]
e. has life or health insurance declined, postponed, changed, rated-up or withdrawn? ................................. [ ] [X]
f. had life or health insurance canceled, or its renewal or reinstatement refused? ................................... [ ] [X]
- -----------------------------------------------------------------------------------------------------------------------------------
28. Other than as shown above, in the past 5 years has any person to be covered: Yes No
a. consulted or been attended or examined by any doctor or other practitioner? ...................................... [ ] [X]
b. had electrocardiograms, X-rays for diagnosis or treatment, or blood, urine, or other medical tests? .............. [ ] [X]
c. made claim for or received benefits, compensation, or a pension because of sickness or injury? ................... [ ] [X]
- -----------------------------------------------------------------------------------------------------------------------------------
29. Does any person to be covered now have a known sign of any physical disorder, disease or defect not shown above? Yes [ ] No [X]
- -----------------------------------------------------------------------------------------------------------------------------------
30. What are the full details of the answer to 25 and to each part of 23 and 26 thru 29 which is answered "Yes"?
Name & Full names and addresses of
Question No. Illness or other resason Dates and duration of illness doctors and hospitals
- -----------------------------------------------------------------------------------------------------------------------------------
JOHN #25 Cold and Sore Throat 6-82, 1 week Dr. W. Brown, Newark, N.J.
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
- -----------------------------------------------------------------------------------------------------------------------------------
Those who sign below, declare to the best of their knowledge and belief, that the statements in this application are complete and
true.
When the Company gives a Temporary Insurance Agreement form, ORD 84376A-82, of the same date as this Part 1, coverage will start as
shown in that form. Otherwise, no coverage will start unless: (1) a contract is issued, (2) it is accepted, and (3) the full first
premium is paid while all persons to be covered are living and their health remains as stated in Part 1. If all these take place,
coverage will start on the contract date. If the Company makes a change as indicated in 22 it will be approved by acceptance of the
contract. But where the law requires written consent for any change in the application, such a change can be made only if those
who sign this form approve the change in writing. No agent can make or change a contract, or waive any of the Company's rights or
needs.
OWNERSHIP: Unless otherwise asked for above, the owner of the contract will be (1) the applicant if other than the proposed Insured,
otherwise (2) the proposed Insured. But this is subject to any automatic transfer of owership stated in the contract.
Signature of Proposed Insured (If Age 8 or over)
JOHN DOE
----------------------------------------------------------------------
Dated at (Name of City & State) on Nov. 1, 1982 Signature of Applicant (If other than prposed Insured)
- ---------------------------------------------------
City/State ----------------------------------------------------------------------
Witness (If applicant is a firm or corporation, show that company's name)
JOHN ROE
- --------------------------------------------------- By
(Licensed agent must witness where required by law) ----------------------------------------------------------------------
(Signature and title of officer signing for that company)
ORD 84376-82 Page 2
</TABLE>
II-67
<PAGE>
No.
[ ] PRUCO LIFE INSURANCE COMPANY * XX XXX XXX
[ ] PRUCO LIFE INSURANCE COMPANY OF NEW JERSEY *
* A Subsidiary of The Prudential Insurance Company of America
A Supplement to the Application for Life Insurance in which __ John Doe ______
is named as the proposed insured.
The person who signs below:
1. acknowledges receipt of the current prospectus, dated November 1, 1982
for the Variable Life Insurance contract:
2. UNDERSTANDS THAT THE DEATH BENEFIT (EXCEPT SUPPLEMENTARY BENEFITS) MAY
INCREASE OR DECREASE DEPENDING ON THE CONTRACT'S INVESTMENT RETURN BUT WILL
NEVER BE LESS THAN THE GUARANTEED MINIMUM, IF PREMIUMS ARE DULY PAID AND
THERE IS NO CONTRACT DEBT;
3. UNDERSTANDS THAT THE CASH VALUES MAY INCREASE OR DECREASE DEPENDING ON THE
CONTRACT'S INVESTMENT RETURN AND THAT THERE IS NO GUARANTEED MINIMUM CASH
VALUE:
4. believes that this contract will meet insurance needs and financial
objectives; and
5. requests that the net premium payments (as described in the prospectus) be
allocated to the Pruco Life Variable Insurance Account as follows:
Subaccount Allocation
---------- ----------
Money Market 40%
Common Stock 40%
Bond 20%
----
100%
+ If any portion of a net premium is allocated to a particular subaccount, that
portion must be at least 10% on the date the allocation takes effect. All
percentage allocations must be in whole numbers (e.g. 33% can be selected, but
33 1/3% cannot).
Date Signature of Applicant
November 15, 1982 JOHN DOE
PLI 49-42 Printed In U.S.A. By PROF
II-68
<PAGE>
ENDORSEMENTS
(Only we can endorse this contract.)
BASIS OF COMPUTATION
Mortality Tables Described.--Except as we state in the next paragraph. (1) we
base all net premiums and net values to which we refer in this contract on the
Insured's issue age and sex and on the length of time since the contract date;
(2) we use the Commissioners 1980 Standard Ordinary Mortality Table; and (3) we
use continuous functions based on age last birthday.
For extended insurance, we base net premiums and net values on the Commissioners
1980 Extended Term Insurance Table.
Interest Rate.--For all net premiums and net values to which we refer in this
contract we use an effective rate of 4% a year.
Exclusions.--When we compute net values we exclude the value of any
Supplementary Benefits and any other extra benefits added by rider to this
contract.
Values.--Tabular cash values at the end of each contract year are not less than
reserves determined according to the Commissioners Reserve Valuation Method
using the mortality tables and interest rate we describe above. There will be
the same exclusions.
Minimum Legal Values.--The cash, loan and other values in this contract are at
least as large as those set by law where it is delivered. Where required, we
have given the insurance regulator a detailed statement of how we compute values
and benefits.
Pruco Life Insurance Company,
By /s/ [SPECIMEN]
Secretary
PLIY 22--82
<TABLE>
CONTRACT SUMMARY (Continued from Page 2)
TABLE OF BASIC AMOUNTS
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------------------------
When the proceeds arise from the Insured's death:
- ------------------------------------------------------------------------------------------------------------------------------------
And The Contract Then The Basic And We Adjust The Basic
Is In Force: Amount Is: Amount For:
- ------------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C>
with no premium in the insurance amount contract debt (see
default past its (see page 8), plus page 13) and premium in
days of grace the amount of any default or paid (other
extra benefit arising than by a waiver benefit,
from the Insured's if any) past the date of
death death (see page 7).
- ------------------------------------------------------------------------------------------------------------------------------------
as reduced paid-up the amount of reduced contract debt since the
insurance (see page 11 paid-up insurance (see reduced paid-up insurance
page 11) began.
- ------------------------------------------------------------------------------------------------------------------------------------
as extended insurance the amount of term nothing.
(see page 11) insurance, if the
Insured dies in the
term (see page 11);
otherwise zero.
- ------------------------------------------------------------------------------------------------------------------------------------
</TABLE>
Page 19 (VL--83)
II-69
<PAGE>
GUIDE TO CONTENTS
PAGE
Contract Summary .......................................... 2
Table of Basic Amounts .................................. 19
Contract Data ............................................. 3
Rating Class; List of
Supplementary Benefits, if any:
Schedule of Premiums; Table of Net Premiums;
List of Subaccounts and Portfolios
Tabular Cash Values ....................................... 4
A table showing Cash Values
Table of Net Single Premiums .............................. 4A
General Provisions ........................................ 5
Definitions; The Contract; Contract
Modifications; Non-participating; Service
Office; Ownership and Control;
Suicide Exclusion; Currency; Misstatement
of Age or Sex; Incontestability; Assignment;
Annual Report; Payment of Death Claim
Beneficiary ............................................... 3 & 6
Premiums .................................................. 3 & 7
Payment of Premiums; Change of
Frequency; Grace Period; Premium
Adjustment
Reinstatement ............................................. 7
Insurance Provisions ...................................... 8
Insurance Amount; Variable Insurance
Amount; Variable Adjustment Amount
Separate Account .......................................... 8
The Account; Subaccounts;
The Fund; Account Investments; Change in
Investment Policy; Change of Fund
Investment Base and Return on Investment .................. 9
Investment Base; Base on Monthly Date;
Base on Other Dates: Assumed Rate
of Return;
Investment Base and Return on Investment .................. 9
(Continued)
Excess Investment Return;
Transfers Among Subaccounts
Contract Value Options .................................... 11
(Describes Nonforfeiture Benefits)
Benefit After the Grace Period;
Extended Insurance; Reduced Paid-up
Insurance; Computations; Automatic
Benefit; Optional Benefit; Cash Value
Option; Tabular Values
Loans ..................................................... 13
Loan Requirements; Contract Debt; Loan
Value; Interest Charge; Repayment; Effect
of a Loan; Excess Contract Debt; Payment of
Loan
Exchange of Contract ...................................... 14
Right to Exchange; Conditions;
Exchange Date; Contract Specifications;
Other Exchanges
Settlement Options ........................................ 15
Payee Defined; Choosing an Option;
Options Described; First Payment
Due Date; Residue Described; Income
Tables; Withdrawal of Residue;
Designating Contingent Payee(s);
Changing Options; Conditions;
Death of Payee
Automatic Mode of Settlement .............................. 18
Applicability; Interest on
Proceeds; Settlement at Payee's
Death; Spendthrift and Creditor
Basis of Computation ...................................... 19
Mortality Tables Described; Interest Rate;
Exclusions; Values;
Minimum Legal Values
Any Supplementary Benefits and a copy of the
application follow page 18.
Page 20
VARIABLE LIFE INSURANCE POLICY. INSURANCE PAYABLE ONLY UPON DEATH. FIXED
PREMIUMS PAYABLE DURING INSURED'S LIFETIME. BENEFITS REFLECT INVESTMENT RESULTS.
GUARANTEED MINIMUM DEATH BENEFIT IF PREMIUMS DULY PAID AND NO CONTRACT DEBT.
NON-PARTICIPATING.
VL--83 Printed in U.S.A.
II-70
Exhibit A(5)(b)
Illustrative Tabular Cash Values
MALE AGE 25
FACE AMOUNT = $50,000 ANNUAL PREMIUM = $541.50
END OF. POLICY YEAR TABULAR CASH VALUE
------------------- ------------------
1 $ 25.50
2 $ 400.50
3 $ 792.00
4 $ 1199.50
5 $ 1633.00
6 $ 2082.50
7 $ 2548.50
8 $ 3031.00
9 $ 3529.50
10 $ 4044.50
-----------------------------------------------------
11 $ 4575.50
12 $ 5122.00
13 $ 5684.00
14 $ 6261.00
15 $ 6853.50
16 $ 7460.00
17 $ 8081.00
18 $ 8717.00
19 $ 9367.50
20 $10033.00
-----------------------------------------------------
35 (AGE 60) $21616.50
40 (AGE 65) $25903.00
II-71
<PAGE>
MALE AGE 35
FACE AMOUNT = $50,000 ANNUAL PREMIUM = $787.50
END OF POLICY YEAR TABULAR CASH VALUE
------------------ ------------------
1 $ 152.00
2 $ 720.00
3 $ 1303.50
4 $ 1902.00
5 $ 2552.00
6 $ 3217.50
7 $ 3899.00
8 $ 4596.50
9 $ 5310.00
10 $ 6040.00
-----------------------------------------------------
11 $ 6786.00
12 $ 7548.50
13 $ 8327.50
14 $ 9124.00
15 $ 9936.50
16 $10765.00
17 $11608.00
18 $12463.50
19 $13330.00
20 $14207.00
-----------------------------------------------------
25 (AGE 60) $18758.00
30 (AGE 65) $23476.00
II-72
<PAGE>
MALE AGE 40
FACE AMOUNT - $50,000 ANNUAL PREMIUM = $944.00
END OF POLICY YEAR TABULAR CASH VALUE
------------------ ------------------
1 $ 210.50
2 $ 873.50
3 $ 1551.00
4 $ 2242.50
5 $ 3024.50
6 $ 3823.50
7 $ 4641.00
8 $ 5476.00
9 $ 6329.50
10 $ 7200.50
-----------------------------------------------------
11 $ 8089.00
12 $ 8992.50
13 $ 9910.00
14 $10839.50
15 $11779.50
16 $12730.00
17 $13691.50
18 $14663.50
19 $15646.50
20 $16639.50
-----------------------------------------------------
20 (AGE 60) $16639.50
25 (AGE 65) $21677.50
II-73
<PAGE>
MALE AGE 45
FACE AMOUNT = $50,000 ANNUAL PREMIUM = $1,149.50
END OF POLICY YEAR TABULAR CASH VALUE
------------------ ------------------
1 $ 273.00
2 $ 1071.00
3 $ 1884.50
4 $ 2713.50
5 $ 3656.50
6 $ 4618.50
7 $ 5597.00
8 $ 6590.50
9 $ 7596.50
10 $ 8615.00
-----------------------------------------------------
11 $ 9644.00
12 $10685.00
13 $11737.50
14 $12801.50
15 $13877.00
16 $14961.00
17 $16052.00
18 $17146.00
19 $18240.50
20 $19332.00
-----------------------------------------------------
15 (AGE 60) $13877.00
20 (AGE 65) $19332.00
II-74
<PAGE>
MALE AGE 55
FACE AMOUNT = $50,000 ANNUAL PREMIUM = $1,858.00
END OF POLICY YEAR TABULAR CASH VALUE
------------------ ------------------
1 $ 447.00
2 $ 1594.50
3 $ 2750.00
4 $ 3912.00
5 $ 5244.50
6 $ 6587.50
7 $ 7939.50
8 $ 9295.00
9 $10650.50
10 $12003.00
-----------------------------------------------------
11 $13352.00
12 $14697.00
13 $16039.50
14 $17379.00
15 $18714.00
16 $20038.50
17 $21346.50
18 $22628.00
19 $23876.00
20 $25086.50
-----------------------------------------------------
5 (AGE 60) $ 5244.50
10 (AGE 65) $12003.00
II-75
<PAGE>
FEMALE AGE 25
FACE AMOUNT = S50,O00 ANNUAL PREMIUM - $451.50
END OF POLICY YEAR TABULAR CASH VALUE
------------------ ------------------
1 $ 21.00
2 $ 340.00
3 $ 670.50
4 $ 1012.50
5 $ 1374.00
6 $ 1748.00
7 $ 2135.00
8 $ 2536.00
9 $ 2950.00
10 $ 3378.00
-----------------------------------------------------
11 $ 3819.00
12 $ 4273.50
13 $ 4740.00
14 $ 5219.00
15 $ 5709.00
16 $ 6211.00
17 $ 6724.00
18 $ 7249.00
19 $ 7786.50
20 $ 8338.00
-----------------------------------------------------
35 (AGE 60) $18379.50
40 (AGE 65) $22559.00
II-76
<PAGE>
FEMALE AGE 35
FACE AMOUNT = $50,000 ANNUAL PREMIUM = $660.50
END OF POLICY YEAR TABULAR CASH VALUE
------------------ ------------------
1 $ 87.50
2 $ 563.00
3 $ 1051.50
4 $ 1552.50
5 $ 2081.50
6 $ 2623.00
7 $ 3176.50
8 $ 3743.00
9 $ 4323.50
10 $ 4918.50
-------------------------------------------------------
11 $ 5528.00
12 $ 6153.00
13 $ 6794.00
14 $ 7450.50
15 $ 8123.00
16 $ 8811.00
17 $ 9514.50
18 $10233.00
19 $10966.50
20 $11715.00
-------------------------------------------------------
25 (AGE 60) $15764.50
30 (AGE 65) $20289.50
II-77
<PAGE>
FEMALE AGE 40
FACE AMOUNT = $50,000 ANNUAL PREMIUM - $778.50
END OF POLICY YEAR TABULAR CASH VALUE
------------------ ------------------
1 $ 127.50
2 $ 672.50
3 $ 1229.50
4 $ 1799.50
5 $ 2429.00
6 $ 3074.00
7 $ 3735.50
8 $ 4414.00
9 $ 5109.00
10 $ 5820.50
-------------------------------------------------------
11 $ 6549.00
12 $ 7294.00
13 $ 8054.50
14 $ 8831.50
15 $ 9624.50
16 $10435.00
17 $11265.50
18 $12118.00
19 $12994.50
20 $13895.00
-------------------------------------------------------
20 (AGE 60) $13895.00
25 (AGE 65) $18667.00
II-78
<PAGE>
FEMALE AGE 45
FACE AM0UNT = $50,0O ANNUAL PREMIUM = $935.00
END OR POLICY YEAR TABULAR CASH VALUE
------------------ ------------------
1 $ 177.50
2 $ 826.00
3 $ 1489.50
4 $ 2168.50
5 $ 2926.50
6 $ 3702.50
7 $ 4496.50
8 $ 5307.00
9 $ 6134.50
10 $ 6979.50
-------------------------------------------------------
11 $ 7843.50
12 $ 8728.00
13 $ 9636.50
14 $10570.50
15 $11530.00
16 $12513.50
17 $13518.50
18 $14539.50
19 $15572.00
20 $16614.50
-------------------------------------------------------
15 (AGE 60) $11530.00
20 (AGE 65) $16614.50
II-79
<PAGE>
FEMALE AGE 55
FACE AMOUNT = $50,000 ANNUAL PREMIUM = $1,468.50
END OF POLICY YEAR TABULAR CASH VALUE
------------------ ------------------
1 $ 362.00
2 $ 1296.50
3 $ 2253.00
4 $ 3234.50
5 $ 4372.50
6 $ 5539.50
7 $ 6731.00
8 $ 7942.00
9 $ 9167.00
10 $10403.00
--------------------------------------------------------
11 $11651.50
12 $12913.50
13 $14194.50
14 $15497.00
15 $16821.00
16 $18161.00
17 $19510.00
18 $20856.50
19 $22190.50
20 $23506.00
--------------------------------------------------------
5 (AGE 60) $ 4372.50
10 (AGE 65) $10403.00
II-80
Exhibit A(5)(c)
ENDORSEMENTS
(Only we can endorse this contract.)
GENERAL PROVISIONS
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.
We. Our, Us and Company.--Pruco Life Insurance Company, an Arizona Corporation.
You and Your.--The owner of the contract.
Insured.--The person named as the Insured on the first page. He or she need not
be the owner.
Example: Suppose we issue a contract on the life of your spouse. You applied for
it and named no one else as owner. Your spouse is the Insured and you are the
owner.
SEC.--The Securities and Exchange Commission. Issue Date.--The contract date.
Monthly Date.--The date on which we compute variable insurance amounts. It
occurs on the contract date and on the same day as the contract date in each
later month.
Example: If the contract date is March 9, 1986, the Monthly Dates are each March
9, April 9, May 9 and so on.
Anniversary or Contract Anniversary.--The same day and month as the contract
date in each later year.
Example: If the contract date is March 9, 1986, the first anniversary is March
9, 1987. The second is March 9, 1988, and so on.
Contract Year.--A year that starts on the contract date or on an anniversary.
Example: If the contract date is March 9, 1986, the first contract year starts
then and ends on March 8, 1987. The second starts on March 9, 1987 and ends on
March 8, 1988, and so on.
Contract Month.--A month that starts on a Monthly Date.
Example: If March 9, 1986 is a Monthly Date, a contract month starts then and
ends on April 8, 1986. The next contract month starts on April 9, 1986 and ends
on May 8, 1986, and so on.
Attained Age.--The Insured's attained age at any time is the issue age plus the
length of time since the contract date. You will find the issue age near the top
of page 3.
The Contract.--This policy and the application. a copy of which is attached,
form the whole contract. We assume that all statements in the application were
made to the best of the knowledge and belief of the person(s) who made them; in
the absence of fraud they are deemed to be representations and not warranties.
We relied on those statements when we issued the contract. We will not use any
statement, unless made in the application, to try to void the contract or to
deny a claim.
Contract Modifications.--Only a Company officer may agree to modify this
contract, and then only in writing.
Non-Participating.--This contract will not share in our profits or surplus
earnings. We will pay no dividends on it.
Service Office.--This is the office that will service this contract. Its mailing
address is the one we show on the Contract Data page, unless we notify you of
another one.
Ownership and Control.--Unless we endorse this contract to say otherwise: (1)
the owner of the contract is the Insured; and (2) while the Insured is living
the owner alone is entitled to (a) any contract benefit and value, and (b) the
exercise of any right and privilege granted by the contract or by us.
Suicide Exclusion.--If the Insured, whether sane or insane, dies by suicide
within one year from the issue date, we will pay no more under this contract
than the sum of the premiums paid.
Currency.--Any money we pay, or that is paid to us, must be in United States
currency. Any amount we owe will be payable at our Service Office.
(Continued on Next Page)
Page 5 (VL-83) (COL. & N.D.)
II-81
<PAGE>
GENERAL PROVISIONS (Continued)
Misstatement of Age or Sex.--lf the Insured's stated age or sex or both are not
correct, we will change each benefit and any amount to be paid to what the
premium would have bought for the correct age and sex.
The Schedule of Premiums may show that premiums change or stop on a certain
date. We may have used that date because the Insured would attain a certain age
on that date. If we find that the issue age was wrong, we will correct that
date.
Incontestability.--Except for non-payment of premium, we will not contest this
contract after it has been in force during the Insured's lifetime for two years
from the issue date.
Assignment.--We will not be deemed to know of an assignment unless we receive
it, or a copy of it, at our Service Office. We are not obliged to see that an
assignment is valid or sufficient.
Annual Report.--Each year we will send you a report. It will show: (1) the
insurance amount; (2) the net cash value; (3) the amount of net cash value in
each subaccount; and (4) any contract debt and the interest on the debt for the
prior year. The report will, of course, include any other data that may be
currently required where this contract is delivered. No report will be sent if
this contract is being continued under any contract value options provision.
Payment of Death Claim.--lf we settle this contract in one sum as a death claim,
we will usually pay the proceeds within 7 days after we receive at our Service
Office proof of death and any other information we need to pay the claim. But we
have the right to defer paying any portion of the proceeds equal to the variable
insurance amount if (1) the New York Stock Exchange is closed; or (2) the SEC
requires that trading be restricted or declares an emergency; or (3) the SEC
lets us defer payment to protect our contract owners.
BENEFICIARY
You may designate or change a beneficiary. Your request must be in writing and
in a form that meets our needs. It will take effect only when we file it at our
Service Office; this will be after you send the contract to us to be endorsed,
if we ask you to do so. Then any previous beneficiary's interest will end as of
the date of the request. It will end then even if the Insured is not living when
we file the request. Any beneficiary's interest is subject to the rights of any
assignee of whom we know.
When a beneficiary is designated, any relationship shown is to the Insured,
unless otherwise stated. To show priority, we may use numbered classes, so that
the class with first priority is called class 1, the class with next priority is
called class 2, and so on. When we use numbered classes, these statements apply
to beneficiaries unless the form states otherwise:
1. One who survives the Insured will have the right to be paid only if no one in
a prior class survives the Insured.
2. One who has the right to be paid will be the only one paid if no one else in
the same class survives the Insured.
3. Two or more in the same class who have the right to be paid will be paid in
equal shares.
4. If none survives the Insured, we will pay in one sum to the Insured's estate.
Example: Suppose the class 1 beneficiary is Jane and the class 2 beneficiaries
are Paul and John. We owe Jane the proceeds if she is living at the Insured's
death. We owe Paul and John the proceeds if they are living then but Jane is
not. But if only one of them is living, we owe him the proceeds. If none of them
is living we owe the Insured's estate.
Beneficiaries who do not have a right to be paid under these terms may still
have a right to be paid under the Automatic Mode of Settlement.
Before we make a payment, we have the right to decide what proof we need of the
identity, age or any other facts about any persons designated as beneficiaries,
If beneficiaries are not designated by name and we make payment(s) based on that
proof, we will not have to make the payment(s) again.
Page 6 (VL--83) Printed in U.S.A.
Exhibit 1A(5)(d)
<PAGE>
ENDORSEMENTS
(Only we can endorse this contract.)
GENERAL PROVISIONS
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.
We, Our, Us and Company.--Pruco Life Insurance Company, an Arizona Corporation.
You and Your.--The owner of the contract.
Insured.--The person named as the Insured on the first page. He or she need not
be the owner.
Example: Suppose we issue a contract on the life of your spouse. You applied for
it and named no one else as owner. Your spouse is the Insured and you are the
owner.
SEC.--The Securities and Exchange Commission. Issue Date.--The contract date.
Monthly Date.--The date on which we compute variable insurance amounts. It
occurs on the contract date and on the same day as the contract date in each
later month.
Example: If the contract date is March 9, 1986, the Monthly Dates are each March
9, April 9, May 9 and so on.
Anniversary or Contract Anniversary.--The same day and month as the contract
date in each later year.
Example: If the contract date is March 9, 1986, the first anniversary is March
9, 1987. The second is March 9, 1988, and so on.
Contract Year.--A year that starts on the contract date or on an anniversary.
Example: If the contract date is March 9, 1986. the first contract year starts
then and ends on March 8, 1987. The second starts on March 9, 1987 and ends on
March 8, 1988, and so on.
Contract Month.--A month that starts on a Monthly Date.
Example: If March 9, 1986 is a Monthly Date, a contract month starts then and
ends on April 8.1986. The next contract month starts on April 9,1986 and ends on
May 8,1986, and so on.
Attained Age.--The Insured's attained age at any time is the issue age plus the
length of time since the contract date. You will find the issue age near the top
of page 3.
The Contract.--This policy and the application, a copy of which is attached,
form the whole contract. We assume that all statements in the application were
made to the best of the knowledge and belief of the person(s) who made them; in
the absence of fraud they are deemed to be representations and not warranties.
We relied on those statements when we issued the contract. We will not use any
statement, unless made in the application, to try to void the contract or to
deny a claim.
Contract Modifications.--Only a Company officer may agree to modify this
contract, and then only in writing.
Non-Participating.--This contract will not share in our profits or surplus
earnings. We will pay no dividends on it.
service office.--This is the office that will service this contract. Its mailing
address is the one we show on the Contract Data page, unless we notify you of
another one.
Ownership and Control.--Unless we endorse this contract to say otherwise: (1)
the owner of the contract is the Insured; and (2) while the Insured is living
the owner alone is entitled to (a) any contract benefit and value, and (b) the
exercise of any right and privilege granted by the contract or by us.
Suicide Exclusion.--lf the Insured, whether sane or insane, dies by suicide
within two years from the issue date, we will pay no more under this contract
than the sum of the premiums paid.
Currency.--Any money we pay, or that is paid to us, must be in United States
currency. Any amount we owe will be payable at our Service Office.
(Continued on Next Page)
Page 5 (VL-83) (OKLA.)
II-83
<PAGE>
GENERAL PROVISIONS (Continued)
Misstatement of Age or Sex.--If the Insured's stated age or sex or both are not
correct, we will change each benefit and any amount to be paid to what the
premium would have bought for the correct age and sex.
The Schedule of Premiums may show that premiums change or stop on a certain
date. We may have used that date because the Insured would attain a certain age
on that date. If we find that the issue age was wrong, we will correct that
date.
Incontestability.--Except for non-payment of premium, we will not contest this
contract after it has been in force during the Insured's lifetime for two years
from the issue date.
Assignment.--WE will not be deemed to know of an assignment unless we receive
it, or a copy of it, at our Service Office. We are not obliged to see that an
assignment is valid or sufficient.
Annual Report.--Each year we will send you a report. It will show: (1) the
insurance amount; (2) the net cash value; (3) the amount of net cash value in
each subaccount: and (4) any contract debt and the interest on the debt for the
prior year. The report will, of course. include any other data that may be
currently required where this contract is delivered. No report will be sent if
this contract is being continued under any contract value options provision.
Payment of Death Claim.--lf we settle this contract in one sum as a death claim,
we will usually pay the proceeds within 7 days after we receive at our Service
Office proof of death and any other information we need to pay the claim. But we
have the right to defer paving any portion of the proceeds equal to the variable
insurance amount if (1) the New York Stock Exchange is closed; or (2) the SEC
requires that trading be restricted or declares an emergency; or (3) the SEC
lets us defer payment to protect our contract owners.
BENEFICIARY
You may designate or change a beneficiary. Your request must be in writing and
in a form that meets our needs. It will take effect only when we file it at our
Service Office; this will be after you send the contract to us to be endorsed,
if we ask you to do so. Then any previous beneficiary's interest will end as of
the date of the request. It will end then even if the Insured is not living when
we file the request. Any beneficiary's interest is sublect to the rights of any
assignee of whom we know.
When a beneficiary is designated, any relationship shown is to the Insured,
unless otherwise stated. To show priority, we may use numbered classes, so that
the class with first priority is called class 1, the class with next priority is
called class 2. and so on. When we use numbered classes, these statements apply
to beneficiaries unless the form states otherwise:
1. One who survives the Insured will have the right to be paid only if no one in
a prior class survives the Insured.
2. One who has the right to be paid will be the only one paid if no one else in
the same class survives the Insured.
3. Two or more in the same class who have the right to be paid will be paid in
equal shares.
4. If none survives the Insured, we will pay in one sum to the Insured's estate.
Example: Suppose the class 1 beneficiary is Jane and the class 2 beneficiaries
are Paul and John, We owe Jane the proceeds if she is living at the Insured's
death. We owe Paul and John the proceeds if they are living then but Jane is
not. But if only one of them is living, we owe him the proceeds. If none of them
is living we owe the Insured's estate.
Beneficiaries who do not have a right to be paid under these terms may still
have a right to be paid under the Automatic Mode of Settlement.
Page 6 (VL-83) (OKLA.) Printed in U.S.A.
II-84
Exhibit 1A(5)(e)
ENDORSEMENTS
(Only we can endorse this contract.)
GENERAL PROVISIONS
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.
We, Our, Us and Company.--Pruco Life Insurance Company, an Arizona Corporation.
You and Your.--The owner of the contract.
Insured.--The person named as the Insured on the first page. He or she need not
be the owner.
Example: Suppose we issue a contract on the life of your spouse. You applied
for it and named no one else as owner. Your spouse is the Insured and you are
the owner.
SEC.--The Securities and Exchange Commission.
Issue Date.--The contract date.
Monthly Date.--The date on which we compute variable insurance amounts. It
occurs on the contract date and on the same day as the contract date in each
later month.
Example: If the contract date is March 9, 1986, the Monthly Dates are each March
9, April 9, May 9 and so on.
Anniversary or Contract Anniversary.--The same day and month as the contract
date in each later year.
Example: If the contract date is March 9, 1986, the first anniversary is March
9, 1987. The second is March 9, 1988, and so on.
Contract Year.--A year that starts on the contract date or on an anniversary.
Example: If the contract date is March 9, 1986, the first contract year starts
then and ends on March 8, 1987. The second starts on March 9, 1987 and ends on
March 8, 1988, and so on.
Contract Month.--A month that starts on a Monthly Date.
Example: If March 9, 1986 is a Monthly Date, a contract month starts then and
ends on April 8, 1986. The next contract month starts on April 9, 1986 and ends
on May 8, 1986, and so on.
Attained Age.--The Insured's attained age at any time is the issue age plus the
length of time since the contract date. You will find the issue age near the top
of page 3.
The Contract.--This policy and the application, a copy of which is attached,
form the whole contract. We assume that all statements in the application were
made to the best of the knowledge and belief of the person(s) who made them; in
the absence of fraud they are deemed to be representations and not warranties.
We relied on those statements when we issued the contract. We will not use any
statement, unless made in the application, to try to void the contract or to
deny a claim.
Contract Modifications.--Only a Company officer may agree to modify this
contract, and then only in writing.
Non-participating.--This contract will not share in our profits or surplus
earnings. We will pay no dividends on it.
Service Office.--This is the office that will service this contract. Its mailing
address is the one we show on the Contract Data page, unless we notify you of
another one.
Ownership and Control.--Unless we endorse this contract to say otherwise: (1)
the owner of the contract is the Insured; and (2) while the Insured is living
the owner alone is entitled to (a) any contract benefit and value, and (b) the
exercise of any right and privilege granted by the contract or by us.
Suicide Exclusion.--lf the Insured, whether sane or insane, dies by suicide
within two years from the issue date, we will pay no more under this contract
than the sum of the premiums paid.
Currency.--Any money we pay, or that is paid to us, must be in United States
currency. Any amount we owe will be payable at our Service Office.
(Continued on Next Page)
Page 5 (VL--83) (S.C.) Printed in U.S.A.
II-85
<PAGE>
GENERAL PROVISIONS (Continued)
Misstatement of Age or Sex.--lf the Insured's stated age or sex or both are not
correct, we will change each benefit and any amount to be paid to what the
premium would have bought for the correct age and sex.
The Schedule of Premiums may show that premiums change or stop on a certain
date. We may have used that date because the Insured would attain a certain age
on that date. If we find that the issue age was wrong, we will correct that
date.
Incontestability.--Except for non-payment of premium, we will not contest this
contract after two years from the issue date.
Assignment.--We will not be deemed to know of an assignment unless we receive
it, or a copy of it; at our Service Office. We are not obliged to see that an
assignment is valid or sufficient.
Annual Report.--Each year we will send you a report. It will show: (1) the
insurance amount: (2) the net cash value; (3) the amount of net cash value in
each subaccount; and (4) any contract debt and the interest on the debt for the
prior year. The report will, of course, include any other data that may be
currently required where this contract is delivered. No report will be sent if
this contract is being continued under any contract value options provision.
Payment of Death Claim.--If we settle this contract in one sum as a death claim,
we will usually pay the proceeds within 7 days after we receive at our Service
Office proof of death and any other information we need to pay the claim. But we
have the right to defer paying any portion of the proceeds equal to the variable
insurance amount if (1) the New York Stock Exchange is closed; or (2) the SEC
requires that trading be restricted or declares an emergency; or (3) the SEC
lets us defer payment to protect our contract owners.
BENEFICIARY
You may designate or change a beneficiary. Your request must be in writing and
in a form that meets our needs. It will take effect only when we file it at our
Service Office; this will be after you send the contract to us to be endorsed,
if we ask you to do so. Then any previous beneficiary's interest will end as of
the date of the request. It will end then even if the Insured is not living when
we file the request. Any beneficiary's interest is subject to the rights of any
assignee of whom we know.
When a beneficiary is designated, any relationship shown is to the Insured,
unless otherwise stated. To show priority, we may use numbered classes, so that
the class with first priority is called class 1, the class with next priority is
called class 2, and so on. When we use numbered classes, these statements apply
to beneficiaries unless the form states otherwise:
1. One who survives the Insured will have the right to be paid only if no one in
a prior class survives the Insured.
2. One who has the right to be paid will be the only one paid if no one else in
the same class survives the Insured.
3. Two or more in the same class who have the right to be paid will be paid in
equal shares.
4. If none survives the Insured, we will pay in one sum to the Insured's estate.
Example: Suppose the class 1 beneficiary is Jane and the class 2 beneficiaries
are Paul and John. We owe Jane the proceeds if she is living at the Insured's
death. We owe Paul and John the proceeds if they are living then but Jane is
not. But if only one of them is living, we owe him the proceeds. If none of them
is living we owe the Insured's estate.
Beneficiaries who do not have a right to be paid under these terms may still
have a right to be paid under the Automatic Mode of Settlement.
Before we make a payment, we have the right to decide what proof we need of the
identity, age or any other facts about any persons designated as beneficiaries.
If beneficiaries are not designated by name and we make payment(s) based on that
proof, we will not have to make the payment(s) again.
Page 6 (VL--83)(S.C.) Printed in U.S.A.
II-86
<PAGE>
Exhibit 1A(5)(f)
PRUCO LIFE INSURANCE COMPANY
Phoenix, Arizona
A Stock Company Subsidiary of The Prudential Insurance Company of America
- --------------------------------------------------------------------------------
INSURED POLICY NUMBER
CONTRACT DATE
FACE AMOUNT
PREMIUM PERIOD
AGENCY
- --------------------------------------------------------------------------------
We will pay the beneficiary the proceeds of this contract promptly if we
receive due proof that the Insured died. We make this promise subject to
all the provisions of the contract.
The Death Benefit will be the insurance amount plus the amount of any extra
benefit if no premium is in default and if there is no contract debt.
During the first contract month, the insurance amount is the face amount we
show above. After that, it depends on the payment of premiums and on
investment results. The insurance amount may increase or decrease for any
month as we state under Insurance Provisions on page 8. But it will not be
less than the face amount if no premium is in default.
The net cash value may increase or decrease daily depending on the
investment experience of the separate account. There is no guaranteed
minimum.
Premiums are fixed as to amount. They will not vary with investment
results.
Please read this contract with care. A guide to its contents is on the last
page. A summary is on page 2. If there is ever a question about it, or if
there is a claim, just see one of our representatives or get in touch with
one of our offices.
Right To Cancel Contract.--You may return this contract to us within (1) 10
days after you get it, or (2) 45 days after Part 1 of the application was
signed, or (3) 10 days after we mail the Notice of Withdrawal Right,
whichever is latest. All you have to do is take the contract or mail it to
one of our offices or to the representative who sold it to you. It will be
canceled from the start and we will give back your money promptly.
Signed for Pruco Life Insurance Company,
an Arizona Corporation.
/s/ ISABELLE L. KIRCHNER /s/ RICHARD A. YORKS
Secretary President
VARIABLE LIFE INSURANCE POLICY. INSURANCE PAYABLE ONLY UPON DEATH. FIXED
PREMIUMS PAYABLE DURING INSURED'S LIFETIME. BENEFITS REFLECT INVESTMENT RESULTS.
GUARANTEED MINIMUM DEATH BENEFIT IF PREMIUMS DULY PAID AND NO CONTRACT DEBT.
NON-PARTICIPATING.
VL--83 P
II-87
<PAGE>
CONTRACT SUMMARY
We offer this summary to help you understand this contract. We do not intend
that it change any of the provisions of the contract.
This is a contract of life insurance. Premiums are to be paid throughout the
Insured's lifetime. The insurance amount and the net cash value will vary with
the investment performance of those subaccounts of the Pruco Life Variable
Insurance Account that you select. But, except as we state in the next sentence,
the insurance amount will never be less than the face amount. If a premium is
not paid before its days of grace are over, the contract may end or it may stay
in force with reduced benefits. If either occurs, you may be able to reinstate
it.
Proceeds is a word we use to mean the amount we would pay if we were to settle
the contract in one sum. To compute the proceeds that may arise from the
Insured's death, we start with a basic amount. We may adjust that amount if
there is a loan, a premium in default, or a premium paid (but not waived under a
waiver of premium benefit, if any) for a period past the date of death. The
table on page 19 tells you how we adjust the basic amount. If you surrender the
contract, the proceeds will be the net cash value. We describe it under Cash
Value Option on page 11.
Proceeds often are not taken in one sum. For instance, on surrender, you may be
able to put proceeds under a settlement option to provide retirement income or
for some other purpose. Also, for all or part of the proceeds that arise from
the Insured's death, you may be able to choose a manner of payment to fit the
beneficiary's expected needs. If the Insured dies, and a manner of payment has
not been chosen, the beneficiary may be able to choose one. We will pay interest
under Option 3 from the date of death on any proceeds to which no other manner
of payment applies. This will be automatic as we state on page 18. There is no
need to ask for it.
You and we may agree on a change in the ownership of this contract. Also, unless
we endorse it to say otherwise, the contract gives you these rights, among
others:
o You may change the beneficiary under it.
o You may change the allocation of future net premiums among the subaccounts.
o You may transfer amounts among subaccounts.
o You may borrow on it up to its loan value.
o You may surrender it for its net cash value.
The contract, as issued, may or may not have extra benefits that we call
Supplementary Benefits. If it does, we list them under Supplementary Benefits on
the Contract Data page(s) and describe them after page 18. The contract may or
may not have other extra benefits. If it does, we add them by rider. Any extra
benefit ends as soon as any premium is in default past its days of grace, unless
the form that describes it states otherwise.
(Contract Summary Continued an Page 19)
Page 2 (VL--83)
II-88
<PAGE>
ENDORSEMENTS
(Only we can endorse this contract.)
BASIS OF COMPUTATION
Mortality Tables Described.--Except as we state in the next paragraph, (1) we
base all net premiums and net values to which we refer in this contract on the
Insured's issue age and sex and on the length of time since the contract date;
(2) we use the Commissioners 1980 Standard Ordinary Mortality Table; and (3) we
use continuous functions based on age last birthday.
For extended insurance, we base net premiums and net values on the Commissioners
1980 Extended Term Insurance Table.
Interest Rate.--For all net premiums and net values to which we refer in this
contract we use an effective rate of 4% a year.
Exclusions.--When we compute net values we exclude the value of any
Supplementary Benefits and any other extra benefits added by rider to this
contract.
Values.--Tabular cash v~lues at the end of each contract year are not less than
reserves determined according to the commissioners Reserve Valuation Method
using the mortality tables and interest rate we describe above. There will be
the same exclusions.
Minimum Legal Values.--The cash, loan and other values in this contract are at
least as large as those set by law where it is delivered. Where required, we
have given the insurance regulator a detailed statement of how we compute values
and benefits.
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
------------------------
Secretary
PLIY 22--82
CONTRACT SUMMARY (continued from Page 2)
- --------------------------------------------------------------------------------
TABLE OF BASIC AMOUNTS
- --------------------------------------------------------------------------------
When the proceeds arise from the Insured's death:
- --------------------------------------------------------------------------------
And The Contract Is Then The Basic And We Adjust The Basic
In Force: Amount Is: Amount For:
- --------------------------------------------------------------------------------
with no premium in the insurance amount contract debt (see
default past its (see page 8), plus page 13) and premium in
days of grace the amount of any default or paid (other
extra benefit arising than by a waiver benefit,
from the Insured's if any) past the date of
death death (see page 7).
- --------------------------------------------------------------------------------
as reduced paid-up the amount of reduced contract debt since the
insurance (see page 11) paid-up insurance (see reduced paid-up insurance
page 11) began.
- --------------------------------------------------------------------------------
as extended insurance the amount of term nothing.
(see page 11) insurance, if the
Insured dies in the
term (see page 11);
otherwise zero.
- --------------------------------------------------------------------------------
Page 19 (VL--83)
II-89
<PAGE>
GUIDE TO CONTENTS
Page
Contract Summary .............................................................2
Table of Basic Amounts ....................................................19
Contract Data ................................................................3
Rating Class; List of
Supplementary Benefits, if any;
Schedule of Premiums; Table of Net Premiums;
List of Subaccounts and Portfolios
Tabular Cash Values ..........................................................4
A table showing Cash Values
Table of Net Single Premiums ................................................4A
General Provisions ...........................................................5
Definitions; The Contract; Contract
Modifications; Non-participating; Service
Office; Ownership and Control;
Suicide Exclusion; Currency; Misstatement
of Age or Sex; Incontestability; Assignment;
Annual Report; Payment of Death Claim
Beneficiary ..............................................................3 & 6
Premiums .................................................................3 & 7
Payment of Premiums; Change of
Frequency; Grace Period; Premium
Adjustment
Reinstatement ................................................................7
Insurance Provisions .........................................................8
Insurance Amount; Variable Insurance
Amount; Variable Adjustment Amount
Separate Account .............................................................8
The Account; Subaccounts;
The Fund; Account Investments; Change in
Investment Policy; Change of Fund
Investment Base and Return on Investment .....................................9
Investment Base; Base on Monthly Date;
Base on Other Dates; Assumed Rate
of Return;
Investment Base and Return on Investment .....................................9
(Continued)
Excess Investment Return;
Transfers Among Subaccounts
Contract Value Options ......................................................11
(Describes Nonforfeiture Benefits)
Benefit After the Grace Period;
Extended Insurance; Reduced Paid-up
Insurance; Computations; Automatic
Benefit; Optional Benefit; Cash Value
Option; Tabular Values
Loans .......................................................................13
Loan Requirements; Contract Debt; Loan
Value; Interest Charge; Repayment; Effect
of a Loan; Excess Contract Debt; Payment of
Loan
Exchange of Contract ........................................................14
Right to Exchange; Conditions;
Exchange Date; Contract Specifications;
Other Exchanges
Settlement Options ..........................................................15
Payee Defined; Choosing an Option;
Options Described; First Payment
Due Date; Residue Described; Income
Tables; Withdrawal of Residue;
Designating Contingent Payee(s);
Changing Options; Conditions;
Death of Payee
Automatic Mode of Settlement ................................................18
Applicability; Interest on
Proceeds; Settlement at Payee's
Death; Spendthrift and Creditor
Basis of Computation ........................................................19
Mortality Tables Described; Interest Rate;
Exclusions; Values;
Minimum Legal Values
Any Supplementary Benefits and a copy of the
application follow page 18.
Page 20
VARIABLE LIFE INSURANCE POLICY. INSURANCE PAYABLE ONLY UPON DEATH. FIXED
PREMIUMS PAYABLE DURING INSURED'S LIFETIME. BENEFITS REFLECT INVESTMENT RESULTS.
GUARANTEED MINIMUM DEATH BENEFIT IF PREMIUMS DULY PAID AND NO CONTRACT DEBT.
NON-PARTICIPATING.
VL--83 - P Printed in U.S.A.
II-90
<PAGE>
EXHIBIT 1A(5)(G)
PRUDENTIAL Pruco Life Insurance Company
A Subsidiary of
The Prudential Insurance Company of America
NOTICE
Pruco Life's goal is to provide our contractholders with fast and personal
service.
If you have any need for service with or a question about your Pruco Life
contract, please contact your Pruco Life representative. You may also get in
touch with the Pruco Life office named below.
Should you desire any more help with a problem, assistance may be requested of
the Illinois State Department identified below.
PRUCO LIFE STATE
Service Office Illinois Department
Pruco Life Insurance Company of Insurance
P.O. Box 9469 Consumer Service Section
Minneapolis, Minnesota 55440 Springfield, Illinois 62767
PLI 3 ED 1-82 Printed in U.S.A.
II-91
<PAGE>
EXHIBIT A(5)(h)
PLEASE READ THIS RIDER CAREFULLY
The waiting period in the Incontestability provision for the rider differs from
that in the contract and starts on the date of the request for the rider.
Pruco Life Insurance Company,
By /s/ DOROTHY K. LIGHT
-------------------------
Secretary
PLI 16-82
II-92
<PAGE>
EXHIBIT A(5)(i)
PLEASE READ THIS RIDER CAREFULLY
The waiting period in the Suicide Exclusion and Incontestability provisions for
the rider differs from that in the contract and starts on the date of the
request for the rider.
Pruco Life Insurance Company
By
/s/ SPECIMEN
Secretary
PLI 17-82 Printed in U.S.A.
II-93
<PAGE>
EXHIBIT A(5)(J)
ENDORSEMENTS
(Only we can endorse this contact.)
This endorsement is attached to and made a part of this contract on the contract
date:
Suicide is no defense to payment of life insurunce benefits nor is suicide while
insane a defense to payment of accidental death benefits. If the contract has
any, unless we can show that the deceased person on whose life the benefit was
provided intended suicide when application was made for the contract.
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
--------------------------
Secretary
PLI 18-82 Printed in the U.S.A.
II-94
<PAGE>
EXHIBIT A(5)(k)
ENDORSEMENTS
(Only we can endorse this contract.)
This endorsement is attached to and made a part of this contract on the contract
date:
This endorsement applies only if the Insured dies by suicide within two years
from the issue date and our liability is limited as we state for suicide in the
General Provisions. If this occurs, any provision for paid-up insurance on the
life of any other person who was, until the Insured died, insured under this
contract will not apply.
Instead, any such person will then have the right to buy a new contract of life
insurance either from us or from an affiliate of ours. The new contract will be
subject to conditions and charges that are then determined, in accord with
regular rules in effect at the time. Its amount will not be less than the
greater of (1) the amount of insurance on that person's life under this
contract, and (2) the lowest amount offered for the plan of insurance to be
provided by the new contract. And proof that the person is insurable will not be
required, unless the new contract is to provide either an increased amount of
insurance or a benefit that did not apply to that person under this contract.
Pruco Life Insurance Company,
By /s ISABELLE L. KIRCHNER
Secretary
PLI 21--82
<PAGE>
EXHIBIT A(5)(l)
ENDORSEMENTS
(Only we can endorse this contract.)
This endorsement is attached to and made a part of this contract on the contract
date:
DELAYED CLAIM INTEREST
If this contract becomes a claim by reason of the Insured's death, here is what
we will do. We will include interest to the date the settlement is made: (1) at
the effective rate of 10% a year from the date we receive at our Service Office
written notice of the Insured's death, or (2) at the rate that applies to Option
3 of the Settlement Options provision from the date of death, whichever produces
the larger amount.
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
Secretary
PLI 35--82
II-96
<PAGE>
EXHIBIT A(5)(m)
ENDORSEMENTS
(Only we can endorse this contract.)
AUTOMATIC PREMIUM LOAN
This endorsement is attached to and made a part of this contract on the contract
date:
If this provision is in effect at the end of the days of grace of a premium in
default, the premium will be paid by charging it as a loan on the contract. But
this will be done only if there is enough loan value to do so.
If a monthly premium is in default, a quarterly premium will be paid by loan if
there is enough loan value to do so. Then premiums will start to fall due
quarterly. But they will again fall due monthly, starting on the date to which
they have been paid by loan, if: (1) there is enough loan value to pay a monthly
premium but not a quarterly one; or (2) a monthly premium is paid, other than by
loan.
A loan to pay a premium is just like any other loan on the contract (described
under Loans). When we compute the loan values, we will do so as if the premium
to be borrowed had been paid. When a premium is paid by loan, we will not use
the net cash value to provide extended or reduced paid-up insurance at that
time.
This provision will take effect on the contract date unless there was a request
to the contrary in the application. You have the right to decide whether or not
you want the provision to be in effect at any time. If you change your mind, you
must ask us in writing; your new request will take effect as soon as we have it
at our Service Office.
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
Secretary
PLI 47--82
II-97
<PAGE>
EXHIBIT A(5)(n)
(Only we can endorse this contract.)
AUTOMATIC PREMIUM LOAN
This endorsement is attached to and made a part of this contract on the contract
date:
If this provision is in effect at the end of the days of grace of a premium in
default, the premium will be paid by charging it as a loan on the contract. But
this will be done only if there is enough loan value to do so.
If a monthly premium is in default, a quarterly premium will be paid by loan if
there is enough loan value to do so. Then premiums will start to fall due
quarterly. But they will again fall due monthly, starting on the date to which
they have been paid by loan, if: (1) there is enough loan value to pay a monthly
premium but not a quarterly one; or (2) a monthly premium is paid, other than by
loan.
A loan to pay a premium is just like any other loan on the contract (described
under Loans). When we compute the loan values, we will do so as if the premium
to be borrowed had been paid. When a premium is paid by loan, we will not use
the net cash value to provide extended or reduced paid-up insurance at that
time.
This provision will take effect on the contract date if this was requested in
the application. You have the right to decide whether or not you want the
provision to be in effect at any time. If you change your mind, you must ask us
in writing; your new request will take effect as soon as we have it at our
Service Office.
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
Secretary
PLI 48--82
II-98
<PAGE>
EXHIBIT A(5)(o)
ENDORSEMENT
RIGHT TO CANCEL CONTRACT.--You may return this contract to us within (1) 10 days
after you get it, or (2) 45 days after Part 1 of the application was signed, or
(3)10 days after we mail the Notice of Withdrawal Right, whichever is latest.
All you have to do is take it or mail it to one of our offices or to the person
who sold it to you. We will cancel the contract from the start and give back
your money within ten days after we receive the contract.
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
--------------------------
Secretary
PLI 50-82 Printed in U.S.A.
II-99
<PAGE>
EXHIBIT A(5)(p)
ENDORSEMENTS
(Only we can endorse this contract.)
This endorsement is attached to and made a part of this contract on the contract
date:
In this contract, we use the phrase the insured spouse. When we do, we mean the
Insured's spouse who is named for coverage in the request for change, even
though we state otherwise elsewhere in the contract. The request for change
resulted in our issuing the contract; it is attached to and made a part of the
contract.
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
--------------------------
Secretary
PLI 28-82 Printed in U.S.A.
II-100
<PAGE>
EXHIBIT A(5)(q)
ENDORSEMENTS
(Only we can endorse this contract.)
Right to Obtain a New Contract.--We refer in this contract to the right of a
person insured under the contract, subject to certain conditions, to obtain a
new contract from The Prudential Insurance Company of America. This right is
guaranteed by a certification on file with the Commissioner of Insurance of
Virginia.
Pruco Life Insurance Company,
By /s/ SPECIMEN
--------------------------
Secretary
Printed in U.S.A.
PLI 73--82
II-101
<PAGE>
EXHIBIT A(5)(r)
ENDORSEMENTS
(Only we can endorse this contract.)
Right to Buy a New Contract.--Some provisions of this contract refer to the
right of an individual, subject to certain conditions, to obtain a new contract
of insurance from The Prudential Insurance Company of America. Prudential has
agreed to this arrangement, as shown by the following Certification.
CERTIFICATION
The Prudential Insurance Company of America is aware that some provisions of
Pruco Life Insurance Company form VL-83-P provide an individual the right,
subject to certain conditions, to obtain a new contract of insurance from
Prudential. We certify that if any such individual wishes to exercise that right
Prudential will make available to that individual the contract described in form
VL-83-P
Signed for The Prudential Insurance Company of America,
/s/ DAVID J. SHERWOOD
President
/s/
Assistant Secretary
If The Prudential Insurance Company of America is not engaged in the insurance
business at the time an individual wishes to exercise this right to buy a new
contract, Pruco Life Insurance Company will make available to that individual a
contract that it currently issues.
This endorsement attached to the contract on the Contract Date
By /s/ ISABELLE L. KIRCHNER
------------------------
Secretary
PLI 86-82 Printed in U.S.A.
II-102
<PAGE>
EXHIBIT A(5)(s)
(Only we can endorse this contract)
This endorsement is attached to and made a part of this contract on the contract
date.
ALTERATION OF TEXT
1. The section captioned "Change of Frequency" in the Premium Payment and
Reinstatement provisions on page 7 is amended to add the following
sentence:
The premium frequencies from which you may choose, and the premium
rates which apply are those that were available and applicable on the
contract date.
2. The section captioned "Tabular Values" in the Contract Value Options
provisions on page 11 is amended to define the tabular value on a
Monthly Date which is a premium due date.
Tabular Values--In the table on page 4 we show tabular values at the
ends of contract years. The tabular value at the beginning of the
first contract year is the net premium then due. The tabular value on
a Monthly Date which is a premium due date includes the net premium
that applies on that date. If we need to compute tabular values at
some time during a contract year, we will count the time since the
start of the year and any premiums paid for the year. We will let you
know the tabular values for other durations if you ask for them.
3. The section captioned "Interest Charge" in the Loans provisions on page
13 is amended to read as follows:
Interest Charge--We will charge interest daily on any loan. The loan
interest rate is 6% a year. Interest is due on each contract
anniversary, or when the loan is paid back if that comes first. if
interest is not paid when due, it will become part of the loan. Then
we will start to charge interest on it too.
Example 3: Suppose the contract date is in 1987. Six months before the
anniversary in 1996 you
PLI 90
II-103
<PAGE>
-2-
borrow $1,000 out of a $4,000 loan value. Three months later, but
still three months before the anniversary, we will have charged about
$15 interest. This amount will be a few cents more or less than $15
since some months have more days than others. The interest will not be
due until the anniversary unless the loan is paid back sooner. The
loan will still be $1,000. The contract debt will be $1,015 since
contract debt includes interest charged but not yet due. On the
anniversary in 1996 we will have charged about $30 interest. The
interest will then be due.
Example 4: Suppose the $30 interest in example 3 is paid on the
anniversary. The loan and contract debt will each become $1,000 right
after the payment.
Example 5: Suppose the $30 interest in example 3 is not paid on the
anniversary. The interest will become part of the loan, and we will
begin to charge interest on it, too. The loan and contract debt will
each become $1,030.
4. The fifth paragraph of the section captioned "Contract Specifications"
in the Exchange of Contract provisions on page 14 is amended to add the
following sentence:
A detailed statement of the method of computing the adjustment is on
file with the Insurance Commissioner of the State of Texas.
Pruco Life Insurance Company,
By_________________________
Secretary
II-104
<PAGE>
EXHIBIT A(5)(t)
(Only we can endorse this contract.)
Right to Obtain a New Contract.--We refer in this rider to the right of a person
insured under the rider, subject to certain conditions. to obtain a new contract
from The Prudential Insurance Company of America. This right is guaranteed by a
certification on file with the Commissioner of Insurance of Iowa.
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
__________________________
Secretary
PLI 97--84 Printed in U.S.A.
II-105
EXHIBIT A(5)(u)
(Only we can endorse this oontract.)
This endorsement is attached to and made a part of this contract on the contract
date:
Beginning in 1986 you may be able to withdraw all or part of any existing
Variable Insurance Amount without surrendering the contract. The total death
benefit will be reduced by an amount equal to the amount of paid-up whole life
insurance which the sum withdrawn would have purchased at your attained age and
sex, on the date of the withdrawal. The guaranteed minimum death benefit will be
reduced such that the difference between the total death benefit and the
guaranteed minimum death benefit is the same percentage of cash value before and
after surrender.
The amount of cash withdrawn must be at least $500, and in multiples of $100 if
greater, unless it is used to pay premiums on this contract or on other
contracts with us.
You may make no more than two such withdrawals in a contract year without our
permission.
If you ask us in writing in a form that meets our needs, we will tell you:
1. Your Variable Insurance Amount;
2. The cash value of your Variable Insurance Amount;
3. The reduction in total death benefit and guaranteed minimum death
benefit if you withdraw your Variable Insurance Amount; and
4. The reduction in total death benefit and guaranteed minimum death
benefit if you withdraw a permitted amount of your choice which is less
than the entire cash value of the Variable Insurance Amount.
Pruco Life Insurance Company,
By /s/ [SPECIMEN]
___________________________
Secretary
PLI 99--84 Printed in U.S.A.
II-106
EXHIBIT A(5)(v)
PRUDENTIAL Pruco Life Insurance Company
Phoenix, Arizona
A Stock Company subsidiary of
The Prudential Insurance Company of America
Insured Policy Number
Contract Date
Face Amount
Premium Period
Agency
We will pay the beneficiary the proceeds of this contract promptly if we receive
due proof that the Insured died. We make this promise subject to all the
provisions of the contract.
The Death Benefit will be the insurance amount plus the amount of any extra
benefit if no premium is in default and if there is no contract debt. During the
first contract month, the insurance amount is the face amount we show above.
After that, it depends on the payment of premiums and on investment results. The
insurance amount may increase or decrease for any month as we state under
Insurance Provisions on page 8. But it will not be less than the face amount if
no premium is in default.
The net cash value may increase or decrease daily depending on the investment
experience of the separate account. There is no guaranteed minimum.
During the first contract year the loan value is zero. After the first contract
year it is 90% of the sum of the net cash value and any existing contract debt.
Premiums are fixed as to amount. They will not vary with investment results.
Please read this contract with care. A guide to its contents is on the last
page. A summary is on page 2. If there is ever a question about it, or if there
is a claim, just see one of our representatives or get in touch with one of our
offices.
Right to Cancel Contract.--You may return this contract to us within (1) 10 days
after you get it, or (2) 45 days after Part 1 of the application was signed, or
(3)10 days after we mail the Notice of Withdrawal Right. whichever is latest.
All you have to do is take the contract or mail it to one of our offices or to
the representative who sold it to you. It will be canceled from the start and we
will give back your money promptly.
Signed for Pruco Life Insurance Company,
an Arizona Corporation.
/s/ SPECIMEN /s/ SPECIMEN
Secretary President
Variable Life Insurance Policy. Insurance payable only upon death. Fixed
premiums payable during Insured's lifetime. Benefits reflect investment results.
Guaranteed minimum death benefit if premiums duly paid and no contract debt.
Non-participating.
VL--83--V
II-107
EXHIBIT A(5)(w)
SEPARATE ACCOUNT (Continued)
Change in Investment Policy.--A portfolio of the fund might make a material
change in its investment policy. In that case. we will send you a notice of the
change. Within 60 days after you receive the notice. or within 60 days after the
effective date of the change, if later, you may exchange this contract for a new
contract of fixed benefit insurance on the Insured's life. The conditions for
exchange, and the specifications for the new contract, are described under
Exchange of Contract on page 14.
Change of Fund.--A portfolio might, in our judgment, become unsuitable for
investment by a subaccount. This might happen because of a change in investment
policy, or a change in the laws or regulations, or because the shares are no
longer available for investment, or for same other reason. If that occurs, we
have the right to substitute another portfolio of the fund, or to invest in a
fund other than the one we show on the Contract Data page(s). But we would first
seek approval from the SEC and, where required, the insurance regulator where
this contract is delivered, and the insurance regulator of our domiciliary
state. The procedures to be followed in such cases are on file with the State
Corporation Commission of the State of Virginia.
INVESTMENT BASE AND RETURN ON INVESTMENT
Investment Base.--The investment base for this contract is the amount we use to
compute the excess investment return and the variable insurance amount. The
investment base is allocated among the subaccounts. The amount of the investment
base and its allocation to subaccounts depend on (1) how you choose to allocate
net premiums: (2) whether or not you transfer amounts among subaccounts, as we
discuss below; (3) the investment performance of the subaccounts to which
amounts are allocated or transferred: and (4) whether or not you take any loan.
The investment base exists only if the contract is in force with no premium in
default past its days of grace.
Base on Monthly Date.--On a Monthly Date. the investment base is equal to the
sum of these three items:
1. the net cash value on the Monthly Date (we explain net cash value under
Contract Value Options);
2. on any loan, the interest we have charged that is not yet due and that we
have not yet added to the loan (we explain these terms under Loans); and
3. during the first contract year, the issue charge instalments due during the
rest of the year (we show this charge on the Contract Data page(s).
Base on other Dates.--On a date other than a Monthly Date, the investment base
is equal to:
1. what it was on the prior Monthly Date; plus
2. any increase due to investment results in the value of the subaccounts to
which amounts are allocated; minus
3. any decrease due to investment results in the value of the subaccounts
to which amounts are allocated; minus
4. a charge against the investment base at a rate of not more than .0009572% a
day (.35% a year) for mortality and expense risks that we assume; minus
5. any amount charged against the investment base for federal or state income
taxes; minus
6. any loan you made since the prior Monthly Date; plus
7. any loan principal you paid back since the prior Monthly Date.
Assumed Rate of Return.--The assumed rate of return is an effective rate of 4% a
year. This is the same as .01074598% a day compounded daily. We use this daily
rate when we make computations for less than a whole year.
Excess Investment Return.--The excess investment return for any period is equal
to:
1. the investment base at the end of the period; minus
2. what the investment base would have been at the end of the period if: (a) the
value of the assets in the subaccounts to which amounts are allocated had earned
interest at a rate equal to the assumed rate of return during the period; and
(b) we had made no charge for the mortality and expense risks described in item
4 under Base on Other Dates, or for federal or state income taxes.
The excess investment return can be less than, equal to, or more than zero. If a
premium was paid and accepted under the terms of this contract, then for the
purpose of computing the excess investment return it will be deemed to have been
paid as of its due date.
Transfers Among Subaccounts.--You may transfer amounts among subaccounts as
often as four times in a contract year, if all due premiums have been paid. To
do so, you must notify us in writing and in a form that meets our needs. The
transfer will take effect on the date we receive your notice at our Service
Office.
Page 9 (VL--83) (VI)
II-108
EXHIBIT A(5)(x)
CONTRACT VALUE OPTIONS
(NONFORFEITURE BENEFITS ARE DESCRIBED HERE)
Benefit After the Grace Period.--If a premium is in default past its days of
grace and if the net cash value (which we describe under Cash Value Option) is
more than zero, we will use that value to keep the contract in force a: one of
two kinds of insurance. One kind is extended insurance. The other is reduced
paid-up insurance. We describe bath below. You will find under Automatic Benefit
which kind it will be. Any extra benefit(s) will, of course, end as soon as a
premium is in default past its days of grace unless the form that describes it
states otherwise.
Extended Insurance.--This will be term insurance on the Insured's life. We will
pay the amount of term insurance if the Insured dies in the term we describe
below. Before the end of the term there will be cash values but no loan value.
The amount of term insurance will be equal to the insurance amount on the due
date of the premium in default, minus any contract debt. The amount of the
insurance will not vary. The term is a period of time that will start on the due
date of the premium in default. The length of the term will be what is provided
when we use the net cash value as a net single premium for extended term
insurance. The length of the term will depend on the net cash value, the amount
of insurance, the Insured's issue age and sex, and on the length of time since
the contract date. (The net single premiums that we refer to here are not those
we show on the Contract Data page(s). The ones we show there are used to compute
the variable insurance amount.)
Example: Suppose the face amount is $50,000. On the day a premium is due, the
variable insurance amount is $5,140. There is contract debt of $1,300. If the
premium due is not paid at the end of its days of grace, the amount of term
insurance will be $53.840. This comes from the insurance amount of $55.140
(the face amount of $50,000 plus the variable insurance amount $5,140) minus
the $1,300 contract debt. The term insurance will last as long as the net cash
value will provide it.
There may be extra days of term insurance. This will occur if. on the due date
of the premium in default, the term of extended insurance provided by the net
cash value does not exceed 90 days, or the number of days for which premiums
have been paid, if less. The number of extra days will be (I) 90, or the number
of days for which premiums have been paid, if less, minus (2) the number of days
of extended insurance that would be provided by the net cash value, if there
were no contract debt. The extra days, if any, start on the day after the last
day of term insurance provided by the net cash value, if any. If there is no
such term insurance, they start on the due date of the premium in default. The
term insurance for the extra days has no cash value. There will be no extra days
if you replace the extended insurance with reduced paid-up insurance or you
surrender the contract before the extra days start.
Reduced Paid-Up Insurance.--This will be paid-up life insurance on the Insured's
life. We will pay the amount of this insurance when the Insured dies. There will
be cash values and loan values.
The amount of this insurance will be what is provided when we use the net cash
value at the net single premium rate. This rate depends on the Insured's issue
age and sex and on the length of time since the contract date. The amount of
this insurance will not vary.
Computations.--We will make all computations for either of these benefits as of
the due date of the premium in default. But we will consider any loan you take
out or pay back in the days of grace of that premium.
Automatic Benefit.--When a premium is in default past its days of grace, the
contract will stay in force as extended insurance. But it will stay in force as
reduced paid-up insurance if we issued the contract in a rating class for which
we do not provide extended insurance. In this case, the phrase No Extended
Insurance is in the Rating Class on page 3.
Optional Benefit.--You may choose to replace any extended insurance that has a
cash value by reduced paid-up insurance. To make this choice, you must do so in
writing to us and in a form that meets our needs, not more than three months
after the due date of the premium in default. You must also send the contract to
us to be endorsed.
Cash Value Option.--You may surrender this contract for its net cash value, if
this value is more than zero. If this value is less than zero, the proceeds on
surrender will be equal to zero. To do so, you must ask us in writing and in a
form that meets our needs. You must also send the contract to us. Here is how we
will compute the net cash value:
1. On a Monthly Date if no premium is in default: The net cash value on a
Monthly Date will be equal to (a) the tabular cash value on that date: plus (b)
the net single premium at the Insured's then attained age for the variable
insurance amount that applies on that date; minus (c) if that date is a premium
due date, and the premium has not
(Continued on Next Page)
Page 11 (VL--83)-W
II-109
EXHIBIT 1.A.(5)(y)
LOANS
Loan Requirements.--On or after the first contract anniversary, you may borrow
from us on the contract. All these conditions must be met:
1. The Insured is living.
2. The contract is in force other than as extended insurance.
3. The contract debt will not be more than the loan value. (We explain these
phrases below.)
4. As sole security for the loan, you assign the contract to us in a form that
meets our needs.
5. Except when used to pay premiums on this contract, the amount you borrow at
any one time must be at least $500.
If there is already contract debt when you borrow from us, we will add the new
amount you borrow to that debt.
Contract Debt.--Contract debt at any time means the loan on the contract plus
the interest we have charged that is not yet due and that we have not yet added
to the loan.
Loan Value.--During the first contract year the loan value is zero. After the
first contract year, it is 90% of the sum of the net cash value and any existing
contract debt.
If the difference between the loan value and any existing contract debt is $500
or more, you may borrow any amount from $500 up to that difference. If the
difference is less than $500, you may not borrow any amount unless it is to pay
premiums on this contract.
Example 1: Suppose the net cash value is $8,000. You borrowed $1,500 a few
months ago. Suppose also that now there is interest of $40 charged but not yet
due. The contract debt is now $1,540, which is made up of the $1,500 loan and
the $40 interest.
Example 2: Suppose, in example 1, you want to borrow all that you can. The loan
value is $8,586: to compute it we add the net cash value ($8,000, to the
contract debt ($7,540) and take 90% of the sum. We will lend you $7,046 which is
the difference between the $8,586 loan value and the $1,540 contract debt. This
will increase the contract debt to $8,586. We will add the new amount borrowed
to the existing loan and will charge interest on it, too.
There are three exceptions to the above definition of loan value. The first is
that in the days of grace of a premium in default, the loan value is what it was
on the due date of that premium, plus 90% of the excess investment return since
that date. The second is that if the contract is in force as reduced paid-up
insurance we use anniversaries and not premium due dates to find the loan value
since there are no more of those due dates. The third is that if the contract is
in force as reduced paid-up insurance, the loan value is the amount that would
grow with interest to equal the net single premium on the next anniversary.
Interest Charge.--We will charge interest daily on any loan. The loan interest
rate is 51 1/2% a year. Interest is due on each contract anniversary, or when
the loan is paid back if that comes first. If interest is not paid when due, it
will become part of the loan. Then we will start to charge interest on it, too.
Example 3: Suppose the contract date is in 1987. Six months before the
anniversary in 1996 you borrow $1,000 out of a $4,000 loan value. Three months
later, but still three months before the anniversary, we will have charged about
$13.75 interest. This amount will be a few cents more or less than $13.75 since
some months have more days than others. The interest will not be due until the
anniversary unless the loan is paid back sooner. The loan will still be $1,000.
The contract debt will be $1,013, since contract debt includes interest charged
but not yet due. On the anniversary in 1996 we will have charged about $27.50
interest. The interest will then be due.
Example 4: Suppose the $27.50 interest in example 3 is paid on the anniversary.
The loan and contract debt will each become $1,000 right after the payment.
Example 5: Suppose the $27.50 interest in example 3 is not paid on the
anniversary. The interest will become part of the loan, and we will begin to
charge interest on it, too. The loan and contract debt will each become
$1,027.50.
Repayment.--All or part of any contract debt may be paid back at any time while
the Insured is living. But if there is contract debt at the end of the last day
of grace of a premium in default, it may be paid back only if the contract is
reinstated. When we settle the contract, any contract debt is due us. We will
make an adjustment so that the proceeds will not include the amount of that
debt.
(Continued on Next Page)
Page 13 (VL--83) (VI)
II-110
EXHIBIT 1.A(5)(z)
LOANS
Loan Requirements.--On or after the first contract anniversary, you may borrow
from us on the contract. All these conditions must be met:
1. The Insured must be living.
2. The contract must be in force other than as extended insurance.
3. The contract debt will not be more than the loan value. (We explain these
phrases below.)
4. As sole security for the loan, you must assign the contract to us in a form
that meets our needs.
5. Except when used to pay premiums on this contract, the amount you borrow at
any one time must be at least $500.
If there is already contract debt when you borrow from us, we will add the new
amount you borrow to that debt.
Contract Debt.--Contract debt at any time means the loan on the contract plus
the interest we have charged that is not yet due and that we have not yet added
to the loan.
Loan Value.--During the first contract year the loan value is zero. After the
first contract year, it is 90% of the sum of the net cash value and any existing
contract debt.
If the difference between the loan value and any existing contract debt is $500
or more, you may borrow any amount from $500 up to that difference. If the
difference is less than $500, you may not borrow any amount unless it is to pay
premiums on this contract.
Example 1: Suppose the net cash value is $8,000. You borrowed $1,500 a few
months ago. Suppose also that now there is interest of $40 charged but not yet
due. The contract debt is now $7,540, which is made up of the $1,500 loan and
the $40 interest.
Example 2: Suppose, in example 1, you want to borrow all that you can. The loan
value is $8,586; to compute it we add the net cash value ($8,000) to the
contract debt ($1,540) and take 90% of the sum. We will lend you $7,046 which is
the difference between the $8,586 loan value and the $1,540 contract debt. This
will increase the contract debt to $8,586. We will add the new amount borrowed
to the existing loan and will charge interest on it, too.
There are three exceptions to the above definition of loan value. The first is
that in the days of grace of a premium in default, the loan value is what it was
on the due date of that premium, plus 90% of the excess investment return since
that date. The second is that if the contract is in force as reduced paid-up
insurance we use anniversaries and not premium due dates to find the loan value
since there are no more of those due dates. The third is that if the contract is
in force as reduced paid-up insurance, the loan value is the amount that would
grow with interest to equal the net single premium on the next anniversary.
Interest Charge.--We will charge interest daily on any loan. Interest is due on
each contract anniversary, or when the loan is paid back if that comes first. If
interest is not paid when due, it will become part of the loan. Then we will
start to charge interest on it, too.
The loan interest rate is the annual rate we set from time to time. The rate
will never be greater than is permitted by law, 18%. It will change only on a
contract anniversary.
Before the start of each contract year, we will determine the loan interest rate
we can charge for that contract year. To do this, we will first find the rate
that is the greater of (1) The Published Monthly Average (which we describe
below) for the calendar month ending two months before the calendar month of the
contract anniversary; and (2) the assumed rate of return for this contract, plus
1%.
If that greater rate is at least 1/2% more than the loan interest rate we had
set for the current contract year, we have the right to increase the loan
interest rate by at least 1/2%, up to the lesser of 18% and that greater rate.
If it is at least 1/2% less, we will decrease the loan interest rate to be no
more than the greater rate. We will not change the loan interest rate by less
than 1/2%.
When you make a loan we will tell you the initial interest rate for the loan. We
will send you a notice if there is to be an increase in the rate.
The Published Monthly Average means:
1. Moody's Corporate Bond Yield Average--Monthly Average Corporates, as
published by Moody's Investors Service, Inc. or any successor to that service;
or
2. If that average is no longer published, a substantially similar average,
established by the insurance regulator where this contract is delivered.
Example 3: Suppose the contract date is in 1987. Six months before the
anniversary in 1996 you borrow $1,000 out of a $4,000 loan value. Assume we
charge 8% a year. Three months later, but still three months before the
anniversary, we will have charged about $20 interest, This amount will be a few
cents more or less than $20 since some months have more days than others. The
interest will not be due until the anniversary unless the loan is paid back
sooner. The loan will still be $1,000. The contract debt will be $1,020. since
contract debt includes interest charged but not yet due. On the anniversary in
1996 we will have charged about $40 interest. The interest will then be due.
(Continued on Next Page)
Page 13 (VL--83)(KY)
II-111
EXHIBIT A(5)(aa)
(Only we can endorse this contract.)
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 the owner of the contract is
the applicant for it. But if the applicant is not living the owner, except as we
state below, is the beneficiary(ies) who at the time would be entitled to any
proceeds arising from the Insured's death. If there is no such beneficiary at
the time, the owner is the Insured. A beneficiary named by the Insured will not
replace the Insured as owner.
After the Insured is 21 years of age, the owner is the Insured.
While the Insured is living the owner alone is entitled to any contract benefit
and value, and to the exercise of any right and privilege granted by the
contract or by us. This includes, but is not limited to, these rights: (1) to
assign the contract; and (2) to change any subsequent owner. A request for such
a change must be in writing to us at our Service Office and in a form which
meets our needs. The change will take effect only when we endorse the contract
to show it.
If the owner is the Insured, but he or she (1) is not able, due to age, to
exercise rights, and (2) has no legal guardian to do so, we have the right to
let a person who appears to us to be responsible for the Insured's support or
welfare, act for the Insured. We will not do so unless the action appears to us
to be for the Insured's benefit.
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
___________________________
Secretary
PLI 25--82 Printed in U.S.A.
II-112
EXHIBIT A(5)(bb)
(Only we can endorse this contract.)
This endorsement is attached to and made a part of this contract on the contract
date:
Beginning in 1986 you may be able to surrender all or part of any existing
Variable Insurance Amount and receive its cash value without surrendering the
contract. The total death benefit will be reduced by the portion of Variable
Insurance Amount which you surrender. The net cash value of the contract will be
reduced by an amount which we compute by multiplying the portion of the Variable
Insurance Amount which you surrender by the net single premium at the Insured's
attained age on the date of the surrender; we show net single premiums on the
Contract Data page(s). The guaranteed minimum death benefit will be reduced such
that the difference between the total death benefit and the guaranteed minimum
death benefit is the same percentage of cash value before and after surrender.
The cash value of the surrendered Variable Insurance Amount must be at least
$500, and in multiples of $100 if greater, unless it is used to pay premiums on
this contract or on other contracts with us.
You may make no more than two such surrenders in a contract year without our
permission.
If you ask us in writing in a form that meets our needs, we will tell you:
1. Your Variable Insurance Amount;
2. The cash value of your Variable Insurance Amount;
3. The reduction in total death benefit and guaranteed minimum death
benefit if you surrender all of your Variable Insurance Amount; and
4. The reduction in total death benefit and guaranteed minimum death
benefit if you surrender a permitted amount of your choice which is less
than all of your Variable Insurance Amount.
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
___________________________
Secretary
PLI 104--84 Printed in U.S.A
II-113
EXHIBIT 1.A.(5)(cc)
(Only we can endorse this contract.)
This endorsement is attached to and made a part of this contract on the contract
date.
ALTERATION OF TEXT
The section captioned "Excess Investment Return" on page 9 is amended to read as
follows.
Excess Investment Return.--The excess investment return for any period is equal
to:
1. the investment base at the end of the period; minus
2. what the investment base would have been at the end of the period if: (a) the
value of the assets in the subaccounts to which amounts are allocated had earned
interest at a rate equal to the assumed rate of return during the period; and
(b) we had made no charge for the mortality and expense risks described in item
4 under Base on Other Dates, or for federal or state income taxes; plus
3. an amount that we determine for this contract, which is the difference
between the guaranteed cost of mortality (see Mortality Tables Described on page
19) and any lower cost of mortality we set, based on the attained age and sex of
the Insured and the length of time the contract has been in force; this amount
will never be less than zero.
We set the cost of mortality based on our expectations as to future mortality
experience. At least once every five years, but no more often than once a year,
we will consider the need to change the cost of mortality. We will change it
only if we do so for all contracts like this one in force for the same length of
time as this one on Insureds of the same attained age and sex.
The excess investment return can be less than, equal to, or more than zero. If a
premium was paid and accepted under the terms of this contract, then for the
purpose of computing the excess investment return it will be deemed to have been
paid as of its due date.
Pruco Life Insurance Company,
By SPECIMEN SIGNATURE
___________________________
Secretary
- -----------
PLI 134--84
- -----------
II-114
EXHIBIT 1.A.(5)(dd)
ThePrudential [LOGO] Pruco Life Insurance Company
a Subsidiary of
The Prudential Insurance Company of America
NOTICE
Pruco Life's goal is to provide our planholders with fast and personal
service.
If you have any need for service with or a question about your Pruco
Life insurance, please contact your Pruco Life representative. You may
also call the staff of the Pruco Life office in your locale for
assistance or the Pruco Life office named below.
Should you desire any more help with a problem, assistance may be
requested of the Illinois State Department identified below.
Pruco Life State
Consumer Affairs Unit Illinois Department of Insurance
Pruco Life Insurance Company Consumer Service Section
North Central Service Office Springfield, Illinois 62767
P.O. Box 1505
Minneapolis, MN 55440
- -------
PLI 109 ED 6-84
- -------
II-115
EXHIBIT 1.A.(5)(ee)
Prudential Pruco Life Insurance Company
- ---------- A Subsidiary of
The Prudential Insurance Company of America
COMPLAINT NOTICE: Should any dispute arise about your premiums or consideration
or about a claim that you have filed, contact the agent who sold you this
contract or write to the company that issued the contract. If the problem is not
resolved, you may write the State Board of Insurance, Department C, 1110 San
Jacinto, Austin, Texas 78786.
(This notice of complaint procedure is for information only and does not become
a part or condition of this contract.)
- -------
PLI 118 Ed 9-84
- -------
II-116
EXHIBIT 1.A.(5)(ff)
(Only we can endorse this contract.)
Right to Buy a New Contract.--Some provisions of this form refer to the right of
an individual, subject to certain conditions, to obtain a new contract of
insurance from The Prudential Insurance Company of America. Prudential has
agreed to this arrangement, as shown by the following Certification.
CERTIFICATION
The Prudential Insurance Company of America is aware that some provisions of
this Pruco Life Insurance Company form provide an individual the right, subject
to certain conditions, to obtain a new contract of insurance from Prudential.
We certify that if any such individual wishes to exercise that right Prudential
will make available to that individual the contract described in this form.
Signed for The Prudential Insurance Company of America,
SPECIMEN SIGNATURE
President
SPECIMEN SIGNATURE
Vice President
If The Prudential Insurance Company of America is not engaged in the insurance
business at the time an individual wishes to exercise this right to buy a new
contract, Pruco Life Insurance Company will make available to that individual a
contract that it currently issues.
This endorsement attached to the contract on the Contract Date
By SPECIMEN SIGNATURE
____________________________
Secretary
- -----------
PLI 150--84
- -----------
II-117
EXHIBIT 1.A.(5)(gg)
(Only we can endorse this contract.)
ALTERATION OF TEXT
The provision of this policy entitled "CONTRACT VALUE OPTIONS" is replaced at
issue by the following:
Benefit After the Grace Period.--If a premium is in default past its days of
grace and if the net cash value (which we describe under Cash Value Option) is
more than zero, we will use that value to keep the contract in force as one of
three kinds of insurance. One kind is extended insurance; another kind is
reduced paid-up insurance; and the third kind is variable reduced paid-up
insurance. We describe them below. You will find under Automatic Benefit which
kind it will be. Any extra benefit(s) will, of course, end as soon as a premium
is in default past its days of grace unless the form that describes it states
otherwise.
Extended Insurance.--This will be term insurance on the Insured's life. We will
pay the amount of term insurance if the Insured dies in the term we describe
below. Before the end of the term there will be cash values but no loan value.
The amount of term insurance will be equal to the insurance amount on the due
date of the premium in default, minus any contract debt. The amount of the
insurance will not vary. The term is a period of time that will start on the due
date of the premium in default. The length of the term will be what is provided
when we use the net cash value as a net single premium for extended term
insurance. The length of the term will depend on the net cash value, the amount
of insurance, the Insured's issue age and sex, and on the length of time since
the contract date. (The net single premiums that we refer to here are not those
we show on the Contract Data page(s). The ones we show there are used to compute
the variable insurance amount.)
Example: Suppose the face amount is $50,000. On the day a premium is due, the
variable insurance amount is $5,140. There is contract debt of $1,300. If the
premium due is not paid at the end of its days of grace, the amount of term
insurance will be $53,840. This comes from the insurance amount of $55,140 (the
face amount of $50,000 plus the variable insurance amount $5,140) minus the
$1,300 contract debt. The term insurance will last as long as the net cash value
will provide it.
There may be extra days of term insurance. This will occur if, on the due date
of the premium in default, the term of extended insurance provided by the net
cash value does not exceed 90 days, or the number of days for which premiums
have been paid, if less. The number of extra days will be (1) 90, or the number
of days for which premiums have been paid, if less, minus (2) the number of days
of extended insurance that would be provided by the net cash value, if there
were no contract debt. The extra days, if any, start on the day after the last
day of term insurance provided by the net cash value, if any. If there is no
such term insurance, they start on the due date of the premium in default. The
term insurance for the extra days has no cash value. There will be no extra days
if you replace the extended insurance with reduced paid-up insurance or variable
reduced paid-up insurance or if you surrender the contract before the extra days
start.
Reduced Paid-up Insurance.--This will be paid-up life insurance on the Insured's
life. We will pay the amount of this insurance when the Insured dies. There will
be cash values and loan values. The amount of this insurance will be what is
provided when we use the net cash value at the net single premium rate. This
rate depends on the Insured's issue age and sex and on the length of time since
the contract date. The amount of this insurance will not vary.
Variable Reduced Paid-up lnsurance.--This will be paid-up variable life
insurance on the Insured's life. The death benefit may change from day to day,
as we explain below, but if there is no contract debt, it will not be less than
a minimum guaranteed amount determined as of the day when the contract went into
default. There will be cash values and loan values.
The minimum guaranteed amount of insurance will be computed by using the net
cash value at the net single premium rate. The net single premium rate depends
on the Insured's issue age and sex and on the length of time since the contract
date. The amount payable in event of death thereafter will be the greater of (a)
the minimum guaranteed amount and (b) the investment base divided by the net
single premium at the Insured's attained age. In either case the amount will be
adjusted for any contrect debt.
Except when it is provided as the automatic benefit, (see below) the Variable
Reduced Paid Up lnsurance Option will be available only when the guaranteed
death benefit under the option will be $5,000 or more.
(Continued on Next Page)
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PLI 168--85
- -----------
II-118
<PAGE>
ALTERATION OF TEXT (Continued)
Computations.--We will make all computations for any of these benefits as of the
due date of the premium in default. But we will consider any loan you take out
or pay back in the days of grace of that premium.
Automatic Benefit.--When a premium is in default past its days of grace, the
contract will stay in force as extended insurance. But it will stay in force as
variable reduced paid-up insurance if either of these statements applies: (1) We
issued the contract in a rating class for which we do not provide extended
insurance; in this case the phrase No Extended Insurance is in the Rating Class
on page 3. (2) The amount of variable reduced paid-up insurance would be at
least as great as the amount of extended insurance.
Optional Benefit.--You may choose to replace any extended insurance that has a
cash value by either variable reduced paid-up insurance or reduced paid-up
insurance. To make this choice, you must do so in writing to us and in a form
that meets our needs, not more than three months after the due date of the
premium in default. You must also send the contract to us to be endorsed.
Cash Value Option.--You may surrender this contract for its net cash value, if
this value is more than zero. If this value is less than zero, the proceeds on
surrender will be equal to zero. To do so, you must ask us in writing and in a
form that meets our needs. You must also send the contract to us. Here is how we
will compute the net cash value:
1. On a Monthly Date if no premium is in default: The net cash value on a
Monthly Date will be equal to (a) the tabular cash value on that date; plus (b)
the net single premium at the Insured's then attained age for the variable
insurance amount that applies on that date; minus (c) if that date is a premium
due date, and the premium has not been paid, the net premium that applies on
that date; minus (d) any contract debt; minus (e) in the first contract year,
any issue charge instalments that have not yet been paid. The amount of (b) will
be less than zero if the variable insurance amount is less than zero.
2. On any other date if no premium is in default: The net cash value on a date
other than a Monthly Date will be equal to (a) the tabular cash value on that
date; plus (b) the net single premium at the Insured's then attained age for the
variable insurance amount that applies on that date; plus (c) the excess
investment return since the last Monthly Date; minus (d) any contract debt;
minus (e) in the first contract year, any issue charge instalments that have not
yet been paid. The amount of (b) will be less than zero if the variable
insurance amount is less than zero.
3. During the days of grace of a premium in default: The net cash value on any
date will be the net cash value as of the due date of the first unpaid premium
plus the excess investment return since that due date. But we will adjust this
value for any loan you took out or paid back since that due date.
4. After the days of grace of a premium in default: The net cash value as of any
date will be the net value on that date of whichever of these benefits is then
in force: extended insurance; reduced paid-up insurance; or variable reduced
paid-up insurance, less any contract debt. However, within 30 days after an
anniversary, the net cash value will not be less than it was on that
anniversary. We will, of course, adjust it for any loan you took out or paid
back since that anniversary.
If the due date of a paid premium is on or after the date a contract value
option takes effect, we will pay that premium to you in cash.
If all due premiums have been paid, or during the days of grace of a premium in
default, or if the contract is in force as variable reduced paid-up insurance,
we will usually pay any cash value within 7 days after we receive your request
and the contract at our Service Office. But we have the right to defer payment
if (1) the New York Stock Exchange is closed; or (2) the SEC requires that
trading be restricted or declares an emergency; or (3) the SEC lets us defer
payments to protect our contract owners.
If a premium is in default past its days of grace, we have the right to postpone
paying a cash value for up to six months. If we do so for more than 30 days, we
will pay interest at the rate of 3% a year.
Tabular Values.--ln the table on page 4 we show tabular values at the ends of
contract years. The tabular value at the beginning of the first contract year is
the net premium then due. If we need to compute tabular values at some time
during a contract year, we will count the time since the start of the year and
any premiums paid for the year. We will let you know the tabular values for
other durations if you ask for them.
Rider attached to and made a part of this contract on the
Contract Date
Pruco Life Insurance Company,
By /S/ ISABELLE L. KIRCHNER
-------------------------
Secretary
- -----------
PLI 168--85
- -----------
II-119
<TABLE>
<CAPTION>
EXHIBIT 1.A.(10)(a)
<S> <C>
- ----------------------------------------------------===============================================================================
Part 1 Application for Life Insurance to
[Prudential LOGO] [ ] The Prudential Insurance Company of America
[ ] Pruco Life Insurance Company
A Subsidiary of The Prudential Insurance Company of America
No.
- -----------------------------------------------------------------------------------------------------------------------------------
1a. Proposed Insured's name--first, initial, last (Print) 1b. Sex 2a. Date of birth 2b. Age 2c. Place of birth
M F Mo. Day Yr.
[ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
3. [ ] Single [ ] Married [ ] Widowed [ ] Separated [ ] Divorced 4. Social Security No. / /
- -----------------------------------------------------------------------------------------------------------------------------------
5a. Occupation(s) 5b. Duties
- -----------------------------------------------------------------------------------------------------------------------------------
6. Address for mail No. Street City State Zip
- -----------------------------------------------------------------------------------------------------------------------------------
7a. Kind of policy 7b. Initial amount 8. Accidental death coverage
$ initial amount
If a Variable contract is applied for complete appropriate suitability form. $
- -----------------------------------------------------------------------------------------------------------------------------------
9. Beneficiary: (Include name, age and relationship.) 10. List all life insurance on proposed Insured. Check here if None [ ]
a. Primary (Class 1): Company Initial Yr. Kind Medical
amt. issued (Indiv., Group) Yes No
______________________________________ [ ] [ ]
________________________________________________________________________
_______________________________________________________ [ ] [ ]
________________________________________________________________________
b. Contingent (Class 2) if any: [ ] [ ]
________________________________________________________________________
____________________________________________________ [ ] [ ]
________________________________________________________________________
[ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
11. Other person(s) proposed for coverage including the Applicant for Applicant's Waiver of Premium benefit (AWP)
Relationship to Date of birth Total life insurance
Name--first, initial, last Sex proposed Insured Mo. Day Yr. Age Place of birth in all companies
a. Spouse $
___________________________________________________________________________________________________________________________________
b. $
___________________________________________________________________________________________________________________________________
c. $
___________________________________________________________________________________________________________________________________
d. $
___________________________________________________________________________________________________________________________________
e. $
___________________________________________________________________________________________________________________________________
f. $
- -----------------------------------------------------------------------------------------------------------------------------------
12. Supplementary benefits and riders: a. For proposed Insured b. For spouse, children, Applicant for AWP
Type and duration of benefit Amount Type and duration of benefit Amount
$ $
___________________________________________________________________________________________________________________________________
$ $
___________________________________________________________________________________________________________________________________
$ $
___________________________________________________________________________________________________________________________________
$ $
___________________________________________________________________________________________________________________________________
[ ] Option to Purchase Additional Ins. $ [ ] Applicant's Waiver of Premium benefit
- -----------------------------------------------------------------------------------------------------------------------------------
13. State any special request.
- -----------------------------------------------------------------------------------------------------------------------------------
14. Has any person named in 1a or 11, within the last 12 months:
a. been treated by a doctor for or had a known heart attack, stroke or cancer (including melanoma) other Yes No
than of the skin? ............................................................................................. [ ] [ ]
b. had an electrocardiogram for any physical complaint, or taken medication for high blood pressure? ............. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
15. Premium payable [ ] Ann. [ ] Semi-Ann. [ ] Quar. [ ] Mon. [ ] Pay. Budg. [ ] Pru-Matic [ ] Gov't. Allot.
- -----------------------------------------------------------------------------------------------------------------------------------
16. Amount paid $ [ ] None (Must be "None" if either 14a or b is answered "Yes".)
- -----------------------------------------------------------------------------------------------------------------------------------
17. Is a medical examination to be made on: Yes No
a. the proposed Insured? ......................................................................................... [ ] [ ]
b. spouse (if proposed for coverage)? ............................................................................ [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
18. If 17a or b is "Yes", is it agreed that no insurance will take effect on anyone proposed for coverage until Yes No
the person(s) indicated in 17 have been examined, even if 16 shows that an amount has been paid? ................. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
ORD 84376-86 Page 1 (Continued on page 2)
</TABLE>
II-120
<PAGE>
<TABLE>
<CAPTION>
<S> <C>
- -----------------------------------------------------------------------------------------------------------------------------------
Continuation of Part 1 of Application
- -----------------------------------------------------------------------------------------------------------------------------------
19. Will this insurance replace or change any existing insurance or annuity in any company on any person named Yes No
in 1a or 11? If "Yes", give their names, name of company, plan, amount, policy numbers and enclose any [ ] [ ]
required state replacement form(s).
- -----------------------------------------------------------------------------------------------------------------------------------
20. Is anyone applying for, or trying to reinstate, life or health insurance on any person named in 1a or 11 in Yes No
this or any company? If "Yes", give amount, details and company. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
21. Does any person named in 1a or 11 plan to live or travel outside the United States and Canada within the Yes No
next 12 months? If "Yes", give country(ies), purpose and duration of trip. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
22. Has any person named in 1a or 11 operated or had any duties aboard an aircraft, glider, balloon, or like Yes No
device, within the last 2 years, or does any such person have any plans to do so in the future? If "Yes", [ ] [ ]
complete Aviation Questionnaire.
- -----------------------------------------------------------------------------------------------------------------------------------
23. Has any person named in 1a or 11 engaged in hazardous sports such as: auto, motorcycle or power boat Yes No
sports; bobsledding, scuba or skin diving; mountain climbing; parachuting or sky diving; snowmobile [ ] [ ]
racing or any other hazardous sport or hobby within the last 2 years or does any such person plan to
do so in the future? If "Yes", complete Avocation Questionnaire.
- -----------------------------------------------------------------------------------------------------------------------------------
24. Has any person (age 15 or over) named in 1a or 11 in the last 3 years: Yes No
a. had a driver's license denied, suspended or revoked? ......................................................... [ ] [ ]
b. been convicted of three or more moving violations of any motor vehicle law or of driving while under
the influence of alcohol or drugs? ........................................................................... [ ] [ ]
c. been involved as a driver in 2 or more auto accidents? ....................................................... [ ] [ ]
If "Yes", give name, driver's license number and state of issue, type of violation and reason for license
denial, suspension or revocation.
- -----------------------------------------------------------------------------------------------------------------------------------
25. a. Has the proposed Insured smoked cigarettes within the past twelve months? .............................. Yes [ ] No [ ]
b. Has the spouse (if proposed for coverage) smoked cigarettes within the past twelve months? ............. Yes [ ] No [ ]
c. If the proposed Insured or spouse has ever smoked cigarettes, cigars or a pipe, show date(s) last smoked:
Cigarettes Cigars Pipe
Proposed Insured Mo. _______ Yr. _______ Mo. _______ Yr. _______ Mo._______ Yr. _______
Spouse Mo. _______ Yr. _______ Mo. _______ Yr. _______ Mo._______ Yr. _______
- -----------------------------------------------------------------------------------------------------------------------------------
26. Changes made by the Company. (Not applicable in West Virginia)
- -----------------------------------------------------------------------------------------------------------------------------------
To the best of the knowledge and belief of those who sign below, the statements in this application are complete and true. It
is understood that, if any of the above statements (for example, the smoking data) is a material misrepresentation, coverage
could be invalidated as a result. The beneficiary named in the application is for insurance payable upon death of (1) the Insured,
and (2) an insured child after the death of the Insured if there is no insured spouse.
When the Company gives a Limited Insurance Agreement form, ORD 84376A-86, of the same date as this Part 1, coverage will start as
shown in that form. Otherwise, no coverage will start unless: (1) a contract is issued, (2) it is accepted, and (3) the full first
premium is paid while all persons to be covered are living and their health remains as stated in Parts 1 and 2. If all these take
place, coverage will start on the contract date. If the Company makes a change as indicated in 26 it will be approved by acceptance
of the contract. But where the law requires written consent for any change in the application, such change can be made only if those
who sign this form approve the change in writing. No agent can make or change a contract, or waive any of the Company's rights or
needs.
Ownership: Unless otherwise asked for above, the owner of the contract will be (1) the applicant if other than the proposed Insured,
otherwise (2) the proposed Insured. But this is subject to any automatic transfer of ownership stated in the contract.
--------------------------------------------------------------------
Signature of Proposed Insured (If age 8 or over)
Dated at on , 19
- ----------------------------------------------------------- --------------------------------------------------------------------
(City/State) Signature of Applicant (If other than proposed Insured --
If applicant is a firm or corporation, show that company's name
Witness By
- ----------------------------------------------------------- --------------------------------------------------------------------
(Licensed agent must witness where required by law) (Signature and title of officer signing for that company)
- -----------------------------------------------------------------------------------------------------------------------------------
ORD 84376-86 Page 2
</TABLE>
II-121
<PAGE>
<TABLE>
<S> <C>
- -----------------------------------------------------------------------------------------------------------------------------------
Part 2 of Application--Complete on persons indicated if anyone named in 1a & 11 of Part 1 is eligible on a non-medical basis.
- -----------------------------------------------------------------------------------------------------------------------------------
Complete 1 only on Proposed Insured's family 2. Height and weight of:
1. Family Living Dead a. Proposed Insured Ht. __________ Wt. __________
Record (give age) Cause of Death Age Year b. Spouse Ht. __________ Wt. __________
c. Applicant for AWP Ht. __________ Wt. __________
Father
- --------------------------------------------------------------- Has the weight changed more than 10 pounds in the past year
Mother on any person proposed for coverage? Yes [ ] No [ ] (If "Yes",
- --------------------------------------------------------------- give name and reason for change)
Brothers -------------------------------------------------
- ---------------------------------------------------------------
Sisters -------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
3. When was a doctor last consulted by: a. Proposed Insured? b. Spouse? c. Applicant for AWP?
(Give details in 10.) Mo. _____ Yr. _____ Mo. _____ Yr. _____ Mo. _____ Yr. _____
- -----------------------------------------------------------------------------------------------------------------------------------
4. Is any person to be covered now being treated or taking medicine for any condition or disease? ............. Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
5. Has any person to be covered ever: Yes No
a. had any surgery or been advised to have surgery and has not done so? ............................................ [ ] [ ]
b. been in a hospital, sanitarium or other institution for observation, rest, diagnosis or treatment? .............. [ ] [ ]
c. used or is any such person now using valium or other tranquilizers; barbiturates or other sedatives; marijuana,
cocaine, hallucinogens or other mood-altering drugs; heroin, methadone or other narcotics; amphetamines or
other stimulants; or any other narcotics or controlled substances, except as legally prescribed by a doctor? .... [ ] [ ]
d. been treated or counseled for alcoholism or other drug dependency? .............................................. [ ] [ ]
e. had life or health insurance declined, postponed, changed, rated-up or withdrawn? ............................... [ ] [ ]
f. had life or health insurance canceled, or its renewal or reinstatement refused? ................................. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
6. Has any person to be covered ever been treated by a doctor for or had any known sign of:
Yes No Yes No
a. high blood pressure? ................... [ ] [ ] d. asthma, emphysema or tuberculosis? ....................... [ ] [ ]
b. chest pain, pressure or discomfort? .... [ ] [ ] e. tumor, cancer, leukemia, diabetes or syphillis? .......... [ ] [ ]
c. heart murmur or rheumatic fever? ....... [ ] [ ] f. nervous trouble, convulsions, epilepsy or mental disorder? [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
7. Other than as shown above, has any person to be covered ever been treated by a doctor for or had any known sign of a disease
or disorder of the: Yes No Yes No
a. heart, arteries or veins? .............. [ ] [ ] e. kidney, bladder, genital organs or urinary tract? ........ [ ] [ ]
b. lungs, chest or throat? ................ [ ] [ ] f. liver, gallbladder, stomach, intestines or rectum? ....... [ ] [ ]
c. brain or nervous system? ............... [ ] [ ] g. blood, glands or skin? ................................... [ ] [ ]
d. spine, joints, skull or other bones? ... [ ] [ ] h. ears, eyes, nose or sinuses? ............................. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
8. Other than as shown above, in the past 5 years has any person to be covered: Yes No
a. consulted or been attended or examined by any doctor or other practitioner? ...................................... [ ] [ ]
b. had electrocardiograms, X-rays for diagnosis or treatment, or blood, urine, or other medical tests? .............. [ ] [ ]
c. made claim for or received benefits, compensation, or a pension because of sickness or injury? ................... [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
9. Does any person to be covered now have a known sign of any physical disorder, disease or defect not shown above? Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
10. What are the full details of the answer to 3 and to each part of 4 thru 9 which is answered "Yes"?
Name & Illness, operation or other reason. Reason for any Dates and Full names and addresses
Question No. check-up, doctor's advice, treatment and medication. duration of illness of doctors and hospitals
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
- -----------------------------------------------------------------------------------------------------------------------------------
To the best of my knowledge and belief the above statements are complete and true. It is understood that, if any of the above
statements is a material misrepresentation, coverage should be invalidated as a result.
, 19
- --------------------- ------------------------------------ -------------------------------------------------------------------
Date Witness Signature of Proposed Insured (If age 15 or over) otherwise Applicant
- -----------------------------------------------------------------------------------------------------------------------------------
ORD 84376-86 Page 3
</TABLE>
II-122
EXHIBIT 1.A.(10)(b)
The Prudential Insurance Company of America No. XX XXX XXX
A Supplement to the Life Insurance Application for a variable contract in which
John Doe is named as the proposed Insured.
- --------------------------------------------------------------------------------
I BELIEVE THIS CONTRACT MEETS MY INSURANCE NEEDS AND FINANCIAL OBJECTIVES. I
ACKNOWLEDGE RECEIPT OF A CURRENT PROSPECTUS FOR THE CONTRACT. I UNDERSTAND THAT
THE CONTRACT'S VALUE AND DEATH BENEFIT MAY VARY DEPENDING ON THE CONTRACT'S
INVESTMENT EXPERIENCE............................................YES [X] NO [ ]
Date Signature of Applicant
Aug 3, 1987 /s/ JOHN DOE
- --------------
ORD. 86218--83
- --------------
II-123
<TABLE>
<CAPTION>
Prudential EXHIBIT A(10)(c)
- -----------------------------------------------------------------------------------------------------------------------------------
APPLICATION FOR LIFE INSURANCE
LOGO
----------------------------------------------------
Proposed Insured
- -----------------------------------------------------------------------------------------------------------------------------------
Submitted By
- -----------------------------------------------------------------------------------------------------------------------------------
<S> <C>
----------------------- -------------------- ------------------------------ ---------------------- -------------------
Name & Title Contract No. Agcy. No./Rep. Init. Office Code Detached Office
_____% ----------------------- -------------------- ------------------------------ ---------------------- -------------------
Credit
- -----------------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
[ ] Debit Ord. [ ] New Acct. [ ] Existing Acct. No. of Apps.__________ Fam. Acct. No.
-------------------------------------------------------------------------------------------------------------
[ ] Reg. Ord. Premium Quoted/Scheduled Premium Payment $______________________________________ (According to mode selected)
-------------------------------------------------------------------------------------------------------------
[ ] Pruco FOR FIELD OFFICE STAFF TO COMPLETE: Control No. _________ County Code __________
- -----------------------------------------------------------------------------------------------------------------------------------
ORD 84376 82 MARYLAND
</TABLE>
II-124
<PAGE>
<TABLE>
<CAPTION>
<S> <C>
- -----------------------------------------------------------------------------------------------------------------------------------
Part 1 Application to No.
[ ] The Prudential Insurance Company of America
[ ] Pruco Life Insurance Company -- A Subsidiary of The Prudential Insurance Company of America
- -----------------------------------------------------------------------------------------------------------------------------------
1a. Proposed Insured's name -- first, initial, last (Print) 1b. Sex 2a. Date of birth 2b. Age 2c. Place of birth
Mo. Day Yr.
[ ]M [ ]F
- -----------------------------------------------------------------------------------------------------------------------------------
3. [ ] Single [ ] Married [ ] Widowed [ ] Separated [ ] Divorced 4. Occupation(s)
- -----------------------------------------------------------------------------------------------------------------------------------
5. Address for mail No. Street City State Zip
- -----------------------------------------------------------------------------------------------------------------------------------
6a. Kind of policy 6b. Initial amount 7. Accidental death coverage
$ initial amount $
- -----------------------------------------------------------------------------------------------------------------------------------
8. Beneficiary: (Include name, age and relationship.) 9. List all life insurance on proposed Insured. (If NONE, so state.)
a. Primary (Class 1): b. Contingent (Class 2) if any: Initial Yr. Kind Medical
Company amt. issued (Indiv., Group) Yes No
[ ] [ ]
_________________________________________________________ ___________________________________________________________________
For insurance payable upon death of (1) the Insured, and [ ] [ ]
(2) an insured child after the death of the Insured if ___________________________________________________________________
there is no insured spouse.) [ ] [ ]
___________________________________________________________________
[ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
10. Other person(s) proposed for coverage including the Applicant for Applicant's Waiver of Premium benefit (AWP)
Relationship to Date of birth Total life insurance
Name--first, initial, last Sex proposed Insured Mo. Day Yr. Age Place of birth in all companies
a. Spouse $
___________________________________________________________________________________________________________________________________
b. $
___________________________________________________________________________________________________________________________________
c. $
___________________________________________________________________________________________________________________________________
d. $
___________________________________________________________________________________________________________________________________
e. $
___________________________________________________________________________________________________________________________________
f. $
- -----------------------------------------------------------------------------------------------------------------------------------
11. Supplementary benefits: a. For proposed Insured b. For spouse, children, Applicant for AWP
Type and duration of benefit Amount Type and duration of benefit Amount
$ $
___________________________________________________________________________________________________________________________________
$ $
___________________________________________________________________________________________________________________________________
$ $
___________________________________________________________________________________________________________________________________
[ ] Option to Purchase Additional Ins. $ [ ] Applicant's Waiver of Premium benefit
- -----------------------------------------------------------------------------------------------------------------------------------
12. State any special request.
- -----------------------------------------------------------------------------------------------------------------------------------
13. Will this insurance replace or change any existing insurance or annuity in any company on any person named Yes No
in 1a or 10? If "Yes", give their names, name of company, plan, amount and policy numbers. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
14. Is anyone applying for, or trying to reinstate, life or health insurance on any person named in 1a or 10 in Yes No
this or any company? If "Yes", give amount, details and company. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
15. Does any person named in 1a or 10 plan to live or travel outside the United States and Canada within the next Yes No
12 months? If "Yes", give details. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
16. Has any person named in 1a or 10 operated or had any duties aboard an aircraft, glider, balloon, or like Yes No
device, within the last 2 years, or does any such person have any plans to do so in the future? If "Yes", [ ] [ ]
complete Aviation Questionnaire.
- -----------------------------------------------------------------------------------------------------------------------------------
17. Has any person named in 1a or 10, within the last 12 months: Yes No
a. been treated by a doctor for or had a known heart attack, stroke or cancer other than of the skin? ............ [ ] [ ]
b. had an electrocardiogram for any physical complaint, or taken medication for high blood pressure? ............. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
18. Premiums payable [ ] Ann. [ ] Semi-Ann. [ ] Quar. [ ] Mon. [ ] Pay. Budg. [ ] Pru-Matic [ ] Gov't. Allot.
- -----------------------------------------------------------------------------------------------------------------------------------
19. Amount paid $ [ ] None (Must be "None" if either 17a or 17b is answered "Yes".)
- -----------------------------------------------------------------------------------------------------------------------------------
20. Is a medical examination to be made on a. the proposed Insured?.................................................. Yes [ ] No [ ]
b. spouse (if proposed for coverage)? .................................... Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
21. If 20a or 20b is "Yes", is it agreed that no insurance will take effect on anyone proposed for coverage until Yes No
the person(s) indicated in 20 have been examined, even if 19 shows that an amount has been paid? ................. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
22. Changes made by the Company
- -----------------------------------------------------------------------------------------------------------------------------------
ORD 84376-82 MARYLAND Page 1 (Continued on page 2)
</TABLE>
II-125
<PAGE>
<TABLE>
<CAPTION>
<S> <C>
- -----------------------------------------------------------------------------------------------------------------------------------
Continuation of Part 1 of Application
Complete on all persons named in 1a and 10 if any one of them can have insurance on a non-medical basis.
- -----------------------------------------------------------------------------------------------------------------------------------
23. Height and weight of:
a. Proposed Insured Ht._______ Wt._______ b. Spouse Ht.________ Wt.________ c. Applicant for AWP Ht.________ Wt.________
Has the weight changed more than 10 pounds in the past year? Yes [ ] No [ ] If "Yes", give details in 30.
- -----------------------------------------------------------------------------------------------------------------------------------
24. Has the proposed insured or spouse ever smoked? a. Proposed Insured Yes [ ] No [ ] b. Spouse Yes [ ] No [ ]
If "Yes", give date(s) last smoked: Cigarettes Cigars Pipe
Proposed Insured Mo.______ Yr. ______ Mo.______ Yr. ______ Mo.______ Yr. ______
Spouse Mo.______ Yr. ______ Mo.______ Yr. ______ Mo.______ Yr. ______
- -----------------------------------------------------------------------------------------------------------------------------------
25. When was a doctor last consulted by: a. Proposed Insured? b. Spouse? c. Applicant for AWP?
Mo.______ Yr. ______ Mo.______ Yr. ______ Mo.______ Yr. ______
- -----------------------------------------------------------------------------------------------------------------------------------
26. Has any person to be covered now being treated or taking medicine for any condition or disease ................. Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
27. Has any person to be covered ever:
Yes No
a. had any surgery or been advised to have surgery and has not done so?............................................... [ ] [ ]
b. been in a hospital, sanitarium or other institution for observaation, rest, diagnosis or treatment ................ [ ] [ ]
c. used or is any such person now using, barbiturates or amphetamines, marijuana or other hallucinatory
drugs, or heroin, opiates or other narcotics, except as prescribed by a doctor? ................................... [ ] [ ]
d. been treated or counseled for alcoholism? ......................................................................... [ ] [ ]
e. had life or health insurance declined, postponed, changed, rated-up or withdrawn? ................................. [ ] [ ]
f. had life or health insurance canceled, or its renewal or reinstatement refused? ................................... [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
28. Other than as shown above, in the past 5 years has any person to be covered: Yes No
a. consulted or been attended or examined by any doctor or other practitioner? ...................................... [ ] [ ]
b. had electrocardiograms, X-rays for diagnosis or treatment, or blood, urine, or other medical tests? .............. [ ] [ ]
c. made claim for or received benefits, compensation, or a pension because of sickness or injury? ................... [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
29. Does any person to be covered now have a known sign of any physical disorder, disease or defect not shown above? Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
30. What are the full details of the answer to 25 and to each part of 23 and 26 thru 29 which is answered "Yes"?
Name & Full names and addresses of
Question No. Illness or other resason Dates and duration of illness doctors and hospitals
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
- -----------------------------------------------------------------------------------------------------------------------------------
Those who sign below declare, to the best of their knowledge and belief, that the statements in this application are complete and
true.
When the Company gives a Temporary Indurance Agreement form, ORD 84376A-82, of the same date as this Part 1, coverage will start as
shown in that form. Otherwise, no coverage will start unless: (1) a contract is issued, (2) it is accepted, and (3) the full first
premium is paid while all persons to be covered are living and their health remains as stated in Part 1. If all these take place,
coverage will start on the contract date. If the Company makes a change as indicated in 22 it will be approved by acceptance of the
contract. But where the law requires written consent for any change in the application, such as change can be made only if those
who sign this form approve the change in writing. No agent can make or change a contract, or waive any of the Company's rights or
needs.
OWNERSHIP: Unless otherwise asked for above, the owner of the contract will be (1) the applicant if other than the proposed Insured,
otherwise (2) the proposed Insured. But this is subject to any automatic transfer of owership stated in the contract.
Signature of Proposed Insured (If Age 8 or over)
----------------------------------------------------------------------
Dated at on , 19 Signature of Applicant (If other than proposed Insured)
- ---------------------------------------------------
City/State ----------------------------------------------------------------------
Witness (If applicant is a firm or corporation, show that company's name)
- --------------------------------------------------- By
(Licensed agent must witness where required by law) ----------------------------------------------------------------------
(Signature and title of officer signing for that company)
ORD 84376-82 MARYLAND Page 2
No change in the application shall be made without written consent of those who sign this form.
</TABLE>
II-126
<PAGE>
ACKNOWLEDGEMENT
I have received and read a copy of the IMPORTANT NOTICE ABOUT YOUR APPLICATION
FOR INSURANCE.
--------------------------------
Date
, 19
----------------------------------------
AUTHORIZATION For the Release of Information to:
[ ] The Prudential Insurance Company of America
[ ] Pruco Life Insurance Company
To: Any licensed physician, medical practitioner, hospital, clinic or like
facility, insurance company or the Medical Information Bureau, Inc. or other
organization, institution or person.
To determine eligibility for life insurance coverage, I authorize you to give
the Company checked above and, through it, to its reinsurers and the Medical
Information Bureau, any data or records you may have about me or my mental or
physical health. This also applies to any child proposed for insurance in the
application.
This authorization is valid until two years after the effective date of any
contract issued in connection with this authorization. A photo of this form will
be as valid as the original. (The person who signs this form may have a copy of
it upon request.)
Signature of Proposed Insured (if age 15 or over) otherwise Applicant
- -------------------------------------------------------------------------------
Signature of Spouse (if proposed for coverage)
- -------------------------------------------------------------------------------
ORD 84377 82
- -------------------------------------------------------------------------------
[ ] The Prudential Insurance Company of America [ ] Pruco Life Insurance Company
IMPORTANT NOTICE ABOUT YOUR APPLICATION FOR INSURANCE
-----------------------------------------------------
Before we can issue a policy we must first underwrite your application. This
means that we evaluate all the information necessary to determine if you qualify
for the insurance.
In addition to the information on the application, a medical examination may be
required. We also ask you to authorize any doctor, hospital or other
organization or person to give us any information which they may have about you
or your mental or physical health.
We may ask for a report from a consumer reporting agency. These reports provide
information about a person's character, residence, activities, general
reputation, personal characteristics and mode of living. The agency may get this
information through interviews with friends, neighbors and associates. Any
person on whom we ask for a report has a right to ask to be interviewed. You may
also get a copy of the report from the consumer reporting agency which completed
it. An agency may keep the information it has about you and disclose it to other
persons. If you would like further information as to the nature and scope of
these reports, it will be provided upon request.
Any information which we obtain about you will be treated as confidential.
However, we may give this information, as necessary, to: your doctor, if we find
a serious health problem which you do not know about; persons conducting
mortality or morbidity studies; and affiliate companies for marketing purposes.
If you ask. we will describe any other circumstances when we may disclose
information about you without your prior authorization.
ORD 84378-82
(Continued on reverse)
- -------------------------------------------------------------------------------
[ ] The Prudential Insurance Company of America
[ ] Pruco Life Insurance Company
A Subsidiary of The Prudential Insurance Company of America
TEMPORARY INSURANCE AGREEMENT
We, the Company, agree to provide temporary insurance as follows:
1. It will start on the latest of these dates: (a) the date of this agreement,
(b) the date of completion of all medical examinations agreed to, and (c)
any date asked for in the application.
2. This insurance is subject to the terms of the contract applied for.
3. The sum of all death benefits for any person who is to be covered by this
insurance will be the amount asked for on that person or $250,000,
whichever is less.
The temporary insurance will end:
1. When we issue a contract as applied for. It will replace the temporary
insurance.
2. When we issue a contract other than as applied for. It will replace the
temporary insurance if: (a) it is accepted on delivery (this includes
paying at the same time any excess of the correct first premium over the
amount shown below); and (b) the persons who are to be covered are living
when the contract is delivered. If the contract is not accepted on delivery
the temporary insurance will end at once.
3. When we tell you that we rejected the application or when we tell you that
we will not consider it on a prepaid basis.
4. At the end of 60 days if the temporary insurance has not been ended as we
state in 1, 2 or 3.
ORD 84376A-82 (Continued on reverse) Printed in U.S.A.
- -------------------------------------------------------------------------------
Names and addresses of three Friends or Business Associates:
1. Name _______________________________________________________________________
Address ____________________________________________________________________
2. Name _______________________________________________________________________
Address ____________________________________________________________________
- -------------------------------------------------------------------------------
II-127
<PAGE>
- --------------------------------------------------------------------------------
We may also make a brief report to the Medical Information Bureau (MIB) which
provides an information exchange for its member insurance companies. When you
apply for life or health insurance or submit a claim for benefits to any member
company, MIB will, on request, give that company the information in its file. If
you have any questions about any report which MIB may have on you, you may
contact MIB at Post Office Box 105, Essex Station, Boston, MA 02112, (617)
426-3660.
If you have any questions concerning any of the personal information which we
obtain or report, let us know. You have the right to see this information and to
correct, amend or delete any information which may be wrong. We will tell you
how to do this if you ask us.
If we are unable to issue the policy you requested, we will tell you and explain
the reasons.
Thank you for applying to us for insurance.
Corporate Offices, Newark, N.J.
These Regional Home Offices of The Prudential Insurance Company of America are
also Service Offices of Pruco Life Insurance Company.
Central Atlantic Home Office, Northeastern Home Office,
Fort Washington, Pa. Boston, Mass.
Eastern Home Office, South-Central Home Office,
South Plainfield, N.J. Jacksonville, Fla.
Mid-America Home Office, Southwestern Home Office,
Chicago, Ill. Houston, Tex.
North Central Home Office, Western Home Office,
Minneapolis. Minn. Los Angeles, Calif.
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
We received $_____________ on_________, 19___ from __________________________.
This amount was paid when a life insurance application was signed, on the same
date, in which ____________________________________________ is named as the
proposed Insured. This agreement is issued on the condition that any check,
draft or other order for the payment of money is good and can be collected.
ALL CHECKS MUST BE DRAWN ONLY TO THE COMPANY AND NOT TO ANY OTHER PARTY.
No change may be made in the terms and conditions of this form. No statement
which claims to make such a change will bind the Company.
Field Office Writing Representative (Agent)
_____________________________________________________________
The Prudential Insurance Company of America Pruco Life Insurance Company
Corporate Offices, Newark, N.J.
These Regional Home Offices of The Prudential Insurance Company of America are
also Service Offices of Pruco Life Insurance Company.
Central Atlantic Home Office, Northeastern Home Office,
Fort Washington, Pa. Boston, Mass.
Eastern Home Office, South-Central Home Office,
South Plainfield, N.J. Jacksonville, Fla.
Mid-America Home Office, Southwestern Home Office,
Chicago, Ill. Houston, Tex.
North Central Home Office, Western Home Office,
Minneapolis, Minn. Los Angeles, Calif.
_____________________________________________________________
Note--Unless you get a contract, or your money back within eight weeks from the
date of this agreement, please notify the Company. Give the amount paid, date of
payment, and name of person to whom paid. (Locations are shown above.)
- --------------------------------------------------------------------------------
- --------------------------------------------------------------------------------
3. Name _______________________________________________________________________
Address ____________________________________________________________________
Furnished by ___________________________________________________________
(Name of Proposed Insured/Applicant)
Proposed Insured's Expiration Dates: Auto ___________ Homeowners ______________
- --------------------------------------------------------------------------------
II-128
<TABLE>
<CAPTION>
Prudential
- -----------------------------------------------------------------------------------------------------------------------------------
Application for Life Insurance
LOGO
----------------------------------------------------
Proposed Insured
- -----------------------------------------------------------------------------------------------------------------------------------
Submitted By
- -----------------------------------------------------------------------------------------------------------------------------------
<S> <C>
----------------------- -------------------- ------------------------------ ---------------------- -------------------
Name & Title Contract No. Agcy. No./Rep. Init. Office Code Detached Office
_____% ----------------------- -------------------- ------------------------------ ---------------------- -------------------
Credit
- -----------------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
[ ] Debit Ord. [ ] New Acct. [ ] Existing Acct. No. of Apps.__________ Fam. Acct. No.
-------------------------------------------------------------------------------------------------------------
[ ] Reg. Ord. Premium Quoted/Scheduled Premium Payment $_______________ (According to mode selected)
-------------------------------------------------------------------------------------------------------------
[ ] Pruco FOR FIELD OFFICE STAFF TO COMPLETE: Control No. _________ County Code __________
- -----------------------------------------------------------------------------------------------------------------------------------
ORD 84376 82 CONNECTICUT
</TABLE>
II-129
<PAGE>
- -------------------------------------------------------------------------------
AGENT'S SUPPLEMENTAL INFORMATION
<TABLE>
<CAPTION>
<S> <C>
- -----------------------------------------------------------------------------------------------------------------------------------
1. Give current and last previous HOME and BUSINESS addresses.
From To Employer No. Street City or Town State
Home
Mo. Yr. Mo. Yr.
Present
- -----------------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
Bus.
Present
- -----------------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
2. If an Investigative Consumer Report is necessary, is a direct interview desired? .............................. Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
3. What is the total yearly income of: a. Proposed Insured? $ b. Spouse? $
- -----------------------------------------------------------------------------------------------------------------------------------
4. Does more than 50% of the Insured's support come from someone else? Yes [ ] No [ ] If "Yes", give that person's:
Full name Relationship Amt. of Life ins. force $
- -----------------------------------------------------------------------------------------------------------------------------------
5. Who is to pay the premium? (Check one) [ ] Insured [ ] Employer [ ] Spouse [ ] Parent [ ] Other _______________________________
- -----------------------------------------------------------------------------------------------------------------------------------
6 a. Did someone other than you suggest this insurance? Yes [ ] No [ ] If "Yes", state who and what prompted the request?
-----------------------------------------------------------------------------------------------------------------------
b. What was the primary source of the Sales Lead? (Check one) (1) [ ] Policyholder Service (2) [ ] Referred Lead
(3) [ ] Cold Call
- -----------------------------------------------------------------------------------------------------------------------------------
7. What Sales Services did you use? (Check appropriate boxes)
a. [ ] FACTOR 1 b. [ ] FACTOR 2 c. [ ] Other CPI d. [ ] CNA e. [ ] FNA f. [ ] Business Security Analysis
g. [ ] Employer's Advisory Service h. [ ] Estate Conservation Service i. [ ] Other __________________________________
- -----------------------------------------------------------------------------------------------------------------------------------
8. Complete if this application is for business insurance: c. Amount of business insurance in force and applied for in all
a. Is firm a: (1) [ ] Sole Proprietorship companies on each officer or member of the firm.
(2) [ ] Partnership (3) [ ] Corporation Name Age Position Inforce Applied for
b. Is proposed Insured: $ $
--------------------------------------------------------------
[ ] Owner of firm (state _______%) [ ] Employee
- -----------------------------------------------------------------------------------------------------------------------------------
9. Do you have, from any source, facts which you have not stated any place else in the application which indicae that
any person named in 1a or 10 of the application may: (Give details of "Yes" answers in "REMARKS".) Yes No
a. replace or change any current insurance or annuity in any company? ............................................ [ ] [ ]
b. have in the last 3 years participated in hazardous sports (such as auto racing or parachuting), or been
arrested for driving recklessly or while intoxicated? ......................................................... [ ] [ ]
c. have frequently drunk to excess, illegally used habit forming drugs or have a record of indictment or
conviction of any crime? ...................................................................................... [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
10. Has the last name of any person named in 1a or 10 of the application been changed in the last 5 years (marriage, Yes No
court order, etc.)? If "Yes", who, and what was the previous last name? [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
11. Are the proposed Insured and agent related? Yes [ ] No [ ] If "Yes", state relationship: [ ] Self [ ] Other ______________
- -----------------------------------------------------------------------------------------------------------------------------------
12. a. Proposed Insured's telephone no. b. Social Security no.
- -----------------------------------------------------------------------------------------------------------------------------------
Complete 13 if proposed Insured is age 0-14
13. Family Name Date of Present Pending Family Name Date of Present Pending
details birth insurance Pru app.? details birth insurance Pru app.?
Father Brothers
----------------------------------------------------------
Mother & Sisters
- -----------------------------------------------------------------------------------------------------------------------------------
Complete 14 and 15 if dependent children are proposed for coverage (Give details of "Yes" answers in "REMARKS".)
14. Are any children named in 10 of the application: Yes No
a. foster children or children whole legal adoption has not yet been made final? ................................. [ ] [ ]
b. living in a household other than the proposed Insured's or dependent on someone other than the
proposed Insured? ............................................................................................. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
15. Are there any other children less than 18 years of age who have not been named in 10 of the application? ..... Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
CERTIFICATION
I certify that (a) on this date I saw the proposed Insured and (b), except as stated in "REMARKS", I am not aware of any information
not shown in the answers to the questions in any Part of this application, that would adversely affect the eligibility,
acceptability or insurability of any person proposed for coverage, I recommend that the Company accept the risks proposed for
coverage.
Date Signature of Writing Representative (Agent) Mgr., Asst. Mgr. or Sales Mgr. must sign if present
when application signed
, 19
- -----------------------------------------------------------------------------------------------------------------------------------
REMARKS:
ORD 84376 82
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II-130
<PAGE>
<TABLE>
<CAPTION>
<S> <C>
Continuation of Part 1 of Application
Complete on all persons named in 1a and 10 if any one of them can have insurance on a non-medical basis.
- -----------------------------------------------------------------------------------------------------------------------------------
23. Height and weight of:
a. Proposed Insured Ht._______ Wt._______ b. Spouse Ht.________ Wt.________ c. Applicant for AWP Ht.________ Wt.________
Has the weight changed more than 10 pounds in the past year? Yes [ ] No [ ] If "Yes", give details in 30.
- -----------------------------------------------------------------------------------------------------------------------------------
24. Has the proposed Insured or spouse ever smoked? a. Proposed Insured Yes [ ] No [ ] b. Spouse Yes [ ] No [ ]
If "Yes", give date(s) last smoked: Cigarettes Cigars Pipe
Proposed Insured Mo.______ Yr. ______ Mo.______ Yr. ______ Mo.______ Yr. ______
Spouse Mo.______ Yr. ______ Mo.______ Yr. ______ Mo.______ Yr. ______
- -----------------------------------------------------------------------------------------------------------------------------------
25. When was a doctor last consulted by: a. Proposed Insured? b. Spouse? c. Applicant for AWP?
Mo.______ Yr. ______ Mo.______ Yr. ______ Mo.______ Yr. ______
- -----------------------------------------------------------------------------------------------------------------------------------
26. Has any person to be covered now been treated or taking medicine for any condition or disease? ................. Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
27. Has any person to be covered ever: Yes No
a. had any surgery or been advised to have surgery and has not done so?............................................... [ ] [ ]
b. been in a hospital, sanitarium or other institution for observation, rest, diagnosis or treatment? ................ [ ] [ ]
c. used or is any such person now using, barbiturates or amphetamines, marijuana or other hallucinatory
drugs, or heroin, opiates or other narcotics, except as prescribed by a doctor? ................................... [ ] [ ]
d. been treated or counseled for alcoholism? ......................................................................... [ ] [ ]
e. had life or health insurance declined, postponed, changed, rated-up or withdrawn? ................................. [ ] [ ]
f. had life or health insurance canceled, or its renewal or reinstatement refused? ................................... [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
28. Other than as shown above, in the past 5 years has any person to be covered: Yes No
a. consulted or been attended or examined by any doctor or other practitioner? ...................................... [ ] [ ]
b. had electrocardiograms, X-rays for diagnosis or treatment, or blood, urine, or other medical tests? .............. [ ] [ ]
c. made claim for or received benefits, compensation, or a pension because of sickness or injury? ................... [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
29. Does any person to be covered now have a known sign of any physical disorder, disease or defect not shown above? Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
30. What are the full details of the answer to 25 and to each part of 23 and 26 thru 29 which is answered "Yes"?
Name & Full names and addresses of
Question No. Illness or other resason Dates and duration of illness doctors and hospitals
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
- -----------------------------------------------------------------------------------------------------------------------------------
Those who sign below declare, to the best of their knowledge and belief, that the statements in this application are complete and
true.
When the Company gives a Temporary Insurance Agreement form, ORD 84376A-82, of the same date as this Part 1, coverage will start as
shown in that form. Otherwise, no coverage will start unless: (1) a contract is issued, (2) it is accepted, and (3) the full first
premium is paid while all persons to be covered are living and their health remains as stated in Part 1. If all these take place,
coverage will start on the contract date. If the Company makes a change as indicated in 22 it will be approved by acceptance of the
contract. But where the law requires written consent for any change in the application, such as change can be made only if those
who sign this form approve the change in writing. No agent can make or change a contract, or waive any of the Company's rights or
needs.
OWNERSHIP: Unless otherwise asked for above, the owner of the contract will be (1) the applicant if other than the proposed Insured,
otherwise (2) the proposed Insured. But this is subject to any automatic transfer of owership stated in the contract.
Signature of Proposed Insured (If Age 8 or over)
----------------------------------------------------------------------
Dated at on , 19 Signature of Applicant (If other than proposed Insured)
- ---------------------------------------------------
(City/State) ----------------------------------------------------------------------
Witness (If applicant is a firm or corporation, show that company's name)
- --------------------------------------------------- By
(Licensed agent must witness where required by law) ----------------------------------------------------------------------
(Signature and title of officer signing for that company)
- ------------
ORD 84376-82 CONNECTICUT Page 2
- ------------
</TABLE>
II-131
<PAGE>
<TABLE>
<CAPTION>
<S> <C>
Part 1 Application to No.
[ ] The Prudential Insurance Company of America
[ ] Pruco Life Insurance Company--A Subsidiary of The Prudential Insurance Company of America -------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
1a. Proposed Insured's name--first, initial, last (Print) 1b. Sex 2a. Date of birth 2b. Age 2c. Place of birth
Mo. Day Yr.
[ ] M [ ] F
- -----------------------------------------------------------------------------------------------------------------------------------
3. [ ] Single [ ] Married [ ] Widowed [ ] Separated [ ] Divorced 4. Occupation(s)
- -----------------------------------------------------------------------------------------------------------------------------------
5. Address for mail No. Street City State Zip
- -----------------------------------------------------------------------------------------------------------------------------------
6a. Kind of policy 6b. Initial amount 7. Accidental death coverage
$ initial amount $
- -----------------------------------------------------------------------------------------------------------------------------------
8. Beneficiary: (Include name, age and relationship.) 9. List all life insurance on proposed Insured. (If NONE, so state.)
a. Primary (Class 1): Company Initial Yr. Kind Medical
amt. issued (Indiv., Group) Yes No
_______________________________________________________ [ ] [ ]
________________________________________________________________________
b. Contingent (Class 2) if any: [ ] [ ]
________________________________________________________________________
_______________________________________________________ [ ] [ ]
(For insurance payable upon death of (1) the Insured, and ________________________________________________________________________
(2) an insured child after the death of the Insured if [ ] [ ]
there is no insured spouse.)
- -----------------------------------------------------------------------------------------------------------------------------------
10. Other person(s) proposed for coverage including the Applicant for Applicant's Waiver of Premium benefit (AWP)
Relationship to Date of birth Total life insurance
Name--first, initial, last Sex proposed Insured Mo. Day Yr. Age Place of birth in all companies
a. Spouse $
___________________________________________________________________________________________________________________________________
b. $
___________________________________________________________________________________________________________________________________
c. $
___________________________________________________________________________________________________________________________________
d. $
___________________________________________________________________________________________________________________________________
e. $
___________________________________________________________________________________________________________________________________
f. $
- -----------------------------------------------------------------------------------------------------------------------------------
11. Supplementary benefits and riders: a. For proposed Insured b. For spouse, children, Applicant for AWP
Type and duration of benefit Amount Type and duration of benefit Amount
$ $
___________________________________________________________________________________________________________________________________
$ $
___________________________________________________________________________________________________________________________________
$ $
___________________________________________________________________________________________________________________________________
[ ] Option to Purchase Additional Ins. $ [ ] Applicant's Waiver of Premium benefit
- -----------------------------------------------------------------------------------------------------------------------------------
12. State any special request.
- -----------------------------------------------------------------------------------------------------------------------------------
13. Will this insurance replace or change any existing insurance or annuity in any company on any person named Yes No
in 1a or 10? If "Yes", give their names, name of company, plan, amount and policy numbers. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
14. Is anyone applying for, or trying to reinstate, life or health insurance on any person named in 1a or 10 in Yes No
this or any company? If "Yes", give amount, details and company. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
15. Does any person named in 1a or 10 plan to live or travel outside the United States and Canada within the next Yes No
12 months? If "Yes", give details. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
16. Has any person named in 1a or 10 operated or had any duties aboard an aircraft, glider, balloon, or like Yes No
device, within the last 2 years, or does any such person have any plans to do so in the future? If "Yes", [ ] [ ]
complete Aviation Questionnaire.
- -----------------------------------------------------------------------------------------------------------------------------------
17. Has any person named in 1a or 10, within the last 12 months: Yes No
a. been treated by a doctor for or had a known heart attack, stroke or cancer other than of the skin? ............ [ ] [ ]
b. had an electrocardiogram for any physical complaint, or taken medication for high blood pressure? ............. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
18. Premium payable [ ] Ann. [ ] Semi-Ann. [ ] Quar. [ ] Mon. [ ] Pay. Budg. [ ] Pru-Matic [ ] Gov't. Allot.
- -----------------------------------------------------------------------------------------------------------------------------------
19. Amount paid $ [ ] None (Must be "None" if either 17a or 17b is answered "Yes".)
- -----------------------------------------------------------------------------------------------------------------------------------
20. Is a medical examination to be made on Yes No
a. the proposed Insured? .................................................. [ ] [ ]
b. spouse (if proposed for coverage)? ..................................... [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
21. If 20a or 20b is "Yes", is it agreed that no insurance will take effect on anyone proposed for coverage until Yes No
the person(s) indicated in 20 have been examined, even if 19 shows that an amount has been paid? ................. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
22. Changes made by the Company
- -----------------------------------------------------------------------------------------------------------------------------------
ORD 84376-82 CONNECTICUT Page 1 (Continued on page 2)
- ------------
</TABLE>
II-132
<PAGE>
ACKNOWLEDGEMENT
I have received and read a copy of the IMPORTANT NOTICE ABOUT YOUR APPLICATION
FOR INSURANCE.
--------------------------------
Date
, 19
----------------------------------------
AUTHORIZATION For the Release of Information to:
[ ] The Prudential Insurance Company of America
[ ] Pruco Life Insurance Company
To: Any licensed physician, medical practitioner, hospital, clinic or like
facility, insurance company or the Medical Information Bureau, Inc. or other
organization, institution or person.
To determine eligibility for life insurance coverage, I authorize you to give
the Company checked above and, through it, to its reinsurers and the Medical
Information Bureau, any data or records you may have about me or my mental or
physical health. This also applies to any child proposed for insurance in the
application.
This authorization is valid until two years after the effective date of any
contract issued in connection with this authorization. A photo of this form will
be as valid as the original. (The person who signs this form may have a copy of
it upon request.)
Signature of Proposed Insured (if age 15 or over) otherwise Applicant
- -------------------------------------------------------------------------------
Signature of Spouse (if proposed for coverage)
- -------------------------------------------------------------------------------
ORD 84377 82
- -------------------------------------------------------------------------------
[ ] The Prudential Insurance Company of America [ ] Pruco Life Insurance Company
IMPORTANT NOTICE ABOUT YOUR APPLICATION FOR INSURANCE
-----------------------------------------------------
Before we can issue a policy we must first underwrite your application. This
means that we evaluate all the information necessary to determine if you qualify
for the insurance.
In addition to the information on the application, a medical examination may be
required. We also ask you to authorize any doctor, hospital or other
organization or person to give us any information which they may have about you
or your mental or physical health.
We may ask for a report from a consumer reporting agency. These reports provide
information about a person's character, residence, activities, general
reputation, personal characteristics and mode of living. The agency may get this
information through interviews with friends, neighbors and associates. Any
person on whom we ask for a report has a right to ask to be interviewed. You may
also get a copy of the report from the consumer reporting agency which completed
it. An agency may keep the information it has about you and disclose it to other
persons. If you would like further information as to the nature and scope of
these reports, it will be provided upon request.
Any information which we obtain about you will be treated as confidential.
However, we may give this information, as necessary, to: your doctor, if we find
a serious health problem which you do not know about; persons conducting
mortality or morbidity studies; and affiliate companies for marketing purposes.
If you ask. we will describe any other circumstances when we may disclose
information about you without your prior authorization.
ORD 84378-82
(Continued on reverse)
- -------------------------------------------------------------------------------
[ ] The Prudential Insurance Company of America
[ ] Pruco Life Insurance Company
A Subsidiary of The Prudential Insurance Company of America
TEMPORARY INSURANCE AGREEMENT
We, the Company, agree to provide temporary insurance as follows:
1. It will start on the latest of these dates: (a) the date of this agreement,
(b) the date of completion of all medical examinations agreed to, and (c)
any date asked for in the application.
2. This insurance is subject to the terms of the contract applied for.
3. The sum of all death benefits for any person who is to be covered by this
insurance will be the amount asked for on that person or $250,000,
whichever is less.
The temporary insurance will end:
1. When we issue a contract as applied for. It will replace the temporary
insurance.
2. When we issue a contract other than as applied for. It will replace the
temporary insurance if: (a) it is accepted on delivery (this includes
paying at the same time any excess of the correct first premium over the
amount shown below); and (b) the persons who are to be covered are living
when the contract is delivered. If the contract is not accepted on delivery
the temporary insurance will end at once.
3. When we tell you that we rejected the application or when we tell you that
we will not consider it on a prepaid basis.
4. At the end of 60 days if the temporary insurance has not been ended as we
state in 1, 2 or 3.
ORD 84376A-82 (Continued on reverse) Printed in U.S.A.
- -------------------------------------------------------------------------------
Names and addresses of three Friends or Business Associates:
1. Name _______________________________________________________________________
Address ____________________________________________________________________
2. Name _______________________________________________________________________
Address ____________________________________________________________________
- -------------------------------------------------------------------------------
II-133
<PAGE>
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<CAPTION>
AGENT'S SUPPLEMENTAL INFORMATION
- -----------------------------------------------------------------------------------------------------------------------------------
<S> <C>
- -----------------------------------------------------------------------------------------------------------------------------------
1. Give current and last previous HOME and BUSINESS addresses.
From To Employer No. Street City or Town State
Home
Mo. Yr. Mo. Yr.
Present
- -----------------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
Bus.
- -----------------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
2. If an Investigative Consumer Report is necessary, is a direct interview desired? .............................. Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
3. What is the total yearly income of: a. Proposed Insured? $ b. Spouse? $
- -----------------------------------------------------------------------------------------------------------------------------------
4. Does more than 50% of the proposed Insured's support come from someone else? Yes [ ] No [ ] If "Yes", give that person's:
Full name Relationship Amt. of Life ins. force $
- -----------------------------------------------------------------------------------------------------------------------------------
5. Who is to pay the premium? (Check one) [ ] Insured [ ] Employer [ ] Spouse [ ] Parent [ ] Other _______________________________
- -----------------------------------------------------------------------------------------------------------------------------------
6 a. Did someone other than you suggest this insurance? Yes [ ] No [ ] If "Yes", state who and what prompted the request?
-----------------------------------------------------------------------------------------------------------------------
b. What was the primary source of the Sales Lead? (Check one)(1) [ ] Policyholder Service (2) [ ] Referred Lead (3) [ ] Cold Call
- -----------------------------------------------------------------------------------------------------------------------------------
7. What Sales Services did you use? (Check appropriate boxes)
a. [ ] FACTOR 1 b. [ ] FACTOR 2 c. [ ] Other CPI d. [ ] CNA e. [ ] FNA f. [ ] Business Security Analysis
g. [ ] Employer's Advisory Service h. [ ] Estate Conservation Service i. [ ] Other __________________________________
- -----------------------------------------------------------------------------------------------------------------------------------
8. Complete if this application is for business insurance: c. Amount of business insurance in force and applied for in all
a. Is firm a: (1) [ ] Sole Proprietorship companies on each officer or member of the firm.
(2) [ ] Partnership (3) [ ] Corporation Name Age Position Inforce Applied for
b. Is proposed Insured: $ $
--------------------------------------------------------------
[ ] Owner of firm (state _______%) [ ] Employee
- -----------------------------------------------------------------------------------------------------------------------------------
9. Do you have, from any source, facts which you have not stated any place else in the application which indicae that
any person named in 1a or 10 of the application may: (Give details of "Yes" answers in "REMARKS".) Yes No
a. replace or change any current insurance or annuity in any company? ............................................ [ ] [ ]
b. have in the last 3 years participated in hazardous sports (such as auto racing or parachuting), or been
arrested for driving recklessly or while intoxicated? ......................................................... [ ] [ ]
c. have frequently drunk to excess, illegally used habit forming drugs or have a record of indictment or
conviction of any crime? ...................................................................................... [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
10. Has the last name of any person named in 1a or 10 of the application been changed in the last 5 years (marriage, Yes No
court order, etc.)? If "Yes", who, and what was the previous last name? [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
11. Are the proposed Insured and agent related? Yes [ ] No [ ] If "Yes", state relationship: [ ] Self [ ] Other ______________
- -----------------------------------------------------------------------------------------------------------------------------------
12. a. Proposed Insured's telephone no. b. Social Security no.
- -----------------------------------------------------------------------------------------------------------------------------------
Complete 13 if proposed Insured is age 0-14
13. Family Name Date of Present Pending Family Name Date of Present Pending
details birth insurance Pru app.? details birth insurance Pru app.?
Father Brothers
---------------------------------------------------------- & Sisters
Mother
- -----------------------------------------------------------------------------------------------------------------------------------
Complete 14 and 15 if dependent children are proposed for coverage (Give details of "Yes" answers in "REMARKS".)
14. Are any children named in 10 of the application: Yes No
a. foster children or children whole legal adoption has not yet been made final? ................................. [ ] [ ]
b. living in a household other than the proposed Insured's or dependent on someone other than the
proposed Insured? ............................................................................................. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
15. Are there any other children less than 18 years of age who have not been named in 10 of the application? ..... Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
CERTIFICATION
I certify that (a) on this date I saw the proposed Insured and (b), except as stated in "REMARKS", I am not aware of any information
not shown in the answers to the questions in any Part of this application, that would adversely affect the eligibility,
acceptability or insurability of any person proposed for coverage, I recommend that the Company accept the risks proposed for
coverage.
Date Signature of Writing Representative (Agent) Mgr., Asst. Mgr. or Sales Mgr. must sign if present
when application signed
, 19
- -----------------------------------------------------------------------------------------------------------------------------------
REMARKS:
ORD 84376 82
</TABLE>
II-134
<TABLE>
<CAPTION>
EXHIBIT A(10)(e)
Prudential
- -----------------------------------------------------------------------------------------------------------------------------------
APPLICATION FOR LIFE INSURANCE
LOGO
----------------------------------------------------
Proposed Insured
- -----------------------------------------------------------------------------------------------------------------------------------
Submitted By
- -----------------------------------------------------------------------------------------------------------------------------------
<S> <C>
----------------------- -------------------- ------------------------------ ---------------------- -------------------
Name & Title Contract No. Agcy. No./Rep. Init. Office Code Detached Office
_____% ----------------------- -------------------- ------------------------------ ---------------------- -------------------
Credit
- -----------------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
[ ] Debit Ord. [ ] New Acct. [ ] Existing Acct. No. of Apps.__________ Fam. Acct. No.
-------------------------------------------------------------------------------------------------------------
[ ] Reg. Ord. Premium Quoted/Scheduled Premium Payment $______________________________________ (According to mode selected)
-------------------------------------------------------------------------------------------------------------
[ ] Pruco FOR FIELD OFFICE STAFF TO COMPLETE: Control No. _________ County Code __________
- -----------------------------------------------------------------------------------------------------------------------------------
ORD 84376 82 MISSOURI
</TABLE>
II-135
<PAGE>
- -------------------------------------------------------------------------------
We may also make a brief report to the Medical Information Bureau (MIB) which
provides an information exchange for its member insurance companies. When you
apply for life or health insurance or submit a claim for benefits to any member
company, MIB will, on request, give that company the information in its file. If
you have any questions about any report which MIB may have on you, you may
contact MIB at Post Office Box 105, Essex Station, Boston, MA 02112, (617)
426-3660.
If you have any questions concerning any of the personal information which we
obtain or report, let us know. You have the right to see this information and to
correct, amend or delete any information which may be wrong. We will tell you
how to do this if you ask us. If we are unable to issue the policy you
requested, we will tell you and explain the reasons. Thank you for applying to
us for insurance.
Corporate Offices, Newark, N.J.
These Regional Home Offices of The Prudential Insurance Company of America are
also Service Offices of Pruco Life Insurance Company.
Central Atlantic Home Office, Fort Washington, Pa.
Eastern Home Office, South Plainfield, N.J.
Mid-America Home Office, Chicago, Ill.
North Central Home Office, Minneapolis, Minn.
Northeastern Home Office, Boston, Mass.
South-Central Home Office, Jacksonville, Fla.
Southwestern Home Office, Houston, Tex.
Western Home Office, Los Angeles, Calif.
- -------------------------------------------------------------------------------
We received $_____________ on _____________, 19___ from _______________________
This amount was paid when a life insurance application was signed, on the same
date, in which ____________________________________________ is named as the
proposed Insured. This agreement is issued on the condition that any check,
draft or other order for the payment of money is good and can be collected. All
checks must be drawn only to the Company and not to any other party.
No change may be made in the terms and conditions of this form. No statement
which claims to make such a change will bind the Company.
Field Office Writing Representative (Agent)
- -------------------------------------------------------------------------------
The Prudential Insurance Company of America Pruco Life Insurance Company
Corporate Offices, Newark. N.J.
These Regional Home Offices of The Prudential Insurance Company of America are
also Service Offices of Pruco Life Insurance Company.
Central Atlantic Home Office, Fort Washington, Pa.
Eastern Home Office, South Plainfield, N.J.
Mid-America Home Office, Chicago, Ill.
North Central Home Office, Minneapolis, Minn.
Northeastern Home Office, Boston, Mass.
South-Central Home Office, Jacksonville, Fla.
Southwestern Home Office, Houston, Tex.
Western Home Office, Los Angeles, Calif.
----------------------------------------------------------------------
Note--Unless you get a contract, or your money back within eight weeks from the
date of this agreement, please notify the Company. Give the amount paid, date of
payment, and name of person to whom paid. (Locations are shown above.)
- -------------------------------------------------------------------------------
3. Name _______________________________________________________________________
Address ____________________________________________________________________
Furnished by ___________________________________________________________
(Name of Proposed Insured/Applicant)
Proposed Insured's Expiration Dates: Auto ___________ Homeowners ______________
II-136
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<CAPTION>
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- -----------------------------------------------------------------------------------------------------------------------------------
Continuation of Part 1 of Application
Complete on all persons named in 1a and 10 if any one of them can have insurance on a non-medical basis.
- -----------------------------------------------------------------------------------------------------------------------------------
23. Height and weight of:
a. Proposed Insured Ht._______ Wt._______ b. Spouse Ht.________ Wt.________ c. Applicant for AWP Ht.________ Wt.________
Has the weight changed more than 10 pounds in the past year? Yes [ ] No [ ] If "Yes", give details in 30.
- -----------------------------------------------------------------------------------------------------------------------------------
24. Has the proposed Insured or spouse ever smoked? a. Proposed Insured Yes [ ] No [ ] b. Spouse Yes [ ] No [ ]
If "Yes", give date(s) last smoked: Cigarettes Cigars Pipe
Proposed Insured Mo.______ Yr. ______ Mo.______ Yr. ______ Mo.______ Yr. ______
Spouse Mo.______ Yr. ______ Mo.______ Yr. ______ Mo.______ Yr. ______
- -----------------------------------------------------------------------------------------------------------------------------------
25. When was a doctor last consulted by: a. Proposed Insured? b. Spouse? c. Applicant for AWP?
Mo.______ Yr. ______ Mo.______ Yr. ______ Mo.______ Yr. ______
- -----------------------------------------------------------------------------------------------------------------------------------
26. Is any person to be covered now being treated or taking medicine for any condition or disease? ................. Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
27. Has any person to be covered ever:
Yes No
a. had any surgery or been advised to have surgery and has not done so?............................................... [ ] [ ]
b. been in a hospital, sanitarium or other institution for observation, rest, diagnosis or treatment? ................ [ ] [ ]
c. regularly used or is any such person now using, barbiturates or amphetamines, marijuana or other hallucinatory
drugs, or heroin, opiates or other narcotics, except as prescribed by a doctor? ................................... [ ] [ ]
d. been treated or counseled for alcoholism? ......................................................................... [ ] [ ]
e. had life or health insurance declined, postponed, changed, rated-up or withdrawn? ................................. [ ] [ ]
f. had life or health insurance canceled, or its renewal or reinstatement refused? ................................... [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
28. Other than as shown above, in the past 5 years has any person to be covered: Yes No
a. consulted or been attended or examined by any doctor or other practitioner? ...................................... [ ] [ ]
b. had electrocardiograms, X-rays for diagnosis or treatment, or blood, urine, or other medical tests? .............. [ ] [ ]
c. made claim for or received benefits, compensation, or a pension because of sickness or injury? ................... [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
29. Does any person to be covered now have a known sign of any physical disorder, disease or defect not shown above? Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
30. What are the full details of the answer to 25 and to each part of 23 and 26 thru 29 which is answered "Yes"?
Name & Full names and addresses of
Question No. Illness or other resason Dates and duration of illness doctors and hospitals
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
- -----------------------------------------------------------------------------------------------------------------------------------
Those who sign below declare, to the best of their knowledge and belief, that the statements in this application are complete and
true.
When the Company gives a Temporary Indurance Agreement form, ORD 84376A-82, of the same date as this Part 1, coverage will start as
shown in that form. Otherwise, no coverage will start unless: (1) a contract is issued, (2) it is accepted, and (3) the full first
premium is paid while all persons to be covered are living and their health remains as stated in Part 1. If all these take place,
coverage will start on the contract date. If the Company makes a change as indicated in 22 it will be approved by acceptance of the
contract. But where the law requires written consent for any change in the application, such as change can be made only if those
who sign this form approve the change in writing. No agent can make or change a contract, or waive any of the Company's rights or
needs.
OWNERSHIP: Unless otherwise asked for above, the owner of the contract will be (1) the applicant if other than the proposed Insured,
otherwise (2) the proposed Insured. But this is subject to any automatic transfer of ownership stated in the contract.
Signature of Proposed Insured (If Age 8 or over)
----------------------------------------------------------------------
Dated at on , 19 Signature of Applicant (If other than proposed Insured)
- ---------------------------------------------------
(City/State) ----------------------------------------------------------------------
Witness (If applicant is a firm or corporation, show that company's name)
- --------------------------------------------------- By
(Licensed agent must witness where required by law) ----------------------------------------------------------------------
(Signature and title of officer signing for that company)
ORD 84376-82 MISSOURI Page 2
</TABLE>
II-137
<PAGE>
<TABLE>
<CAPTION>
<S> <C>
No.
Part 1 Application to _________________
[ ] The Prudential Insurance Company of America
[ ] Pruco Life Insurance Company--A Subsidiary of The Prudential Insurance Company of America
- -----------------------------------------------------------------------------------------------------------------------------------
1a. Proposed Insured's name--first, initial, last (Print) 1b. Sex 2a. Date of birth 2b. Age 2c. Place of birth
M F Mo. Day Yr.
[ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
3. [ ] Single [ ] Married [ ] Widowed [ ] Separated [ ] Divorced 4. Occupation(s)
- -----------------------------------------------------------------------------------------------------------------------------------
5. Address for mail No. Street City State Zip
- -----------------------------------------------------------------------------------------------------------------------------------
6a. Kind of policy 6b. Initial amount 7. Accidental death coverage
$ initial amount $
- -----------------------------------------------------------------------------------------------------------------------------------
8. Beneficiary: (Include name, age and relationship.) 9. List all life insurance on proposed Insured. (If NONE, so state.)
a. Primary (Class 1): b. Contingent (Class 2) if any: Initial Yr. Kind Medical
Company amt. issued (Indiv., Group) Yes No
[ ] [ ]
_________________________________________________________ ___________________________________________________________________
(For insurance payable upon death of (1) the Insured, and [ ] [ ]
(2) an insured child after the death of the Insured if ___________________________________________________________________
there is no insured spouse.) [ ] [ ]
___________________________________________________________________
[ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
10. Other person(s) proposed for coverage including the Applicant for Applicant's Waiver of Premium benefit (AWP)
Relationship to Date of birth Total life insurance
Name--first, initial, last Sex proposed Insured Mo. Day Yr. Age Place of birth in all companies
a. Spouse $
___________________________________________________________________________________________________________________________________
b. $
___________________________________________________________________________________________________________________________________
c. $
___________________________________________________________________________________________________________________________________
d. $
___________________________________________________________________________________________________________________________________
e. $
___________________________________________________________________________________________________________________________________
f. $
- -----------------------------------------------------------------------------------------------------------------------------------
11. Supplementary benefits: a. For proposed Insured b. For spouse, children, Applicant for AWP
Type and duration of benefit Amount Type and duration of benefit Amount
$ $
___________________________________________________________________________________________________________________________________
$ $
___________________________________________________________________________________________________________________________________
$ $
___________________________________________________________________________________________________________________________________
[ ] Option to Purchase Additional Ins. $ [ ] Applicant's Waiver of Premium benefit
- -----------------------------------------------------------------------------------------------------------------------------------
12. State any special request.
- -----------------------------------------------------------------------------------------------------------------------------------
13. Will this insurance replace or change any existing insurance or annuity in any company on any person named Yes No
in 1a or 10? If "Yes", give their names, name of company, plan, amount and policy numbers. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
14. Is anyone applying for, or trying to reinstate, life or health insurance on any person named in 1a or 10 in Yes No
this or any company? If "Yes", give amount, details and company. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
15. Does any person named in 1a or 10 plan to live or travel outside the United States and Canada within the next Yes No
12 months? If "Yes", give details. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
16. Has any person named in 1a or 10 operated or had any duties aboard an aircraft, glider, balloon, or like Yes No
device, within the last 2 years, or does any such person have any plans to do so in the future? If "Yes", [ ] [ ]
complete Aviation Questionnaire.
- -----------------------------------------------------------------------------------------------------------------------------------
17. Has any person named in 1a or 10, within the last 12 months: Yes No
a. been treated by a doctor for or had a known heart attack, stroke or cancer other than of the skin? ............ [ ] [ ]
b. had an electrocardiogram for any physical complaint, or taken medication for high blood pressure? ............. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
18. Premiums payable [ ] Ann. [ ] Semi-Ann. [ ] Quar. [ ] Mon. [ ] Pay. Budg. [ ] Pru-Matic [ ] Gov't. Allot.
- -----------------------------------------------------------------------------------------------------------------------------------
19. Amount paid $ [ ] None (Must be "None" if either 17a or 17b is answered "Yes".)
- -----------------------------------------------------------------------------------------------------------------------------------
20. Is a medical examination to be made on Yes No
a. the proposed Insured? ......................................................................................... [ ] [ ]
b. spouse (if proposed for coverage)? ............................................................................ [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
21. If 20a or 20b is "Yes", is it agreed that no insurance will take effect on anyone proposed for coverage until Yes No
the person(s) indicated in 20 have been examined, even if 19 shows that an amount has been paid? ................. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
22. Changes made by the Company
- -----------------------------------------------------------------------------------------------------------------------------------
ORD 84376-82 MISSOURI Page 1 (Continued on page 2)
</TABLE>
II-138
<PAGE>
ACKNOWLEDGEMENT
I have received and read a copy of the IMPORTANT NOTICE ABOUT YOUR APPLICATION
FOR INSURANCE.
- ------------------------------------
Date
, 19
- ------------------------------------
AUTHORIZATION For the Release of Information to:
[ ] The Prudential Insurance Company of America
[ ] Pruco Life Insurance Company
To: Any licensed physician, medical practitioner, hospital, clinic or like
facility, insurance company or the Medical Information Bureau, Inc. or other
organization, institution or person.
To determine eligibility for life insurance coverage, I authorize you to give
the Company checked above and, through it, to its reinsurers and the Medical
Information Bureau, any data or records you may have about me or my mental or
physical health. This also applies to any child proposed for insurance in the
application.
This authorization is valid until two years after the effective date of any
contract issued in connection with this authorization. A photo of this form will
be as valid as the original. (The person who signs this form may have a copy of
it upon request.)
Signature of Proposed Insured (if age 15 or over) otherwise Applicant
- -------------------------------------------------------------------------------
Signature of Spouse (if proposed for coverage)
- -------------------------------------------------------------------------------
ORD 84377 82
- -------------------------------------------------------------------------------
[ ] The Prudential Insurance Company of America [ ] Pruco Life Insurance Company
IMPORTANT NOTICE ABOUT YOUR APPLICATION FOR INSURANCE
-----------------------------------------------------
Before we can issue a policy we must first underwrite your application. This
means that we evaluate all the information necessary to determine if you qualify
for the insurance.
In addition to the information on the application, a medical examination may be
required. We also ask you to authorize any doctor, hospital or other
organization or person to give us any information which they may have about you
or your mental or physical health.
We may ask for a report from a consumer reporting agency. These reports provide
information about a person's character, residence, activities, general
reputation, personal characteristics and mode of living. The agency may get this
information through interviews with friends, neighbors and associates. Any
person on whom we ask for a report has a right to ask to be interviewed. You may
also get a copy of the report from the consumer reporting agency which completed
it. An agency may keep the information it has about you and disclose it to other
persons. If you would like further information as to the nature and scope of
these reports, it will be provided upon request.
Any information which we obtain about you will be treated as confidential.
However, we may give this information, as necessary, to: your doctor, if we find
a serious health problem which you do not know about; persons conducting
mortality or morbidity studies; and affiliate companies for marketing purposes.
If you ask, we will describe any other circumstances when we may disclose
information about you without your prior authorization.
ORD 84378-82
(Continued on reverse)
- -------------------------------------------------------------------------------
[ ] The Prudential Insurance Company of America
[ ] Pruco Life Insurance Company
A Subsidiary of The Prudential Insurance Company of America
TEMPORARY INSURANCE AGREEMENT
We, the Company, agree to provide temporary insurance as follows:
1. It will start on the latest of these dates: (a) the date of this agreement,
(b) the date of completion of all medical examinations agreed to, and (c)
any date asked for in the application.
2. This insurance is subject to the terms of the contract applied for.
3. The sum of all death benefits for any person who is to be covered by this
insurance will be the amount asked for on that person or $250,000,
whichever is less.
The temporary insurance will end:
1. When we issue a contract as applied for. It will replace the temporary
insurance.
2. When we issue a contract other than as applied for. It will replace the
temporary insurance if: (a) it is accepted on delivery (this includes
paying at the same time any excess of the correct first premium over the
amount shown below); and (b) the persons who are to be covered are living
when the contract is delivered. If the contract is not accepted on delivery
the temporary insurance will end at once.
3. When we tell you that we rejected the application or when we tell you that
we will not consider it on a prepaid basis.
4. At the end of 60 days if the temporary insurance has not been ended as we
state in 1, 2 or 3.
ORD 84376A-82 (Continued on reverse) Printed in U.S.A.
- -------------------------------------------------------------------------------
Names and addresses of three Friends or Business Associates:
1. Name _______________________________________________________________________
Address ____________________________________________________________________
2. Name _______________________________________________________________________
Address ____________________________________________________________________
- -------------------------------------------------------------------------------
II-139
<PAGE>
<TABLE>
<CAPTION>
AGENT'S SUPPLEMENTAL INFORMATION
- -----------------------------------------------------------------------------------------------------------------------------------
<S> <C>
- -----------------------------------------------------------------------------------------------------------------------------------
1. Give current and last previous HOME and BUSINESS addresses.
From To Employer No. Street City or Town State
Home
Mo. Yr. Mo. Yr.
Present
- -----------------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
Bus.
Mo. Yr. Mo. Yr.
Present
- -----------------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
2. If an Investigative Consumer Report is necessary, is a direct interview desired? .............................. Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
3. What is the total yearly income of: a. Proposed Insured? $ b. Spouse? $
- -----------------------------------------------------------------------------------------------------------------------------------
4. Does more than 50% of the Insured's support come from someone else? Yes [ ] No [ ] If "Yes", give that person's:
Full name Relationship Amt. of Life ins. force $
- -----------------------------------------------------------------------------------------------------------------------------------
5. Who is to pay the premium? (Check one) [ ] Insured [ ] Employer [ ] Spouse [ ] Parent [ ] Other _______________________________
- -----------------------------------------------------------------------------------------------------------------------------------
6 a. Did someone other than you suggest this insurance? Yes [ ] No [ ] If "Yes", state who and what prompted the request?
-----------------------------------------------------------------------------------------------------------------------
b. What was the primary source of the Sales Lead? (Check one) (1) [ ] Policyholder Service (2) [ ] Referred Lead
(3) [ ] Cold Call
- -----------------------------------------------------------------------------------------------------------------------------------
7. What Sales Services did you use? (Check appropriate boxes)
a. [ ] FACTOR 1 b. [ ] FACTOR 2 c. [ ] Other CPI d. [ ] CNA e. [ ] FNA f. [ ] Business Security Analysis
g. [ ] Employer's Advisory Service h. [ ] Estate Conservation Service i. [ ] Other __________________________________
- -----------------------------------------------------------------------------------------------------------------------------------
8. Complete if this application is for business insurance: c. Amount of business insurance in force and applied for in all
a. Is firm a: (1) [ ] Sole Proprietorship companies on each officer or member of the firm.
(2) [ ] Partnership (3) [ ] Corporation Name Age Position Inforce Applied for
b. Is proposed Insured: $ $
[ ] Owner of firm (state _______%) [ ] Employee --------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
9. Do you have, from any source, facts which you have not stated any place else in the application which indicate that
any person named in 1a or 10 of the application may: (Give details of "Yes" answers in "REMARKS".) Yes No
a. replace or change any current insurance or annuity in any company? ............................................ [ ] [ ]
b. have in the last 3 years participated in hazardous sports (such as auto racing or parachuting), or been
arrested for driving recklessly or while intoxicated? ......................................................... [ ] [ ]
c. have frequently drunk to excess, illegally used habit forming drugs or have a record of indictment or
conviction of any crime? ...................................................................................... [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
10. Has the last name of any person named in 1a or 10 of the application been changed in the last 5 years (marriage, Yes No
court order, etc.)? If "Yes", who, and what was the previous last name? [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
11. Are the proposed Insured and agent related? Yes [ ] No [ ] If "Yes", state relationship: [ ] Self [ ] Other ______________
- -----------------------------------------------------------------------------------------------------------------------------------
12. a. Proposed Insured's telephone no. b. Social Security no.
- -----------------------------------------------------------------------------------------------------------------------------------
Complete 13 if proposed Insured is age 0-14
13. Family Name Date of Present Pending Family Name Date of Present Pending
details birth insurance Pru app.? details birth insurance Pru app.?
Father Brothers
---------------------------------------------------------- & Sisters
Mother
- -----------------------------------------------------------------------------------------------------------------------------------
Complete 14 and 15 if dependent children are proposed for coverage (Give details of "Yes" answers in "REMARKS".)
14. Are any children named in 10 of the application: Yes No
a. foster children or children whole legal adoption has not yet been made final? ................................. [ ] [ ]
b. living in a household other than the proposed Insured's or dependent on someone other than the
proposed Insured? ............................................................................................. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
15. Are there any other children less than 18 years of age who have not been named in 10 of the application? ..... Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
CERTIFICATION
I certify that (a) on this date I saw the proposed Insured and (b), except as stated in "REMARKS", I am not aware of any information
not shown in the answers to the questions in any Part of this application, that would adversely affect the eligibility,
acceptability or insurability of any person proposed for coverage, I recommend that the Company accept the risks proposed for
coverage.
Date Signature of Writing Representative (Agent) Mgr., Asst. Mgr. or Sales Mgr. must sign if present
when application signed
, 19
- -----------------------------------------------------------------------------------------------------------------------------------
REMARKS:
ORD 84376 82
</TABLE>
II-140
<TABLE>
<CAPTION>
Prudential EXHIBIT A(10)(f)
- -----------------------------------------------------------------------------------------------------------------------------------
APPLICATION FOR LIFE INSURANCE
LOGO
----------------------------------------------------
Proposed Insured
- -----------------------------------------------------------------------------------------------------------------------------------
Submitted By
- -----------------------------------------------------------------------------------------------------------------------------------
<S> <C>
----------------------- -------------------- ------------------------------ ---------------------- -------------------
Name & Title Contract No. Agcy. No./Rep. Init. Office Code Detached Office
_____% ----------------------- -------------------- ------------------------------ ---------------------- -------------------
Credit
- -----------------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
[ ] Debit Ord. [ ] New Acct. [ ] Existing Acct. No. of Apps.__________ Fam. Acct. No.
-------------------------------------------------------------------------------------------------------------
[ ] Reg. Ord. Premium Quoted/Scheduled Premium Payment $______________________________________ (According to mode selected)
-------------------------------------------------------------------------------------------------------------
[ ] Pruco FOR FIELD OFFICE STAFF TO COMPLETE: Control No. _________ County Code __________
- -----------------------------------------------------------------------------------------------------------------------------------
ORD 84376 82 PSC
</TABLE>
II-141
<PAGE>
- --------------------------------------------------------------------------------
We may also make a brief report to the Medical Information Bureau (MIB) which
provides an information exchange for its member insurance companies. When you
apply for life or health insurance or submit a claim for benefits to any member
company, MIB will, on request, give that company the information in its file. If
you have any questions about any report which MIB may have on you, you may
contact MIB at Post Office Box 105, Essex Station, Boston, MA 02112, (617)
426-3660.
If you have any questions concerning any of the personal information which we
obtain or report, let us know. You have the right to see this information and to
correct, amend or delete any information which may be wrong. We will tell you
how to do this if you ask us.
If we are unable to issue the policy you requested, we will tell you and explain
the reasons.
Thank you for applying to us for insurance.
Corporate Offices, Newark, N.J.
These Regional Home Offices of The Prudential Insurance Company of America are
also Service Offices of Pruco Life Insurance Company.
Central Atlantic Home Office, Fort Washington, Pa.
Eastern Home Office, South Plainfield, N.J.
Mid-America Home Office, Chicago, Ill.
North Central Home Office, Minneapolis. Minn.
Northeastern Home Office, Boston. Mass.
South-Central Home Office, Jacksonville, Fla.
Southwestern Home Office, Houston, Tex.
Western Home Office, Los Angeles. Calif.
- -------------------------------------------------------------------------------
We received $_____________ on, 19___ from __________________________ This amount
was paid when a life insurance application was signed, on the same date, in
which ____________________________________________ is named as the proposed
Insured.
This agreement is issued on the condition that any check, draft or other order
for the payment of money is good and can be collected. All checks must be drawn
only to the Company and not to any other party.
No change may be made in the terms and conditions of this form. No statement
which claims to make such a change will bind the Company.
Field Office Writing Representative (Agent)
- ------------------------------------- ----------------------------------------
The Prudential Insurance Company of America Pruco Life Insurance Company
Corporate Offices, Newark. N.J.
These Regional Home Offices of The Prudential Insurance Company of America are
also Service Offices of Pruco Life Insurance Company.
Central Atlantic Home Office, Fort Washington, Pa.
Eastern Home Office, South Plainfield, N.J.
Mid-America Home Office, Chicago, III.
North Central Home Office, Minneapolis, Minn.
Northeastern Home Office. Boston, Mass.
South-Central Home Office, Jacksonville, Fla.
Southwestern Home Office, Houston, Tex.
Western Home Office, Los Angeles, Calif.
----------------------------------------------------------------------
Note--Unless you get a contract, or your money back within eight weeks from the
date of this agreement, please notify the Company. Give the amount paid, date of
payment, and name of person to whom paid. (Locations are shown above.)
- -------------------------------------------------------------------------------
3. Name _______________________________________________________________________
Address ____________________________________________________________________
Furnished by ___________________________________________________________
(Name of Proposed Insured/Applicant)
Proposed Insured's Expiration Dates: Auto _____________ Homeowners ____________
- -------------------------------------------------------------------------------
II-142
<PAGE>
ACKNOWLEDGEMENT
I have received and read a copy of the IMPORTANT NOTICE ABOUT YOUR APPLICATION
FOR INSURANCE.
--------------------------------
Date
, 19
----------------------------------------
AUTHORIZATION For the Release of Information to:
[ ] The Prudential Insurance Company of America
[ ] Pruco Life Insurance Company
To: Any licensed physician, medical practitioner, hospital, clinic or like
facility, insurance company or the Medical Information Bureau, Inc. or other
organization, institution or person.
To determine eligibility for life insurance coverage, I authorize you to give
the Company checked above and, through it, to its reinsurers and the Medical
Information Bureau, any data or records you may have about me or my mental or
physical health. This also applies to any child proposed for insurance in the
application.
This authorization is valid until two years after the effective date of any
contract issued in connection with this authorization. A photo of this form will
be as valid as the original. (The person who signs this form may have a copy of
it upon request.)
Signature of Proposed Insured (if age 15 or over) otherwise Applicant
- -------------------------------------------------------------------------------
Signature of Spouse (if proposed for coverage)
- -------------------------------------------------------------------------------
ORD 84377 82
- -------------------------------------------------------------------------------
[ ] The Prudential Insurance Company of America [ ] Pruco Life Insurance Company
IMPORTANT NOTICE ABOUT YOUR APPLICATION FOR INSURANCE
-----------------------------------------------------
Before we can issue a policy we must first underwrite your application. This
means that we evaluate all the information necessary to determine if you qualify
for the insurance.
In addition to the information on the application, a medical examination may be
required. We also ask you to authorize any doctor, hospital or other
organization or person to give us any information which they may have about you
or your mental or physical health.
We may ask for a report from a consumer reporting agency. These reports provide
information about a person's character, residence, activities, general
reputation, personal characteristics and mode of living. The agency may get this
information through interviews with friends, neighbors and associates. Any
person on whom we ask for a report has a right to ask to be interviewed. You may
also get a copy of the report from the consumer reporting agency which completed
it. An agency may keep the information it has about you and disclose it to other
persons. If you would like further information as to the nature and scope of
these reports, it will be provided upon request.
Any information which we obtain about you will be treated as confidential.
However, we may give this information, as necessary, to: your doctor, if we find
a serious health problem which you do not know about; persons conducting
mortality or morbidity studies; and affiliate companies for marketing purposes.
If you ask, we will describe any other circumstances when we may disclose
information about you without your prior authorization.
ORD 84378-82
(Continued on reverse)
- -------------------------------------------------------------------------------
[ ] The Prudential Insurance Company of America
[ ] Pruco Life Insurance Company
A Subsidiary of The Prudential Insurance Company of America
TEMPORARY INSURANCE AGREEMENT
We, the Company, agree to provide temporary insurance as follows:
1. It will start on the latest of these dates: (a) the date of this agreement,
(b) the date of completion of all medical examinations agreed to, and (c)
any date asked for in the application.
2. This insurance is subject to the terms of the contract applied for.
3. The sum of all death benefits for any person who is to be covered by this
insurance will be the amount asked for on that person or $250,000.
whichever is less.
The temporary insurance will end:
1. When we issue a contract as applied for. It will replace the temporary
insurance.
2. When we issue a contract other than as applied for. It will replace the
temporary insurance if: (a) it is accepted on delivery (this includes
paying at the same time any excess of the correct first premium over the
amount shown below); and (b) the persons who are to be covered are living
when the contract is delivered. If the contract is not accepted on
delivery, the temporary insurance will end at once.
3. When we tell you that we rejected the application or when we tell you that
we will not consider it on a prepaid basis.
4. At the end of 60 days if the temporary insurance has not been ended as we
state in 1, 2 or 3.
ORD 84376A-82 (Continued on reverse) Printed in U.S.A.
- -------------------------------------------------------------------------------
Names and addresses of three Friends or Business Associates:
1. Name _______________________________________________________________________
Address ____________________________________________________________________
2. Name _______________________________________________________________________
Address ____________________________________________________________________
- -------------------------------------------------------------------------------
II-143
<PAGE>
<TABLE>
<CAPTION>
<S> <C>
- ----------------------------------------------------===============================================================================
No.
Part 1 Application to ______________________
[ ] The Prudential Insurance Company of America
[ ] Pruco Life Insurance Company--A Subsidiary of The Prudential Insurance Company of America
- -----------------------------------------------------------------------------------------------------------------------------------
1a. Proposed Insured's name--first, initial, last (Print) 1b. Sex 2a. Date of birth 2b. Age 2c. Place of birth
[ ] M [ ] F Mo. Day Yr.
- -----------------------------------------------------------------------------------------------------------------------------------
3. [ ] Single [ ] Married [ ] Widowed [ ] Separated [ ] Divorced 4. Occupation(s)
- -----------------------------------------------------------------------------------------------------------------------------------
5. Address for mail No. Street City State Zip
- -----------------------------------------------------------------------------------------------------------------------------------
6a. Kind of policy 6b. Initial amount 7. Accidental death coverage
$ initial amount $
- -----------------------------------------------------------------------------------------------------------------------------------
8. Beneficiary: (Include name, age and relationship.) 9. List all life insurance on proposed Insured. (If NONE, so state.)
a. Primary (Class 1): b. Contingent (Class 2) if any: Initial Yr. Kind Medical
Company amt. issued (Indiv., Group) Yes No
[ ] [ ]
_________________________________________________________ ___________________________________________________________________
For insurance payable upon death of (1) the Insured, and [ ] [ ]
(2) an insured child after the death of the Insured if ___________________________________________________________________
there is no insured spouse.) [ ] [ ]
___________________________________________________________________
[ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
10. Other person(s) proposed for coverage including the Applicant for Applicant's Waiver of Premium benefit (AWP)
Relationship to Date of birth Total life insurance
Name--first, initial, last Sex proposed Insured Mo. Day Yr. Age Place of birth in all companies
a. Spouse $
___________________________________________________________________________________________________________________________________
b. $
___________________________________________________________________________________________________________________________________
c. $
___________________________________________________________________________________________________________________________________
d. $
___________________________________________________________________________________________________________________________________
e. $
___________________________________________________________________________________________________________________________________
f. $
- -----------------------------------------------------------------------------------------------------------------------------------
11. Supplementary benefits: a. For proposed Insured b. For spouse, children, Applicant for AWP
Type and duration of benefit Amount Type and duration of benefit Amount
$ $
___________________________________________________________________________________________________________________________________
$ $
___________________________________________________________________________________________________________________________________
$ $
___________________________________________________________________________________________________________________________________
[ ] Option to Purchase Additional Ins. $ [ ] Applicant's Waiver of Premium benefit
- -----------------------------------------------------------------------------------------------------------------------------------
12. State any special request.
- -----------------------------------------------------------------------------------------------------------------------------------
13. Will this insurance replace or change any existing insurance or annuity in any company on any person named Yes No
in 1a or 10? If "Yes", give their names, name of company, plan, amount and policy numbers. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
14. Is anyone applying for, or trying to reinstate, life or health insurance on any person named in 1a or 10 in Yes No
this or any company? If "Yes", give amount, details and company. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
15. Does any person named in 1a or 10 plan to live or travel outside the United States and Canada within the next Yes No
12 months? If "Yes", give details. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
16. Has any person named in 1a or 10 operated or had any duties aboard an aircraft, glider, balloon, or like Yes No
device, within the last 2 years, or does any such person have any plans to do so in the future? If "Yes", [ ] [ ]
complete Aviation Questionnaire.
- -----------------------------------------------------------------------------------------------------------------------------------
17. Has any person named in 1a or 10, within the last 12 months: Yes No
a. been treated by a doctor for or had a known heart attack, stroke or cancer other than of the skin? ............ [ ] [ ]
b. had an electrocardiogram for any physical complaint, or taken medication for high blood pressure? ............. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
18. Premiums payable [ ] Ann. [ ] Semi-Ann. [ ] Quar. [ ] Mon. [ ] Pay. Budg. [ ] Pru-Matic [ ] Gov't. Allot.
- -----------------------------------------------------------------------------------------------------------------------------------
19. Amount paid $ [ ] None (Must be "None" if either 17a or 17b is answered "Yes".)
- -----------------------------------------------------------------------------------------------------------------------------------
Yes No
20. Is a medical examination to be made on a. the proposed Insured?................................................. [ ] [ ]
b. spouse (if proposed for coverage)? ................................... [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
21. If 20a or 20b is "Yes", is it agreed that no insurance will take effect on anyone proposed for coverage until Yes No
the person(s) indicated in 20 have been examined, even if 19 shows that an amount has been paid? ................. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
22. Changes made by the Company
- -----------------------------------------------------------------------------------------------------------------------------------
ORD 84376-82 PSC Page 1 (Continued on page 2)
</TABLE>
II-144
<PAGE>
<TABLE>
<CAPTION>
<S> <C>
- -----------------------------------------------------------------------------------------------------------------------------------
Continuation of Part 1 of Application
Complete on all persons named in 1a and 10 if any one of them can have insurance on a non-medical basis.
- -----------------------------------------------------------------------------------------------------------------------------------
23. Height and weight of:
a. Proposed Insured Ht._______ Wt._______ b. Spouse Ht.________ Wt.________ c. Applicant for AWP Ht.________ Wt.________
Has the weight changed more than 10 pounds in the past year? Yes [ ] No [ ] If "Yes", give details in 30.
- -----------------------------------------------------------------------------------------------------------------------------------
24. Has the proposed Insured or spouse ever smoked? a. Proposed Insured Yes [ ] No [ ] b. Spouse Yes [ ] No [ ]
If "Yes", give date(s) last smoked: Cigarettes Cigars Pipe
Proposed Insured Mo.______ Yr. ______ Mo.______ Yr. ______ Mo.______ Yr. ______
Spouse Mo.______ Yr. ______ Mo.______ Yr. ______ Mo.______ Yr. ______
- -----------------------------------------------------------------------------------------------------------------------------------
25. When was a doctor last consulted by: a. Proposed Insured? b. Spouse? c. Applicant for AWP?
Mo.______ Yr. ______ Mo.______ Yr. ______ Mo.______ Yr. ______
- -----------------------------------------------------------------------------------------------------------------------------------
26. Is any person to be covered now being treated or taking medicine for any condition or disease ................. Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
27. Has any person to be covered ever: Yes No
a. had any surgery or been advised to have surgery and has not done so?............................................... [ ] [ ]
b. been in a hospital, sanitarium or other institution for observaation, rest, diagnosis or treatment ................ [ ] [ ]
c. regularly used or is any such person now using, barbiturates or amphetamines, marijuana or other hallucinatory
drugs, or heroin, opiates or other narcotics, except as prescribed by a doctor? ................................... [ ] [ ]
d. been treated or counseled for alcoholism? ......................................................................... [ ] [ ]
e. had life or health insurance declined, postponed, changed, rated-up or withdrawn? ................................. [ ] [ ]
f. had life or health insurance canceled, or its renewal or reinstatement refused? ................................... [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
28. Other than as shown above, in the past 5 years has any person to be covered: Yes No
a. consulted or been attended or examined by any doctor or other practitioner? ...................................... [ ] [ ]
b. had electrocardiograms, X-rays for diagnosis or treatment, or blood, urine, or other medical tests? .............. [ ] [ ]
c. made claim for or received benefits, compensation, or a pension because of sickness or injury? ................... [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
29. Does any person to be covered now have a known sign of any physical disorder, disease or defect not shown above? Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
30. What are the full details of the answer to 25 and to each part of 23 and 26 thru 29 which is answered "Yes"?
Name & Full names and addresses of
Question No. Illness or other resason Dates and duration of illness doctors and hospitals
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
- -----------------------------------------------------------------------------------------------------------------------------------
Those who sign below declare, to the best of their knowledge and belief, that the statements in this application are complete and
true.
When the Company gives a Temporary Insurance Agreement form, ORD 84376A-82, of the same date as this Part 1, coverage will start as
shown in that form. Otherwise, no coverage will start unless: (1) a contract is issued, (2) it is accepted, and (3) the full first
premium is paid while all persons to be covered are living and their health remains as stated in Part 1. If all these take place,
coverage will start on the contract date. If the Company makes a change as indicated in 22 it will be approved by acceptance of the
contract. But where the law requires written consent for any change in the application, such as change can be made only if those
who sign this form approve the change in writing. No agent can make or change a contract, or waive any of the Company's rights or
needs.
OWNERSHIP: Unless otherwise asked for above, the owner of the contract will be (1) the applicant if other than the proposed Insured,
otherwise (2) the proposed Insured. But this is subject to any automatic transfer of owership stated in the contract.
Signature of Spouse (If proposed for coverage)
Signature of Proposed Insured (If Age 8 or over)
- ---------------------------------------------------
----------------------------------------------------------------------
Dated at on , 19 Signature of Applicant (If other than proposed Insured)
- ---------------------------------------------------
City/State ----------------------------------------------------------------------
Witness (If applicant is a firm or corporation, show that company's name)
- --------------------------------------------------- By
(Licensed agent must witness where required by law) ----------------------------------------------------------------------
(Signature and title of officer signing for that company)
ORD 84376-82 PSC Page 2
</TABLE>
II-145
<PAGE>
<TABLE>
<CAPTION>
AGENT'S SUPPLEMENTAL INFORMATION
- -----------------------------------------------------------------------------------------------------------------------------------
<S> <C>
- -----------------------------------------------------------------------------------------------------------------------------------
1. Give current and last previous HOME and BUSINESS addresses.
From To Employer No. Street City or Town State
Home
Mo. Yr. Mo. Yr.
Present
- -----------------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
Bus.
Present
- -----------------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
2. If an Investigative Consumer Report is necessary, is a direct interview desired? .............................. Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
3. What is the total yearly income of: a. Proposed Insured? $ b. Spouse? $
- -----------------------------------------------------------------------------------------------------------------------------------
4. Does more than 50% of the proposed Insured's support come from someone else? Yes [ ] No [ ] If "Yes", give that person's:
Full name Relationship Amt. of Life ins. force $
- -----------------------------------------------------------------------------------------------------------------------------------
5. Who is to pay the premium? (Check one) [ ] Insured [ ] Employer [ ] Spouse [ ] Parent [ ] Other _______________________________
- -----------------------------------------------------------------------------------------------------------------------------------
6 a. Did someone other than you suggest this insurance? Yes [ ] No [ ] If "Yes", state who and what prompted the request?
-----------------------------------------------------------------------------------------------------------------------
b. What was the primary source of the Sales Lead? (Check one) (1) [ ] Policyholder Service (2) [ ] Referred Lead
(3) [ ] Cold Call
- -----------------------------------------------------------------------------------------------------------------------------------
7. What Sales Services did you use? (Check appropriate boxes)
a. [ ] FACTOR 1 b. [ ] FACTOR 2 c. [ ] Other CPI d. [ ] CNA e. [ ] FNA f. [ ] Business Security Analysis
g. [ ] Employer's Advisory Service h. [ ] Estate Conservation Service i. [ ] Other __________________________________
- -----------------------------------------------------------------------------------------------------------------------------------
8. Complete if this application is for business insurance: c. Amount of business insurance in force and applied for in all
a. Is firm a: (1) [ ] Sole Proprietorship companies on each officer or member of the firm.
(2) [ ] Partnership (3) [ ] Corporation Name Age Position Inforce Applied for
b. Is proposed Insured: $ $
--------------------------------------------------------------
[ ] Owner of firm (state _______%) [ ] Employee
- -----------------------------------------------------------------------------------------------------------------------------------
9. Do you have, from any source, facts which you have not stated any place else in the application which indicae that
any person named in 1a or 10 of the application may: (Give details of "Yes" answers in "REMARKS".) Yes No
a. replace or change any current insurance or annuity in any company? ............................................ [ ] [ ]
b. have in the last 3 years participated in hazardous sports (such as auto racing or parachuting), or been
arrested for driving recklessly or while intoxicated? ......................................................... [ ] [ ]
c. have frequently drunk to excess, illegally used habit forming drugs or have a record of indictment or
conviction of any crime? ...................................................................................... [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
10. Has the last name of any person named in 1a or 10 of the application been changed in the last 5 years (marriage, Yes No
court order, etc.)? If "Yes", who, and what was the previous last name? [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
11. Are the proposed Insured and agent related? Yes [ ] No [ ] If "Yes", state relationship: [ ] Self [ ] Other ______________
- -----------------------------------------------------------------------------------------------------------------------------------
12. a. Proposed Insured's telephone no. b. Social Security no.
- -----------------------------------------------------------------------------------------------------------------------------------
Complete 13 if proposed Insured is age 0-14
13. Family Name Date of Present Pending Family Name Date of Present Pending
details birth insurance Pru app.? details birth insurance Pru app.?
Father Brothers
---------------------------------------------------------- & Sisters
Mother
- -----------------------------------------------------------------------------------------------------------------------------------
Complete 14 and 15 if dependent children are proposed for coverage (Give details of "Yes" answers in "REMARKS".)
14. Are any children named in 10 of the application: Yes No
a. foster children or children whole legal adoption has not yet been made final? ................................. [ ] [ ]
b. living in a household other than the proposed Insured's or dependent on someone other than the
proposed Insured? ............................................................................................. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
15. Are there any other children less than 18 years of age who have not been named in 10 of the application? ..... Yes [ ] No [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
Complete 16 for Pennsylvania Only:
16. Did you deliver the Disclosure Statement required by the Commonwealth of Pennsylvania Insurance Department Yes No
to the applicant no later than the time the application was signed by the applicant?.............................. [ ] [ ]
- -----------------------------------------------------------------------------------------------------------------------------------
CERTIFICATION
I certify that (a) on this date I saw the proposed Insured and (b), except as stated in "REMARKS", I am not aware of any information
not shown in the answers to the questions in any Part of this application, that would adversely affect the eligibility,
acceptability or insurability of any person proposed for coverage, I recommend that the Company accept the risks proposed for
coverage.
Date Signature of Writing Representative (Agent) Mgr., Asst. Mgr. or Sales Mgr. must sign if present
when application signed
, 19
- -----------------------------------------------------------------------------------------------------------------------------------
REMARKS:
ORD 84376 82 PSC
</TABLE>
II-146
EXHIBIT 1.A.(11)
[LOGO] PRUDENTIAL
PRUCO LIFE INSURANCE COMPANY*
North Central Service Office
P. O. Box 1143
Minneapolis, MN 55440
* Subsidiary of The Prudential Insurance Company of America
_________________________________________
| INSURED | POLICY NUMBER | | FOR INSURANCE SERVICE, CONTACT
| | | | YOUR REPRESENTATIVE OR THIS
|______________________|_________________| | OFFICE
|
|
|
|________________________________
NOTICE OF WITHDRAWAL RIGHT
In order to comply with the laws administered by the Securities and Exchange
Commission, we are sending you this notice. Please read it carefully and keep it
with your records.
You have recently purchased a variable life insurance contract from Pruco Life.
The benefits of this contract depend on the investment experience of the money
market. bond, and common stock subaccounts of Pruco Life's variable insurance
account. These subaccounts are described in the Prospectus that was given to you
at the time of the sale.
You have the right to examine and cancel this contract. Upon its return, you are
entitled to a full refund of all premiums paid. The cancellation deadline is the
latest of:
1. 10 days after you have received the contract.
2. 45 days from the date you completed PART 1 of the application.
3. 10 days from the date of delivery of this notice.
in determining whether or not to cancel your contract you should consider, along
with other factors such as the needs and other reasons which motivated you to
purchase this contract, the projected cost and your ability to make the
scheduled premium payments as stated in your contract. Please consult and review
the Prospectus you have received. The Prospectus describes the deductions from
payments before amounts are allocated to the subaccounts mentioned above. These
are:
o A total yearly administration fee of $30.00 if premiums are paid
annually, $32.00 if paid semi-annually, $36.00 if paid quarterly, or
$48.00 if paid monthly.
o A deduction for sales load of not more than 30% in the first year,
10% in contract years 2 through 4, and 7.5% in contract years 5 and
after.
o A risk charge of not more than 1.2% to guarantee the minimum death
benefit.
o A deduction of not more than 2% for premium tax.
o For each $1,000.00 of face amount of insurance, a deduction from each
premium in the contract year for additional administration expenses of
$5.00 if premiums are paid annually, $2.52 if paid semi-annually,
$1.27 if paid quarterly, or $.43 if paid monthly.
These deductions do not include premiums for extra mortality risks or
optional insurance benefits.
Similar charges for many of the foregoing are made in all permanent life
insurance policies but are not specified as to expense or amount.
If you decide to cancel your contract complete the enclosed form and return it
along with your contract. The postmark of the returned contract must be on or
before the deadline described above.
II-147
<PAGE>
INSTRUCTIONS
Please read carefully
If after reading the enclosed notice, you decide to return your contract for
cancellation, you must:
1. Sign and date the bottom portion of this form.
2. Mail this notice together with your contract to:
Pruco Life Insurance Company
North Central Service Office
P. O. Box 1143, Minneapolis, MN 55440
3. Make certain that the postmark on the envelope is on or before the
latest date permitted for cancellation as described in the enclosed
notice.
4. Check the box at the bottom if you have not yet received your
contract when mailing this form.
TO BE FILLED OUT BY OWNER
To: Pruco Life
Pursuant to the terms of the notice previously furnished me by Pruco Life, I
hereby return the contract numbered below for cancellation and request a full
refund of all premiums paid by me. I release Pruco Life from any claims in
connection with the sale or issuance of this contract and acknowledge that
Pruco Life's only liability is the refund of the premiums paid for the contract.
___________________________________ _____________________________________
Date Signature of Contract Owner
_____________________________________
Policy Number
_____________________________________
Name of Insured (if other than owner)
I have not yet received the contract and,
should it be received, I will return it to Pruco Life.
II-148
Exhibit A(12)
Description of Pruco Life's Issuance, Transfer and
Redemption Procedures for Policies
Pursuant to Rule 6e-2(b)(12)(ii)
and
Method of Computing Adjustments in
Payments and Cash Values of Policies
Upon Conversion to Fixed benefit Policies
Pursuant to Rule 6e-2(b)(13)(v)(B)
This document sets forth the administrative procedures that will be
followed by Pruco Life Insurance Company ("Pruco Life") in connection with the
issuance of its Variable Life Insurance Contract ("Contract"), the transfer of
assets held thereunder, and the redemption by Contract owners of their interests
in said Contracts. The document also explains the method that Pruco Life will
follow in making a cash adjustment when a Contract is exchanged for a fixed
benefit insurance policy pursuant to Rule 6e-2(b)(13)(iv)(B).
I. Procedures Relating to Issuance and Purchase of the Contracts
A. Premium Schedules and Underwriting Standards
Premium for Pruco Life's Contract will not be the same for all Owners.
Insurance is based on the principle of pooling and distribution of mortality
risks, which assumes that each Owner pays a premium commensurate with the
Insured's mortality risk as actuarially determined utilizing factors such as
age, sex, health and occupation. A uniform premium for all Insureds would
discriminate unfairly in favor of those Insureds representing
II-149
<PAGE>
greater risks. Although there will be no uniform premium for all Insureds, there
will be a single price for all Insureds in a given risk classification.
The Contract will be offered and sold pursuant to established premium
schedules(1) and underwriting standards in accordance with state insurance laws.
The prospectus specifies premiums for illustrative ages. In addition, the
premiums to be paid by an Owner will be specified in the Contract.
B. Application and Initial Premium Processing
Upon receipt of a completed application from a prospective Owner, Pruco
Life will follow certain insurance underwriting (i.e. evaluation of risk)
procedures designed to determine whether the proposed Insured is insurable. This
process may involve such verification procedures as medical examinations and may
require that further information be provided by the proposed Insured before a
determination can be made. A Contract cannot be issued, i.e. physically issued
through Pruco Life's computerized issue system, until this underwriting
procedure has been completed.
- ------------
(1) In accordance with industry practice, Pruco Life will establish procedures
to handle errors in initial and subsequent premium payments to refund
overpayments and collect underpayments, except for de minimis amounts.
II-150
<PAGE>
If the initial premium is paid with the application and the Contract is
issued as applied for, the Contract date will be that of the latest of Part 1 of
the application, Part 2 of the application (any medical examination), or 21 days
prior to the date of physical issue. If the first premium is not paid with the
application, the Contract date will be the Contract date as stated in the
Contract (which is ordinarily two or three days after the application is
approved), provided the Owner pays the necessary premium.
The contract date marks the date on which benefits begin to vary in
accordance with the investment performance of the selected subaccounts of the
Pruco Life Variable Insurance Account ("Account"). It is also the date as of
which the insurance age of the proposed Insured is determined. It represents the
first day of the Contract year and therefore determines the Contract anniversary
and also the monthly dates. It also represents the commencement of the suicide
and contestable periods for purposes of the Contract.
There are two principal variations in the foregoing procedure. First, if
the Owner wishes that permanent insurance protection and variability of benefits
commence at a future date, he can select a period of initial term insurance.
Pruco Life may sell such temporary insurance with coverage commencing on the
II-151
<PAGE>
latest of (1) the date of the temporary insurance agreement; (2) the date of
completion of all medical examinations agreed to; and (3) any date asked for in
the application. The length of initial term insurance available varies from
state to state.
Second, subject to state insurance laws, the Contract may be dated back up
to 6 months, provided that the premium is paid with the application and that the
backdating results in a lower insurance age for the Insured. In that case the
variability of benefits will begin on this backdated Contract date.
Pruco Life will transfer the appropriate amount from its general account to
the Account on the date the contract is approved unless, as noted above, the
Owner selects a period of preliminary term insurance in which case the first net
premium will be transferred to the Account on the contract date. The variable
benefits under all contracts will be calculated on the assumption that the
initial net premium was transferred to the Account on the Contract date.
C. Premium Processing
On each premium due date, Pruco Life will transfer a net premium from the
general account to the Account, whether or not the premium has been paid by the
Owner. This procedure will sometimes result in Pruco Life's advancing monies
prior to
II-152
<PAGE>
receipt of premiums. The amount of the net premium will depend upon such factors
as the Insured's age, sex, risk classification, the Contract's face amount, and
the period for which the Contract has been in force. The amount of the net
premium for the second, third, and forth Contract years will always be greater
than the net premium for the first Contract year, and the net premium for
subsequent years will be at least equal to that for prior years.
The size of the premiums is computed on the assumption that, on the
average, premiums will be paid on the due date, although some may be paid before
and some later in the grace period.
Premiums paid less frequently are lower than the sum of the premiums paid
more frequently over the same period. This reflects an increased administrative
charge because of the additional expense incurred in collecting and processing
additional premiums as well as an interest adjustment to take account of the
fact that when premiums are paid annually the insurer has the use of the funds
for the entire year.
The net premium added to the Account for an annual premium Contract is
lower than the sum of the twelve net premiums for a monthly premium Contract.
The annual net premium is calculated so that if the Account earns the assumed
investment return of 4%, it will accumulate to the same amount as twelve
II-153
<PAGE>
monthly net premiums would have. Also, the larger annual premium provides
greater participation in the investment experience of the Account at an earlier
time than the monthly net premiums. which are added to the Account later
periodically throughout the contract year.
D. Reinstatement
The Contract may be reinstated within three years after the due date of the
first unpaid premium unless the net cash value has been paid. A contract will be
reinstated upon receipt by Pruco Life of a written application for
reinstatement, production of evidence of insurability satisfactory to Pruco Life
and payment of an amount equal to the greater of" (a) all overdue premiums with
interest of 6% compounded annually; or (b) 110% of the excess of the net cash
value immediately following reinstatement over the net cash value immediately
preceding reinstatement, plus total premiums in arrears for extra benefits with
compound interest at 6% a year.
Any Contract debt must be restored with interest to date at 5 1/2% a year.
If that debt with interest would exceed the loan value of the reinstated
contract, the excess must be paid to Pruco Life before reinstatement.
Upon reinstatement, the Contract will have the same death benefit, net cash
value, and contract debt, if any, as if default had not occurred. This
reinstatement provision is
II-154
<PAGE>
designed to comply with the insurance laws of a number of states.
In order to assist an Owner of a lapsed Contract in making a considered
judgment as to whether to reinstate, Pruco Life may calculate the amount payable
upon reinstatement and "freeze" the amount for up to fourteen days.
The reinstatement will take effect as of the date the required proof of
insurability and payment of the reinstatement amount have been received by Pruco
Life at its Service Office. Pruco Life will place the reinstatement amount in
its general account and transfer to the Account assets equal to the amount
required to support the reinstated benefits.
E. Repayment of Loan
A loan made under Pruco Life's contract may be repaid with an amount equal
to the monies borrowed plus 5 1/2% interest.
When a loan is made, Pruco Life will transfer from the Account to the
general account an amount equal to the contract debt thereby created. Since the
Contract owner will be credited at the assumed rate of return of 4% upon the
amount of the outstanding Contract debt, Pruco Life will realize the difference
between that rate and the 5 1/2% loan interest rate charged to the Owner in
order to cover the loan investment expenses, income taxes, if any, and a charge
for expenses and mortality risks and
II-155
<PAGE>
other contingencies. Upon repayment of contract debt, Pruco Life will reduce its
general account loan asset and transfer assets supporting corresponding reserves
to the Account.
II. Transfer Among Subaccounts
The Account currently has three subaccounts, each of which is invested in
shares of a corresponding portfolio of the Pruco Life Series Fund, Inc.
("Fund"), which is registered under the 1940 Act as an open-end diversified
management investment company. The Owner, as often as four times in each
contract year, may transfer amounts among subaccounts, if premiums have been
duly paid. All or a portion of the amount attributable to the Contract in a
subaccount may be transferred, but if only a portion is tranferred, the transfer
may not result in less than $100 being held in any subaccount on the day of
transfer. If an Owner reallocates amounts among subaccounts on a percentage
basis, the percentage must be in whole numbers. The transfer will take effect as
of the date of receipt in Pruco Life's Service Office of written notice in a
form satisfactory to Pruco Life.
II-156
<PAGE>
III. "Redemption" Procedures: Surrender and Related Transactions
A. Surrender for Cash Value
If the insured party under a Contract is alive, Pruco Life will pay, within
seven days, the net cash value as of the date of receipt, at its Service office,
of the Contract and a signed request for surrender. Computations with respect to
the investment experience of the Account will be made on each day during which
the New York Stock Exchange is open for trading, as of the time of the close of
trading on such Exchange. Computations for days on which the Exchange is not
open for trading will be based on the investment experience as of the last prior
day on which the Exchange was open for trading.
On each monthly date, Pruco Life adjusts the insurance amount and
calculates the net cash value. The monthly date occurs on the Contract date and
then in each later month on the same day of the month as the contract date. On a
monthly date if no premium is in default, the net cash value is equal to (a) the
tabular cash value on that date; plus (b) the net single premium for the
variable insurance amount that applies on that date; minus (c) if that date is a
premium due date, and the premium has not been paid, the net premium that
applies on that date; minus (d) any contract debt; minus (e) in the first
contract year, any issue charge installments that have not yet been paid. The
amount of (b) will be less than zero if the variable insurance
II-157
<PAGE>
amount is less than zero. The net premium is equal to the premium less various
charges disclosed in the prospectus. The amounts of the net premiums and the
issue charge installment will be shown on page 3 of the Contract. Each Contract
will contain a table showing the amount of the "tabular cash value" applicable
to the Contract as of each Contract anniversary date. When necessary, the
tabular cash value for dates between contract anniversary dates will be
determined by interpolation.
The issue charge installments in the first contract year are designed to
recover, a far as possible, the administrative expenses incurred before the
Contract is issued. As a result, in the early months of the first contract year,
there may be no net cash value where premiums are paid more frequently than
annually.
The net cash value on a date other than a monthly date will be equal to:
(a) the tabular cash value on that date; plus (b) the net single premium at the
insured's attained age for the variable insurance amount on that date; plus (c)
the excess investment return since the last monthly date; minus (d) any Contract
debt; minus (e) in the first Contract year, any issue charge installments that
have not yet been paid.
If the due date of a paid premium is on or after the effective date of
surrender, Pruco Life will refund that premium. During the days of grace of a
premium in default, the
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<PAGE>
net cash value will be the net cash value as of the due date of the unpaid
premium, adjusted up or down depending on whether the assets relating to the
Contract have increased at more than 4% a year or not. After the days of grace
have expired, a Contract's net cash value is the net cash value of any extended
term or reduced paid-up insurance then in force.
Pruco Life will make the payment of the surrender value out of its general
account and, at the same time, transfer assets from the Account or the general
account in an amount equal to the reserve liability applicable to the Contract
held in the Account.
In lieu of the payment of the net cash value in a single sum upon surrender
of a Contract, an election may be made by the Contract owner to apply all or a
portion of the proceeds under one of the fixed benefit settlement options
described in the Contract or, with the approval of Pruco Life, a combination of
options. An option is available only if the proceeds to be applied are $1,000 or
more or would result in periodic payments of at least $20.00. The fixed benefit
settlement options are subject to the restrictions and limitations set forth in
the Contract.
B. Death Claims
Pruco Life will pay a death benefit to the beneficiary within seven days
after receipt at its Service Office of due
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<PAGE>
proof of death of the Insured, and all other requirements necessary(2) to make
payment.
On each Monthly date to which premiums have been duly paid, Pruco Life will
adjust the variable insurance amount to take account of investment experience of
the Account for the previous Contract month. Provided premiums are duly paid,
the insurance amount during a Contract month will be equal to the sum of (a) the
face amount and (b) the variable insurance amount (computed on the previous
monthly date) if greater than zero. The insurance amount is guaranteed not to be
less than the face amount. The insurance amount will not be adjusted downward or
upward during the Contract month. Provided that no premium is in default more
than 31 days, the death benefit payable to the beneficiary will be equal to (a)
the insurance amount; plus (b) a pro rata refund of any premiums paid for
periods beyond the date of death; minus (c) any contract debt; minus (d) the pro
rata part of any premium in default if death occurs during the 31 day grace
period. The proceeds payable on death also reflect interest from the date of
death to the date of payment.
- ------------
(2) State insurance laws impose various requirements, such as receipt of a tax
waiver, before payment of the death benefit may be made. In addition,
payment of the death benefit is subject to the provisions of the Contract
regarding suicide and incontestability.
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<PAGE>
Pruco Life will make payment of the death benefit out of its general
account, and will transfer assets from the Account to the general account in an
amount equal to the reserve liability applicable to the Contract held in the
Account. The excess of the insurance amount over the sum of the face amount and
the variable insurance amount, if any, will be paid out of a general account
reserve maintained for that purpose.
In lieu of payment of the death benefit in a single sum, an election may be
made to apply all or a portion of the proceeds under one of the fixed benefit
settlement options described in the Contract or, with the approval of Pruco
Life, a combination of options. The election may be made by the Owner during the
Insured's lifetime, or, if no election is in effect at death, by the
beneficiary. An option in effect at death may not be changed to another form of
benefit after death. An option is available only if the proceeds to be applied
are $1,000 or more or would result in periodic payments of at least $20.00. The
fixed benefit settlement options are subject to the restrictions and limitations
set forth in the Contract.
C. Default and Options on Lapse
A premium not paid on or before its due date is in default, but Pruco
Life's Contact provides for a 31 day grace period for the payment of each
premium after the first. The insurance coverage continues in force during the
grace period,
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<PAGE>
but if the Insured dies during the grace period, the portion of the premium due
which is applicable to the period from the premium due date to the date on which
the Insured dies is deducted from the insurance amount.
Except for Contracts issued on certain insureds in high risk rating
classes, a lapsed Contract will be converted to extended term insurance at
expiration of the grace period. The insurance amount of the extended term
insurance is equal to the insurance amount of the Contract as of the due date of
the premium in default, less any Contract debt. The extended term insurance will
continue for a length of time that depends on the net cash value on the due date
of the first unpaid premium, the amount of insurance and the age and sex of the
insured.
Contracts issued on the above-mentioned high risk insureds will be
converted to reduced paid-up whole-life insurance at expiration of the grace
period. Moreover, extended term insurance may be exchanged for reduced paid-up
insurance within three months of the due date of the first unpaid premium. The
insurance amount will depend on the net cash value on the due date of the first
premium in default, and the age and sex of the insured.
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<PAGE>
D. Loans
Pruco Life's Contract provides that an Owner, if no premium is in default
beyond the grace period(3) may make a loan at any time a loan value is available
after the first Contract year. The Owner may borrow money on completion of a
form satisfactory to Pruco Life assigning the Contract as the only security for
the loan. Payment of the loan will be made from Pruco Life's general account
within seven days of receipt of the form at Pruco Life's Service Office.
Allocation of the loan among the subaccounts of the Account will be in the same
proportion as reserves applicable to the Contract are held in those subaccounts.
An Owner may borrow up to the Contract's loan value. During the first
contract year, the loan value is zero. After the first contract year, the loan
value is 75% of the cash value. Interest accrues daily at an effective annual
rate of 5 1/2% and, if not paid, is added to the amount of the loan on each
Contract anniversary. Except when used to pay premiums, a loan will not be
permitted unless it is for at least $500.
A loan does not affect the amount of premiums due. When a loan is made, an
amount equal to the Contract debt thereby
- ----------
(3) The Contract also provides for a loan value if the Contract is in effect
under the contract value option for Reduced Paid-Up Insurance, but not if it
is in effect under the Contract value option for Extended Term Insurance.
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<PAGE>
created is transferred from the Account to Pruco Life's general account. Because
of the transfer, the investment base in the Account available to affect the
investment experience is smaller and the monthly adjustment of the insurance
amount and the daily changes in the net cash value will be different from what
they would have been had no loan been taken. The death benefit and cash value
are thus permanently affected by any Contract debt, whether or not repaid.
The quaranteed minimum death benefit is not affected by Contract debt if
premiums are duly paid. However, on settlement the amount of any contract debt
is subtracted from the insurance amount.
If contract debt ever becomes equal to or more than what the net cash value
would be if there were no Contract debt, all the Contract's benefits will end 31
days after notice is mailed to the Owner and any known assignee, unless
repayment is made within that period.
IV. Cash Adjustment Upon Exchange of Contract
Purco Life's Contract, in accordance with Rule 6e-2(b)(13)(v)(B), provides
that the Owner, within 24 months of issuance of a Contract, may exchange the
Contract, without submission of new evidence of insurability, for a permanent
fixed benefit insurance policy offered by Prudential. The new Policy will have a
face amount equal to the face amount of the original
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Contract. The new policy will be a Life Paid-Up at Age 85 plan. It will have the
same Contract date and insurance age as the original Contract, and be in the
same risk classification. This exchange privilege is designed to permit a
Contract Owner to change his mind and obtain a fixed benefit policy.
There will be a cash adjustment upon exercise of the exchange privilege
under Rule 6e-2(b)(13)(v)(B). That adjustment will be: (1) the difference
between the premiums that would have been required under the new policy had it
been purchased at the outset and premiums paid under the Contract; minus (2) the
difference, if positive, between the actual cash value under the Contract at the
date of exchange and what that cash value would have been had the assets in the
Account relating to the Contract earned a uniform net investment return of 4% a
year.
Once the exchange takes effect, there will be an appropriate transfer of
funds between Pruco Life and Prudential to reflect the assumption of the risk by
Prudential. At the same time, Pruco Life will transfer assets from the Account
to the general account in an amount equal to the applicable reserve.
II-165
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EXHIBIT 1.A(13)(a)
RIDER FOR INSURED'S WAIVER OF PREMIUM BENEFIT
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
Total Disability Benefit.--We will waive contract premiums that fall due while
the Insured is totally disabled. But this is subject to all the provisions of
this Benefit and of the rest of this contract.
Disability Defined.--When we use the words disability and disabled in this
Benefit we mean total disability and totally disabled. Here is how we define
them: (1) until the Insured has stayed disabled for two years, we mean that he
or she cannot, due to sickness or injury, do any of the duties of his or her
regular occupation; but (2) after the Insured has stayed disabled for two years,
we mean that he or she cannot, due to sickness or injury, do any gainful work
for which he or she is reasonably fitted by education, training, or experience.
Except for what we state in the next sentence, we will at no time regard an
Insured as disabled who is doing gainful work for which he or she is reasonably
fitted by education, training, or experience. We will regard an Insured as
disabled, even if working or able to work, if he or she incurs, during a period
in which premiums are eligible to be waived as we describe below, one of the
following: (1) permanent and complete blindness of both eyes; or (2) severance
of both hands at or above the wrists or both feet at or above the ankles; or (3)
severance of one hand at or above the wrist and one foot at or above the ankle.
Premiums Eligible To Be Waived.--If the Insured becomes disabled before the
first contract anniversary after his or her 60th birthday and that disability
begins (1) on or after the first contract anniversary after his or her 5th
birthday, if the contract date was before that birthday; or (2) on or after the
contract date, if that date was on or after his or her 5th birthday, we will
waive all premiums that fall due while he or she stays disabled.
If the Insured becomes disabled on or after the first contract anniversary after
his or her 60th birthday, we will waive only those premiums that fall due before
the first contract anniversary after his or her 65th birthday and while he or
she stays disabled.
If the Insured becomes disabled on or after the first contract anniversary after
his or her 65th birthday, we will not waive any premiums that fall due in that
period of disability.
Conditions.--Both of these conditions must be met: (1) The Insured must become
disabled while this contract is in force with no premium in default past its
days of grace. (2) The Insured must stay disabled for a period of at least six
months while living.
Exceptions.--We will not waive any premium if the Insured becomes disabled from:
(1) an injury he causes to himself, or she causes to herself, on purpose; or (2)
sickness or injury due to service on or after the contract date in the armed
forces of any country(ies) at war. The word war means declared or undeclared war
and includes resistance to armed aggression.
Successive Disabilities.--Here is what happens if the Insured has at least one
premium waived while disabled, then gets well so that premium payment resumes,
and then becomes disabled again. In this case, we will not apply the six-month
period that would otherwise be required by Condition (2) and will consider the
second period of disability to be part of the first period unless: (1) the
Insured has done gainful work, for which he or she is reasonably fitted, for at
least six months between the periods; or (2) the Insured became disabled the
second time from an entirely different cause.
If we do not apply the six-month period required by Condition (2), we also will
not count the days when there was no disability as part of the two year period
when disability means the Insured cannot do any of the duties of his or her
regular occupation.
Notice and Proof of Claim.--Notice and proof of any claim must be given to us
while the Insured is living and disabled, or as soon as reasonably possible. If
notice or proof is not given as soon as reasonably possible, we will not waive
any premium due more than one year before the date the notice or proof is given
to us. We may require proof at reasonable times that the Insured is still
disabled. After he or she has been disabled for two years, we will not ask for
proof more than once a year. As a part of any proof, we have the right to
require that the Insured be examined at our expense by doctors of our choice.
Recovery from Disability.--We will stop waiving premiums if (1) disability ends;
or (2) we ask for proof that the Insured is disabled and we do not receive it;
or
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(3) we require that the Insured be examined and he or she fails to do so.
Miscellaneous.--Any premiums that fall due are payable until we approve a claim.
We will refund any premium paid that is later waived. But we will not, of
course, refund any premium or part of a premium that was or is to be returned in
accord with the Premium Adjustment provision in this contract.
There might be unpaid premiums that fall due (1) after disability starts; but
(2) more than one year before we have notice of claim at our Service Office. Or
disability might start in the days of grace of an unpaid premium. In either
case, if we are otherwise able to approve a claim, those unpaid premiums that we
do not waive will be due us with compound interest at 6% a year. If we do not
receive them, we will deduct them with interest from any amount we pay under the
contract.
Any premium we waive will be at the frequency in effect when the Insured becomes
disabled.
If we waive premiums, the effect on this contract will be the same as if the
premiums had been paid in cash. But the Premium Adjustment provision will not
apply to any premium that was not paid because it was waived under this Benefit.
If we owe the Insured a refund of premium but have not paid it before his or her
death, we have the choice of paying the beneficiary for insurance payable upon
the death of the Insured or the Insured's estate.
Benefit Premiums.--The premiums for this Benefit are a part of the contract
premiums due before the first contract anniversary after the Insured's 65th
birthday.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the day that is the last premium due date in the premium period;
3. the end of the day before the first contract anniversary after the Insured's
65th birthday, unless the Insured has stayed disabled since before the first
contract anniversary after the 60th birthday;
4. the date the contract is surrendered under its Cash Value Option, if it has
one; and
5. the date the contract ends for any other reason.
This Supplementary Benefit rider
attached to this contract on the Contract Date
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
--------------------------------
Secretary
VL 100 Printed in U.S.A.
II-167
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EXHIBIT 1.A(13)(b)
RIDER FOR INSURED'S ACCIDENTAL DEATH BENEFIT
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
Benefit.--We will pay the amount of this Benefit that we show on the Contract
Data page(s) for the Insured's accidental loss of life. But our payment is
subject to all the provisions of the Benefit and of the rest of this contract.
Manner of Payment.--We will include in the proceeds of this contract any payment
under this Benefit.
Conditions.--Both of these conditions must be met: (1) We must receive due proof
that the Insured's death was the direct result, independent of all other causes,
of accidental bodily injury that occurred on or after the contract date. (2) The
death must occur (a) no more than 90 days after the injury; (b) while the
contract is in force with no premium in default past its days of grace; and (c)
before the end of the contract's term, renewal or endowment period, if any.
Exclusions.--We will not pay under this Benefit for death caused or contributed
to by: (1) suicide or attempted suicide while sane or insane; or (2) infirmity
or disease of mind or body or treatment for it; or (3) any infection other than
one caused by an accidental cut or wound.
Even if death is caused by accidental bodily injury, we will not pay for it
under this benefit if it is caused or contributed to by: (1) service in the
armed forces of any country(ies) at war; or (2) war or any act of war; or (3)
travel by, or descent from, any aircraft if the Insured had any duties or acted
in any capacity other than as a passenger at any time during the flight. But we
will ignore (3) if all these statements are true of the aircraft: (a) it has
fixed wings and a permitted gross takeoff weight of at least 75,000 pounds. (b)
It is operated by an air carrier that is certificated under the laws of the
United States or Canada to carry passengers to or from places in those
countries. (c) It is not being operated for any armed forces for training or
other purposes. As used here, the word aircraft includes rocket craft or any
other vehicle for flight in or beyond the earth's atmosphere. The word war means
declared or undeclared war and includes resistance to armed aggression.
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s).
Termination.--This benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the date the contract is surrendered under its Cash Value Option, if it has
one; and
3. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
This Supplementary Benefit rider
attached to this contract on the Contract Date
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
-----------------------------------------
Secretary
VL 110
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EXHIBIT 1A(13)(c)
RIDER FOR
TERM INSURANCE BENEFIT ON LIFE OF INSURED-DECREASING AMOUNT
Read the list of Supplementary Benefits on the
Contract Data page(s). This Benefit is a part of
this contract only if it is listed there.
Benefit.--We will pay an amount under this Benefit if we receive due proof that
the Insured died (1) in the term period for the Benefit; and (2) while this
contract is in force with no premium in default past its days of grace. Any
proceeds under this contract that may arise from the Insured's death will
include this amount. But our payment is subject to all the provisions of the
Benefit and of the rest of this contract.
We will use the table below to compute the amount we will pay. We show the
Initial Amount of Term Insurance under this Benefit on the Contract Data
page(s). We also show the term period for the Benefit there. It starts on the
contract date, which we show on the first page. The anniversary at the end of
the term period is part of that period.
TABLE OF AMOUNTS OF INSURANCE
Amounts Payable.--We show here the amount we will pay for each $1,000 of Initial
Amount of Term Insurance if death occurs in the contract year ending with the
anniversary shown.
- ----------------------------------- --------------------------------------
ANNIVERSARY AMOUNT ANNIVERSARY AMOUNT
- ----------------------------------- --------------------------------------
1 $1,000 12 $706
2 986 13 658
3 970 14 603
4 951 15 543
5 931 16 475
6 909 17 400
7 883 18 316
8 855 19 222
9 824 20 200
10 789 BENEFIT EXPIRES
11 750 ON 20TH ANNIVERSARY
- ----------------------------------- --------------------------------------
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CONVERSION TO ANOTHER PLAN OF INSURANCE
Right to Convert.--You may be able to exchange this Benefit for a new contract
of life insurance on the Insured's life in either this company or The Prudential
Insurance Company of America. In any of these paragraphs, when we use the phrase
the company we mean whichever of these companies may issue the new contract. And
where we use the phrase new contract we mean the contract for which the Benefit
may be exchanged. You will not have to prove that the Insured is insurable.
Conditions.--Your right to make this exchange is subject to all these
conditions: (1) The amount we would have paid under this Benefit if the Insured
had died just before the contract date of the new contract must be large enough
to meet the minimum for a new contract, as we describe under Contract
Specifications. (2) You must ask for the exchange in writing and in a form that
meets our needs. (3) You must send this contract to us to be endorsed. (4) We
must have your request and the contract at our Service Office while the Benefit
is in force and at least five years before the end of its term period.
The new contract will not take effect unless the premium for it is paid while
the Insured is living and within 31 days after its contract date. If the premium
is paid as we state, it will be deemed that: (1) the insurance under the new
contract took effect on its contract date; and (2) this Benefit ended just
before that contract date. We will return that part, if any, of the last premium
paid for the Benefit that is more than was needed to pay premiums to that
contract date.
Contract Date.--The date of the new contract will be the date you ask for in
your request. But it may not be after the date to which premiums are paid for
this Benefit. It may not be less than five years before the end of the term
period for the Benefit. And it may not be more than 31 days before we have your
request at our Service Office.
Contract Specifications.--The new contract will be in the same rating class as
this contract. The company will set the issue age and the premiums for the new
contract in accord with its regular rules in use on the date of the new
contract.
The new contract may call for annual premiums. If the company agrees, you will
be able to have premiums fall due more often.
The contract may be either one of the following:
1. A Life Paid Up at Age 85 plan. In this case the new contract will be issued
by The Prudential Insurance Company of America. Its face amount will be the
amount you ask for in your request. But it cannot be less than $10,000 or more
than 80% of the amount we would have paid under this Benefit if the Insured had
died just before the contract date of the new contract. (Since $10,000 is 80% of
$12,500. the amount we would have paid must be at least $12,500 for this
exchange to be possible.)
2. A contract like the one to which this Benefit is attached. Its face amount
will be the amount you ask for in your request. But it cannot be less than
$25,000 or more than 80% of the amount we would have paid under the Benefit if
the Insured had died just before the contract date of the new contract. (Since
$25,000 is 80% of $31,250, the amount we would have paid must be at least
$31,250 for this exchange to be possible.)
The new contract will not have Supplementary Benefits other than as we describe
in this and in the next two paragraphs. If this contract has a benefit for
waiving premiums in the event of disability and the company would include that
kind of benefit in other contracts like the new contract, the company will put
the benefit in the new contract. The benefit, if any, in the new contract will
be the same one, with the same provisions, that the company puts in other
contracts like it on its contract date. In this paragraph, when we use the
phrase other contracts like it, we mean contracts the company would regularly
issue on the same plan and for the same rating class, amount, issue age and sex.
A benefit for waiving premiums that would have been allowed under this contract,
and that would otherwise be allowed under the new contract, will not be denied
just because disability started before the contract date of the new contract.
But any premium to be waived for that disability under the new contract must be
at the frequency that was in effect for this contract when the disability
started.
No premium will be waived under the new contract unless it has a benefit for
waiving premiums in the event of disability. This will be so even if premiums
have been waived under this contract.
Changes.--You may be able to have this Benefit changed to a new contract of life
insurance other than in accord with the requirements for exchange that we state
above. But any change may be made only if the company consents, and will be
subject to conditions and charges that are then determined.
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VL 130
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MISCELLANEOUS PROVISIONS
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the contract anniversary at the end of the term period for
the Benefit.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the last day before the contract date of any other contract (a)
for which the Benefit is exchanged, or (b) to which the Benefit is changed;
3. the date the contract is surrendered under its Cash Value Option, if it has
one; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
THIS SUPPLEMENTARY BENEFIT RIDER
ATTACHED TO THIS CONTRACT ON THE CONTRACT DATE
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
--------------------------------------------
Secretary
VL 130 Printed in U.S.A.
II-171
EXHIBIT A(13)(d)
RIDER FOR
OPTION TO PURCHASE ADDITIONAL INSURANCE
ON LIFE OF INSURED
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
Benefit.--You have the right under this Benefit to buy more insurance on the
Insured's life in either this company or The Prudential Insurance Company of
America. You may do this for certain normal option dates and advance option
dates, as we explain below. You will not have to prove that the Insured is
insurable. We will provide term insurance for a period before any advance option
dates as we state under Term Insurance below. But these promises are subject to
all the provisions of the Benefit and of the rest of this contract.
In any of these paragraphs when we use the phrase the company we mean whichever
of these companies may issue the new contract.
Normal Option Dates.--These are the anniversaries of this contract on which the
Insured's attained age is 25, 28, 31, 34, 37, 40, 43, 46, 49 and 52.
You may buy a new contract for each normal option date if these four statements
apply: (1) You have not used your right for that date by buying a new contract
on an advance option date (we explain this below). (2) The Insured signs an
application for the new contract, and you sign it, too, if you are not the
Insured. (3) We receive the application and the first premium, less the premium
credit that we describe below, at our Service Office not more than 31 days after
the normal option date. (4) On the normal option date, or, if later, the date we
receive the application, the Insured is living and this contract is in force
with no premium in default past its days of grace. The new contract will take
effect on the later of those two dates. That date will be its contract date.
Your right to buy the new contract will end on the 31st day after the normal
option date. But this will not change your right to buy a new contract for any
later normal or advance option date.
Advance Option Dates.--Except as we state in the next paragraph, an advance
option date is the date three months after any of these events:
1. The Insured's marriage.
2. While the Insured is living, the birth of a live child of the Insured for
whom the Insured accepts legal responsibility.
3. The Insured's legal adoption of a child.
But the event must take place (1) on or after the later of the date of this
contract and the date of Part 1 of its application; and (2) not later than the
date that is one month before the contract anniversary on which the Insured's
attained age is 52. If the event takes place less than three months before that
anniversary, the related advance option date will be that anniversary and not
the date three months after the event.
You may buy a new contract for each advance option date if these four statements
apply: (1) The Insured signs an application for the new contract, and you sign
it, too, if you are not the Insured. (2) We receive the application and the
first premium, less the premium credit that we describe below, at our Service
Office not later than the advance option date. (3) The Insured is living on the
advance option date. (4) This contract is in force on that date, with no premium
in default past its days of grace. The new contract will take effect on the
advance option date. That will be its contract date.
Your right to buy the new contract will end on the advance option date. But this
will not change your right to buy a new contract for any later normal or advance
option date.
Each time you buy a new contract for an advance option date, you will have used
your right to buy a new contract for the next normal option date, if any, for
which you could otherwise have bought one. But even if you have used your right
to buy for all normal option dates, advance option dates may still occur as we
state above. If the company lets you combine two or more new contracts you can
buy under this Benefit into one, you will use your right to buy new contracts
for the same number of future normal option dates as if the new contracts had
not been combined.
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VL 140
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Term Insurance.--For each event that gives rise to an advance option date, we
will provide term insurance on the Insured's life. But this contract must be in
force with no premium in default past its days of grace, The term insurance will
be automatic. There is no need to ask for it. Its amount will be the option
amount. We will pay that amount if the Insured dies on or after the date of the
event but before (1) the advance option date; or (2) the date this Benefit ends,
if sooner. We will include it in the proceeds of this contract. But if this
contract limits or excludes war or aviation risks, the term insurance will limit
or exclude them in the same way.
Contract Specifications.--The new contract you buy for a normal option date or
advance option date will be in the same rating class as this contract.
If this contract limits or excludes war or aviation risks, the company will have
the right to limit or exclude them in the new contract, too. If the company does
so, the provision in the new contract will be the same one the company puts in
other contracts like the new one on its contract date. The company will set the
issue age and the premiums for the new contract in accord with its regular rules
in use on the date of the new contract.
The new contract may call for annual premiums. If the company agrees, you will
be able to have premiums fall due more often.
If the option amount for this Benefit which we show on the Contract Data page(s)
is $25,000 or more, the new contract may be either of those we describe in
paragraphs 1 and 2 below. If the option amount is less than $25,000 the new
contract can only be the one we describe in paragraph 1.
1. A Life Paid Up at Age 85 plan. In this case the new contract will be
issued by The Prudential Insurance Company of America. Its face amount will be
the amount you ask for in your request. But it cannot be less than $10,000, or
more than the option amount for this Benefit.
2. A contract like the one to which this Benefit is attached. Its face amount
will be the amount you ask for in your request. But it cannot be less than
$25,000 or more than the option amount for this Benefit.
The new contract will not have Supplementary Benefits other than as we describe
in this and in the next three paragraphs. If this contract has a benefit for
waiving premiums in the event of disability and the company would include that
kind of benefit in other contracts like the new contract, the company will put
the benefit in the new contract.
A benefit for waiving premiums that would have been allowed under this contract,
and that would otherwise be allowed under the new contract will not be denied
just because disability started before the contract date of the new contract.
But any premium to be waived for that disability under the new contract must be
at the frequency that was in effect for this contract when the disability
started.
No premium will be waived under the new contract unless it has a benefit for
waiving premiums in the event of disability. This will be so even if premiums
have been waived under this contract.
If this contract has an accidental death benefit, and the company would
regularly issue contracts like the new contract with either that benefit or an
accidental death and dismemberment benefit, the company will put that kind of
benefit in the new contract, as stated in General below. But (1) you must ask
for it when you apply for the new contract: and (2) the amount of any accidental
death benefit in the new contract will not be more than the face amount of the
new contract.
General.--Any benefit for waiving premiums and any accidental death benefit or
accidental death and dismemberment benefit in the new contract will be the same
one, with the same provisions, that the company puts in other contracts like it
on its contract date. In any of these paragraphs, when we use the phrases other
contracts like it and other contracts like the new contract, we mean contracts
the company would regularly issue on the same plan and for the same rating
class, amount, issue age and sex.
You may be able to buy a new contract of life insurance other than in accord
with the requirements that we state above. But this may be done only if the
company consents, and will be subject to conditions and charges that are then
determined.
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Premium Credit.--A premium credit will be allowed on the first premium for the
new contract. The credit will be at least $1 for each full $1,000 of face amount
of the new contract. If (1) the new contract calls for premiums to be paid more
often than annually; and (2) the credit would be more than that first premium,
you may choose to have premiums paid less often to get the full credit.
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the contract anniversary on which the Insured's attained
age is 52 or on the anniversary at the end of the premium period, if sooner.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the 31st day after the contract anniversary on which the Insured's attained
age is 52;
3. the date the contract is surrendered under its Cash Value Option, if it has
one; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
This Supplementary Benefit rider
attached to this contract on the Contract Date
Pruco Life Insurance Company,
By /s/ SPECIMEN
-------------------------
Secretary
VL 140
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EXHIBIT 1.A.(13)(e)
RIDER FOR
INTERIM TERM INSURANCE BENEFIT
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
Benefit.--We will pay the beneficiary an amount under this Benefit if we receive
due proof that the Insured died on or after the date of the Benefit but before
the contract date. But our payment is subject to the provisions of the Benefit
and of the rest of this contract. The amount of the Benefit is equal to the
amount of insurance provided by the contract on the contract date. We show the
contract date and the date of the Benefit on the Contract Data page(s).
Changes in Contract Provisions.--This contract has a Suicide Exclusion and an
Incontestability provision. In each of them, we refer to a period of time that
extends from the issue date. But for each of them we will count the time from
the date of this Benefit, not from the issue date.
This contract might have a benefit for waiving premiums in the event of
disability; it might have one that provides accidental death coverage. If so, we
might refer in either or both of those benefits to the contract date. But we
will use the date of this Benefit, not the contract date.
This contract might be a term life contract that provides for monthly payments
if the Insured dies in the term period. Or the contract might be one that has a
family income benefit. In either case, if we settle a claim under this Interim
Term Insurance Benefit, we will do so as if the term period had begun on the
date the Insured died, not on the contract date. But we will make no more
payments than we would have made if the Insured had died on the contract date.
The first contract premium is due on the contract date. We will grant 31 days of
grace for paying it. This will be so even though we state otherwise under Grace
Period.
Except for the changes we describe above, all the provisions of this contract
will be in effect on and after the contract date if the Insured is then living,
as if the contract did not have this Benefit. The Benefit will not make any
contract value or any endowment that may be provided by the contract, available
any sooner.
Benefit Premium.--We show the premium for this Benefit on the Contract Data
page(s). This premium is to be paid on or before the date of the Benefit. It is
not the premium for the contract. Neither the Benefit nor the premium for it
provides any insurance or changes the number or amount of premiums payable, on
or after the contract date.
Premium Adjustment.--The Insured might die before the contract date. If so, we
will return that part of the premium for this Benefit that is more than was
needed to pay for the Benefit through the date of death. We will add the amount
we return to the amount we would otherwise pay under the Benefit.
THIS SUPPLEMENTARY BENEFIT RIDER ATTACHED TO THIS CONTRACT ON THE CONTRACT DATE
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
Secretary
VL 160 Printed in U.S.A.
II-175
EXHIBIT 1.A(13)(f)
RIDER FOR TERM INSURANCE BENEFIT ON LIFE OF
INSURED SPOUSE -- DECREASING AMOUNT
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
Benefit.--We will pay an amount under this Benefit if we receive due proof that
the insured spouse died (1) in the term period for the Benefit; and (2) while
this contract is in force with no premium in default past its days of grace. We
will pay this amount to the beneficiary for insurance payable upon the insured
spouse's death. But our payment is subject to all the provisions of the Benefit
and of the rest of this contract. The phrase insured spouse means the Insured's
spouse named in the application for this contract.
We will use the table below to compute the amount we will pay. We show the
Initial Amount of Term Insurance under this Benefit on the Contract Data
page(s). We also show the term period for the Benefit there. It starts on the
contract date, which we show on the first page. The anniversary at the end of
the term period is part of that period.
TABLE OF AMOUNTS OF INSURANCE
Amounts Payable.--We show here the amount we will pay for each $1,000 of Initial
Amount of Term Insurance if death occurs in the contract year ending with the
anniversary shown.
------------------------------------------------------------
ANNIVERSARY AMOUNT ANNIVERSARY AMOUNT
----------- ------ ----------- ------
1 $1,000 12 $706
2 986 13 658
3 970 14 603
4 951 15 543
5 931 16 475
6 909 17 400
7 883 18 316
8 855 19 222
9 824 20 200
10 789 BENEFIT EXPIRES
11 750 ON 20TH ANNIVERSARY
------------------------------------------------------------
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VL 180 20 YEARS
II-176
<PAGE>
(Continued from Preceding Page)
PAID-UP INSURANCE
Paid-up Insurance on Life of Insured Spouse.--The Insured might die (1) in the
term period for this Benefit; (2) while this contract is in force with no
premium in default past its days of grace; and (3) while the insured spouse is
living. In this case, the insurance on the life of the insured spouse under the
Benefit will become paid-up term insurance for decreasing amounts. We will
compute these amounts from the Table of Amounts of Insurance. While the paid-up
insurance is in effect, the contract will remain in force until the end of the
term period for the Benefit. The paid-up insurance will have cash values but no
loan value.
If this Benefit becomes paid-up, it may be surrendered for its net cash value.
This will be the net value on the date of surrender of the paid-up insurance.
But, within 30 days after a contract anniversary, the net cash value will not be
less than it was on that anniversary. We base this net cash value on the insured
spouse's age and sex. The insured spouse's age at any time will be his or her
age last birthday on the contract date plus the length of time since that date.
We use the Commissioners 1980 Standard Ordinary Mortality Table. We use
continuous functions based on age last birthday. We use an effective interest
rate of 4% a year.
We will usually pay any cash value promptly. But we have the right to postpone
paying it for up to six months. If we do so for more than 30 days. we will pay
interest at the rate of 3% a year. If we are asked for the values which apply,
we will furnish them.
CONVERSION TO ANOTHER PLAN OF INSURANCE
Right to Convert.--While the Insured is living, you may be able to exchange this
Benefit for a new contract of life insurance on the life of the insured spouse
in either this company or The Prudential Insurance Company of America. In any of
these paragraphs, when we use the phrase the company we mean whichever of these
companies may issue the new contract. And where we use the phrase new contract
we mean the contract for which the Benefit may be exchanged. You will not have
to prove that the insured spouse is insurable.
Conditions.--Your right to make this exchange is subject to all these
conditions: (1) The amount we would have paid under this Benefit if the insured
spouse had died just before the contract date of the new contract must be large
enough to meet the minimum for a new contract, as we describe under Contract
Specifications. (2) You must ask for the exchange in writing and in a form that
meets our needs. (3) You must send this contract to us to be endorsed. (4) We
must have your request and the contract at our Service Office while the Benefit
is in force and at least five years before the end of its term period.
The new contract will not take effect unless the premium for it is paid while
the insured spouse is living and within 31 days after its contract date. If the
premium is paid as we state, it will be deemed that: (1) the insurance under the
new contract took effect on its contract date; and (2) this Benefit ended just
before that contract date. We will return that part, if any, of the last premium
paid for the Benefit that is more than was needed to pay premiums to that
contract date.
Contract Date.--The date of the new contract will be the date you ask for in
your request. But it may not be after the date to which premiums are paid for
this Benefit. It may not be less than five years before the end of the term
period for the Benefit. And it may not be more than 31 days before we have your
request at our Service Office.
Contract Specifications.--The new contract will be in the standard rating class.
The company will set the issue age and the premiums for the new contract in
accord with its regular rules in use on the date of the new contract.
The new contract may call for annual premiums. If the company agrees, you will
be able to have premiums fall due more often.
The contract may be either one of the following:
1. A Life Paid Up at Age 85 plan. In this case the new contract will be issued
by The Prudential Insurance Company of America. Its face amount will be the
amount you ask for in your request. But it cannot be less than $10,000 or more
than 80% of the amount we would have paid under this Benefit if the insured
spouse had died just before the contract date of the new contract. (Since
$10,000 is 80% of $12,500, the amount we would have paid must be at least
$12,500 for this exchange to be possible.)
2. A contract like the one to which this Benefit is attached. Its face amount
will be the amount you ask for in your request. But it cannot be less than
$25,000 or more than 80% of the amount we would have paid under the Benefit if
the insured spouse had died just before the contract date of the new contract.
(Since $25,000 is 80% of $31,250, the amount we would have paid must be at least
$31,250 for this exchange to be possible.)
The new contract will not have Supplementary Benefits other than as we describe
in this and in the next
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VL 180
II-177
<PAGE>
(Continued from Preceding Page)
paragraph. If the company would include in other contracts like the new contract
a benefit for waiving premiums in the event of disability, here is what the
company will do. Even though this contract does not have that benefit on the
life of the insured spouse, the company will put it in the new contract on his
or her life. The benefit, if any, in the new contract will be the same one, with
the same provisions, that the company puts in other contracts like it on its
contract date. In this paragraph, when we use the phrase other contracts like
it, we mean contracts the company would regularly issue on the same plan and for
the same rating class, amount, issue age and sex.
No premium will be waived under the new contract unless the disability started
on or after its contract date. And no premium will be waived under a new
contract unless it has a benefit for waiving premiums in the event of
disability. This will be so even if premiums have been waived under this
contract.
Changes.--You may be able to have this Benefit changed to a new contract of life
insurance other than in accord with the requirements for exchange that we state
above. But any change may be made only if the company consents, and will be
subject to conditions and charges that are then determined.
MISCELLANEOUS PROVISIONS
Ownership and Control.--Unless we endorse this contract to say otherwise, while
the Insured is living the owner alone may exercise all ownership and control of
this contract. This includes, but is not limited to, these rights: (1) to assign
the contract; and (2) to change any subsequent owner. A request for such a
change must be in writing to us at our Service Office and in a form that meets
our needs. The change will take effect only when we endorse the contract to show
it.
Unless we endorse this contract to say otherwise:
(1) while any insurance is in force after the Insured's death, the owner of the
contract will be the insured spouse; and (2) the owner alone will be entitled to
(a) any contract benefit and value, and (b) the exercise of any right and
privilege granted by the contract or by us. But any insurance payable upon the
Insured's death will be payable to the beneficiary for that insurance.
Beneficiary.--The word beneficiary where we use it in this contract without
qualification means the beneficiary for insurance payable upon the death of the
Insured.
Unless we endorse this contract to say otherwise, the beneficiary for insurance
payable upon the death of the insured spouse will be the Insured if living,
otherwise the estate of the insured spouse.
The beneficiary for insurance payable upon the death of the insured spouse may
be changed. The request must be in writing and in a form that meets our needs.
It will take effect only when we file it at our Service Office; this will be
after the contract is sent to us to be endorsed, if we ask for it. Then any
previous beneficiary's interest in such insurance will end as of the date of the
request. It will end then even if the insured spouse is not living when we file
the request. Any beneficiary's interest is subject to the rights of any assignee
of whom we know.
When a beneficiary is designated, any relationship shown is to the Insured,
unless otherwise stated.
Misstatement of Age or Sex.--If the insured spouse's stated age or sex or both
are not correct, we will change each benefit and any amount payable to what the
premium would have bought for the correct age and sex.
Suicide Exclusion.--If the insured spouse, whether sane or insane, dies by
suicide within the period which we state in the Suicide Exclusion under General
Provisions, we will not pay the amount we describe under Benefit above. Instead,
we will pay no more than the sum of the premiums paid for this Benefit. We will
make that payment in one sum.
Reinstatement.--If this contract is reinstated, it will not include the
insurance that we provide under this Benefit on the life of the insured spouse
unless we are given any facts we need to satisfy us that the insured spouse is
insurable for the Benefit.
Contract Value Options.--If this contract has a Contract Value Options
provision, it will apply only during the Insured's lifetime. Any extended or
reduced paid-up insurance that may be described there is on the life of the
Insured only.
Contract Loans.--If this contract has a Loans provision, we will not consider
any contract debt when we determine the amount payable, if any, at the death of
the insured spouse.
Incontestability.--Except for non-payment of premium, we will not contest this
Benefit after it has been in force during the insured spouse's lifetime for two
years from the issue date.
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the
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VL 180
II-178
<PAGE>
(Continued from Preceding Page)
earliest of (1) the death of the Insured, (2) the death of the insured spouse,
and (3) the contract anniversary at the end of the term period for the Benefit.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the last day before the contract date of any other contract (a)
for which the Benefit is exchanged, or (b) to which the Benefit is changed;
3. the date the contract is surrendered under its Cash Value Option, if it has
one, or the paid-up insurance, if any, under the Benefit is surrendered; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
This Supplementary Benefit rider
attached to this contract on the Contract Date
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
--------------------------
Secretary
VL 180 Printed in U.S.A.
II-179
EXHIBIT A(13)(g)
RIDER FOR
LEVEL TERM INSURANCE BENEFIT ON DEPENDENT CHILDREN
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
Benefit.--We will pay an amount under this Benefit if we receive due proof that
a dependent child died (1) before the term insurance provided by the Benefit on
his or her life ends; and (2) while this contract is in force with no premium in
default past its days of grace. But our payment is subject to all the provisions
of the Benefit and of the rest of this contract.
The phrase dependent child means the Insured's child, stepchild or legally
adopted child who (1) has reached the 15th day of life; and (2) has not reached
the first contract anniversary after his or her 25th birthday; and either (3) is
named in the application for this contract and on the date of the application
has not reached his or her 18th birthday; or (4) is acquired by the Insured
after the date of the application but before the child's 18th birthday.
We show the amount of term insurance under this Benefit on the Contract Data
page(s). The insurance on each dependent child's life will end on the earlier
of: (1) the day before the first contract anniversary after the child's 25th
birthday; and (2) the day before the first contract anniversary after the
Insured's 65th birthday.
PAID-UP INSURANCE
Paid-up Insurance on Dependent Children.--The Insured might die while this
contract is in force with no premium in default past its days of grace. In this
case, any term insurance provided by this Benefit on a dependent child's life
will become paid-up term insurance. While this paid-up insurance is in effect,
the contract will remain in force. The paid-up insurance will have cash values
but no loan value.
If this Benefit becomes paid-up, it may be surrendered for its net cash value.
This will be the net value on the date of surrender of the paid-up insurance.
But, within 30 days after a contract anniversary, the net cash value will not be
less than it was on that anniversary. To compute this net cash value, we use the
Commissioners 1980 Standard Ordinary Mortality Table. We use continuous
functions based on age last birthday. We use an effective interest rate of 4% a
year.
We will usually pay any cash value promptly. But we have the right to postpone
paying it for up to six months. If we do so for more than 30 days, we will pay
interest at the rate of 3% a year. If we are asked for the values which apply,
we will furnish them.
CONVERSION OF INSURANCE ON DEPENDENT CHILDREN
Right to Convert.--lf the insurance on a dependent child ends as we state in the
last paragraph under Benefit above, that child may be able to obtain a new
contract of life insurance on his or her life, in either this company or The
Prudential Insurance Company of America. In any of these paragraphs, when we use
the phrase the company we mean whichever of these companies may issue the new
contract. It will not be necessary to prove that the child is insurable.
Conditions.--The right to obtain a new contract is subject to all these
conditions: (1) The insurance on the child must end while this contract is in
force with no premium in defauit past its days of grace. (2) The amount of the
new contract must meet the minimum as we describe under Contract Specifications.
(3) We must have a written application for the new contract at our Service
Office no later than the date the insurance on the child ends.
The new contract will not take effect unless the premium for it is paid while
the child is living and within 31 days after its contract date. If the premium
is paid as we state, it will be deemed that the insurance under the new contract
took effect on its contract date.
(Continued on Next Page)
VL 182
II-180
<PAGE>
(Continued from Preceding Page)
Contract Date.--The date of the new contract will be the day after the date the
insurance on the dependent child ends.
Contract Specifications.--The new contract will be in the standard rating class.
The company will set the issue age and the premiums for the new contract in
accord with its regular rules in use on the date of the new contract.
The new contract may call for annual premiums. If the company agrees, the owner
of the new contract will be able to have premiums fall due more often.
The contract may be either one of the following:
1. A contract like the one to which this Benefit is attached. Its face amount
will be the amount asked for in the application. But it cannot be less than
$25,000 or more than five times the amount of insurance on the child's life
under the Benefit.
2. A Life Paid Up at Age 85 plan (Life Paid Up at Age 65 plan if the issue age
for the new contract is less than 15 years). In this case the new contract will
be issued by The Prudential Insurance Company of America. Its face amount will
be the amount asked for in the application. But it cannot be less than $5,000 or
more than five times the amount of insurance on the child's life under this
Benefit.
The new contract will not have Supplementary Benefits other than as we describe
in this and in the next paragraph. If the company would include in other
contracts like the new contract a benefit for waiving premiums in the event of
disability, here is what the company will do. Even though this contract does not
have that benefit on the life of that child, the company will put it in the new
contract on his or her life. The benefit, if any, in the new contract will be
the same one, with the same provisions, that the company puts in other contracts
like it on its contract date. In this paragraph, when we use the phrase other
contracts like it, we mean contracts the company would regularly issue on the
same plan and for the same rating class, amount, issue age and sex.
No premium will be waived under the new contract unless the disability started
on or after its contract date. And no premium will be waived under a new
contract unless it has a benefit for waiving premiums in the event of
disability. This will be so even if premiums have been waived under this
contract.
Changes.--If the insurance on a dependent child ends as we state in the last
paragraph under Benefit above, that child may be able to obtain a new contract
of life insurance other than in accord with the requirements we state in this
form. But this kind of change may be made only if the company consents and will
be subject to conditions and charges that are then determined.
MISCELLANEOUS PROVISIONS
Beneficiary.--The word beneficiary where we use it in this contract without
qualification means the beneficiary for insurance payable upon the death of the
Insured.
Unless we endorse this contract to say otherwise, these two statements will
apply: (1) The beneficiary for insurance payable upon the death of a dependent
child will be the Insured if living, otherwise the beneficiary for this
insurance named in the application. (2) If no such beneficiary is living when
insurance under this Benefit becomes payable, we will make the payment in one
sum to the estate of the later to die of the Insured and such beneficiary.
The beneficiary for insurance payable upon the death of a dependent child may be
changed. The request must be in writing and in a form that meets our needs. It
will take effect only when we file it at our Service Office; this will be after
the contract is sent to us to be endorsed, if we ask for it. Then any previous
beneficiary's interest in such insurance will end as of the date of the request.
It will end then even if the child is not living when we file the request. Any
beneficiary's interest is subject to the rights of any assignee of whom we know.
When a beneficiary is designated, any relationship shown is to the Insured,
unless otherwise stated.
(Continued on Next Page)
VL 182
II-181
<PAGE>
(Continued from Preceding Page)
Reinstatement.--If this contract is reinstated, it will not include the
insurance that we provide under this Benefit on the dependent children unless
you give us any facts we need to satisfy us that each child who is to be insured
on or within 15 days after the date of reinstatement is insurable for the
Benefit. If you do not give us the facts we need for any child, the Benefit may
be reinstated if all the other conditions are met to reinstate the contract. But
you must send the contract to us to be endorsed to show that the child is not
insured under the Benefit.
Contract Value Options.--If this contract has a Contract Value Options
provision, it will apply only during the Insured's lifetime. Any extended or
reduced paid-up insurance that may be described there is on the life of the
Insured only.
Contract Loans.--If this contract has a Loans provision, we will not consider
any contract debt when we determine the amount payable, if any, at the death of
a dependent child.
Incontestability.--Except for non-payment of premium, we will not contest this
Benefit with respect to the insurance on any dependent child's life after it has
been in force during the child's lifetime for two years from the issue date.
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the earlier of the date of the Insured's death and the
first contract anniversary after the Insured's 65th birthday.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the day before the first contract anniversary after the Insured's
65th birthday;
3. the date the contract is surrendered under its Cash Value Option, if it has
one, or the paid-up insurance, if any, under the Benefit is surrendered; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
This Supplementary Benefit rider attached to this contract on the Contract Date
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
Secretary
VL 182
II-182
EXHIBIT 1.A(13)(h)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
There is an impairment of the Insured's eyesight. If he or she becomes disabled
as a result of the loss of eyesight, here is what will apply for that
disability. We will not allow benefits under any benefit for waiving premiums in
the event of disability in (1) this contract, or (2) any other contract on the
Insured's life to which you change or for which you exchange this contract or
any of its benefits.
I have signed the copy of this rider
to be attached to the contract as well
as the copy for the Service Office.
I have witnessed the signature(s) | Signature of Proposed Insured
on the copy of this rider to be |
attached to the contract as well as |
on the copy for the Service Office. |_______________________________________
| Signature of Witness | Signature of Applicant
| | (If other than proposed Insured)
| |
|___________________________________ |_______________________________________
(If applicant is a firm or corporation,
show that company's name)
| By
|
|
|_______________________________________
(signature and title of officer
signing for that company)
RIDER ATTACHED TO AND MADE A PART OF
THIS CONTRACT ON THE CONTRACT DATE
PRUCO LIFE INSURANCE COMPANY,
By /s/ ISABELLE L. KIRCHNER
----------------------------
Secretary
- ----------
PLI 52--82 THIS COPY IS TO BE ATTACHED TO THE CONTRACT Printed in U.S.A.
- ----------
II-183
EXHIBIT A(13)(i)
Pruco Life Insurance Company
Insured Rider for Policy No.
John Doe XX XXX XXX
INSURED'S WAIVER OF PREMIUM BENEFIT
Total Disability Benefit.--We will waive contract premiums that fall due while
the Insured is totally disabled. But this is subject to all the provisions of
this Benefit and of the rest of this contract.
Disability Defined.--When we use the words disability and disabled in this
Benefit we mean total disability and totally disabled. Here is how we define
them: (1) until the Insured has stayed disabled for two years. we mean that he
or she cannot, due to sickness or injury, do any of the duties of his or her
regular occupation; but (2) after the Insured has stayed disabled for two years,
we mean that he or she cannot, due to sickness or injury, do any gainful work
for which he or she is reasonably fitted by education, training, or experience.
Except for what we state in the next sentence, we will at no time regard an
Insured as disabled who is doing gainful work for which he or she is reasonably
fitted by education, training, or experience. We will regard an Insured as
disabled, even if working or able to work, if he or she incurs, during a period
in which premiums are eligible to be waived as we describe below, one of the
following: (1) permanent and complete blindness of both eyes; or (2) severance
of both hands at or above the wrists or both feet at or above the ankles; or (3)
severance of one hand at or above the wrist and one foot at or above the ankle.
Premiums Eligible To Be Waived.--lf the Insured becomes disabled before the
first contract anniversary after his or her 60th birthday and that disability
begins (1) on or after the first contract anniversary after his or her 5th
birthday. if the date of this rider was before that birthday; or (2) on or after
the date of the rider, if that date was on or after his or her 5th birthday. we
will waive all premiums that fall due while he or she stays disabled.
If the Insured becomes disabled on or after the first contract anniversary after
his or her 60th birthday, we will waive only those premiums that fall due
before, the first contract anniversary after his or her 65th birthday and while
he or she stays disabled.
If the Insured becomes disabled on or after the first contract anniversary after
his or her 65th birthday, we will not waive any premium that falls due in that
period of disability.
Conditions.--Both of these conditions must be met: (1) The Insured must become
disabled while this contract is in force with no premium in default past its
days of grace. (2) The Insured must stay disabled for a period of at least six
months while living.
Exceptions.--We will not waive any premium if the Insured becomes disabled
from: (1) an injury he causes to himself, or she causes to herself, on purpose;
or (2) sickness or iniury due to service on or after the date of this rider in
the armed forces of any country(ies) at war. The word war means declared or
undeclared war and includes resistance to armed aggression.
Successive Disabilities.--Here is what happens if the Insured has at least one
premium waived while disabled, then gets well so that premium payment resumes,
and then becomes disabled again. In this case, we will not apply the six-month
period that would otherwise be required by Condition (2) and will consider the
second period of disability to be part of the first period unless (1) the
Insured has done gainful work, for which he or she is reasonably fitted, for at
least six months between the periods; or (2) the Insured became disabled the
second time from an entirely different cause.
If we do not apply the six-month period required by Condition (2), we also will
not count the days when there was no disability as part of the two year period
when disability means the Insured cannot do any of the duties of his or her
reguIar occupation.
Notice and Proof of Claim.--Notice and proof of any claim must be given to us
while the Insured is living and disabled, or as soon as reasonably possible. If
notice or proof is not given as soon as reasonably possible, we will not waive
any premium due more than one year before the date the notice or proof is given
to us. We may require proof at reasonable times that the Insured is still
disabled.
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PLI 57-82
II-184
<PAGE>
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After he or she has been disabled for two years, we will not ask for proof more
than once a year. As a part of any proof, we have the right to require that the
Insured be examined at our expense by doctors of our choice.
Recovery from Disability.--We will stop waiving premiums if (1) disability ends;
or (2) we ask for proof that the Insured is disabled and we do not receive it;
or (3) we require that the Insured be examined and he or she fails to do so.
Miscellaneous.--Any premiums that fall due are payable until we approve a claim.
We will refund any premium paid that is later waived. But we will not, of
course, refund any premium or part of a premium that was or is to be returned in
accord with the Premium Adjustment provision in this contract.
There might be unpaid premiums that fall due (1) after disability starts; but
(2) more than one year before we have notice of claim at our Service Office. Or
disability' might start in the days of grace of an unpaid premium. In either
case, if we are otherwise able to approve a claim, those unpaid premiums that we
do not waive will be due us with compound interest at 6% a year. If we do not
receive them, we will deduct them with interest from any amount we pay under the
contract.
Any premium we waive will be at the frequency in effect when the Insured becomes
disabled.
If we waive premiums, the effect on this contract will be the same as if the
premiums had been paid in cash. But the Premium Adjustment provision will not
apply to any premium that was not paid because it was waived under this Benefit.
If we owe the Insured a refund of premium but have not paid it before his or her
death, we have the choice of paying the beneficiary for insurance payable upon
the death of the Insured or the Insured's estate.
Benefit Premiums.--The premiums for this Benefit are a part of the contract
premiums due before the first contract anniversary after the Insured's 65th
birthday.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the oontract;
2. the end of the day that is the last premium due date in the premium period;
3. the end of the day before the first contract anniversary after the Insured's
65th birthday, unless the Insured has stayed disabled since before the first
contract anniversary after the 6Oth birthday;
4. the date the contract is surrendered under its Cash Value Option, if it has
one; and
5. the date the contract ends for any other reason.
Rider attached to and made a part of this contract
Signed for the Company,
By /s/ SPECIMEN
---------------------
Secretary
Date September 7, 1983 Attest M. Smith
PLI 57--82
II-185
EXHIBIT 1.A(13)(j)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
INSURED'S ACCIDENTAL DEATH BENEFIT
All previous provisions of this contract with regard to accidental death benefit
will end just before the date of this rider.
Benefit.--We will pay $___________ for the Insured's accidental loss of life.
But our payment is subject to all the provisions of this Benefit and of the rest
of this contract.
Manner of Payment.--We will include in the proceeds of this contract any payment
under this Benefit.
Conditions.--Both of these conditions must be met:
(1) We must receive due proof that the Insured's death was the direct result,
independent of all other causes, of accidental bodily injury that occurred on or
after __________________. (2) The death must occur (a) no more than 90 days
after the injury; (b) while the contract is in force with no premium in default
past its days of grace; and (c) before the end of the contract's term or
endowment period, if any.
Exclusions.--We will not pay under this Benefit for death caused or contributed
to by: (1) suicide or attempted suicide while sane or insane; or (2) infirmity
or disease of mind or body or treatment for it; or (3) any infection other than
one caused by an accidental cut or wound.
Even if death is caused by accidental bodily injury, we will not pay for it
under this Benefit if it is caused or contributed to by: (1) service in the
armed forces of any country(ies) at war; or (2) war or any act of war; or (3)
travel by, or descent from, any aircraft if the Insured had any duties or acted
in any capacity other than as a passenger at any time during the flight. But we
will ignore (3) if all these statements are true of the aircraft: (a) It has
fixed wings and a permitted gross takeoff weight of at least 75,000 pounds. (b)
It is operated by an air carrier that is certificated under the laws of the
United States or Canada to carry passengers to or from places in those
countries. (c) It is not being operated for any armed forces for training or
other purposes. As used here, the word aircraft includes rocket craft or any
other vehicle for flight in or beyond the earth's atmosphere. The word war means
declared or undeclared war and includes resistance to armed aggression.
Benefit Premiums.--We grant this Benefit in consideration of: (1) payment now of
an extra premium of $____________, and (2) payment on and after ________________
of an extra _______________ premium of $____________ . This latter amount will
be added to, due at the same time as, and subject to the same conditions of
payment and adjustment as the contract premiums due on and after that date.
Neither this Benefit nor the extra premium charged for it will change any loan
or contract value that may be in this contract. But if the contract has a
benefit for waiving premiums in the event of disability, that benefit will apply
to the extra premium charged for this Benefit.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the date the contract is surrendered under its Cash Value Option, if it has
one; and
3. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
| RIDER ATTACHED TO AND MADE A PART OF THIS CONTRACT
|
|
| Signed by the Company,
|
|
| By /s/ ISABELLE L. KIRCHNER
| -----------------------------
| Secretary
|
|
| Date Attest
|____________________________________________________
- ----------
PLI 58--82 Printed in U.S.A.
- ----------
II-186
EXHIBIT 1.A(13)(k)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
AVIATION RISK EXCLUSION
Conditions of Exclusion.--We will pay the limited payment we describe below, and
not what we would otherwise pay, if the Insured dies as a result of travel by,
or descent from, any kind of aircraft.
But this Exclusion will apply only if at least one of these two statements is
true: (1) The Insured is a pilot, officer, or member of the crew of the
aircraft, or is taking aeronautic or aviation training during the flight. (2)
The Insured (a) is in the armed forces of any country, (b) is being transported
in an armed forces aircraft, and (c) has any duties or acted in any capacity
other than as a passenger at any time during the flight.
And even so, this Exclusion will apply only if death occurs within five years
after the issue date of this contract, unless at least one of these statements
is true on the issue date: (1) The Insured has taken aeronautic or aviation
training. (2) The Insured's occupation calls for duties aboard aircraft in
flight.
This Exclusion will not apply if all these statements are true of the aircraft:
(1) It has fixed wings and a permitted gross takeoff weight of at least 75,000
pounds. (2) It is operated by an air carrier that is certificated under the laws
of the United States or Canada to carry passengers to or from places in those
countries. (3) It is not being operated for any armed forces for training or
other purposes.
Limited Payment.--The limited payment will be (1) the sum of the premiums that
became due and were paid for the insurance on the Insured's life, minus (2) any
contract debt. But if the reserve for the insurance on the Insured's life, when
computed as we state under Reserves, is more than the amount we determine in
(1), we will use that reserve in place of that amount. Also, the limited payment
will never be more than what we would have paid if this Exclusion were not in
the contract.
The limited payment will be payable to the beneficiary for insurance otherwise
payable upon the Insured's death.
Reduced Paid-up, Extended and Other Insurance on the Insured's Life.--This
Exclusion also applies to any reduced paid-up or extended insurance that might
be in force under the Contract Value Options, if any. We will put the Exclusion
in any contract on the Insured's life to which you change, or for which you
exchange, this contract or any of its benefits.
Paid-up Insurance on Other Persons.--This contract might include insurance on
the life of someone other than the Insured. And it might have a provision that
makes that insurance paid-up if the Insured dies. This Exclusion will not affect
any such provision.
EFfect of Incontestability.--In any case where this Exclusion applies, the
Incontestability provision of this contract will not be deemed to make us pay
more than as we state under Limited Payment.
Reserves.--We might have to compute a reserve to find the limited payment. If
so, we will use the same table and rate(s) that we use to compute net values for
the insurance on the Insured's life, as we describe under Basis of Computation
in this contract.
| RIDER ATTACHED TO AND MADE A PART OF THIS CONTRACT
|
|
| PRUCO LIFE INSURANCE COMPANY,
|
|
| By /s/ ISABELLE L. KIRCHNER
| -----------------------------
| Secretary
|
|
| Date Attest
|____________________________________________________
- ----------
PLI 59--82 MINNESOTA Printed in U.S.A.
- ----------
II-187
EXHIBIT 1.A(13)(l)
PRUCO LIFE INSURANCE COMPANY
AMENDMENT TO APPLICATION TO PRUCO LIFE INSURANCE COMPANY
| Proposed Insured | Application Dated
| |
| |
|_____________________________________ |___________________________________
1. Has proposed Insured ever had aeronautic
or aviation training? _______________________________________________________
2. Does proposed Insured's occupation call for duty
aboard aircraft in flight? __________________________________________________
The undersigned agree(s) that any contract issued will contain the following
provisions:
AVIATION RISK EXCLUSION
Conditions of Exclusion.--We will pay the limited payment we describe below, and
not what we would otherwise pay, if the Insured dies as a result of travel by,
or descent from, any kind of aircraft.
But this Exclusion will apply only if at least one of these two statements is
true: (1) The Insured is a pilot, officer, or member of the crew of the
aircraft, or is taking aeronautic or aviation training during the flight. (2)
The Insured (a) is in the armed forces of any country, (b) is being transported
in an armed forces aircraft, and (c) has any duties or acted in any capacity
other than as a passenger at any time during the flight.
And even so, this Exclusion will apply only if death occurs within five years
after the issue date of this contract, unless at least one of these statements
is true on the issue date: (1) The Insured has taken aeronautic or aviation
training. (2) The Insured's occupation calls for duties aboard aircraft in
flight.
This Exclusion will not apply if all these statements are true of the aircraft:
(1) It has fixed wings and a permitted gross takeoff weight of at least 75,000
pounds. (2) It is operated by an air carrier that is certificated under the laws
of the United States or Canada to carry passengers to or from places in those
countries. (3) It is not being operated for any armed forces for training or
other purposes.
Limited Payment.--The limited payment will be (1) the sum of the premiums that
because due and were paid for the insurance on the Insured's life, minus (2) any
contract debt. But if the reserve for the insurance on the Insured's life, when
computed as we state under Reserves, is more than the amount we determine in
(1), we will use that reserve in place of that amount. Also, the limited payment
will never be more than what we would have paid if this Exclusion were not in
the contract.
The limited payment will be payable to the beneficially for insurance otherwise
payable upon the Insured's death.
Reduced Paid-up, Extended and Other Insurance on the Insured's Life.--This
Exclusion also applies to any reduced paid-up or extended insurance that might
be in force under the Contract Value Options, if any. We will put the Exclusion
in any contract on the Insured's life to which you change, or for which you
exchange, this contract or any of its benefits.
Paid-up Insurance on Other Persons.--This contract might include insurance on
the life of someone other than the Insured. And it might have a provision that
makes that insurance paid-up if the Insured dies. This Exclusion will not affect
any such provision.
Effect of Incontestability.--In any case where this Exclusion applies, the
Incontestability provision of this contract will not be deemed to make us pay
more than as we state under Limited Payment.
Reserves.--We might have to compute a reserve to find the limited payment. If
so, we will use the same table and rate(s) that we use to compute net values for
the insurance on the Insured's life, as we describe under Basis of Computation
in this contract.
The proposed Insured declares, that, to the best of his or her knowledge and
belief, the above statements are complete and true. The undersigned agree(s)
that this amendment is a part of the application and of any contract issued.
| Date | Signature of Proposed Insured
| |
|___________________________________ |_______________________________________
| Witness | Signature of Applicant
| | (If other than proposed Insured)
|___________________________________ |_______________________________________
(If applicant is a firm or corporation,
show that company's name)
| Agency/District | By
| |
|___________________________________ |_______________________________________
(Signature and title of officer signing
for that company)
- ---------
PLI 60-82 MINNESOTA Printed in U.S.A.
- ---------
II-188
EXHIBIT A(13)(m)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
MILITARY AVIATION RISK EXCLUSION
Conditions of Exclusion.--We will pay the limited payment we describe below, and
not what we would otherwise pay, if the Insured dies as a result of travel by,
or descent from, any kind of aircraft operated by or for any armed forces.
But this Exclusion will apply only if the Insured (1) has any duties or acted in
any capacity other than as a passenger at any time during the flight and (2) is
in the armed forces of any country. And it will apply only if death occurs
within five years after the issue date of the contract unless at least one of
these statements is true on the issue date: (a) The Insured has taken aeronautic
or aviation training. (b) The Insured's occupation calls for duties aboard
aircraft in flight.
Limited Payment.--The limited payment will be (1) the sum of the premiums that
became due and were paid for the insurance on the Insured's life, minus (2) any
contract debt. But if the reserve for the insurance on the Insured's life, when
computed as we state under Reserves, is more than the amount we determine in
(1), we will use that reserve in place of that amount. Also, the limited payment
will never be more than what we would have paid if this Exclusion were not in
the contract. The limited payment will be payable to the beneficiary for
insurance otherwise payable upon the Insured's death.
Reduced Paid-up, Extended and Other Insurance on the Insured's Life.--This
Exclusion also applies to any reduced paid-up or extended insurance that might
be in force under the Contract Value Options, if any. We will put the Exclusion
in any contract on the Insured's life to which you change, or for which you
exchange, this contract or any of its benefits.
Paid-up Insurance on Other Persons.--This contract might include insurance on
the life of someone other than the Insured. And it might have a provision that
makes that insurance paid-up if the Insured dies. This Exclusion will not affect
any such provision.
Effect of Incontestability.--In any case where this Exclusion applies, the
Incontestability provision of this contract will not be deemed to make us pay
more than as we state under Limited Payment.
Reserves.--We might have to compute a reserve to find the limited payment. If
so, we will use the same table and rate(s) that we use to compute net values for
the insurance on the Insured's life, as we describe under Basis of Computation
in this contract.
| Rider attached to and made a part of this contract
|
|
| PRUCO LIFE INSURANCE COMPANY,
|
|
| By /s/ ISABELLE L. KIRCHNER
| -----------------------------
| Secretary
|
|
|
| Date Attest
|____________________________________________________
- ---------
PLI 61-82 MINNESOTA Printed in U.S.A.
- ---------
II-189
EXHIBIT 1.A.(13)(n)
PRUCO LIFE INSURANCE COMPANY
AMENDMENT TO APPLICATION TO PRUCO LIFE INSURANCE COMPANY
| Proposed Insured | Application Dated
| |
| | , 19
|_____________________________________ |___________________________________
1. Has proposed Insured ever had aeronautic
or aviation training? _______________________________________________________
2. Does proposed Insured's occupation call
for duty aboard aircraft in flight? _________________________________________
The undersigned agree(s) that any contract issued will contain the following
provisions:
MILITARY AVIATION RISK EXCLUSION
Conditions of Exclusion.--We will pay the limited payment we describe below, and
not what we would otherwise pay, if the Insured dies as a result of travel by,
or descent from, any kind of aircraft operated by or for any armed forces.
But this Exclusion will apply only if the Insured (1) has any duties or acted in
any capacity other than as a passenger at any time during the flight and (2) is
in the armed forces of any country. And it will apply only if death occurs
within five years after the issue date of the contract unless at least one of
these statements is true on the issue date: (a) The Insured has taken aeronautic
or aviation training. (b) The Insured's occupation calls for duties aboard
aircraft in flight.
Limited Payment.--The limited payment will be (1) the sum of the premiums that
became due and were paid for the insurance on the Insured's life, minus (2) any
contract debt. But if the reserve for the insurance on the Insured's life, when
computed as we state under Reserves, is more than the amount we determine in
(1), we will use that reserve in place of that amount. Also, the limited payment
will never be more than what we would have paid if this Exclusion were not in
the contract.
The limited payment will be payable to the beneficiary for insurance otherwise
payable upon the Insured's death.
Reduced Paid-up, Extended and Other Insurance on the Insured's Life.--This
Exclusion also applies to any reduced paid-up or extended insurance that might
be in force under the Contract Value Options, if any. We will put the Exclusion
in any contract on the Insured's life to which you change, or for which you
exchange, this contract or any of its benefits.
Paid-up Insurance on Other Persons.--This contract might include insurance on
the life of someone other than the Insured. And it might have a provision that
makes that insurance paid-up if the Insured dies. This Exclusion will not affect
any such provision.
Effect of Incontestability.--In any case where this Exclusion applies, the
Incontestability provision of this contract will not be deemed to make us pay
more than as we state under Limited Payment.
Reserves.--We might have to compute a reserve to find the limited payment. If
so, we will use the same table and rate(s) that we use to compute net values for
the insurance on the Insured's life, as we describe under Basis of Computation
in this contract.
The proposed Insured declares, that, to the best of his or her knowledge and
belief, the above statements are complete and true. The undersigned agree(s)
that this amendment is a part of the application and of any contract issued.
| Date | Signature of Proposed Insured
| , 19 |
|___________________________________ |_______________________________________
| Witness | Signature of Applicant
| | (If other than proposed Insured)
|___________________________________ |_______________________________________
(If applicant is a firm or corporation,
show that company's name)
| Agency/District | By
| |
|___________________________________ |_______________________________________
(Signature and title of officer signing
for that company)
- ---------
PLI 62-82 MINNESOTA Printed in U.S.A.
- ---------
II-190
EXHIBIT A(13)(o)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
LEVEL TERM INSURANCE BENEFIT ON DEPENDENT CHILDREN
Benefit.--We will pay $___________________ under this Benefit if we receive due
proof that a dependent child died (1) on or after ___________________; (2)
before the term insurance provided by the Benefit on his or her life ends; and
(3) while this contract is in force with no premium in default past its days of
grace. But our payment is subject to all the provisions of the Benefit and of
the rest of this contract.
The phrase dependent child means the Insured's child, stepchild or legally
adopted child who (1) has reached the 15th day of life; and (2) has not reached
the first contract anniversary after his or her 25th birthday; and either (3) is
named in the request for this rider, which is attached to and made a part of
this contract; and on the date of the request has not reached his or her 18th
birthday; or (4) is acquired by the Insured after the date of the request but
before the child's 18th birthday.
The insurance on each dependent child's life will end on the earlier of: (1) the
day before the first contract anniversary after the child's 25th birthday; and
(2) the day before the first contract anniversary after the Insured's 65th
birthday.
Benefit Premiums.--We grant this Benefit in consideration of: (1) payment now
of an extra premium of $________________ and (2) payment on and after
___________________ of an extra ________________ premium of $________________.
This latter amount will be added to, due at the same time as, and subject to the
same conditions of payment and adjustment as the contract premiums due on and
after that date.
Neither this Benefit nor the extra premium charged for it will change any loan
or contract value which may be in this contract. But if the contract has a
benefit for waiving premiums in the event of disability, that benefit will apply
to the extra premium charged for this Benefit.
The premiums for this Benefit will stop on the earlier of the date of the
Insured's death and the first contract anniversary after the Insured's 65th
birthday.
PAID-UP INSURANCE
Paid-up Insurance on Dependent Children.--The Insured might die while this
contract is in force with no premium in default past its days of grace. In this
case, any term insurance provided by this Benefit on a dependent child's life
will become paid-up term insurance. While this paid-up insurance is in effect,
the contract will remain in force. The paid-up insurance will have cash values
but no loan value.
If this Benefit becomes paid-up, it may be surrendered for its net cash value.
This will be the net value on the date of surrender of the paid-up insurance.
But, within 30 days after a contract anniversary, the net cash value will not be
less than it was on that anniversary. To compute this net cash value, we use the
Commissioners 1980 Standard Ordinary Mortality Table. We use continuous
functions based on age last birthday. We use an effective interest rate of 4% a
year.
We will usually pay any cash value promptly. But we have the right to postpone
paying it for up to six months. If we do so for more than 30 days, we will pay
interest at the rate of 3% a year. If we are asked for the values which apply,
we will furnish them.
(Continued on Next Page)
PLI 63-82
II-191
<PAGE>
(Continued from Preceding Page)
CONVERSION OF INSURANCE ON DEPENDENT CHILDREN
Right to Convert.--If the insurance on a dependent child ends as we state in the
last paragraph under Benefit above, that child may be able to obtain a new
contract of life insurance on his or her life, in either this company or The
Prudential Insurance Company of America. In any of these paragraphs, when we use
the phrase the company we mean whichever of these companies may issue the new
contract. It will not be necessary to prove that the child is insurable.
Conditions.--The right to obtain a new contract is subject to all these
conditions: (1) The insurance on the child must end while this contract is in
force with no premium in default past its days of grace. (2) The amount of the
new contract must meet the minimum as we describe under Contract Specifications.
(3) We must have a written application for the new contract at our Service
Office no later than the date the insurance on the child ends.
The new contract will not take effect unless the premium for it is paid while
the child is living and within 31 days after its contract date. If the premium
is paid as we state, it will be deemed that the insurance under the new contract
took effect on its contract date.
Contract Date.--The date of the new contract will be the day after the date the
insurance on the dependent child ends.
Contract Specifications.--The new contract will be in the standard rating class.
The company will set the issue age and the premiums for the new contract in
accord with its regular rules in use on the date of the new contract.
The new contract may call for annual premiums. If the company agrees, the owner
of the new contract will be able to have premiums fall due more often.
The contract may be either one of the following:
1. A contract like the one to which this Benefit is attached. Its face amount
will be the amount asked for in the application. But it cannot be less than
$25,000 or more than five times the amount of insurance on the child's life
under the Benefit.
2. A Life Paid Up at Age 85 plan (Life Paid Up at Age 65 plan if the issue age
for the new contract is less than 15 years). In this case the new contract
will be issued by The Prudential Insurance Company of America. Its face amount
will be the amount asked for in the application. But it cannot be less than
$5,000 or more than five times the amount of insurance on the child's life under
this Benefit.
The new contract will not have Supplementary Benefits other than as we describe
in this and in the next paragraph. If the company would include in other
contracts like the new contract a benefit for waiving premiums in the event of
disability, here is what the company will do. Even though this contract does not
have that benefit on the life of that child, the company will put it in the new
contract on his or her life. The benefit, if any, in the new contract will be
the same one, with the same provisions, that the company puts in other contracts
like it on its contract date. In this paragraph, when we use the phrase other
contracts like it, we mean contracts the company would regularly issue on the
same plan and for the same rating class, amount, issue age and sex.
No premium will be waived under the new contract unless the disability started
on or after its contract date. And no premium will be waived under a new
contract unless it has a benefit for waiving premiums in the event of
disability. This will be so even if premiums have been waived under this
contract.
Changes.--If the insurance on a dependent child ends as we state in the last
paragraph under Benefit above, that child may be able to obtain a new contract
of life insurance other than in accord with the requirements we state in this
form. But this kind of change may be made only if the company consents and will
be subject to conditions and charges that are then determined.
(Continued on Next Page)
PLI 63-82
II-192
EXHIBIT A(13)(p)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
INSURED'S WAIVER OF PREMIUM BENEFIT
Total Disability Benefit.--We will waive contract premiums that fall due while
the Insured is totally disabled. But this is subject to all the provisions of
this Benefit and of the rest of this contract.
Disability Defined.--When we use the words disability and disabled in this
Benefit we mean total disability and totally disabled. Here is how we define
them: (1) until the Insured has stayed disabled for two years, we mean that he
or she is, due to sickness or injury, completely unable to do any of the
substantial duties of his or her regular occupation; but (2) after the Insured
has stayed disabled for two years, we mean that he or she cannot, due to
sickness or injury, do any gainful work for which he or she is reasonably fitted
by education, training, or experience.
Except for what we state in the next sentence, we will at no time regard an
Insured as disabled who is doing gainful work for which he or she is reasonably
fitted by education, training, or experience. We will regard an Insured as
disabled, even if working or able to work, if he or she incurs, during a period
in which premiums are eligible to be waived as we describe below, one of the
following: (1) permanent and complete blindness of both eyes; or (2) severance
of both hands at or above the wrists or both feet at or above the ankles; or (3)
severance of one hand at or above the wrist and one foot at or above the ankle.
Premiums Eligible To Be Waived.--If the Insured becomes disabled before the
first contract anniversary after his or her 60th birthday and that disability
begins (1) on or after the first contract anniversary after his or her 5th
birthday, it the date of this rider was before that birthday; or (2) on or after
the date of the rider, if that date was on or after his or her 5th birthday, we
will waive all premiums that fall due while he or she stays disabled.
If the Insured becomes disabled on or after the first contract anniversary after
his or her 60th birthday, we will waive only those premiums that fall due before
the first contract anniversary after his or her 65th birthday and while he or
she stays disabled.
If the Insured becomes disabled on or after the first contract anniversary after
his or her 60th birthday, we will not waive any premium that falls due in that
period of disability.
Conditions.--Both of these conditions must be met: (1) The Insured must become
disabled while this contract is in force with no premium in default past its
days of grace. (2) The Insured must stay disabled for a period of at least six
months while living.
Exceptions.--We will not waive any premium if the Insured becomes disabled
from: (1) an injury he causes to himself, or she causes to herself, on purpose;
or (2) sickness or injury due to service on or after the date of this rider in
the armed forces of any country(ies) at war. The word war means declared or
undeclared war and includes resistance to armed aggression.
Successive Disabilities.--Here is what happens if the Insured has at least one
premium waived while disabled, then gets well so that premium payment resumes,
and then becomes disabled again. In this case, we will not apply the six-month
period that would otherwise be required by Condition (2) and will consider the
second period of disability to be part of the first period unless (1) the
Insured has done gainful work, for which he or she is reasonably fitted, for at
least six months between the periods; or (2) the Insured became disabled the
second time from an entirely different cause.
If we do not apply the six-month period required by Condition (2), we also will
not count the days when there was no disability as part of the two year period
when disability means the Insured cannot do any of the duties of his or her
regular occupation.
Notice and Proof of Claim.--Notice and proof of any claim must be given to us
while the Insured is living and disabled, or as soon as reasonably possible. If
notice or proof is not given as soon as reasonably possible, we will not waive
any premium due more than one year before the date the notice or proof is given
to us. We may require proof at reasonable times that the Insured is still
disabled.
(Continued on Next Page)
PLI 66--82
II-193
<PAGE>
(Continued from Preceding Page)
After he or she has been disabled for two years, we will not ask for proof more
than once a year. As a part of any proof, we have the right to require that the
Insured be examined at our expense by doctors of our choice.
Recovery from Disability.--We will stop waiving premiums if (1) disability ends;
or (2) we ask for proof that the Insured is disabled and we do not receive it;
or (3) we require that the Insured be examined and he or she fails to do so.
Miscellaneous.--Any premiums that fall due are payable until we approve a claim.
We will refund any premium paid that is later waived. But we will not, of
course, refund any premium or part of a premium that was or is to be returned in
accord with the Premium Adjustment provision in this contract.
There might be unpaid premiums that fall due (1) after disability starts; but
(2) more than one year before we have notice of claim at our Service Office. Or
disability might start in the days of grace of an unpaid premium. In either
case, if we are otherwise able to approve a claim, those unpaid premiums that we
do not waive will be due us with compound interest at 6% a year. If we do not
receive them, we will deduct them with interest from any amount we pay under the
contract.
Any premium we waive will be at the frequency in effect when the Insured becomes
disabled.
If we waive premiums, the effect on this contract will be the same as if the
premiums had been paid in cash. But the Premium Adjustment provision will not
apply to any premium that was not paid because it was waived under this Benefit.
If we owe the Insured a refund of premium but have not paid it before his or her
death, we have the choice of paying the beneficiary for insurance payable upon
the death of the Insured or the Insured's estate.
Benefit Premiums.--The premiums for this Benefit are a part of the contract
premiums due before the first contract anniversary after the Insured's 65th
birthday.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the day that is the last premium due date in the premium period;
3. the end of the day before the first contract anniversary after the Insured's
65th birthday, unless the Insured has stayed disabled since before the first
contract anniversary after the 6Oth birthday;
4. the date the contract is surrendered under its Cash Value Option, if it has
one; and
5. the date the contract ends for any other reason.
| RIDER ATTACHED TO AND MADE A PART OF THIS CONTRACT
|
|
| Signed by the Company,
|
|
| By /s/ ISABELLE L. KIRCHNER
| -----------------------------
| Secretary
|
|
| Date Attest
|____________________________________________________
PLI 66-82 Printed in U.S.A.
II-194
EXHIBIT A(13)(q)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| John Doe | XX XXX XXX
|_____________________________________ |___________________________________
INSURED'S WAIVER OF PREMIUM BENEFIT
Total Disability Benefit.--We will waive contract premiums that fall due while
the Insured is totally disabled. But this is subject to all the provisions of
this Benefit and of the rest of this contract.
Disability Defined.--When we use the words disability and disabled in this
Benefit we mean total disability and totally disabled. Here is how we define
them: (1) until the Insured has stayed disabled for two years, we mean that (a)
he or she cannot, due to sickness or injury, do the main duties of his or her
regular occupation, and (b) he or she does not do any gainful work for which he
or she is reasonably fitted by education, training, or experience; but (2) after
the Insured has stayed disabled for two years, we mean that he or she cannot,
due to sickness or injury, do any gainful work for which he or she is reasonably
fitted by education, training, or experience.
But we will regard an Insured as disabled, even if working or able to work, if
he or she incurs, during a period in which premiums are eligible to be waived as
we describe below, one of the following: (1) permanent and complete blindness of
both eyes; or (2) severance of both hands at or above the wrists or both feet at
or above the ankles; or (3) severance of one hand at or above the wrist and one
foot at or above the ankle.
Premiums Eligible To Be Waived.--If the Insured becomes disabled before the
first contract anniversary after his or her 60th birthday and that disability
begins (1) on or after the first contract anniversary after his or her 5th
birthday, if the date of this rider was before that birthday; or (2) on or after
the date of the rider, if that date was on or after his or her 5th birthday, we
will waive all premiums that fall due while he or she stays disabled.
If the Insured becomes disabled on or after the first contract anniversary after
his or her 60th birthday, we will waive only those premiums that fall due before
the first contract anniversary after his or her 65th birthday and while he or
she stays disabled.
If the Insured becomes disabled on or after the first contract anniversary after
his or her 65th birthday, we will not waive any premium that falls due in that
period of disability.
Conditions.--Both of these conditions must be met: (1) The Insured must become
disabled while this contract is in force with no premium in default past its
days of grace. (2) The Insured must stay disabled for a period of at least six
months while living.
Exceptions.--We will not waive any premium if the Insured becomes disabled
from: (1) an injury he causes to himself, or she causes to herself, on purpose;
or (2) sickness or injury due to service on or after the date of this rider in
the armed forces of any country(ies) at war. The word war means declared or
undeclared war and includes resistance to armed aggression.
Successive Disabilities.--Here is what happens if the Insured has at least one
premium waived while disabled, then gets well so that premium payment resumes,
and then becomes disabled again. In this case, we will not apply the six-month
period that would otherwise be required by Condition (2) and will consider the
second period of disability to be part of the first period unless (1) the
Insured has done gainful work, for which he or she is reasonably fitted, for at
least six months between the periods; or (2) the Insured became disabled the
second time from an entirely different cause.
If we do not apply the six-month period required by Condition (2), we also will
not count the days when there was no disability as part of the two year period
when disability means the Insured cannot do any of the duties of his or her
regular occupation.
Notice and Proof of Claim.--Notice and proof of any claim must be given to us
while the Insured is living and disabled, or as soon as reasonably possible. If
notice or proof is not given as soon as reasonably possible, we will not waive
any premium due more than one year before the date the notice or proof is given
to us. We may require proof at reasonable times that the Insured is still
disabled.
(Continued on Next Page)
PLI 67--82
II-195
<PAGE>
(Continued from Preceding Page)
After he or she has been disabled for two years, we will not ask for proof more
than once a year. As a part of any proof, we have the right to require that the
Insured be examined at our expense by doctors of our choice.
Recovery from Disability.--We will stop waiving premiums if (1) disability
ends; or (2) we ask for proof that the Insured is disabled and we do not receive
it; or (3) we require that the Insured be examined and he or she fails to do so.
Miscellaneous.--Any premiums that fall due are payable until we approve a
claim. We will refund any premium paid that is later waived. But we will not, of
course, refund any premium or part of a premium that was or is to be returned in
accord with the Premium Adjustment provision in this contract.
There might be unpaid premiums that fall due (1) after disability starts; but
(2) more than one year before we have notice of claim at our Service Office. Or
disability might start in the days of grace of an unpaid premium. In either
case, if we are otherwise able to approve a claim, those unpaid premiums that we
do not waive will be due us with compound interest at 6% a year. If we do not
receive them, we will deduct them with interest from any amount we pay under the
contract.
Any premium we waive will be at the frequency in effect when the Insured becomes
disabled.
If we waive premiums, the effect on this contract will be the same as if the
premiums had been paid in cash. But the Premium Adjustment provision will not
apply to any premium that was not paid because it was waived under this Benefit.
If we owe the Insured a refund of premium but have not paid it before his or her
death, we have the choice of paying the beneficiary for insurance payable upon
the death of the Insured or the Insured's estate.
Benefit Premiums.--The premiums for this Benefit are a part of the contract
premiums due before the first contract anniversary after the Insured's 65th
birthday.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the day that is the last premium due date in the premium period;
3. the end of the day before the first contract anniversary after the Insured's
65th birthday, unless the Insured has stayed disabled since before the first
contract anniversary after the 60th birthday;
4. the date the contract is surrendered under its Cash Value Option, if it has
one; and
5. the date the contract ends for any other reason.
| RIDER ATTACHED TO AND MADE A PART OF THIS CONTRACT
|
|
| Signed for the Company,
|
|
| By /s/ ISABELLE L. KIRCHNER
| -----------------------------
| Secretary
|
|
| Date September 7, 1983 Attest: M. Smith
|____________________________________________________
PLI 67--82 Printed in U.S.A.
II-196
EXHIBIT A(13)(r)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
INSURED'S ACCIDENTAL DEATH BENEFIT
All previous provisions of this contract with regard to accidental death benefit
will end just before the date of this rider.
Benefit.--We will pay $____________ for the Insured's accidental loss of life.
But our payment is subject to all the provisions of this Benefit and of the rest
of this contract.
Manner of Payment.--We will include in the proceeds of this contract any
payment under this Benefit.
Conditions.--Both of these conditions must be met: (1) We must receive due
proof that the Insured's death was the direct result, independent of all other
causes, of accidental bodily injury that occurred on or after
_____________________________ (2) The death must occur (a) while the contract is
in force with no premium in default past its days of grace; and (b) before the
end of the contract's term or endowment period, if any.
Exclusions.--We will not pay under this Benefit for death caused or
contributed to by: (1) suicide or attempted suicide while sane or insane; or (2)
infirmity or disease of mind or body or treatment for it; or (3) any infection
other than one caused by an accidental cut or wound.
Even if death is caused by accidental bodily injury, we will not pay for it
under this Benefit if it is caused or contributed to by: (1) service in the
armed forces of any country(ies) at war; or (2) war or any act of war; or (3)
travel by, or descent from, any aircraft if the Insured had any duties or acted
in any capacity other than as a passenger at any time during the flight. But we
will ignore (3) if all these statements are true of the aircraft: (a) It has
fixed wings and a permitted gross takeoff weight of at least 75,000 pounds. (b)
It is operated by an air carrier that is certificated under the laws of the
United States or Canada to carry passengers to or from places in those
countries. (c) It is not being operated for any armed forces for training or
other purposes. As used here, the word aircraft includes rocket craft or any
other vehicle for flight in or beyond the earth's atmosphere. The word war means
declared or undeclared war and includes resistance to armed aggression.
Benefit Premiums.--We grant this Benefit in consideration of: (1) payment now
of an extra premium of $____________ . and (2) payment on and after
____________________________ of an extra premium of $____________. This latter
amount will be added to, due at the same time as, and subject to the same
conditions of payment and adjustment as the contract premiums due on and after
that date.
Neither this Benefit nor the extra premium charged for it will change any loan
or contract value that may be in this contract. But if the contract has a
benefit for waiving premiums in the event of disability, that benefit will apply
to the extra premium charged for this Benefit.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the date the contract is surrendered under its Cash Value Option, if it has
one; and
3. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
| Rider attached to and made a part of this contract
|
|
| Signed by the Company,
|
|
| By /s/ ISABELLE L. KIRCHNER
| -----------------------------
| Secretary
|
|
| Date Attest
|____________________________________________________
PLI 68--82 Printed in U.S.A.
II-197
EXHIBIT A(13)(s)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
INSURED'S ACCIDENTAL DEATH BENEFIT
All previous provisions of this contract with regard to accidental death benefit
will end just before the date of this rider.
Benefit.--We will pay $___________ for the Insured's accidental loss of life.
But our payment is subject to all the provisions of this Benefit and of the rest
of this contract.
Manner of Payment.--We will include in the proceeds of this contract any payment
under this Benefit.
Conditions.--Both of these conditions must be met: (1) We must receive due proof
that the Insured's death was the direct result, independent of all other causes,
of accidental bodily injury that occurred on or after __________________ (2) The
death must occur (a) no more than 90 days after the injury; (b) while the
contract is in force with no premium in default past its days of grace; and (c)
before the end of the contract's term or endowment period, if any.
Exclusions.--We will not pay under this Benefit for death caused by: (1) suicide
or attempted suicide while sane or insane; or (2) infirmity or disease of mind
or body or treatment for it; or (3) any infection other than one caused by (a)
an accidental cut or wound, or (b) accidental ingestion of a poisonous food
substance.
Even if death is caused by accidental bodily injury, we will not pay for it
under this Benefit if it is caused by: (1) service in the armed forces of any
country(ies) at war; or (2) war or any act of war; or (3) travel by, or descent
from, any aircraft if the Insured had any duties or acted in any capacity other
than as a passenger at any time during the flight. But we will ignore (3) if all
these statements are true of the aircraft: (a) It has fixed wings and a
permitted gross takeoff weight of at least 75,000 pounds. (b) It is operated by
an air carrier that is certificated under the laws of the United States or
Canada to carry passengers to or from places in those countries. (c) It is not
being operated for any armed forces for training or other purposes. As used
here, the word aircraft includes rocket craft or any other vehicle for flight in
or beyond the earth's atmosphere. The word war means declared or undeclared war
and includes resistance to armed aggression.
Benefit Premiums.--We grant this Benefit in consideration of: (1) payment now of
an extra premium of $____________, and (2) payment on and after
_________________________ of an extra ________________ premium of $____________.
This latter amount will be added to, due at the same time as, and subject to the
same conditions of payment and adjustment as the contract premiums due on and
after that date.
Neither this Benefit nor the extra premium charged for it will change any loan
or contract value that may be in this contract. But if the contract has a
benefit for waiving premiums in the event of disability, that benefit will apply
to the extra premium charged for this Benefit.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the date the contract is surrendered under its Cash Value Option, if it has
one; and
3. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
| Rider attached to and made a part of this contract
|
|
| Signed by the Company,
|
|
| By /s/ ISABELLE L. KIRCHNER
| -----------------------------
| Secretary
|
|
| Date Attest
|____________________________________________________
PLI 69--82 Printed in U.S.A.
II-198
EXHIBIT A(13)(t)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
ENSURED'S ACCIDENTAL DEATH BENEFIT
All previous provisions of this contract with regard to accidental death benefit
will end just before the date of this rider.
Benefit.--We will pay $ ___________ for the Insured's accidental loss of life.
But our payment is subject to all the provisions of this Benefit and of the rest
of this contract.
Manner of Payment.--We will include in the proceeds of this contract any payment
under this Benefit.
Conditions.--Both of these conditions must be met: (1) We must receive due proof
that the Insured's death was the direct result, independent of all other causes,
of accidental bodily injury that occurred on or after ________________________
(2) The death must occur (a) no more than 90 days after the injury; (b) while
the contract is in force with no premium in default past its days of grace; and
(c) before the end of the contract's term or endowment period, if any.
Exclusions.--We will not pay under this Benefit for death caused by: (1) suicide
or attempted suicide while sane or insane; or (2) infirmity or disease of mind
or body or treatment for it; or (3) any infection other than one caused by an
accidental cut or wound.
Even if death is caused by accidental bodily injury, we will not pay for it
under this Benefit if it is caused by: (1) service in the armed forces of any
country(ies) at war; or (2) war or any act of war; or (3) travel by, or descent
from, any aircraft if the Insured had any duties or acted in any capacity other
than as a passenger at any time during the flight. But we will ignore (3) if all
these statements are true of the aircraft: (a) It has fixed wings and a
permitted gross takeoff weight of at least 75,000 pounds. (b) It is operated by
an air carrier that is certificated under the laws of the United States or
Canada to carry passengers to or from places in those countries. (c) It is not
being operated for any armed forces for training or other purposes. As used
here, the word aircraft includes rocket craft or any other vehicle for flight in
or beyond the earth's atmosphere. The word war means declared or undeclared war
and includes resistance to armed aggression.
Benefit Premiums.--We grant this Benefit in consideration of: (1) payment now of
an extra premium of $ _________________. and (2) payment on and after
_____________________________ of an extra premium of $ ________________. This
latter amount will be added to, due at the same time as, and subject to the same
conditions of payment and adjustment as the contract premiums due on and after
that date.
Neither this Benefit nor the extra premium charged for it will change any loan
or contract value that may be in this contract. But if the contract has a
benefit for waiving premiums in the event of disability, that benefit will apply
to the extra premium charged for this Benefit.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the date the contract is surrendered under itS Cash Value Option, if it has
one; and
3. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
| Rider attached to and made a part of this contract
|
|
| Signed by the Company,
|
|
| By /s/ DOROTHY K. LIGHT
| -----------------------------
| Secretary
|
|
| Date Attest
|____________________________________________________
PLI 70--82
II-199
EXHIBIT A(13)(u)
(Continued from Preceding Page)
MISCELLANEOUS PROVISIONS
Beneficiary.--The word beneficiary where we use it in this contract without
qualification means the beneficiary for insurance payable upon the death of the
Insured.
Unless we endorse this contract to say otherwise, the beneficiary for insurance
payable upon the death of a dependent child will be the Insured if living,
otherwise the estate of the Insured.
The beneficiary for insurance payable upon the death of a dependent child may be
changed. The request must be in writing and in a form that meets our needs. It
will take effect only when we file it at our Service Office; this will be after
the contract is sent to us to be endorsed, if we ask for it. Then any previous
beneficiary's interest in such insurance will end as of the date of the request.
It will end then even if the child is not living when we file the request. Any
beneficiary's interest is subject to the rights of any assignee of whom we know.
When a beneficiary is designated, any relationship shown is to the Insured,
unless otherwise stated.
Reinstatement.--If this contract is reinstated, it will not include the
insurance that we provide under this Benefit on the dependent children unless
you give us any facts we need to satisfy us that each child who is to be insured
on or within 15 days after the date of reinstatement is insurable for the
Benefit. If you do not give us the facts we need for any child, the Benefit may
be reinstated if all the other conditions are met to reinstate the contract. But
you must send the contract to us to be endorsed to show that the child is not
insured under the Benefit.
Contract Value Options.--If this contract has a Contract Value Options
provision, it will apply only during the Insured's lifetime. Any extended or
reduced paid-up insurance that may be described there is on the life of the
Insured only.
Contract Loans.--If this contract has a Loans provision, we will not consider
any contract debt when we determine the amount payable, if any, at the death of
a dependent child.
Incontestability.--Except for non-payment of premium, we will not contest this
Benefit with respect to the insurance on any dependent child's life after it has
been in force during the child's lifetime for two years from the date we show in
the first sentence under Benefit above.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the day before the first contract anniversary after the Insured's
65th birthday;
3. the date the contract is surrendered under its Cash Value Option, if it has
one, or the paid-up insurance, if any, under the Benefit is surrendered; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
RIDER ATACHED TO AND MADE A PART OF THIS CONTRACT
Signed for the Company,
By /s/ DOROTHY K. LIGHT
Secretary
Date Attest
PLI 71-82
II-200
EXHIBIT A(13)(v)
(Continued from Preceding Page)
MISCELLANEOUS PROVISIONS
Beneficiary.--The word beneficiary where we use it in this contract without
qualification means the beneficiary for insurance payable upon the death of the
Insured.
Unless we endorse this contract to say otherwise, the beneficiary for insurance
payable upon the death of a dependent child will be the Insured if living,
otherwise the estate of the Insured.
The beneficiary for insurance payable upon the death of a dependent child may be
changed. The request must be in writing and in a form that meets our needs. It
will take effect only when we file it at our Service Office; this will be after
the contract is sent to us to be endorsed, if we ask for it. Then any previous
beneficiary's interest in such insurance will end as of the date of the request.
It will end then even if the child is not living when we file the request. Any
beneficiary's interest is subject to the rights of any assignee of whom we know.
When a beneficiary is designated, any relationship shown is to the Insured,
unless otherwise stated.
Reinstatement.--lf this contract is reinstated, it will not include the
insurance that we provide under this Benefit on the dependent children unless
you give us any facts we need to satisfy us that each child who is to be insured
on or within 15 days after the date of reinstatement is insurable for the
Benefit. If you do not give us the facts we need for any child, the Benefit may
be reinstated if all the other conditions are met to reinstate the contract. But
you must send the contract to us to be endorsed to show that the child is not
insured under the Benefit.
Contract Value Options.--If this contract has a Contract Value Options
provision, it will apply only during the Insured's lifetime. Any extended or
reduced paid-up insurance that may be described there is on the life of the
Insured only.
Contract Loans.--lf this contract has a Loans provision, we will not consider
any contract debt when we determine the amount payable, if any, at the death of
a dependent child.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the day before the first contract anniversary after the Insured's
65th birthday;
3. the date the contract is surrendered under its Cash Value Option, if it has
one, or the paid-up insurance, if any, under the Benefit is surrendered; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
RIDER ATTACHED TO AND MADE A PART OF THIS CONTRACT
Signed for the Company,
By /s/ DOROTHY K. LIGHT
Secretary
Date Attest
PLI 72-82
II-201
EXHIBIT 1A(13)(w)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
REDUCED PAID-UP INSURANCE
Premiums are no longer being paid on this contract. But it is being kept in
force as reduced paid-up insurance on the lnsured's life, as we state under
Contract Value Options in the contract.
The new amount of insurance and its effective date are shown in the attached
Table of Values. Unless otherwise stated in the Table, any contract debt was
deducted when we computed the net cash value that was used to provide the
reduced paid-up insurance.
As of the effective date shown in the Table each of these items no longer
applies: (1) the Tabular Cash Values shown on page 4 in the contract; (2) any
Supplementary Benefits or other extra benefits that were made a part of the
contract by rider or endorsement; (3) any of the provisions of the contract that
apply to the varying of the insurance amount or cash value due to investment
results in the separate account; and (4) any provisions of the contract that do
not apply to the reduced paid-up insurance.
If this contract is reinstated, the net cash value that applies upon
reinstatement is: (a) the net cash value upon reinstatement computed as we state
in the contract under Premium Payment and Reinstatement, but computed as if no
loans had been taken or repaid and no loan interest had been paid while the
contract was in force as reduced paid-up insurance; minus (b) the excess of the
contract debt immediately after reinstatement over what the contract debt would
have been if no loans had been taken or repaid and no loan interest had been
paid while the contract was in force as reduced paid-up insurance.
The attached Table shows values at the ends of contract years. If we need to
compute values at some time during a contract year, we will count the time since
the start of the year. We will let you know the values for other durations if
you ask for them.
| RIDER ATTACHED TO AND MADE A PART OF THIS CONTRACT
|
|
| PRUCO LIFE INSURANCE COMPANY,
|
|
| By /s/ DOROTHY K. LIGHT
| -----------------------------
| Secretary
|
|
| Date Attest
|____________________________________________________
- ----------
PLI 74--82
- ----------
II-202
EXHIBIT 1.A(13)(x)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
This contract was reinstated on the date of this rider. But we did not have the
facts we needed to satisfy us that the child, ____________________________,
whose date of birth is ___________________________, was insurable. Therefore,
that child will not be insured under this contract on or after the date of this
rider. This will be so even though the contract or an application related to it
may refer to the child. This will still be so if you apply to reinstate the
contract again in the future and you then refer to the child.
| RIDER ATTACHED TO AND MADE A PART OF THIS CONTRACT
|
|
| PRUCO LIFE INSURANCE COMPANY,
|
|
| By /s/ DOROTHY K. LIGHT
| -----------------------------
| Secretary
|
|
| Date Attest
|____________________________________________________
- ---------
PLI 75-82
- ---------
II-203
EXHIBIT A(13)(y)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
| John Doe | XX XXX XXX
|_____________________________________ |__________________________________
This contract is issued as a conversion from an earlier contract.
The period we state under Incontestability in this contract will start on the
issue date of the earlier contract. But if that contract was reinstated before
the date of this contract, for each reinstatement we will have the right to use
as a basis for a contest of this contract the statements that were made to us at
the time. The period during which we will have that right will be the period we
state under Incontestability in this contract; it will start on the date of the
reinstatement.
The period we state under Suicide Exclusion in this contract will start on the
issue date of the earlier contract.
| Rider attached to and made a part of this Contract
| on the Contract Date
|
|
| PRUCO LIFE INSURANCE COMPANY,
|
|
| By /s/ SPECIMEN
| Isabelle L. Kirchner
| Secretary
|
|
|____________________________________________________
- ---------
PLI 76-82 Printed in U.S.A.
- ---------
II-204
EXHIBIT 1.A.(13)(z)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
| John Doe | XX XXX XXX
|_____________________________________ |___________________________________
MODIFICATION OF INSURED'S WAIVER OF PREMIUM BENEFIT PROVISION
There is an impairment of the Insured's eyesight. If he or she becomes disabled
as a result of the loss of eyesight, here is what will apply for that
disability. We will not allow benefits under any benefit for waiving premiums in
the event of disability in (1) this contract, or (2) any other contract on the
Insured's life to which you change or for which you exchange this contract or
any of its benefits.
| Rider attached to and made a part of this Contract
| on the Contract Date
|
|
| PRUCO LIFE INSURANCE COMPANY,
|
|
| By /s/ SPECIMEN
| Isabelle L. Kirchner
| Secretary
|
|
|____________________________________________________
- ---------
PLI 77-82 Printed in U.S.A.
- ---------
II-205
EXHIBIT 1.A.(13)(aa)
Pruco Life Insurance Company
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
TERMINATION OF BENEFIT
We agree that the benefit ______________________________________________________
______________________, will end as of ________________________________________.
Then all references in this contract to that benefit will no longer apply. The
premium for that benefit will not be payable on or after that date.
| RIDER ATTACHED TO AND MADE A PART OF THIS CONTRACT
|
|
| Pruco Life Insurance Company,
|
|
| By /s/ DOROTHY K. LIGHT
| -----------------------------
| Secretary
|
|
|
| Date Attest
|____________________________________________________
- ---------
PLI 78--82 Printed in U.S.A.
- ---------
II-206
EXHIBIT 1.A.(13)(bb)
Pruco Life Insurance Company
Insured Rider for Policy No.
- ----------------------------- --------------------------------------
AVIATION RISK EXCLUSION
Conditions of Exclusion.--We will pay the limited payment we describe below, and
not what we would otherwise pay, if (1) the Insured dies as a result of travel
by, or descent from, any aircraft; and (2) the Insured had any duties or acted
in any capacity other than as a passenger at any time during the flight.
But this Exclusion will not apply if all these statements are true of the
aircraft: (1) It has fixed wings and a permitted gross takeoff weight of at
least 75,000 pounds. (2) It is operated by an air carrier that is certificated
under the laws of the United States or Canada to carry passengers to or from
places in those countries. (3) It is not being operated for any armed forces for
training or other purposes.
As used here, the word aircraft includes rocket craft or any other vehicle for
flight in or beyond the earth's atmosphere.
Limited Payment.--The limited payment will be (1) the sum of the premiums that
became due and were paid for the insurance on the Insured's life, minus (2) any
contract debt. But if the reserve for the insurance on the Insured's life, when
computed as we state under Reserves, is more than the amount we determine in
(1), we will use that reserve in place of that amount. Also, the limited payment
will never be more than what we would have paid if this Exclusion were not in
the contract.
The limited payment will be payable to the beneficiary for insurance otherwise
payable upon the Insured's death.
Reduced Paid-up, Extended and Other Insurance on the Insured's Life.--This
Exclusion also applies to any reduced paid-up or extended insurance that might
be in force under the Contract Value Options, if any. We will put the Exclusion
in any contract on the Insured's life to which you change, or for which you
exchange, this contract or any of its benefits.
Paid-up Insurance on Other Persons.--This contract might include insurance on
the life of someone other than the Insured. And it might have a provision that
makes that insurance paid-up if the Insured dies. This Exclusion will not affect
any such provision.
Effect of Incontestability.--In any case where this Exclusion applies, the
Incontestability provision of this contract will not be deemed to make us pay
more than as we state under Limited Payment.
Reserves.--We might have to compute a reserve to find the limited payment. If
so, we will use the same table and rate(s) that we use to compute net values for
the insurance on the Insured's life, as we describe under Basis of Computation
in this contract.
Rider attached to and made a part of this contract
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
-------------------------------
Secretary
Date Attest
- ----------
PLI 80--82 Printed in U.S.A.
- ----------
II-207
EXHIBIT 1.A.(13)(cc)
Pruco Life Insurance Company
Insured Rider for Policy No.
John Doe XX XXX XXX
- ---------------------------- ---------------------------------------
MILITARY AVIATION RISK EXCLUSION
Conditions of Exclusion.--We will pay the limited payment we describe below, and
not what we would otherwise pay, if (1) the Insured dies as a result of travel
by, or descent from, any aircraft operated by or for any armed forces; and (2)
the Insured had any duties or acted in any capacity other than as a passenger at
any time during the flight. As used here, the word aircraft includes rocket
craft or any other vehicle for flight in or beyond the earth's atmosphere.
Limited Payment.--The limited payment will be (1) the sum of the premiums that
became due and were paid for the insurance on the Insured's life, minus (2) any
contract debt. But if the reserve for the insurance on the Insured's life, when
computed as we state under Reserves, is more than the amount we determine in
(1), we will use that reserve in place of that amount. Also, the limited payment
will never be more than what we would have paid if this Exclusion were not in
the contract.
The limited payment will be payable to the beneficiary for insurance otherwise
payable upon the Insured's death.
Reduced Paid-up, Extended and Other Insurance on the Insured's Life.--This
Exclusion also applies to any reduced paid-up or extended insurance that might
be in force under the Contract Value Options, if any. We will put the Exclusion
in any contract on the Insured's life to which you change, or for which you
exchange, this contract or any of its benefits.
Paid-up Insurance on Other Persons.--This contract might include insurance on
the life of someone other than the Insured. And it might have a provision that
makes that insurance paid-up if the Insured dies. This Exclusion will not affect
any such provision.
Effect of Incontestability.--In any case where this Exclusion applies, the
Incontestability provision of this contract will not be deemed to make us pay
more than as we state under Limited Payment.
Reserves.-We might have to compute a reserve to find the limited payment. If so,
we will use the same table and rate(s) that we use to compute net values for the
insurance on the Insured's life, as we describe under Basis of Computation in
this contract.
Rider attached to and made a part of this contract
Pruco Life Insurance Company,
By SPECIMEN SIGNATURE
Secretary
Date December 1, 1983 Attest M. Smith
- --------- --------------------------------------------------
PLI 61-82 Printed in U.S.A.
- ---------
II-208
EXHIBIT 1A(13)(dd)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
WAR RISK EXCLUSION
Conditions of Exclusion.--We will pay the limited payment we describe below, and
not what we would otherwise pay, if the Insured's death results from any one or
more of the following causes: (1) war; (2) any act of war; or (3) the special
hazards due to service in the armed forces of any country(ies).
But this Exclusion will not apply unless all these conditions exist: (1) The
cause of death occurs while the Insured is in the armed forces of any
country(ies) at war. (2) The cause of death occurs while the Insured is outside
the Home Areas. (3) The death occurs (a) outside the Home Areas, or (b) within
six months after the Insured's return to the Home Areas while in such forces or
within six months after the end of service in such forces, whichever is earlier.
As used here, the word war means declared or undeclared war and includes
resistance to armed aggression. The phrase Home Areas means the fifty states of
the United States of America, the District Qf Columbia, The Commonwealth of
Puerto Rico, the Virgin Islands of the United States, or Canada.
Limited Payment.--The limited payment will be (1) the sum of the premiums that
became due and were paid for the insurance on the Insured's life, minus (2) any
contract debt. But if the reserve for the insurance on the Insured's life, when
computed as we state under Reserves, is more than the amount we determine in
(1), we will use that reserve in place of that amount. Also, the limited payment
will never be more than what we would have paid if this Exclusion were not in
the contract.
The limited payment will be payable to the beneficiary for insurance otherwise
payable upon the Insured's death.
Reduced Paid-up, Extended and Other Insurance on the Insured's Life.--This
Exclusion also applies to any reduced paid-up or extended insurance that might
be in force under the Contract Value Options, if any. We will put the Exclusion
in any contract on the Insured's life to which you change, or for which you
exchange, this contract or any of its benefits.
Paid-up Insurance on Other Persons.--This contract might include insurance on
the life of someone other than the Insured. And it might have a provision that
makes that insurance paid-up if the Insured dies. This Exclusion will not affect
any such provision.
Effect of Incontestability.--ln any case where this Exclusion applies, the
Incontestability provision of this contract will not be deemed to make us pay
more than as we state under Limited Payment.
Reserves.--We might have to compute a reserve to find the limited payment. If
so, we will use the same table and rate(s) that we use to compute net values for
the insurance on the Insured's life, as we describe under Basis of Computation
in this contract.
|Rider attached to and made a part of this Contract
|on the Contract Date
|
|Pruco Life Insurance Company,
|
|
| By /s/ ISABELLE L. KIRCHNER
| Secretary
|
|
| Date Attest
|____________________________________________________
- ----------
PLI 82--82 Printed in U.S.A.
- ----------
II-209
EXHIBIT 1.A.(13)(ee)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
| John Doe | XX XXX XXX
|_____________________________________ |___________________________________
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 of this Insured began under the earlier contract. But if that
contract was reinstated before the date of this contract, for each
reinstatement we will have the right to use as a basis for a contest of this
contract the statements that were made in the application for reinstatement. The
period during which we will have that right will be the period we state under
Incontestability in this contract; it will start on the date of the
reinstatement.
The period we state under Suicide Exclusion in this contract will start on the
date coverage of this Insured began under the earlier contract.
| Rider attached to and made a part of this Contract
| on the Contract Date
|
|
| PRUCO LIFE INSURANCE COMPANY,
|
|
| By /s/ SPECIMEN
| Isabelle L. Kirchner
| Secretary
|
|
|____________________________________________________
- ---------
PLI 83-82 Printed in U.S.A.
- ---------
II-210
EXHIBIT 1.A.(13)(ff)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
| |
|_____________________________________ |___________________________________
This rider applies only if the Insured dies by suicide within two years from the
issue date and our liability is limited as we state for suicide in the General
Provisions. If this occurs, any provision for paid-up insurance on the life of
any other person who was, until the Insured died, insured under this contract
will not apply.
Instead, any such person will then have the right to buy a new contract of life
insurance either from us or from an affiliate of ours. The new contract will be
subject to conditions and charges that are then determined, in accord with
regular rules in effect at the time. Its amount will not be less than the
greater of (1) the amount of insurance on that person's life under this
contract, and (2) the lowest amount offered for the plan of insurance to be
provided by the new contract. And proof that the person is insurable will not be
required, unless the new contract is to provide either an increased amount of
insurance or a benefit that did not apply to that person under this contract.
| RIDER ATTACHED TO AND MADE A PART OF THIS CONTRACT
|
|
| Signed by the Company,
|
|
| By /s/ DOROTHY K. LIGHT
| -----------------------------
| Secretary
|
|
| Date Attest
|____________________________________________________
- ----------
PLI 84--82
- ----------
II-211
EXHIBIT 1.A.(13)(gg)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
| John Doe | XX XXX XXX
|_____________________________________ |___________________________________
This contract is issued as a conversion from an earlier contract.
The period we state under Incontestability in this contract will start on the
most recent date coverage of this Insured began under the earlier(est)) contract
to which this one relates. But if any such earlier contract was reinstated after
that date but before the date of this contract, for each reinstatement we will
have the right to use as a basis for a contest of this contract the statements
that were made to us at the time. The period during which we will have that
right will be the period we state under Incontestability in this contract: it
will start on the date of the reinstatement.
The period we state under Suicide Exclusion in this contract will start on the
date coverage of this Insured began under the earlier(est)) contract to which
this one relates.
| Rider attached to and made a part of this Contract
| on the Contract Date
|
|
| PRUCO LIFE INSURANCE COMPANY,
|
|
| By /s/ SPECIMEN
| Isabelle L. Kirchner
| Secretary
|
|
|____________________________________________________
- ---------
PLI 85-82 Printed in U.S.A.
- ---------
II-212
EXHIBIT A(13)(hh)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
AVIATION RISK EXCLUSION
Conditions of Exclusion.--We will pay the limited payment we describe below, and
not what we would otherwise pay, if (1) the Insured dies as a result of travel
by, or descent from, any aircraft; and (2) the Insured had any duties or acted
in any capacity other than as a passenger at any time during the flight.
But this Exclusion will not apply if all these statements are true of the
aircraft: (1) It has fixed wings and a permitted gross takeoff weight of at
least 75,000 pounds. (2) It is operated by an air carrier that is certificated
under the laws of the United States or Canada to carry passengers to or from
places in those countries. (3) It is not being operated for any armed forces for
training or other purposes.
As used here, the word aircraft includes rocket craft or any other vehicle for
flight in or beyond the earth's atmosphere.
Limited Payment.--The limited payment will be (1) the sum of the premiums that
became due and were paid for the insurance on the lnsured's life, minus (2) any
contract debt. But if the net cash value, when computed as we state under
Contract Value Options, is greater than the limited payment described in the
preceding sentence, we will use that net cash value in place of that limited
payment. Also, the limited payment will never be more than what we would have
paid if this Exclusion were not in the contract.
The limited payment will be payable to the beneficiary for insurance otherwise
payable upon the lnsured's death.
Reduced Paid-up, Extended and Other Insurance on the Insured's Life.--This
Exclusion also applies to any reduced paid-up or extended insurance that might
be in force under the Contract Value Options, if any. We will put the Exclusion
in any contract on the lnsured's life to which you change, or for which you
exchange, this contract or any of its benefits.
Paid-up Insurance on Other Persons.--This contract might include insurance on
the life of someone other than the Insured. And it might have a provision that
makes that insurance paid-up if the Insured dies. This Exclusion will not affect
any such provision.
Effect of Incontestability.--ln any case where this Exclusion applies, the
Incontestability provision of this contract will not be deemed to make us pay
more than as we state under Limited Payment.
|Rider attached to and made a part of this contract
|
|Pruco Life Insurance Company,
|
|
| By /s/ ISABELLE L. KIRCHNER
| Secretary
|
|
| Date Attest
|____________________________________________________
- ----------
PLI 87--82 Printed in U.S.A.
- ----------
II-213
EXHIBIT A(13)(ii)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
MILITARY AVIATION RISK EXCLUSION
Conditions of Exclusion.--We will pay the limited payment we describe below, and
not what we would otherwise pay, if (1) the Insured dies as a result of travel
by, or descent from, any aircraft operated by or for any armed forces; and (2)
the Insured had any duties or acted in any capacity other than as a passenger at
any time during the flight. As used here, the word aircraft includes rocket
craft or any other vehicle for flight in or beyond the earth's atmosphere.
Limited Payment.--The limited payment will be (1) the sum of the premiums that
became due and were paid for the insurance on the Insured's life, minus (2) any
contract debt. But if the net cash value, when computed as we state under
Contract Value Options, is greater than the limited payment described in the
preceding sentence, we will use that net cash value in place of that limited
payment. Also, the limited payment will never be more than what we would have
paid if this Exclusion were not in the contract.
The limited payment will be payable to the beneficiary for insurance otherwise
payable upon the Insured's death.
Reduced Paid-up, Extended and Other Insurance on the Insured's Life.--This
Exclusion also applies to any reduced paid-up or extended insurance that might
be in force under the Contract Value Options, if any. We will put the Exclusion
in any contract on the Insured's life to which you change, or for which you
exchange, this contract or any of its benefits.
Paid-up Insurance on Other Persons.--This contract might include insurance on
the life of someone other than the Insured. And it might have a provision that
makes that insurance paid-up if the Insured dies. This Exclusion will not affect
any such provision.
Effect of Incontestability.--ln any case where this Exclusion applies, the
Incontestability provision of this contract will not be deemed to make us pay
more than as we state under Limited Payment.
|Rider attached to and made a part of this contract
|
|
|Pruco Life Insurance Company,
|
|
| By /s/ ISABELLE L. KIRCHNER
| Secretary
|
|
| Date Attest
|____________________________________________________
- ----------
PLI 88--82 Printed in U.S.A.
- ----------
II-214
EXHIBIT 1.A.(13)(jj)
(Continued from Preceding Page)
MISCELLANEOUS PROVISIONS
Beneficiary.--The word beneficiary where we use it in this contract without
qualification means the beneficiary for insurance payable upon the death of the
Insured.
Unless we endorse this contract to say otherwise, the beneficiary for insurance
payable upon the death of a dependent child will be the Insured if living,
otherwise the estate of the Insured.
The beneficiary for insurance payable upon the death of a dependent child may be
changed. The request must be in writing and in a form that meets our needs. It
will take effect only when we file it at our Service Office; this will be after
the contract is sent to us to be endorsed, if we ask for it. Then any previous
beneficiary's interest in such insurance will end as of the date of the request.
It will end then even if the child is not living when we file the request. Any
beneficiary's interest is subject to the rights of any assignee of whom we know.
When a beneficiary is designated, any relationship shown is to the Insured,
unless otherwise stated.
Reinstatement.--lf this contract is reinstated, it will not include the
insurance that we provide under this Benefit on the dependent children unless
you give us any facts we need to satisfy us that each child who is to be insured
on or within 15 days after the date of reinstatement is insurable for the
Benefit. If you do not give us the facts we need for any child, the Benefit may
be reinstated if all the other conditions are met to reinstate the contract. But
you must send the contract to us to be endorsed to show that the child is not
insured under the Benefit.
Contract Value Options.--lf this contract has a Contract Value Options
provision, it will apply only during the Insured's lifetime. Any extended or
reduced paid-up insurance that may be described there is on the life of the
Insured only.
Contract Loans.--If this contract has a Loans provision, we will not consider
any contract debt when we determine the amount payable, if any, at the death of
a dependent child.
Incontestability.--Except for non-payment of premium, we will not contest this
Benefit with respect to the insurance on any dependent child's life after it has
been in force during the child's lifetime for two years from the date we show in
the first sentence under Benefit above.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the day before the first contract anniversary after the Insured's
65th birthday;
3. the date the contract is surrendered under its Cash Value Option, if it has
one, or the paid-up insurance, if any, under the Benefit is surrendered; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
|Rider attached to and made a part of this contract
|
|
|Signed for the company,
|
|
| By /s/ DOROTHY K. LIGHT
| Secretary
|
|
| Date Attest
|____________________________________________________
II-215
EXHIBIT 1.A.(13)(kk)
Pruco Life Insurance Company
Insured Rider for Policy No.
- ---------------------------- -----------------------------------
INSURED'S WAIVER OF PREMIUM BENEFIT
Total Disability Benefit.--We will waive contract premiums that fall due while
the Insured is totally disabled. But this is subject to all the provisions of
this Benefit and of the rest of this contract.
Disability Defined.--When we use the words disability and disabled in this
Benefit we mean total disability and totally disabled. Here is how we define
them: (1) until the Insured has stayed disabled for two years, we mean that he
or she cannot, due to sickness or injury, do any of the substantial and material
duties of his or her regular occupation; but (2) after the Insured has stayed
disabled for two years, we mean that he or she cannot, due to sickness or
injury, do any gainful work for which he or she is reasonably fitted by
education, training, or experience.
Except for what we state in the next sentence, we will at no time regard an
Insured as disabled who is doing gainful work for which he or she is reasonably
fitted by education, training, or experience. We will regard an Insured as
disabled, even if working or able to work, if he or she incurs, during a period
in which premiums are eligible to be waived as we describe below, one of the
following: (1) permanent and complete blindness of both eyes; or (2) severance
of both hands at or above the wrists or both feet at or above the ankles; or (3)
severance of one hand at or above the wrist and one foot at or above the ankle.
Premiums Eligible To Be Waived.--If the Insured becomes disabled before the
first contract anniversary after his or her 60th birthday and that disability
begins (1) on or after the first contract anniversary after his or her 5th
birthday, if the date of this rider was before that birthday; or (2) on or after
the date of the rider, if that date was on or after his or her 5th birthday, we
will waive all premiums that fall due while he or she stays disabled.
If the Insured becomes disabled on or after the first contract anniversary after
his or her 60th birthday, we will waive only those premiums that fall due before
the first contract anniversary after his or her 65th birthday and while he or
she stays disabled.
If the Insured becomes disabled on or after the first contract anniversary after
his or her 65th birthday, we will not waive any premium that falls due in that
period of disability.
Conditions.--Both of these conditions must be met: (1) The Insured must become
disabled while this contract is in force with no premium in default past its
days of grace. (2) The Insured must stay disabled for a period of at least six
months while living.
Exceptions.--We will not waive any premium if the Insured becomes disabled from:
(1) an injury he causes to himself, or she causes to herself, on purpose; or (2)
sickness or injury due to service on or after the date of this rider in the
armed forces of any country(ies) at war. The word war means declared or
undeclared war and includes resistance to armed aggression.
Successive Disabilities.--Here is what happens if the Insured has at least one
premium waived while disabled, then gets well so that premium payment resumes,
and then becomes disabled again. In this case, we will not apply the six-month
period that would otherwise be required by Condition (2) and will consider the
second period of disability to be part of the first period unless (1) the
Insured has done gainful work, for which he or she is reasonably fitted, for at
least six months between the periods; or (2) the Insured became disabled the
second time from an entirely different cause.
If we do not apply the six-month period required by Condition (2), we also will
not count the days when there was no disability as part of the two year period
when disability means the Insured cannot do any of the duties of his or her
regular occupation.
Notice and Proof of Claim.--Notice and proof of any claim must be given to us
while the Insured is living and disabled, or as soon as reasonably possible. If
notice or proof is not given as soon as reasonably possible, we will not waive
any premium due more than one year before the date the notice or proof is given
to us. We may require proof at reasonable times that the Insured is still
disabled.
(Continued on Next Page)
- ----------
PLI 94--82
- ----------
II-216
<PAGE>
(Continued from Preceding Page)
After he or she has been disabled for two years, we will not ask for proof more
than once a year. As a part of any proof, we have the right to require that the
Insured be examined at our expense by doctors of our choice.
Recovery from DIsability.--We will stop waiving premiums if (1) disability ends;
or (2) we ask for proof that the Insured is disabled and we do not receive it;
or (3) we require that the Insured be examined and he or she fails to do so.
Miscellaneous.--Any premiums that fall due are payable until we approve a claim.
We will refund any premium paid that is later waived. But we will not, of
course, refund any premium or part of a premium that was or is to be returned in
accord with the Premium Adjustment provision in this contract.
There might be unpaid premiums that fall due (1) after disability starts; but
(2) more than one year before we have notice of claim at our Service Office. Or
disability might start in the days of grace of an unpaid premium. In either
case, if we are otherwise able to approve a claim, those unpaid premiums that we
do not waive will be due us with compound interest at 6% a year. If we do not
receive them, we will deduct them with interest from any amount we pay under the
contract.
Any premium we waive will be at the frequency in effect when the Insured becomes
disabled.
If we waive premiums, the effect on this contract will be the same as if the
premiums had been paid in cash. But the Premium Adjustment provision will not
apply to any premium that was not paid because it was waived under this Benefit.
If we owe the Insured a refund of premium but have not paid it before his or her
death, we have the choice of paying the beneficiary for insurance payable upon
the death of the Insured or the Insured's estate.
Benefit Premiums.--The premiums for this Benefit are a part of the contract
premiums due before the first contract anniversary after the Insured's 65th
birthday.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the day that is the last premium due date in the premium period;
3. the end of the day before the first contract anniversary after the Insured's
65th birthday, unless the Insured has stayed disabled since before the first
contract anniversary after the 60th birthday;
4. the date the contract is surrendered under its Cash Value Option, if it has
one; and
5. the date the contract ends for any other reason.
Rider attached to and made a part of this contract
Signed for the Company,
By /s/ DOROTHY K. LIGHT
Secretary
Date Attest
---------------------------------------------------
- ----------
PLI 94--82
- ----------
II-217
EXHIBIT 1.A.(13)(ll)
Pruco Life Insurance Company
Insured Rider for Policy No.
John Doe XX XXX XXX
- ----------------------------- ---------------------------------------
INSURED'S ACCIDENTAL DEATH BENEFIT
All previous provisions of this contract with regard to accidental death benefit
will end just before the date of this rider.
Benefit.--We will pay $25,000.--for the Insured's accidental loss of life. But
our payment is subject to all the provisions of this Benefit and of the rest of
this contract.
Manner of Payment.--We will include in the proceeds of this contract any payment
under this Benefit.
Conditions.--Both of these conditions must be met: (1) We must receive due proof
that the Insured's death was the result of accidental bodily injury that
occurred on or after September 1, 1983. (2) The death must occur (a) no more
than 90 days after the injury; (b) while the contract is in force with no
premium in default past its days of grace; and (c) before the end of the
contract's term or endowment period, if any.
Exclusions.--We will not pay under this Benefit for death caused or contributed
to by: (1) suicide or attempted suicide while sane or insane; or (2) infirmity
or disease of mind or body or treatment for it; or (3) any infection other than
one caused by accidental bodily injury.
Even if death is caused by accidental bodily injury, we will not pay for it
under this Benefit if it is caused or contributed to by: (1) service in the
armed forces of any country(ies) at war; or (2) war or any act of war; or (3)
travel by, or descent from, any aircraft if the Insured had any duties or acted
in any capacity other than as a passenger at any time during the flight. But we
will ignore (3) if all these statements are true of the aircraft: (a) It has
fixed wings and a permitted gross takeoff weight of at least 75,000 pounds. (b)
It is operated by an air carrier that is certificated under the laws of the
United States or Canada to carry passengers to or from places in those
countries. (c) It is not being operated for any armed forces for training or
other purposes. As used here, the word aircraft includes rocket craft or any
other vehicle for flight in or beyond the earth's atmosphere. The word war means
declared or undeclared war and includes resistance to armed aggression.
Benefit Premiums.--We grant this Benefit in consideration of: (1) payment now of
an extra premium of $ XX.XX, and (2) payment on and after September 1, 1984 of
an extra annual premium of $ XX.XX. This latter amount will be added to, due at
the same time as, and subject to the same conditions of payment and adjustment
as the contract premiums due on and after that date.
Neither this Benefit nor the extra premium charged for it will change any loan
or contract value that may be in this contract. But if the contract has a
benefit for waiving premiums in the event of disability, that benefit will apply
to the extra premium charged for this Benefit.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the date the contract is surrendered under its Cash Value Option, if it has
one; and
3. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
Rider attached to and made a part of this contract
Signed for the Company,
By SPECIMEN SIGNATURE
Secretary
Date September 1, 1983 Attest M. Smith
- ---------- --------------------------------------------------
PLI 95--82
- ---------- Printed in U.S.A.
II-218
EXHIBIT 1.A.13(mm)
ENDORSEMENTS
(Only we can endorse this contract.)
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 the owner of the contract is
the applicant for it. But if the applicant is not living the owner, except as we
state below, is the beneficiary(ies) who at the time would be entitled to any
proceeds arising from the Insured's death. If there is no such beneficiary at
the time, the owner is the Insured. A beneficiary named by the Insured will not
replace the Insured as owner.
After the Insured is 21 years of age, the owner is the Insured.
While the Insured is living the owner alone is entitled to any contract benefit
and value, and to the exercise of any right and privilege granted by the
contract or by us. This includes, but is not limited to, these rights: (1) to
assign the contract; and (2) to change any subsequent owner. A request for such
a change must be in writing to us at our Service Office and in a form which
meets our needs. The change will take effect only when we endorse the contract
to show it.
If the owner is the Insured, but he or she (1) is not able, due to age, to
exercise rights, and (2) has no legal guardian to do so, we have the right to
let a person who appears to us to be responsible for the Insured's support or
welfare, act for the Insured. We will not do so unless the action appears to us
to be for the Insured's benefit.
Pruco Life Insurance Company,
By /S/ ISABELLE L. KIRCHNER
Secretary
- ----------
PLI 25--82
- ---------- Printed in U.S.A.
II-219
EXHIBIT 1.A.(13)(nn)
ENDORSEMENTS
(Only we can endorse this contract.)
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 the owner of the contract is
the applicant for it. But if the applicant is not living, the owner, except as
we state below, is the beneficiary(ies) who at the time would be entitled to any
proceeds arising from the Insured's death. If there is no such beneficiary at
the time, the owner is the Insured. A beneficiary named by the Insured will not
replace the Insured as owner.
After the Insured is 21 years of age, the owner is the Insured.
While the Insured is living the owner alone is entitled to any contract benefit
and value, and to the exercise of any right and privilege granted by the
contract or by us. This includes, but is not limited to, these rights: (1) to
assign the contract; and (2) to change any subsequent owner. A request for such
a change must be in writing to us at our Service Office and in a form which
meets our needs. The change will take effect only when we endorse the contract
to show it.
If the owner is the Insured, but he or she (1) is not able, due to age, to
exercise rights, and (2) has no legal guardian to do so, we have the right to
let a person who appears to us to be responsible for the Insured's support or
welfare, act for the Insured. We will not do so unless the action appears to us
to be for the Insured's benefit.
Pruco Life Insurance Company of New Jersey,
By /S/ ISABELLE L. KIRCHNER
Secretary
- ----------
PLY 36--84
- ---------- Printed in U.S.A.
II-220
- --------------------------------------------------------------------------------
EXHIBIT A(13)(oo)
RIDER FOR APPLICANT'S WAIVER OF PREMIUM BENEFIT
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
DEATH PROVISION
Death Benefit.--We will waive those contract premiums that fall due after the
applicant's death but before the benefit termination date which we show on the
Contract Data page(s). For us to do so, we must receive due proof that he or she
died: (1) before that date and (2) while this contract is in force with no
premium in default past its days of the grace. But this promise is subject to
all the provisions of this Benefit and of the rest of this contract.
Suicide Exclusion.--If the applicant, whether sane or insane, dies by suicide
within the period that we state in the Suicide Exclusion on page 5, we will not
waive, under this Benefit, the premiums we describe above. Instead, we will
return the sum of the premiums paid for the Benefit.
DISABILITY PROVISION
Total Disability Benefit.--Before the benefit termination date, we will waive
contract premiums that fall due while the applicant is totally disabled. But
this is subject to all the provisions of this Benefit and of the rest of this
contract.
Disability Defined.--When we use the words disability and disabled in this
Benefit we mean total disability and totally disabled. Here is how we define
them: (1) until the applicant has stayed disabled for two years, we mean that he
or she cannot, due to sickness or injury, do any of the duties of his or her
regular occupation; but (2) after the applicant has stayed disabled for two
years, we mean that he or she cannot, due to sickness or injury, do any gainful
work for which he or she is reasonably fitted by education, training, or
experience.
Except for what we state in the next sentence, we will at no time regard an
applicant as disabled who is doing gainful work for which he or she is
reasonably fitted by education, training, or experience. We will regard an
applicant as disabled, even if working or able to work, if he or she incurs,
during a period in which premiums are eligible to be waived as we describe
below, one of the following: (1) permanent and complete blindness of both eyes;
or (2) severance of both hands at or above the wrists or both feet at or above
the ankles; or (3) severance of one hand at or above the wrist and one foot at
or above the ankle.
Premiums Eligible to be Waived.--If the applicant becomes disabled before the
first contract anniversary after his or her 65th birthday, we will waive only
those premiums that fall due: (1) while he or she stays disabled; and (2) before
the benefit termination date.
If the applicant becomes disabled on or after (1) the first contract anniversary
after his or her 65th birthday, or (2) the benefit termination date, we will not
waive any premium that falls due in that period of disability.
Conditions.--Both of these conditions must be met: (1) The applicant must become
disabled while this contract is in force with no premium in default past its
days of grace. (2) The applicant must stay disabled for a period of at least six
months while living.
Exceptions.--We will not waive any premium if the applicant becomes disabled
from: (1) an injury he causes to himself, or she causes to herself, on purpose;
or (2) sickness or injury due to service on or after the contract date in the
armed forces of any country(ies) at war. The word war means declared or
undeclared war and includes resistance to armed aggression.
Successive Disabilities.--Here is what happens if the applicant has at least one
premium waived while disabled, then gets well so that premium payment resumes,
and then becomes disabled again. In this case, we will not apply the six-month
period that would otherwise be required by Condition (2) and will consider the
second period of disability to be part of the first period unless (1) the
applicant has done gainful work, for which he or she is reasonably fitted, for
at least six months between the periods; or (2) the applicant became disabled
the second time from an entirely different cause.
If we do not apply the six-month period required by Condition (2), we also will
not count the days when there was no disability as part of the two year period
when disability means the applicant cannot do any of the duties of his or her
regular occupation.
(Continued on Next Page)
VL 150
I-221
<PAGE>
(Continued from Preceding Page)
Notice and Proof of Claim.--Notice and proof of any claim must be given to us
while the applicant is living and disabled, or as soon as reasonably possible.
If notice or proof is not given as soon as reasonably possible, we will not
waive any premium due more than one year before the date the notice or proof is
given to us. We may require proof at reasonable times that the applicant is
still disabled. After he or she has been disabled for two years, we will not ask
for proof more than once a year. As a part of any proof, we have the right to
require that the applicant be examined at our expense by doctors of our choice.
Recovery from Disability.--We will stop waiving premiums if (1) disability ends;
or (2) we ask for proof that the applicant is disabled and we do not receive it;
or (3) we require that the applicant be examined and he or she fails to do so.
MISCELLANEOUS PROVISIONS
Reinstatement.--If this contract is reinstated, it will not include this Benefit
on the life of the applicant unless we are given any facts we need to satisfy us
that he or she is insurable for the Benefit.
Misstatement of Age or Sex.--The first paragraph under Misstatement of Age or
Sex on page 6 is changed to: If the Insured's stated age or sex or both are not
correct, or if the applicant's stated age or sex or both are not correct, here
is what we will do. We will change each benefit and any amount to be paid under
this contract to what the premium would have bought for the correct age and sex.
General.--Any premiums that fall due are payable until we approve a claim. We
will refund any premium paid that is later waived. But we will not, of course,
refund any premium or part of a premium that was or is to be returned in accord
with the Premium Adjustment provision in this contract.
There might be unpaid premiums that fall due (1) after disability starts; but
(2) more than one year before we have notice of claim at our Service Office. Or
disability might start in the days of grace of an unpaid premium. In either
case, if we are otherwise able to approve a claim, those unpaid premiums that we
do not waive will be due us with compound interest at 6% a year. If we do not
receive them, we will deduct them with interest from any amount we pay under the
contract.
Any premium we waive will be at the frequency in effect when the applicant
becomes disabled. The provisions of this Benefit, and those of any other benefit
in the contract for waiving premiums in the event of disability, will not cause
any premium to be waived more than once.
If we waive premiums, the effect on this contract will be the same as if the
premiums had been paid in cash. But the Premium Adjustment provision will not
apply to any premium that was not paid because it was waived under this Benefit.
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the earlier of (1) the first contract anniversary after
the Insured's 24th birthday, and (2) the last contract anniversary before the
one at the end of the premium period.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the day that is the last premium due date before the benefit
termination date we show on the Contract Data page(s);
3. the date the contract is surrendered under its Cash Value Option, if it has
one; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
THIS SUPPLEMENTARY BENEFIT RIDER
ATTACHED TO THIS CONTRACT ON THE CONTRACT DATE
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
-------------------------------------------
Secretary
VL 150 Printed in U.S.A.
II-222
EXHIBIT 1.A.(13)(pp)
RIDER FOR
APPLICANT'S WAIVER OF PREMIUM BENEFIT
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
DEATH PROVISION
Death Benefit.--We will waive those contract premiums that fall due after the
applicant's death but before the benefit termination date which we show on the
Contract Data page(s). For us to do so, we must receive due proof that he or she
died (1) before that date and (2) while this contract is in force with no
premium in default past its days of grace. But this promise is subject to all
the provisions of this Benefit and of the rest of this contract.
Suicide Exclusion.--If the applicant, whether sane or insane, dies by suicide
within the period that we state in the Suicide Exclusion on page 5, we will not
waive, under this Benefit, the premiums we describe above. Instead, we will
return the sum of the premiums paid for the Benefit.
DISABILITY PROVISION
Total Disability Benefit.--Before the benefit termination date, we will waive
contract premiums that fall due while the applicant is totally disabled. But
this is subject to all the provisions of this Benefit and of the rest of this
contract.
Disability Defined.--When we use the words disability and disabled in this
Benefit we mean total disability and totally disabled. Here is how we define
them: (1) until the applicant has stayed disabled for two years, we mean that he
or she cannot, due to sickness or injury, do any of the duties of his or her
regular occupation; but (2) after the applicant has stayed disabled for two
years, we mean that he or she cannot, due to sickness or injury, do any gainful
work for which he or she is reasonably fitted by education, training, or
experience.
Except for what we state in the next sentence, we will at no time regard an
applicant as disabled who is doing gainful work for which he or she is
reasonably fitted by education, training, or experience. We will regard an
applicant as disabled, even if working or able to work, if he or she incurs,
during a period in which premiums are eligible to be waived as we describe
below, one of the following: (1) permanent and complete blindness of both eyes;
or (2) severance of both hands at or above the wrists or both feet at or above
the ankles; or (3) severance of one hand at or above the wrist and one foot at
or above the ankle.
Premiums Eligible to be Waived.--If the applicant becomes disabled before the
first contract anniversary after his or her 65th birthday, we will waive only
those premiums that fall due: (1) while he or she stays disabled; and (2) before
the benefit termination date.
If the applicant becomes disabled on or after: (1) the first contract
anniversary after his or her 65th birthday, or (2) the benefit termination date,
we will not waive any premium that falls due in that period of disability.
Conditions.--Both of these conditions must be met: (1) The applicant must become
disabled while this contract is in force with no premium in default past its
days of grace. (2) The applicant must stay disabled for a period of at least six
months while living.
Exceptions.--We will not waive any premium if the applicant becomes disabled
from: (1) an injury he causes to himself, or she causes to herself, on purpose;
or (2) sickness or injury due to service on or after the contract date in the
armed forces of any country(ies) at war. The word war means declared or
undeclared war and includes resistance to armed aggression.
Successive Disabilities.--Here is what happens if the applicant has at least one
premium waived while disabled, then gets well so that premium payment resumes,
and then becomes disabled again. In this case, we will not apply the six-month
period that would otherwise be required by Condition (2) and will consider the
second period of disability to be part of the first period unless (1) the
applicant has done gainful work, for which he or she is reasonably fitted, for
at least six months between the periods; or (2) the applicant became disabled
the second time from an entirely different cause.
If we do not apply the six-month period required by Condition (2), we also will
not count the days when there was no disability as part of the two year period
when disability means the applicant cannot do any of the duties of his or her
regular occupation.
(Continued on Next Page)
VL 150 N
II-223
<PAGE>
(Continued from Preceding Page)
Notice and Proof of Claim.--Notice and proof of any claim must be given to us
while the applicant is living and disabled, or as soon as reasonably possible.
If notice or proof is not given as soon as reasonably possible, we will not
waive any premium due more than one year before the date the notice or proof is
given to us. We may require proof at reasonable times that the applicant is
still disabled. After he or she has been disabled for two years, we will not ask
for proof more than once a year. As a part of any proof, we have the right to
require that the applicant be examined at our expense by doctors of our choice.
Recovery from Disability.--We will stop waiving premiums if (1) disability ends;
or (2) we ask for proof that the applicant is disabled and we do not receive it;
or (3) we require that the applicant be examined and he or she fails to do so.
MISCELLANEOUS PROVISIONS
Reinstatement.--If this contract is reinstated, it will not include this Benefit
on the life of the applicant unless we are given any facts we need to satisfy us
that he or she is insurable for the Benefit.
Misstatement of Age or Sex.--The first paragraph under Misstatement of Age or
Sex on page 6 is changed to: If the Insured's stated age or sex or both are not
correct, or if the applicant's stated age or sex or both are not correct, here
is what we will do. We will change each benefit and any amount to be paid under
this contract to what the premium would have bought for the correct age and sex.
General.--Any premiums that fall due are payable until we approve a claim. We
will refund any premium paid that is later waived. But we will not, of course,
refund any premium or part of a premium that was or is to be returned in accord
with the Premium Adjustment provision in this contract.
There might be unpaid premiums that fall due (1) after disability starts; but
(2) more than one year before we have notice of claim at our Service Office. Or
disability might start in the days of grace of an unpaid premium. In either
case, if we are otherwise able to approve a claim, those unpaid premiums that we
do not waive will be due us with compound interest at 6% a year. If we do not
receive them, we will deduct them with interest from any amount we pay under the
contract.
Any premium we waive will be at the frequency in effect when the applicant
becomes disabled. The provisions of this Benefit, and those of any other benefit
in the contract for waiving premiums in the event of disability, will not cause
any premium to be waived more than once.
If we waive premiums, the effect on this contract will be the same as if the
premiums had been paid in cash. But the Premium Adjustment provision will not
apply to any premium that was not paid because it was waived under this Benefit.
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the earlier of (1) the first contract anniversary after
the Insured's 24th birthday, and (2) the last contract anniversary before the
one at the end of the premium period.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the day that is the last premium due date before the benefit
termination date we show on the Contract Data page(s);
3. the date the contract is surrendered under its Cash Value Option, if it has
one; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
THIS SUPPLEMENTARY BENEFIT RIDER
ATTACHED TO THIS CONTRACT ON THE CONTRACT DATE
Pruco Life Insurance Company of New Jersey,
By /s/ ISABELLE L. KIRCHNER
-------------------------------------------
Secretary
VL 150 N Printed in U.S.A.
II-224
EXHIBIT 1.A.(13)(qq)
RIDER FOR
APPLICANT'S WAIVER OF PREMIUM BENEFIT
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
DEATH PROVISION
Death Benefit.--We will waive those contract premiums that fall due after the
applicant's death but before the benefit termination date which we show on the
Contract Data page(s). For us to do so, we must receive due proof that he or she
died (1) before that date and (2) while this contract is in force with no
premium in default past its days of grace. But this promise is subject to all
the provisions of this Benefit and of the rest of this contract.
Suicide Exclusion.--If the applicant, whether sane or insane, dies by suicide
within the period that we state in the Suicide Exclusion on page 5, we will not
waive, under this Benefit, the premiums we describe above. Instead, we will
return the sum of the premiums paid for the Benefit.
DISABILITY PROVISION
Total Disability Benefit.--Before the benefit termination date, we will waive
contract premiums that fall due while the applicant is totally disabled. But
this is subject to all the provisions of this Benefit and of the rest of this
contract.
Disability Defined.--When we use the words disability and disabled in this
Benefit we mean total disability and totally disabled. Here is how we define
them: (1) until the applicant has stayed disabled for two years, we mean that he
or she cannot, due to sickness or injury, engage in any occupation for
remuneration or profit or do any of the duties of his or her regular occupation;
but (2) after the applicant has stayed disabled for two years, we mean that he
or she cannot, due to sickness or injury, do any gainful work for which he or
she is reasonably fitted by education, training, or experience.
Except for what we state in the next sentence, we will at no time regard an
applicant as disabled who is doing gainful work for which he or she is
reasonably fitted by education, training, or experience. We will regard an
applicant as disabled, even if working or able to work, if he or she incurs,
during a period in which premiums are eligible to be waived as we describe
below, one of the following: (1) permanent and complete blindness of both eyes;
or (2) severance of both hands at or above the wrists or both feet at or above
the ankles; or (3) severance of one hand at or above the wrist and one foot at
or above the ankle.
Premiums Eligible To Be Waived.--If the applicant becomes disabled before the
first contract anniversary after his or her 65th birthday, we will waive only
those premiums that fall due (1) while he or she stays disabled; and (2) before
the benefit termination date.
If the applicant becomes disabled on or after (1) the first contract
anniversary after his or her 65th birthday, or (2) the benefit termination date,
we will not waive any premium that falls due in that period of disability.
Conditions.--Both of these conditions must be met: (1) The applicant must become
disabled while this contract is in force with no premium in default past its
days of grace. (2) The applicant must stay disabled for a period of at least six
months while living.
Exceptions.--We will not waive any premium if the applicant becomes disabled
from: (1) an injury he causes to himself, or she causes to herself, on purpose;
or (2) sickness or injury due to service on or after the contract date in the
armed forces of any country(ies) at war. The word war means declared or
undeclared war and includes resistance to armed aggression.
Successive Disabilities.--Here is what happens if the applicant has at least one
premium waived while disabled, then gets well so that premium payment resumes,
and then becomes disabled again. In this case, we will not apply the six-month
period that would otherwise be required by Condition (2) and will consider the
second period of disability to be part of the first period unless (1) the
applicant has done gainful work, for which he or she is reasonably fitted, for
at least six months between the periods; or (2) the applicant became disabled
the second time from an entirely different cause.
If we do not apply the six-month period required by Condition (2), we also will
not count the days when there was no disability as part of the two year period
when disability means the applicant cannot do any of the duties of his or her
regular occupation.
(Continued on Next Page)
VL 150 Y
II-225
<PAGE>
(Continued from Preceding Page)
Notice and Proof of Claim.--Notice and proof of any claim must be given to us
while the applicant is living and disabled, or as soon as reasonably possible
thereafter. If notice or proof is not given as soon as reasonably possible, we
will not waive any premium due more than one year before the date the notice or
proof is given to us. We may require proof at reasonable times that the
applicant is still disabled. After he or she has been disabled for two years, we
will not ask for proof more than once a year. As a part of any proof, we have
the right to require that the applicant be examined at our expense by doctors of
our choice.
Recovery from Disability.--We will stop waiving premiums if (1) disability ends;
or (2) we ask for proof that the applicant is disabled and we do not receive it;
or (3) we require that the applicant be examined and he or she fails to do so.
MISCELLANEOUS PROVISIONS
Reinstatement.--If this contract is reinstated, it will not include this Benefit
on the life of the applicant unless we are given any facts we need to satisfy us
that he or she is insurable for the Benefit.
Misstatement of Age or Sex.--The first paragraph under Misstatement of Age or
Sex on page 6 is changed to: If the Insured's stated age or sex or both are not
correct, or if the applicant's stated age or sex or both are not correct, here
is what we will do. We will change each benefit and any amount to be paid under
this contract to what the premium would have bought for the correct age and sex.
General.--Any premiums that fall due are payable until we approve a claim. We
will refund any premium paid that is later waived. But we will not, of course,
refund any premium or part of a premium that was or is to be returned in accord
with the Premium Adjustment provision in this contract.
There might be unpaid premiums that fall due (1) after disability starts; but
(2) more than one year before we have notice of claim at our Service Office. Or
disability might start in the days of grace of an unpaid premium. In either
case, if we are otherwise able to approve a claim, those unpaid premiums that we
do not waive will be due us with compound interest at 6% a year. If we do not
receive them, we will deduct them with interest from any amount we pay under the
contract.
Any premium we waive will be at the frequency in effect when the applicant
becomes disabled. The provisions of this Benefit, and those of any other benefit
in the contract for waiving premiums in the event of disability, will not cause
any premium to be waived more than once.
If we waive premiums, the effect on this contract will be the same as if the
premiums had been paid in cash. But the Premium Adjustment provision will not
apply to any premium that was not paid because it was waived under this Benefit.
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the earlier of (1) the first contract anniversary after
the Insured's 24th birthday, and (2) the last contract anniversary before the
one at the end of the premium period.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the day that is the last premium due date before the benefit
termination date we show on the Contract Data page(s);
3. the date the contract is surrendered under its Cash Value Option, if it has
one; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
THIS SUPPLEMENTARY BENEFIT RIDER
ATTACHED TO THIS CONTRACT ON THE CONTRACT DATE
Pruco Life Insurance Company of New Jersey,
By /s/ ISABELLE L. KIRCHNER
-------------------------------------------
Secretary
VL 150 Y Printed in U.S.A.
II-226
- --------------------------------------------------------------------------------
EXHIBIT A(13)(rr)
RIDER FOR
APPLICANT'S WAIVER OF PREMIUM BENEFIT
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
DEATH PROVISION
Death Benefit.--We will waive those contract premiums that fall due after the
applicant's death but before the benefit termination date which we show on the
Contract Data page(s). For us to do so, we must receive due proof that he or she
died: (1) before that date and (2) while this contract is in force with no
premium in default past its days of grace. But this promise is subject to all
the provisions of this Benefit and of the rest of this contract.
Suicide Exclusion.--If the applicant, whether sane or insane, dies by suicide
within the period that we state in the Suicide Exclusion on page 5, we will not
waive, under this Benefit, the premiums we describe above. Instead, we will
return the sum of the premiums paid for the Benefit.
DISABILITY PROVISION
Total Disability Benefit.--Before the benefit termination date, we will waive
contract premiums that fall due while the applicant is totally disabled. But
this is subject to all the provisions of this Benefit and of the rest of this
contract.
Disability Defined.--When we use the words disability and disabled in this
Benefit we mean total disability and totally disabled. Here is how we define
them: (1) until the applicant has stayed disabled for two years, we mean that he
or she cannot, due to sickness or injury, do any of the substantial and material
duties of his or her regular occupation; but (2) after the applicant has stayed
disabled for two years, we mean that he or she cannot, due to sickness or
injury, do any gainful work for which he or she is reasonably fitted by
education, training, or experience.
Except for what we state in the next sentence, we will at no time regard an
applicant as disabled who is doing gainful work for which he or she is
reasonably fitted by education, training, or experience. We will regard an
applicant as disabled, even if working or able to work, if he or she incurs,
during a period in which premiums are eligible to be waived as we describe
below, one of the following: (1) permanent and complete blindness of both eyes;
or (2) severance of both hands at or above the wrists or both feet at or above
the ankles; or (3) severance of one hand at or above the wrist and one foot at
or above the ankle.
Premiums Eligible to be Waived.--If the applicant becomes disabled before the
first contract anniversary after his or her 65th birthday, we will waive only
those premiums that fall due: (1) while he or she stays disabled; and (2) before
the benefit termination date.
If the applicant becomes disabled on or after: (1) the first contract
anniversary after his or her 65th birthday, or (2) the benefit termination date,
we will not waive any premium that falls due in that period of disability.
Conditions.--Both of these conditions must be met: (1) The applicant must become
disabled while this contract is in force with no premium in default past its
days of grace. (2) The applicant must stay disabled for a period of at least six
months while living.
Exceptions.--We will not waive any premium if the applicant becomes disabled
from: (1) an injury he causes to himself, or she causes to herself, on purpose;
or (2) sickness or injury due to service on or after the contract date in the
armed forces of any country(ies) at war. The word war means declared or
undeclared war and includes resistance to armed aggression.
Successive Disabilities.--Here is what happens if the applicant has at least one
premium waived while disabled, then gets well so that premium payment resumes,
and then becomes disabled again. In this case, we will not apply the six-month
period that would otherwise be required by Condition (2) and will consider the
second period of disability to be part of the first period unless (1) the
applicant has done gainful work, for which he or she is reasonably fitted, for
at least six months between the periods; or (2) the applicant became disabled
the second time from an entirely different cause.
If we do not apply the six-month period required by Condition (2), we also will
not count the days when there was no disability as part of the two year period
when disability means the applicant cannot do any of the duties of his or her
regular occupation.
(Continued on Next Page)
VL 150 D
II-227
<PAGE>
(Continued from Preceding Page)
Notice and Proof of Claim.--Notice and proof of any claim must be given to us
while the applicant is living and disabled, or as soon as reasonably possible.
If notice or proof is not given as soon as reasonably possible, we will not
waive any premium due more than one year before the date the notice or proof is
given to us. We may require proof at reasonable times that the applicant is
still disabled. After he or she has been disabled for two years, we will not ask
for proof more than once a year. As a part of any proof, we have the right to
require that the applicant be examined at our expense by doctors of our choice.
Recovery from Disability.--We will stop waiving premiums if (1) disability ends;
or (2) we ask for proof that the applicant is disabled and we do not receive it;
or (3) we require that the applicant be examined and he or she fails to do so.
MISCELLANEOUS PROVISIONS
Reinstatement.--If this contract is reinstated, it will not include this Benefit
on the life of the applicant unless we are given any facts we need to satisfy us
that he or she is insurable for the Benefit.
Misstatement of Age or Sex.--The first paragraph under Misstatement of Age or
Sex on page 6 is changed to: If the Insured's stated age or sex or both are not
correct, or if the applicant's stated age or sex or both are not correct, here
is what we will do. We will change each benefit and any amount to be paid under
this contract to what the premium would have bought for the correct age and sex.
General.--Any premiums that fall due are payable until we approve a claim. We
will refund any premium paid that is later waived. But we will not, of course,
refund any premium or part of a premium that was or is to be returned in accord
with the Premium Adjustment provision in this contract.
There might be unpaid premiums that fall due (1) after disability starts; but
(2) more than one year before we have notice of claim at our Service Office. Or
disability might start in the days of grace of an unpaid premium. In either
case, if we are otherwise able to approve a claim, those unpaid premiums that we
do not waive will be due us with compound interest at 6% a year. If we do not
receive them, we will deduct them with interest from any amount we pay under the
contract.
Any premium we waive will be at the frequency in effect when the applicant
becomes disabled. The provisions of this Benefit, and those of any other benefit
in the contract for waiving premiums in the event of disability, will not cause
any premium to be waived more than once.
If we waive premiums, the effect on this contract will be the same as if the
premiums had been paid in cash. But the Premium Adjustment provision will not
apply to any premium that was not paid because it was waived under this Benefit.
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the earlier of (1) the first contract anniversary after
the Insured's 24th birthday, and (2) the last contract anniversary before the
one at the end of the premium period.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the day that is the last premium due date before the benefit
termination date we show on the Contract Data page(s);
3. the date the contract is surrendered under its Cash Value Option, if it has
one; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
THIS SUPPLEMENTARY BENEFIT RIDER
ATTACHED TO THIS CONTRACT ON THE CONTRACT DATE
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
-------------------------------------------
Secretary
VL 150 D Printed in U.S.A.
II-228
- --------------------------------------------------------------------------------
EXHIBIT A(13)(ss)
RIDER FOR
APPLICANT'S WAIVER OF PREMIUM BENEFIT
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
DEATH PROVISION
Death Benefit.--We will waive those contract premiums that fall due after the
applicant's death but before the benefit termination date which we show on the
Contract Data page(s). For us to do so, we must receive due proof that he or she
died: (1) before that date and (2) while this contract is in force with no
premium in default past its days of grace. But this promise is subject to all
the provisions of this Benefit and of the rest of this contract.
Suicide Exclusion.--If the applicant, whether sane or insane, dies by suicide
within the period that we state in the Suicide Exclusion on page 5, we will not
waive, under this Benefit, the premiums we describe above. Instead, we will
return the sum of the premiums paid for the Benefit.
DISABILITY PROVISION
Total Disability Benefit.--Before the benefit termination date, we will waive
contract premiums that fall due while the applicant is totally disabled. But
this is subject to all the provisions of this Benefit and of the rest of this
contract.
Disability Defined.--When we use the words disability and disabled in this
Benefit we mean total disability and totally disabled. Here is how we define
them: (1) until the applicant has stayed disabled for two years, we mean that he
or she is, due to sickness or injury, completely unable to do any of the duties
of his or her regular occupation; but (2) after the applicant has stayed
disabled for two years, we mean that he or she cannot, due to sickness or
injury, do any gainful work for which he or she is reasonably fitted by
education, training, or experience.
Except for what we state in the next sentence, we will at no time regard an
applicant as disabled who is doing gainful work for which he or she is
reasonably fitted by education, training, or experience. We will regard an
applicant as disabled, even if working or able to work, if he or she incurs,
during a period in which premiums are eligible to be waived as we describe
below, one of the following: (1) permanent and complete blindness of both eyes;
or (2) severance of both hands at or above the wrists or both feet at or above
the ankles; or (3) severance of one hand at or above the wrist and one foot at
or above the ankle.
Premiums Eligible To Be Waived.--If the applicant becomes disabled before the
first contract anniversary after his or her 65th birthday, we will waive only
those premiums that fall due: (1) while he or she stays disabled; and (2) before
the benefit termination date.
If the applicant becomes disabled on or after: (1) the first contract
anniversary after his or her 65th birthday, or (2) the benefit termination date,
we will not waive any premium that falls due in that period of disability.
Conditions.--Both of these conditions must be met: (1) The applicant must become
disabled while this contract is in force with no premium in default past its
days of grace. (2) The applicant must stay disabled for a period of at least six
months while living.
Exceptions.--We will not waive any premium if the applicant becomes disabled
from: (1) an injury he causes to himself, or she causes to herself, on purpose;
or (2) sickness or injury due to service on or after the contract date in the
armed forces of any country(ies) at war. The word war means declared or
undeclared war and includes resistance to armed aggression.
Successive Disabilities.--Here is what happens if the applicant has at least one
premium waived while disabled, then gets well so that premium payment resumes,
and then becomes disabled again. In this case, we will not apply the six-month
period that would otherwise be required by Condition (2) and will consider the
second period of disability to be part of the first period unless (1) the
applicant has done gainful work, for which he or she is reasonably fitted, for
at least six months between the periods; or (2) the applicant became disabled
the second time from an entirely different cause.
If we do not apply the six-month period required by Condition (2), we also will
not count the days when there was no disability as part of the two year period
when disability means the applicant cannot do any of the duties of his or her
regular occupation.
(Continued on Next Page)
VL 150 C
II-229
<PAGE>
(Continued from Preceding Page)
Notice and Proof of Claim.--Notice and proof of any claim must be given to us
while the applicant is living and disabled, or as soon as reasonably possible.
If notice or proof is not given as soon as reasonably possible, we will not
waive any premium due more than one year before the date the notice or proof is
given to us. We may require proof at reasonable times that the applicant is
still disabled. After he or she has been disabled for two years, we will not ask
for proof more than once a year. As a part of any proof, we have the right to
require that the applicant be examined at our expense by doctors of our choice.
Recovery From Disability.--We will stop waiving premiums if (1) disability ends;
or (2) we ask for proof that the applicant is disabled and we do not receive it;
or (3) we require that the applicant be examined and he or she fails to do so.
MISCELLANEOUS PROVISIONS
Reinstatement.--If this contract is reinstated, it will not include this Benefit
on the life of the applicant unless we are given any facts we need to satisfy us
that he or she is insurable for the Benefit.
Misstatement of Age or Sex.--The first paragraph under Misstatement of Age or
Sex on page 6 is changed to: If the Insured's stated age or sex or both are not
correct, or if the applicant's stated age or sex or both are not correct, here
is what we will do. We will change each benefit and any amount to be paid under
this contract to what the premium would have bought for the correct age and sex.
General.--Any premiums that fall due are payable until we approve a claim. We
will refund any premium paid that is later waived. But we will not, of course,
refund any premium or part of a premium that was or is to be returned in accord
with the Premium Adjustment provision in this contract.
There might be unpaid premiums that fall due (1) after disability starts; but
(2) more than one year before we have notice of claim at our Service Office. Or
disability might start in the days of grace of an unpaid premium. In either
case, if we are otherwise able to approve a claim, those unpaid premiums that we
do not waive will be due us with compound interest at 6% a year. If we do not
receive them, we will deduct them with interest from any amount we pay under the
contract.
Any premium we waive will be at the frequency in effect when the applicant
becomes disabled. The provisions of this Benefit, and those of any other benefit
in the contract for waiving premiums in the event of disability, will not cause
any premium to be waived more than once.
If we waive premiums, the effect on this contract will be the same as if the
premiums had been paid in cash. But the Premium Adjustment provision will not
apply to any premium that was not paid because it was waived under this Benefit.
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the earlier of (1) the first contract anniversary after
the Insured's 24th birthday, and (2) the last contract anniversary before the
one at the end of the premium period.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the day that is the last premium due date before the benefit
termination date we show on the Contract Data page(s);
3. the date the contract is surrendered under its Cash Value Option, if it has
one; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
This Supplementary Benefit rider
attached to this contract on the Contract Date
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
-------------------------------------------
Secretary
VL 150 C Printed in U.S.A.
II-230
- --------------------------------------------------------------------------------
EXHIBIT A(13)(tt)
RIDER FOR
APPLICANT'S WAIVER OF PREMIUM BENEFIT
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
DEATH PROVISION
Death Benefit.--We will waive those contract premiums that fall due after the
applicant's death but before the benefit termination date which we show on the
Contract Data page(s). For us to do so, we must receive due proof that he or she
died: (1) before that date and (2) while this contract is in force with no
premium in default past its days of grace. But this promise is subject to all
the provisions of this Benefit and of the rest of this contract.
Suicide Exclusion.--If the applicant, whether sane or insane, dies by suicide
within the period that we state in the Suicide Exclusion on page 5, we will not
waive, under this Benefit, the premiums we describe above. Instead, we will
return the sum of the premiums paid for the Benefit.
DISABILITY PROVISION
Total Disability Benefit.--Before the benefit termination date, we will waive
contract premiums that fall due while the applicant is totally disabled. But
this is subject to all the provisions of this Benefit and of the rest of this
contract.
Disability Defined.--When we use the words disability and disabled in this
Benefit we mean total disability and totally disabled. Here is how we define
them: (1) until the applicant has stayed disabled for two years, we mean that
(a) he or she cannot, due to sickness or injury, do the main duties of his or
her regular occupation, and (b) he or she does not do any gainful work for which
he or she is reasonably fitted by education, training, or experience; but (2)
after the applicant has stayed disabled for two years, we mean that he or she
cannot, due to sickness or injury, do any gainful work for which he or she is
reasonably fitted by education, training, or experience.
But we will regard an applicant as disabled, even if working or able to work, if
he or she incurs, during a period in which premiums are eligible to be waived as
we describe below, one of the following: (1) permanent and complete blindness of
both eyes; or (2) severance of both hands at or above the wrists or both feet at
or above the ankles; or (3) severance of one hand at or above the wrist and one
foot at or above the ankle.
Premiums Eligible To Be Waived.--If the applicant becomes disabled before the
first contract anniversary after his or her 65th birthday, we will waive only
those premiums that fall due: (1) while he or she stays disabled; and (2) before
the benefit termination date.
If the applicant becomes disabled on or after: (1) the first contract
anniversary after his or her 65th birthday, or (2) the benefit termination date,
we will not waive any premium that falls due in that period of disability.
Conditions.--Both of these conditions must be met: (1) The applicant must become
disabled while this contract is in force with no premium in default past its
days of grace. (2) The applicant must stay disabled for a period of at least six
months while living.
Exceptions.--We will not waive any premium if the applicant becomes disabled
from: (1) an injury he causes to himself, or she causes to herself, on purpose;
or (2) sickness or injury due to service on or after the contract date in the
armed forces of any country(ies) at war. The word war means declared or
undeclared war and includes resistance to armed aggression.
Successive Disabilities.--Here is what happens if the applicant has at least one
premium waived while disabled, then gets well so that premium payment resumes,
and then becomes disabled again. In this case, we will not apply the six-month
period that would otherwise be required by Condition (2) and will consider the
second period of disability to be part of the first period unless (1) the
applicant has done gainful work, for which he or she is reasonably fitted, for
at least six months between the periods; or (2) the applicant became disabled
the second time from an entirely different cause.
If we do not apply the six-month period required by Condition (2), we also will
not count the days when there was no disability as part of the two year period
when disability means the applicant cannot do any of the duties of his or her
regular occupation.
(Continued on Next Page)
VL 150 M
II-231
<PAGE>
(Continued from Preceding Page)
Notice and Proof of Claim.--Notice and proof of any claim must be given to us
while the applicant is living and disabled, or as soon as reasonably possible.
If notice or proof is not given as soon as reasonably possible, we will not
waive any premium due more than one year before the date the notice or proof is
given to us. We may require proof at reasonable times that the applicant is
still disabled. After he or she has been disabled for two years, we will not ask
for proof more than once a year. As a part of any proof, we have the right to
require that the applicant be examined at our expense by doctors of our choice.
Recovery From Disability.--We will stop waiving premiums if (1) disability ends;
or (2) we ask for proof that the applicant is disabled and we do not receive it;
or (3) we require that the applicant be examined and he or she fails to do so.
MISCELLANEOUS PROVISIONS
Reinstatement.--If this contract is reinstated, it will not include this Benefit
on the life of the applicant unless we are given any facts we need to satisfy us
that he or she is insurable for the Benefit.
Misstatement of Age or Sex.--The first paragraph under Misstatement of Age or
Sex on page 6 is changed to: If the Insured's stated age or sex or both are not
correct, or if the applicant's stated age or sex or both are not correct, here
is what we will do. We will change each benefit and any amount to be paid under
this contract to what the premium would have bought for the correct age and sex.
General.--Any premiums that fall due are payable until we approve a claim. We
will refund any premium paid that is later waived. But we will not, of course,
refund any premium or part of a premium that was or is to be returned in accord
with the Premium Adjustment provision in this contract.
There might be unpaid premiums that fall due (1) after disability starts; but
(2) more than one year before we have notice of claim at our Service Office. Or
disability might start in the days of grace of an unpaid premium. In either
case, if we are otherwise able to approve a claim, those unpaid premiums that we
do not waive will be due us with compound interest at 6% a year. If we do not
receive them, we will deduct them with interest from any amount we pay under the
contract.
Any premium we waive will be at the frequency in effect when the applicant
becomes disabled. The provisions of this Benefit, and those of any other benefit
in the contract for waiving premiums in the event of disability, will not cause
any premium to be waived more than once.
If we waive premiums, the effect on this contract will be the same as if the
premiums had been paid in cash. But the Premium Adjustment provision will not
apply to any premium that was not paid because it was waived under this Benefit.
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the earlier of (1) the first contract anniversary after
the Insured's 24th birthday, and (2) the last contract anniversary before the
one at the end of the premium period.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the day that is the last premium due date before the benefit
termination date we show on the Contract Data page(s);
3. the date the contract is surrendered under its Cash Value Option, if it has
one; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
This Supplementary Benefit rider
attached to this contract on the Contract Date
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
-------------------------------------------
Secretary
VL 150 M Printed in U.S.A.
II-232
EXHIBIT 1.A.(13)(uu)
RIDER FOR
LEVEL TERM INSURANCE BENEFIT ON LIFE OF INSURED
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
Benefit.--We will pay an amount under this Benefit if we receive due proof that
the Insured died (1) in the term period for the Benefit; and (2) while this
contract is in force with no premium in default past its days of grace. Any
proceeds under this contract that may arise from the Insured's death will
include this amount. But our payment is subject to all the provisions of the
Benefit and of the rest of this contract.
We show the amount of term insurance on the Contract Data page(s). We also show
the term period for the Benefit there. It starts on the contract date, which we
show on the first page. The anniversary at the end of the term period is part of
that period.
CONVERSION TO ANOTHER PLAN OF INSURANCE
Right to Convert.--You may be able to exchange this Benefit for a new contract
of life insurance on the Insured's life in either this company of The Prudential
Insurance Company of America. In any of these paragraphs, when we use the phrase
the company we mean whichever of these companies may issue the new contract. And
where we use the phrase new contract we mean the contract for which the Benefit
may be exchanged. You will not have to prove that the Insured is insurable.
Conditions.--Your right to make this exchange is subject all these conditions:
(1) You must ask for the exchange in writing and in a form that meets our needs.
(2) You must send this contract to us to be endorsed. (3) We must have your
request and the contract at our Service Office while the Benefit is in force and
before the end of its term period.
The new contract will not take effect unless the premium for it is paid while
the Insured is living and within 31 days after its contract date. If the premium
is paid as we state, it will be deemed that: (1) the insurance under the new
contract took effect on its contract date; and (2) this Benefit ended just
before that contract date. We will return that part, if any, of the last premium
paid for the Benefit that is more than was needed to pay premiums to that
contract date.
Contract Date.--The date of the new contract will be the date you ask for in
your request. But it may not be after the date to which premiums are paid for
this Benefit. It may not be after the end of the term period for the Benefit.
And it may not be more than 31 days before we have your request at our Service
Office.
Contract Specifications.--The new contract will be in the same rating class as
this contract. The company will set the issue age and the premiums for the new
contract in accord with its regular rules in use on the date of the new
contract.
We will endorse the new contact to show that the period we state in its
Incontestability provision will start on the issue date of this contract. But if
this contract was reinstated before the date of the new contract, that period
will start on the date of the reinstatement. We will have the right to use the
statements that were made to us as the basis for reinstatement to contest the
new contract. The period during which we will have that right will be the period
we state in the Incontestability provision of the new contract.
We will endorse the new contract to show that the period we state in its Suicide
Exclusion provision will start on the issue date of this contract.
The new contract may call for annual premiums. If the company agrees, you will
be able to have premiums fall due more often.
The contract may be any one of the following:
1. A Life Paid Up at Age 85 plan. In this case the new contract will be issued
by The Prudential Insurance Company of America. Its face amount will be the
amount you ask for in your request. But it cannot be less than $10,000 or more
than the amount of term insurance for this Benefit.
2. A Variable Life contract, if Pruco Life Insurance Company is regularly
issuing such contracts at that time. Its face amount will be the amount you ask
for in your request. But it cannot be less than $25,000 or more than the amount
of term insurance for this Benefit.
3. An Appreciable Life or Variable Appreciable Life contract, if Pruco Life
Insurance Company is regularly issuing such contracts at that time. Its face
amount will be the amount you ask for in your request. But it cannot be less
than $50,000 or more than the amount of term insurance for this Benefit.
(Continued on Next Page)
VL 131 W
II-233
<PAGE>
CONVERSION TO ANOTHER PLAN OF INSURANCE (Continued)
The new contract will not have Supplementary Benefits other than as we describe
in this and in the next two paragraphs. If this contract has a benefit for
waiving premiums in the event of disability and the company would include that
kind of benefit in other contracts like the new contract, the company will put
the benefit in the new contract. The benefit, if any, in the new contract will
be the same one with the same provisions, that the company puts in other
contracts like it on its contract date. In this paragraph, when we use the
phrase other contracts like it, we mean contracts the company would regularly
issue on the same plan and for the same rating class, amount, issue age and sex.
A benefit for waiving premiums that would have been allowed under this contract,
and that would otherwise be allowed under the new contract, will not be denied
just because disability started before the contract date of the new contract.
But any premium to be waived for that disability under the new contract must be
at the frequency that was in effect for this contract when the disability
started.
No premium will be waived under the new contract unless it has a benefit for
waiving premiums in the event of disability. This will be so even if premiums
have been waived under this contract.
Changes.--You may be able to have this Benefit changed to a new contract of life
insurance other than in accord with the requirements for exchange that we state
above. But any change may be made only if the company consents, and will be
subject to conditions and charges that are then determined.
MISCELLANEOUS PROVISIONS
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the contract anniversary at the end of the term period for
the Benefit.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default: will not continue
if a benefit takes effect under any contract value options provision that may be
in the contract:
2. the end of the last day before the contract date of any other contract (a)
for which the Benefit is exchanged, or (b) to which the Benefit is changed;
3. the date the contract is surrendered under its Cash Value Option, if it has
one: and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period we will cancel the
Benefit as of the date to which premiums are paid Contract premiums due then and
later will be reduced accordingly.
This supplementary benefit rider
attached to this Contract on the Contract Date
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
Secretary
VL 131 W
II-234
EXHIBIT 1.A.(13)(vv)
RIDER FOR
LEVEL TERM INSURANCE BENEFIT ON LIFE OF INSURED
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
Benefit.--We will pay an amount under this Benefit if we receive due proof that
the Insured died (1) in the term period for the Benefit; and (2) while this
contract is in force with no premium in default past its days of grace. Any
proceeds under this contract that may arise from the Insured's death will
include this amount. But our payment is subject to all the provisions of the
Benefit and of the rest of this contract.
We show the amount of term insurance on the Contract data page(s). We also show
the term period for the Benefit there. It starts on the contract date, which we
show on the first page. The anniversary at the end of the term period is part of
that period.
CONVERSION TO ANOTHER PLAN OF INSURANCE
Right to Convert.--You may be able to exchange this Benefit for a new contract
of life insurance on the Insured's life in either this company or The Prudential
Insurance Company of America. In any of these paragraphs, when we use the phrase
the company we mean whichever of these companies may issue the new contract. And
where we use the phrase new contract we mean the contract for which the Benefit
may be exchanged. You will not have to prove that the Insured is insurable.
Conditions.--Your right to make this exchange is subject to all these
conditions: (1) You must ask for the exchange in writing and in a form that
meets our needs. (2) You must send this contract to us to be endorsed. (3) We
must have your request and the contract at our Service Office while the Benefit
is in force and before the end of its term period.
The new contract will not take effect unless the premium for it is paid while
the Insured is living and within 31 days after its contract date. If the premium
is paid as we state, it will be deemed that: (1) the insurance under the new
contract took effect on its contract date; and (2) this Benefit ended just
before that contract date. We will return that part, if any, of the last premium
paid for the Benefit that is more than was needed to pay premiums to that
contract date.
Contract Date.--The date of the new contract will be the date you ask for in
your request. But it may not be after the date to which premiums are paid for
this Benefit. It may not be after the end of the term period for the Benefit.
And it may not be more than 31 days before we have your request at our Service
Office.
Contract Specifications.--The new contract will be in the same rating class as
this contract. The company will set the issue age and the premiums for the new
contract in accord with its regular rules in use on the date of the new
contract.
The new contract may call for annual premiums. If the company agrees, you will
be able to have premiums fall due more often.
The contract may be any one of the following:
1. A Life Paid Up at Age 85 plan. In this case the new contract will be issued
by The Prudential Insurance Company of America. Its face amount will be the
amount you ask for in your request. But it cannot be less than $10,000 or more
than the amount of the term insurance for this Benefit.
2. A Variable Life contract if Pruco Life Insurance Company is regularly issuing
such contracts at that time. Its face amount will be the amount you ask for in
your request. But it cannot be less than $25,000 or more than the amount of term
insurance for this Benefit.
3. An Appreciable Life or Variable Appreciable Life contract, if Pruco Life
Insurance Company is regularly issuing such contracts at that time. Its face
amount will be the amount you ask for in your request. But it cannot be less
than $50,000 or more than the amount of term insurance for this Benefit.
The new contract will not have Supplementary Benefits other than as we describe
in this and in the next two paragraphs. If this contract has a benefit for
waiving premiums in the event of disability and the company would include that
kind of benefit in other contracts like the new contract, the company will put
the benefit in the new contract. The benefit, if any, in the new contract will
be the same one, with the same provisions, that the company puts in other
contracts like it on its contract date. In this paragraph, when we use the
phrase other contracts like it, we mean contracts the company would regularly
issue on the same plan and for the same rating class, amount, issue age and sex.
(Continued on Next Page)
VL 131
II-235
EXHIBIT A(13)(ww)
Pruco Life Insurance Company
|Insured | Rider for Policy No.
| |
| John Doe | XX XXX XXX
| |
- -------------------------------------------------------------------------------
SPECIAL PREMIUM REMITTANCE PLAN
Premiums are due monthly. They may be less than the smallest premium we normally
permit; they are being paid under a special plan. If they are no longer to be
paid under such a plan, we have the right to require that they be paid less
often. If we do so: (1) we will apply the rules which we would have used had
there been no special plan; and (2) we will give written notice.
Rider attached to and made a part of this contract
on the Contract Date
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRSCHNER
--------------------------------
Secretary
PLI 101--84
II-236
EXHIBIT 1A(13)(xx)
ENDORSEMENTS
(Only we can endorse this contract.)
ALTERATION OF TEXT
The provisions of this policy entitled "Loan Value", "Interest Charge" and
"Effect of a Loan" are replaced at issue by the following:
LOAN VALUE.--During the first contract year the loan value is zero. After the
first contract year, it is 90% of the sum of the net cash value and any existing
contract debt.
If the difference between the loan value and any existing contract debt is $500
or more, you may borrow any amount from $500 up to that difference. If the
difference is less than $500, you may not borrow any amount unless it is to pay
premiums on this contract.
Example 1: Suppose the net cash value is $8,000. You borrowed $1,500 a few
months ago. Suppose also that now there is interest of $40 charged but not yet
due. The contract debt is now $1,540, which is made up of the $1,500 loan and
the $40 interest.
Example 2: Suppose, in example 1, you want to borrow all that you can. The loan
value is $8,586; to compute it we add the net cash value ($8,000) to the
contract debt ($1,540) and take 90% of the sum. We will lend you $7,046 which is
the difference between the $8,586 loan value and the $1,540 contract debt. This
will increase the contract debt to $8,586. We will add the new amount borrowed
to the existing loan and will charge interest on it, too.
There are three exceptions to the above definition of loan value. The first is
that in the days of grace of a premium in default, the loan value is what it was
on the due date of that premium, plus 90% of the excess investment return since
that date. The second is that if the contract is in force as reduced paid-up
insurance we use anniversaries and not premium due dates to find the loan value
since there are no more of those due dates. The third is that if the contract is
in force as reduced paid-up insurance, the loan value is the amount that would
grow with interest to equal the net single premium on the next anniversary.
INTEREST CHARGE.--We will charge interest daily on any loan. Interest is due on
each contract anniversary, or when the loan is paid back if that comes first. If
interest is not paid when due, it will become part of the loan. Then we will
start to charge interest on it, too.
The loan interest rate is the annual rate we set from time to time. The rate
will never be greater than is permitted by law. It will change only on a
contract anniversary.
Before the start of each contract year, we will determine the loan interest rate
we can charge for that contract year.
To do this, we will first find the rate that is the greater of (1) The Published
Monthly Average (which we describe below) for the calendar month ending two
months before the calendar month of the contract anniversary; and (2) the
assumed rate of return for this contract, plus 1%.
If that greater rate is at least 1/2% more than the loan interest rate we had
set for the current contract year, we have the right to increase the loan
interest rate by at least 1/2%, up to that greater rate. If it is at least 1/2%
less, we will decrease the loan interest rate to be no more than the greater
rate. We will not change the loan interest rate by less than 1/2%.
When you make a loan we will tell you the initial interest rate for the loan. We
will send you a notice if there is to be an increase in the rate.
The Published Monthly Average means:
1. Moody's Corporate Bond Yield Average--Monthly Average Corporates, as
published by Moody's Investors Service, Inc. or any successor to that service;
or
2. If that average is no longer published, a substantially similar average,
established by the insurance regulator where this contract is delivered.
Example 3: Suppose the contract date is in 1987. Six months before the
anniversary in 1996 you borrow $1,000 out of a $4,000 loan value. Assume we
charge 8% a year. Three months later, but still three months before the
anniversary, we will have charged about $20 interest. This amount will be a few
cents more or less than $20 since some months have more days than others. The
interest will not be due until the anniversary unless the loan is paid back
sooner. The loan will still be $1,000. The contract debt will be $1,020, since
contract debt includes interest charged but not yet due. On the anniversary in
1996 we will have charged about $40 interest. The interest will then be due.
Example 4: Suppose the $40 interest in example 3 is paid on the anniversary. The
loan and contract debt will each become $1,000 right after the payment.
Example 5: Suppose the $40 interest in example 3 is not paid on the anniversary.
The interest will become part of the loan, and we will begin to charge interest
on it, too. The loan and contract debt will each become $1,040.
(Continued on Next Page)
PLI 103--84
II-237
<PAGE>
ALTERATION OF TEXT (Continued)
EFFECT OF A LOAN.--When you take a loan, we will reduce the investment base by
the amount you borrow. We will also reduce the investment base by interest that
becomes part of the loan because it is not paid when due. When you repay part or
all of a loan we will increase the investment base by the amount you repay. We
will not increase the investment base by interest that is paid before we make it
part of the loan. We will allocate loans and repayments among the subaccounts in
proportion to the investment base in each subaccount as of the date of the loan
or repayment. Only the amount of the investment base will reflect the investment
results of the subaccounts. The amount of the loan will be credited with a rate
which is 1% less than the loan interest rate for the contract year. Since the
amount you borrow is removed from the investment base, a loan will have a
permanent effect on the death benefit and net cash value of this contract. The
longer the loan is outstanding, the greater this effect is likely to be.
Example 6: Suppose the contract's investment base is $15,000 and that $10,000 is
in subaccount A and $5,000 is in subaccount B. If you make a $9,000 loan we will
reduce the amount in subaccount A by $6,000 and the amount in subaccount B by
$3,000.
Suppose that sometime later, when the investment base in each of the two
subaccounts is the same, you choose to repay the $9,000 loan. We will add $4,500
to the amount in each subaccount.
|Rider attached to and made a part of this Contract
|on the Contract Date
|
|
|Pruco Life Insurance Company,
|
|
|By /s/ ISABELLE L. KIRCHNER
| Secretary
|
|____________________________________________________
- -----------
PLI 103--84 Printed in U.S.A.
- -----------
II-238
EXHIBIT 1A(13)(yy)
ENDORSEMENTS
(Only we can endorse this contract.)
ALTERATION OF TEXT
The provisions of this policy entitled "Loan Value", "Interest Charge" and
"Effect of a Loan" are replaced at issue by the following:
LOAN VALUE.--During the first contract year the loan value is zero. After the
first contract year, it is 90% of the sum of the net cash value and any existing
contract debt.
If the difference between the loan value and any existing contract debt is $500
or more, you may borrow any amount from $500 up to that difference. If the
difference is less than $500, you may not borrow any amount unless it is to pay
premiums on this contract.
Example 1: Suppose the net cash value is $8,000. You borrowed $1,500 a few
months ago. Suppose also that now there is interest of $40 charged but not yet
due. The contract debt is now $1,540, which is made up of the $1,500 loan and
the $40 interest.
Example 2: Suppose, in example 1, you want to borrow all that you can. The loan
value is $8,586; to compute it we add the net cash value ($8,000) to the
contract debt ($1,540) and take 90% of the sum. We will lend you $7,046 which is
the difference between the $8,586 loan value and the $1,540 contract debt. This
will increase the contract debt to $8,586. We will add the new amount borrowed
to the existing loan and will charge interest on it, too.
There are three exceptions to the above definition of loan value. The first is
that in the days of grace of a premium in default, the loan value is what it was
on the due date of that premium, plus 90% of the excess investment return since
that date. The second is that if the contract is in force as reduced paid-up
insurance we use anniversaries and not premium due dates to find the loan value
since there are no more of those due dates. The third is that if the contract is
in force as reduced paid-up insurance, the loan value is the amount that would
grow with interest to equal the net single premium on the next anniversary.
INTEREST CHARGE.--We will charge interest daily on any loan. Interest is due on
each contract anniversary, or when the loan is paid back if that comes first. If
interest is not paid when due, it will become part of the loan. Then we will
start to charge interest on it, too.
The loan interest rate is the annual rate we set from time to time. The rate
will never be greater than is permitted by law, 18%. It will change only on a
contract anniversary.
Before the start of each contract year, we will determine the loan interest rate
we can charge for that contract year.
To do this, we will first find the rate that is the greater of (1) The Published
Monthly Average (which we describe below) for the calendar month ending two
months before the calendar month of the contract anniversary; and (2) the
assumed rate of return for this contract, plus 1%.
If that greater rate is at least 1/2% more than the loan interest rate we had
set for the current contract year, we have the right to increase the loan
interest rate by at least 1/2%, up to the lesser of 18% and that greater rate.
If it is at least 1/2% less, we will decrease the loan interest rate to be no
more than the greater rate. We will not change the loan interest rate by less
than 1/2%.
When you make a loan we will tell you the initial interest rate for the loan. We
will send you a notice if there is to be an increase in the rate.
The Published Monthly Average means:
1. Moody's Corporate Bond Yield Average.--Monthly Average Corporates, as
published by Moody's Investors Service, Inc. or any successor to that service;
or
2. If that average is no longer published, a substantially similar average,
established by the insurance regulator where this contract is delivered.
Example 3: Suppose the contract date is in 1987. Six months before the
anniversary in 1996 you borrow $1,000 out of a $4,000 loan value. Assume we
charge 8% a year. Three months later, but still three months before the
anniversary, we will have charged about $20 interest. This amount will be a few
cents more or less than $20 since some months have more days than others. The
interest will not be due until the anniversary unless the loan is paid back
sooner. The loan will still be $1,000. The contract debt will be $1,020, since
contract debt includes interest charged but not yet due. On the anniversary in
1996 we will have charged about $40 interest. The interest will then be due.
Example 4: Suppose the $40 interest in example 3 is paid on the anniversary. The
loan and contract debt will each become $1,000 right after the payment.
Example 5: Suppose the $40 interest in example 3 is not paid on the anniversary.
The interest will become part of the loan, and we will begin to charge interest
on it, too. The loan and contract debt will each become $1,040.
(Continued on Next Page)
- -----------
PLI 106--84
- -----------
II-239
<PAGE>
ALTERATION OF TEXT (Continued)
EFFECT OF A LOAN.--When you take a loan, we will reduce the investment base by
the amount you borrow. We will also reduce the investment base by interest that
becomes part of the loan because it is not paid when due. When you repay part or
all of a loan we will increase the investment base by the amount you repay. We
will not increase the investment base by interest that is paid before we make it
part of the loan. We will allocate loans and repayments among the subaccounts in
proportion to the investment base in each subaccount as of the date of the loan
or repayment. Only the amount of the investment base will reflect the investment
results of the subaccounts. The amount of the loan will be credited with a rate
which is 1% less than the loan interest rate for the contract year. Since the
amount you borrow is removed from the investment base, a loan will have a
permanent effect on the death benefit and net cash value of this contract. The
longer the loan is outstanding, the greater this effect is likely to be.
Example 6: Suppose the contract's investment base is $15,000 and that $10,000 is
in subaccount A and $5,000 is in subaccount B. If you make a $9,000 loan we will
reduce the amount in subaccount A by $6,000 and the amount in subaccount B by
$3,000.
Suppose that sometime later, when the investment base in each of the two
subaccounts is the same, you choose to repay the $9,000 loan. We will add $4,500
to the amount in each subaccount.
|Rider attached to and made a part of this Contract
|on the Contract Date
|
|
|Pruco Life Insurance Company,
|
|
|By /s/ ISABELLE L. KIRCHNER
| Secretary
|
|____________________________________________________
- -----------
PLI 106--84 Printed in U.S.A.
- -----------
II-240
EXHIBIT 1A(13)(zz)
PRUCO LIFE INSURANCE COMPANY
Insured Rider for Policy No.
________________________________________ ______________________________________
OPTIONAL PREMIUM REMITTANCE PLAN
Premiums are due monthly. They may be less than the smallest premium we normally
permit; they are being paid under a special plan. If they are no longer to be
paid under such a plan, we have the right to require that they be paid less
often. If we do so: (1) we will apply the rules which we would have used had
there been no special plan; and (2) we will give written notice.
|Rider attached to and made a part of this Contract
|on the Contract Date
|
|
|Pruco Life Insurance Company,
|
|
|By /s/ ISABELLE L. KIRCHNER
| Secretary
|
|____________________________________________________
- -----------
PLI 108--84 Printed in U.S.A.
- -----------
II-241
EXHIBIT 1.A.(13)(aaa)
RIDER FOR
TERM INSURANCE BENEFIT
ON LIFE OF INSURED--DECREASING AMOUNT AFTER THREE YEARS
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
Benefit.--We will pay an amount under this Benefit if we receive due proof that
the Insured spouse died (1) in the term period for the Benefit; and (2) while
this contract is in force with no premium in default past its days of grace. Any
proceeds under this contract that may arise from the Insured's death will
include this amount. But our payment is subject to all the provisions of the
Benefit and of the rest of this contract.
We will use the table below to compute the amount we will pay. We show the
Initial Amount of Term Insurance under this Benefit on the Contract Data
page(s). We also show the term period for the Benefit there. It starts on the
contract date, which we show on the first page. The anniversary at the end of
the term period is part of that period.
TABLE OF AMOUNTS OF INSURANCE
Amounts Payable.--We show here the amount we will pay, based on the Insured's
issue age, for each $1,000 of Initial Amount of Term Insurance if death occurs
in the contract year ending with the anniversary shown.
<TABLE>
<CAPTION>
- --------------------------------------------------------------------------------------------------
ISSUE AGE
- --------------------------------------------------------------------------------------------------
ANNIVER-
SARY 18 19 20 21 22 23 24 25 26 27 28
- --------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000
2 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
3 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
4 978 977 977 976 976 975 974 974 973 972 971
5 956 955 953 952 951 950 949 947 946 944 943
6 933 932 930 929 927 925 923 921 919 917 914
7 911 909 907 905 902 900 897 895 892 889 886
8 889 886 884 881 878 875 872 868 865 861 857
9 867 864 860 857 854 850 846 842 838 833 829
10 844 841 837 833 829 825 821 816 811 806 800
11 822 818 814 810 805 800 795 789 784 778 771
12 800 795 791 786 780 775 769 763 757 750 743
13 778 773 767 762 756 750 744 737 730 722 714
14 756 750 744 738 732 725 718 710 703 694 686
15 733 727 721 714 707 700 692 684 676 667 657
16 711 705 698 690 683 675 667 658 649 639 629
17 689 682 674 667 659 650 641 632 622 611 600
18 667 659 651 643 634 625 615 605 595 583 571
19 644 636 628 619 610 600 590 579 568 556 543
20 622 614 605 595 585 575 564 553 540 528 514
21 600 591 581 571 561 550 538 526 513 500 486
22 578 568 558 548 537 525 513 500 486 472 457
23 556 545 535 524 512 500 487 474 459 444 429
24 533 523 512 500 488 475 462 447 432 417 400
25 511 500 488 476 463 450 436 421 405 389 371
26 489 477 465 452 439 425 410 395 378 361 343
27 467 454 442 429 415 400 385 368 351 333 314
28 445 432 419 405 390 375 359 342 324 306 286
29 422 409 395 381 366 350 333 316 297 278 257
30 400 386 372 357 341 325 308 289 270 250 229
31 378 364 349 333 317 300 282 263 243 222 200
32 356 341 325 310 293 275 256 237 216 200 200
33 333 318 302 286 268 250 231 210 200 200 200
34 311 295 279 262 244 225 205 200 200 200 200
35 289 273 256 238 220 200 200 200 200 200 200
- --------------------------------------------------------------------------------------------------
</TABLE>
(Table Continued on Next Page)
VL 136 W
II-242
<PAGE>
(Table Continued from Preceding Page)
<TABLE>
<CAPTION>
- -------------------------------------------------------------------------------------------------
ISSUE AGE
- -------------------------------------------------------------------------------------------------
ANNIVER-
SARY 18 19 20 21 22 23 24 25 26 27 28
- -------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
36 $267 $250 $232 $214 $200 $200 $200 $200 $200 $200 $200
37 245 227 209 200 200 200 200 200 200 200 200
38 222 204 200 200 200 200 200 200 200 200 *
39 200 200 200 200 200 200 200 200 200 *
40 200 200 200 200 200 200 200 200 *
41 200 200 200 200 200 200 200 *
42 200 200 200 200 200 200 *
43 200 200 200 200 200 *
44 200 200 200 200 *
45 200 200 200 *
46 200 200 *
47 200 *
*NO AMOUNT PAYABLE IF DEATH OCCURS
IN THIS CONTRACT YEAR OR ANY LATER CONTRACT YEAR.
- -------------------------------------------------------------------------------------------------
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------------
ISSUE AGE
- ------------------------------------------------------------------------------------------------------------------------
ANNIVER-
SARY 29 30 31 32 33 34 35 36 37 38 39 40 41 42
- ------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000
2 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
3 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
4 971 970 969 968 967 966 964 963 962 960 958 957 955 952
5 941 939 938 935 933 931 929 926 923 920 917 913 909 905
6 912 909 906 903 900 897 893 889 885 880 875 870 864 857
7 882 879 875 871 867 862 857 852 846 840 833 826 818 810
8 853 849 844 839 833 828 821 815 808 800 792 783 773 762
9 824 818 813 806 800 793 786 778 769 760 750 739 727 714
10 794 788 781 774 767 759 750 741 731 720 708 696 682 667
11 765 758 750 742 733 724 714 704 692 680 667 652 636 619
12 735 727 719 710 700 690 679 667 654 640 625 609 591 571
13 706 697 688 677 667 655 643 630 615 600 583 565 546 524
14 676 667 656 645 633 621 607 593 577 560 542 522 500 476
15 647 636 625 613 600 586 571 556 538 520 500 478 455 429
16 618 606 594 581 567 552 536 518 500 480 458 435 409 381
17 588 576 563 548 533 517 500 481 462 440 417 391 364 333
18 559 546 531 516 500 483 464 444 423 400 375 348 318 286
19 529 515 500 484 467 448 429 407 385 360 333 304 273 238
20 500 485 469 452 433 414 393 370 346 320 292 261 227 200
21 471 455 438 419 400 379 357 333 308 280 250 217 200 200
22 441 424 406 387 367 345 322 296 269 240 208 200 200 200
23 412 394 375 355 333 310 286 259 231 200 200 200 200 200
24 382 364 344 323 300 276 250 222 200 200 200 200 200 *
25 353 333 313 290 267 241 214 200 200 200 200 200 *
26 324 303 281 258 233 207 200 200 200 200 200 *
27 294 273 250 226 200 200 200 200 200 200 *
28 265 243 219 200 200 200 200 200 200 *
29 235 212 200 200 200 200 200 200 *
30 206 200 200 200 200 200 200 *
31 200 200 200 200 200 200 *
32 200 200 200 200 200 *
33 200 200 200 200 *
34 200 200 200 *
35 200 200 *
36 200 *
*NO AMOUNT PAYABLE IF DEATH OCCURS
IN THIS CONTRACT YEAR OR ANY LATER CONTRACT YEAR.
- ------------------------------------------------------------------------------------------------------------------------
</TABLE>
(Table Continued on Next Page)
VL 136 W
II-243
<PAGE>
(Table Continued from Preceding Page)
<TABLE>
<CAPTION>
- -------------------------------------------------------------------------------------------------------------------
ISSUE AGE
- -------------------------------------------------------------------------------------------------------------------
ANNIVER-
SARY 43 44 45 46 47 48 49 50 51 52 53 54 55
- -------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000
2 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
3 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
4 950 947 944 941 938 933 929 923 917 909 900 889 875
5 900 895 889 882 875 867 857 846 833 818 800 778 750
6 850 842 833 824 813 800 786 769 750 727 700 667 625
7 800 789 778 765 750 733 714 692 667 636 600 556 500
8 750 737 722 706 688 667 643 615 583 545 500 444 375
9 700 684 667 647 625 600 571 538 500 455 400 333 250
10 650 632 611 588 563 533 500 462 417 364 300 222 200
11 600 579 556 529 500 467 429 385 333 273 200 200 *
12 550 526 500 471 438 400 357 308 250 200 200 *
13 500 474 444 412 375 333 286 231 200 200 *
14 450 421 389 353 313 267 214 200 200 *
15 400 368 333 294 250 200 200 200 *
16 350 316 278 235 200 200 200 *
17 300 263 222 200 200 200 *
18 250 211 200 200 200 *
19 200 200 200 200 *
20 200 200 200 *
21 200 200 *
22 200 *
*NO AMOUNT PAYABLE IF DEATH OCCURS
IN THIS CONTRACT YEAR OR ANY LATER CONTRACT YEAR.
- -------------------------------------------------------------------------------------------------------------------
</TABLE>
CONVERSION TO ANOTHER PLAN OF INSURANCE
Right to Convert.--You may be able to exchange this Benefit for a new contract
of life insurance on the Insured's life in either this company or The Prudential
Insurance Company of America. In any of these paragraphs, when we use the phrase
the company we mean whichever of these companies may issue the new contract. And
where we use the phrase new contract we mean the contract for which the Benefit
may be exchanged. You will not have to prove that the Insured is insurable.
Conditions.--Your right to make this exchange is subject to all these
conditions: (1) The amount we would have paid under this Benefit if the Insured
had died just before the contract date of the new contract must be large enough
to meet the minimum for a new contract, as we describe under Contract
Specifications. (2) You must ask for the exchange in writing and in a form that
meets our needs. (3) You must send this contract to us to be endorsed. (4) We
must have your request and the contract at our Service Office while the Benefit
is in force and at least five years before the end of its term period.
The new contract will not take effect unless the premium for it is paid while
the Insured is living and within 31 days after its contract date. If the premium
is paid as we state, it will be deemed that: (1) the insurance under the new
contract took effect on its contract date; and (2) this Benefit ended just
before that contract date. We will return that part, if any, of the last premium
paid for the Benefit that is more than needed to pay premiums to that contract
date.
Contract Date.--The date of the new contract will be the date you ask for in
your request. But it may not be after the date to which premiums are paid for
this Benefit. It may not be less than five years before the end of the term
period for the Benefit. And it may not be more than 31 days before we have your
request at our Service Office.
Contract Specifications.--The new contract will be in the same rating class as
this contract. The company will set the issue age and the premiums for the new
contract in accord with regular rules in use on the date of the new contract.
We will endorse the new contract to show that the period we state in its
Incontestability provision will start on the issue date of this contract. But if
this contract was reinstated before the date of the new contract, that period
will start on the date of the reinstatement. We will have the right to use the
statements that were made to us as the basis for reinstatement to contest the
new contract. The period during which we will have that right will be the period
we state in the Incontestability provision of the new contract.
We will endorse the new contract to show that the period we state in its Suicide
Exclusion provision will start on the issue date of this contract.
(Continued on Next Page)
VL 136 W
II-244
<PAGE>
(Continued from Preceding Page)
The new contract may call for annual premiums. If the company agrees, you will
be able to have premiums fall due more often.
The contract may be either one of the following:
1. A Life Paid Up at Age 85 plan. In this case the new contract will be issued
by The Prudential Insurance Company of America. Its face amount will be the
amount you ask for in your request. But it cannot be less than $10,000 or more
than 80% of the amount we would have paid under this Benefit if the Insured had
died just before the contract date of the new contract. (Since $10,000 is 80% of
$12,500, the amount we would have paid must be at least $12,500 for this
exchange to be possible.)
2. A contract like the one to which this Benefit is attached. Its face amount
will be the amount you ask for in your request. But it cannot be less than
$25,000 or more than 80% of the amount we would have paid under the Benefit if
the Insured had died just before the contract date of the new contract. (Since
$25,000 is 80% of $31,250, the amount we would have paid must be at least
$31,250 for this exchange to be possible.)
3. A contract of life insurance of a kind regularly being issued by Pruco Life
Insurance Company at that time for $50,000 or more. Its face amount will be the
amount you ask for in your request. But it cannot be less than $50,000 or more
than 80% of the amount we would have paid under the Benefit if the Insured had
died just before the contract date of the new contract. (Since $50,000 is 80% of
$62,500, the amount we would have paid must be at least $62,500 for this
exchange to be possible.)
The new contract will not have Supplementary Benefits other than as we describe
in this and in the next two paragraphs. If this contract has a benefit for
waiving premiums in the event of disability and the company would include that
kind of benefit in other contracts like the new contract, the company will put
the benefit in the new contract. The benefit, if any, in the new contract will
be the same one, with the same provisions, that the company puts in other
contracts like it on its contract date. In this paragraph, when we use the
phrase other contracts like it, we mean contracts the company would regularly
issue on the same plan and for the same rating class, amount, issue age and sex.
A benefit for waiving premiums that would have been allowed under this contract,
and that would otherwise be allowed under the new contract, will not be denied
just because disability started before the contract date of the new contract.
But any premium to be waived for that disability under the new contract must be
at the frequency that was in effect for this contract when the disability
started.
No premium will be waived under the new contract unless it has a benefit for
waiving premiums in the event of disability. This will be so even if premiums
have been waived under this contract.
Changes.--You may be able to have this Benefit changed to a new contract of life
insurance other than in accord with the requirements for exchange that we state
above. But any change may be made only if the company consents, and will be
subject to conditions and charges that are then determined.
MISCELLANEOUS PROVISIONS
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the contract anniversary at the end of the term period for
the Benefit.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the last day before the contract date of any other contract (a)
for which the Benefit is exchanged, or (b) to which the Benefit is changed;
3. the date the contract is surrendered under its Cash Value Option, if it has
one; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
THIS SUPPLEMENTARY BENEFIT RIDER
ATTACHED TO THIS CONTRACT ON THE CONTRACT DATE
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
Secretary
VL 136 W
II-245
EXHIBIT 1.A.(13)(bbb)
- --------------------------------------------------------------------------------
RIDER FOR
TERM INSURANCE BENEFIT ON LIFE OF INSURED--
DECREASING AMOUNT AFTER THREE YEARS
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
Benefit.--We will pay an amount under this Benefit if we receive due proof that
the Insured died (1) in the term period for the Benefit; and (2) while this
contract is in force with no premium in default past its days of grace. Any
proceeds under this contract that may arise from the Insured's death will
include this amount. But our payment is subject to all the provisions of the
Benefit and of the rest of this contract.
We will use the table below to compute the amount we will pay. We show the
Initial Amount of Term Insurance under this Benefit on the Contract Data
page(s). We also show the term period for the Benefit there. It starts on the
contract date, which we show on the first page. The anniversary at the end of
the term period is part of that period.
TABLE OF AMOUNTS OF INSURANCE
Amounts Payable.--We show here the amount we will pay, based on the Insured
issue age, for each $1,000 of Initial Amount of Term Insurance if death
occurs in the contract year ending with the anniversary shown.
<TABLE>
<CAPTION>
- --------------------------------------------------------------------------------------------------
ISSUE AGE
- --------------------------------------------------------------------------------------------------
ANNIVER-
SARY 18 19 20 21 22 23 24 25 26 27 28
- --------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000
2 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
3 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
4 978 977 977 976 976 975 974 974 973 972 971
5 956 955 953 952 951 950 949 947 946 944 943
6 933 932 930 929 927 925 923 921 919 917 914
7 911 909 907 905 902 900 897 895 892 889 886
8 889 886 884 881 878 875 872 868 865 861 857
9 867 864 860 857 854 850 846 842 838 833 829
10 844 841 837 833 829 825 821 816 811 806 800
11 822 818 814 810 805 800 795 789 784 778 771
12 800 795 791 786 780 775 769 763 757 750 743
13 778 773 767 762 756 750 744 737 730 722 714
14 756 750 744 738 732 725 718 710 703 694 686
15 733 727 721 714 707 700 692 684 676 667 657
16 711 705 698 690 683 675 667 658 649 639 629
17 689 682 674 667 659 650 641 632 622 611 600
18 667 659 651 643 634 625 615 605 595 583 571
19 644 636 628 619 610 600 590 579 568 556 543
20 622 614 605 595 585 575 564 553 540 528 514
21 600 591 581 571 561 550 538 526 513 500 486
22 578 568 558 548 537 525 513 500 486 472 457
23 556 545 535 524 512 500 487 474 459 444 429
24 533 523 512 500 488 475 462 447 432 417 400
25 511 500 488 476 463 450 436 421 405 389 371
26 489 477 465 452 439 425 410 395 378 361 343
27 467 454 442 429 415 400 385 368 351 333 314
28 445 432 419 405 390 375 359 342 324 306 286
29 422 409 395 381 366 350 333 316 297 278 257
30 400 386 372 357 341 325 308 289 270 250 229
31 378 364 349 333 317 300 282 263 243 222 200
32 356 341 325 310 293 275 256 237 216 200 200
33 333 318 302 286 268 250 231 210 200 200 200
34 311 295 279 262 244 225 205 200 200 200 200
35 289 273 256 238 220 200 200 200 200 200 200
- --------------------------------------------------------------------------------------------------
</TABLE>
(Table Continued on Next Page)
VL 136
II-246
<PAGE>
(Table Continued from Preceding Page)
<TABLE>
<CAPTION>
- -----------------------------------------------------------------------------------------------
ISSUE AGE
- -----------------------------------------------------------------------------------------------
ANNIVER-
SARY 18 19 20 21 22 23 24 25 26 27 28
- -----------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
36 $267 $250 $232 $214 $200 $200 $200 $200 $200 $200 $200
37 245 227 209 200 200 200 200 200 200 200 200
38 222 204 200 200 200 200 200 200 200 200 *
39 200 200 200 200 200 200 200 200 200 *
40 200 200 200 200 200 200 200 200 *
41 200 200 200 200 200 200 200 *
42 200 200 200 200 200 200 *
43 200 200 200 200 200 *
44 200 200 200 200 *
45 200 200 200 *
46 200 200 *
47 200 *
*NO AMOUNT PAYABLE IF DEATH OCCURS
IN THIS CONTRACT YEAR OR ANY LATER CONTRACT YEAR.
- -----------------------------------------------------------------------------------------------
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------------
ISSUE AGE
- ------------------------------------------------------------------------------------------------------------------------
ANNIVER-
SARY 29 30 31 32 33 34 35 36 37 38 39 40 41 42
- -----------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000
2 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
3 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
4 971 970 969 968 967 966 964 963 962 960 958 957 955 952
5 941 939 938 935 933 931 929 926 923 920 917 913 909 905
6 912 909 906 903 900 897 893 889 885 880 875 870 864 857
7 882 879 875 871 867 862 857 852 846 840 833 826 818 810
8 853 849 844 839 833 828 821 815 808 800 792 783 773 762
9 824 818 813 806 800 793 786 778 769 760 750 739 727 714
10 794 788 781 774 767 759 750 741 731 720 708 696 682 667
11 765 758 750 742 733 724 714 704 692 680 667 652 636 619
12 735 727 719 710 700 690 679 667 654 640 625 609 591 571
13 706 697 688 677 667 655 643 630 615 600 583 565 546 524
14 676 667 656 645 633 621 607 593 577 560 542 522 500 476
15 647 636 625 613 600 586 571 556 538 520 500 478 455 429
16 618 606 594 581 567 552 536 518 500 480 458 435 409 381
17 588 576 563 548 533 517 500 481 462 440 417 391 364 333
18 559 546 531 516 500 483 464 444 423 400 375 348 318 286
19 529 515 500 484 467 448 429 407 385 360 333 304 273 238
20 500 485 469 452 433 414 393 370 346 320 292 261 227 200
21 471 455 438 419 400 379 357 333 308 280 250 217 200 200
22 441 424 406 387 367 345 322 296 269 240 208 200 200 200
23 412 394 375 355 333 310 286 259 231 200 200 200 200 200
24 382 364 344 323 300 276 250 222 200 200 200 200 200 *
25 353 333 313 290 267 241 214 200 200 200 200 200 *
26 324 303 281 258 233 207 200 200 200 200 200 *
27 294 273 250 226 200 200 200 200 200 200 *
28 265 243 219 200 200 200 200 200 200 *
29 235 212 200 200 200 200 200 200 *
30 206 200 200 200 200 200 200 *
31 200 200 200 200 200 200 *
32 200 200 200 200 200 *
33 200 200 200 200 *
34 200 200 200 *
35 200 200 *
36 200 *
*NO AMOUNT PAYABLE IF DEATH OCCURS
IN THIS CONTRACT YEAR OR ANY LATER CONTRACT YEAR.
- -----------------------------------------------------------------------------------------------------------------------
</TABLE>
(Table Continued on Next Page)
VL 136
II-247
<PAGE>
(Table Continued from Preceding Page)
<TABLE>
<CAPTION>
- --------------------------------------------------------------------------------------------------------------------
ISSUE AGE
- --------------------------------------------------------------------------------------------------------------------
ANNIVER-
SARY 43 44 45 46 47 48 49 50 51 52 53 54 55
- -------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000
2 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
3 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
4 950 947 944 941 938 933 929 923 917 909 900 889 875
5 900 895 889 882 875 867 857 846 833 818 800 778 750
6 850 842 833 824 813 800 786 769 750 727 700 667 625
7 800 789 778 765 750 733 714 692 667 636 600 556 500
8 750 737 722 706 688 667 643 615 583 545 500 444 375
9 700 684 667 647 625 600 571 538 500 455 400 333 250
10 650 632 611 588 563 533 500 462 417 364 300 222 200
11 600 579 556 529 500 467 429 385 333 273 200 200 *
12 550 526 500 471 438 400 357 308 250 200 200 *
13 500 474 444 412 375 333 286 231 200 200 *
14 450 421 389 353 313 267 214 200 200 *
15 400 368 333 294 250 200 200 200 *
16 350 316 278 235 200 200 200 *
17 300 263 222 200 200 200 *
18 250 211 200 200 200 *
19 200 200 200 200 *
20 200 200 200 *
21 200 200 *
22 200 *
*NO AMOUNT PAYABLE IF DEATH OCCURS
IN THIS CONTRACT YEAR OR ANY LATER CONTRACT YEAR.
- --------------------------------------------------------------------------------------------------------------------
</TABLE>
CONVERSION TO ANOTHER PLAN OF INSURANCE
Right to Convert.--You may be able to exchange this Benefit for a new contract
of life insurance on the Insured's life in either this company or The Prudential
Insurance Company of America. In any of these paragraphs, when we use the phrase
the company we mean whichever of these companies may issue the new contract. And
where we use the phrase new contract we mean the contract for which the Benefit
may be exchanged. You will not have to prove that the Insured is insurable.
Conditions.--Your right to make this exchange is subject to all these
conditions: (1) The amount we would have paid under this Benefit if the Insured
had died just before the contract date of the new contract must be large
enough to meet the minimum for a new contract, as we describe under Contract
Specifications, (2) You must ask for the exchange in writing and in a form that
meets our needs, (3) You must send this contract to us to be endorsed, (4) We
must have your request and the contract at our Service Office while the Benefit
is in force and at least five years before the end of its term period.
The new contract will not take effect unless the premium for it is paid while
the Insured is living and within 31 days after its contract date. If the
premium is paid as we state, it will be deemed that: (1) the insurance under the
new contract took effect on its contract date; and (2) this Benefit ended just
before that contract date. We will return that part, if any, of the last premium
paid for the Benefit that is more than was needed to pay premiums to that
contract date.
Contract Date.--The date of the new contract will be the date you ask for in
your request. But it may not be after the date to which premiums are paid for
this Benefit. It may not be less than five years before the end of the term
period for the Benefit. And it may not be more than 31 days before we have your
request at our Service Office.
Contract Specifications.--The new contract will be in the same rating class as
this contract. The company will set the issue age and the premiums for the new
contract in accord with regular rules in use on the date of the new contract.
(Continued on Next Page)
VL 136
II-248
<PAGE>
(Continued from Preceding Page)
The new contract may call for annual premiums. If the company agrees you will
be able to have premiums fall due more often.
The contract may be either one of the following:
1. A Life Paid Up at Age 85 plan. In this case the new contract will be issued
by The Prudential Insurance Company of America. Its face amount will be the
amount you ask for in your request. But it cannot be less than $10,000 or more
than 80% of the amount we would have paid under this Benefit if the Insured
had died just before the contract date of the new contract. (Since
$10,000 is 80% of $12,500, the amount we would have paid must be at least
$12,500 for this exchange to be possible.)
2. A contract like the one to which this Benefit is attached. Its face amount
will be the amount you ask for in your request. But is cannot be less than
$25,000 or more than 80% of the amount we would have paid under the Benefit if
the insured spouse had died just before the contract date of the new contract.
(Since $25,000 is 80% of $31,250, the amount we would have paid must be at least
$31,250 for this exchange to be possible.)
3. A contract of life insurance of a kind regularly being issued by Pruco Life
Insurance Company at that time for $50,000 or more. Its face amount will be the
amount you ask for in your request. But it cannot be less than $50,000 or more
than 80% of the amount we would have paid under the Benefit if the Insured had
died just before the contract date of the new contract. (Since $50,000 is 80% of
$62,500, the amount we would have paid must be at least $62,500 for this
exchange to be possible.)
The new contract will not have Supplementary Benefits other than as we describe
in this and in the next two paragraphs. If this contract has a benefit for
waiving premiums in the event of disability and the company would include that
kind of benefit in other contracts like the new contract, the company will put
the benefit in the new contract. The benefit, if any, in the new contract will
be the same one, with the same provisions, that the company puts in other
contracts like it on its contract date. In this paragraph, when we use the
phrase other contracts like it, we mean contracts the company would regularly
issue on the same plan and for the same rating class, amount, issue age and sex.
A benefit for waiving premiums that would have been allowed under this contract,
and that would otherwise be allowed under the new contract, will not be denied
just because disability started before the contract date of the new contract.
But any premium to be waived for that disability under the new contract must be
at the frequency that was in effect for this contract when the disability
started.
No premium will be waived under the new contract unless it has a benefit for
waiving premiums in the event of disability. This will be so even if premiums
have been waived under this contract.
Changes.--You may be able to have this Benefit changed to a new contract of life
insurance other than in accord with the requirements for exchange that we state
above. But any change may be made only if the company consents, and will be
subject to conditions and charges that are then determined.
MISCELLANEOUS PROVISIONS
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the contract anniversary at the end of the
term period for the Benefit.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the last day before the contract date of any other contract (a)
for which the Benefit is exchanged, or (b) to which the Benefit is changed;
3. the date the contract is surrendered under its Cash Value Option, if it has
one; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
This Supplementary Benefit rider
attached to this contract on the Contract Date
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
Secretary
VL 136
II-249
EXHIBIT 1.A(13)(ccc)
- --------------------------------------------------------------------------------
RIDER FOR
TERM INSURANCE BENEFIT ON LIFE OF INSURED SPOUSE
DECREASING AMOUNT AFTER THREE YEARS
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
Benefit.--We will pay an amount under this Benefit if we receive due proof that
the insured spouse died (1) in the term period for the Benefit; and (2) while
this contract is in force with no premium in default past its days of grace. We
will pay this amount to the beneficiary for insurance payable upon the insured
spouse's death. But our payment is subject to all the provisions of the Benefit
and of the rest of this contract. The phrase insured spouse means the Insured's
spouse named in the application for this contract.
We will use the table below to compute the amount we will pay. We show the
Initial Amount of Term Insurance under this Benefit on the Contract Data
page(s). We also show the term period for the Benefit there. It starts on the
contract date, which we show on the first page. The anniversary at the end of
the term period is part of that period.
TABLE OF AMOUNTS OF INSURANCE
Amounts Payable.--We show here the amount we will pay, based on the insured
spouse's issue age, for each $1,000 of Initial Amount of Term Insurance if death
occurs in the contract year ending with the anniversary shown.
<TABLE>
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------------
ISSUE AGE
- ------------------------------------------------------------------------------------------------------------------------
ANNIVER-
SARY 18 19 20 21 22 23 24 25 26 27 28 29 30 31
- ------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000
2 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
3 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
4 978 977 977 976 976 975 974 974 973 972 971 971 970 969
5 956 955 953 952 951 950 949 947 946 944 943 941 939 938
6 933 932 930 929 927 925 923 921 919 917 914 912 909 906
7 911 909 907 905 902 900 897 895 892 889 886 882 879 875
8 889 886 884 881 878 875 872 868 865 861 857 853 849 844
9 867 864 860 857 854 850 846 842 838 833 829 824 818 813
10 844 841 837 833 829 825 821 816 811 806 800 794 788 781
11 822 818 814 810 805 800 795 789 784 778 771 765 758 750
12 800 795 791 786 780 775 769 763 757 750 743 735 727 719
13 778 773 767 762 756 750 744 737 730 722 714 706 697 688
14 756 750 744 738 732 725 718 710 703 694 686 676 667 656
15 733 727 721 714 707 700 692 684 676 667 657 647 636 625
16 711 705 698 690 683 675 667 658 649 639 629 618 606 594
17 689 682 674 667 659 650 641 632 622 611 600 588 576 563
18 667 659 651 643 634 625 615 605 595 583 571 559 546 531
19 644 636 628 619 610 600 590 579 568 556 543 529 515 500
20 622 614 605 595 585 575 564 553 540 528 514 500 485 469
21 600 591 581 571 561 550 538 526 513 500 486 471 455 438
22 578 568 558 548 537 525 513 500 486 472 457 441 424 406
23 556 545 535 524 512 500 487 474 459 444 429 412 394 375
24 533 523 512 500 488 475 462 447 432 417 400 382 364 344
25 511 500 488 476 463 450 436 421 405 389 371 353 333 313
26 489 477 465 452 439 425 410 395 378 361 343 324 303 281
27 467 454 442 429 415 400 385 368 351 333 314 294 273 250
28 445 432 419 405 390 375 359 342 324 306 286 265 243 219
29 422 409 395 381 366 350 333 316 297 278 257 235 212 200
30 400 386 372 357 341 325 308 289 270 250 229 206 200 200
- ------------------------------------------------------------------------------------------------------------------------
</TABLE>
(Table Continued on Next Page)
VL 181
II-250
<PAGE>
(Table Continued from Preceding Page)
<TABLE>
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------------
ISSUE AGE
- ------------------------------------------------------------------------------------------------------------------------
ANNIVER-
SARY 18 19 20 21 22 23 24 25 26 27 28 29 30 31
- ------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
31 $378 $364 $349 $333 $317 $300 $282 $263 $243 $222 $200 $200 $200 $200
32 356 341 325 310 293 275 256 237 216 200 200 200 200 200
33 333 318 302 286 268 250 231 210 200 200 200 200 200 200
34 311 295 279 262 244 225 205 200 200 200 200 200 200 200
35 289 273 256 238 220 200 200 200 200 200 200 200 200 *
36 267 250 232 214 200 200 200 200 200 200 200 200 *
37 245 227 209 200 200 200 200 200 200 200 200 *
38 222 204 200 200 200 200 200 200 200 200 *
39 200 200 200 200 200 200 200 200 200 *
40 200 200 200 200 200 200 200 200 *
41 200 200 200 200 200 200 200 *
42 200 200 200 200 200 200 *
43 200 200 200 200 200 *
44 200 200 200 200 *
45 200 200 200 *
46 200 200 *
47 200 *
48 *
*NO AMOUNT PAYABLE IF DEATH OCCURS IN THIS CONTRACT YEAR OR ANY LATER CONTRACT YEAR.
- ------------------------------------------------------------------------------------------------------------------------
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------------
ISSUE AGE
- ------------------------------------------------------------------------------------------------------------------------
ANNIVER-
SARY 32 33 34 35 36 37 38 39 40 41 42 43 44 45
- ------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000
2 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
3 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
4 968 967 966 964 963 962 960 958 957 955 952 950 947 944
5 935 933 931 929 926 923 920 917 913 909 905 900 895 889
6 903 900 897 893 889 885 880 875 870 864 857 850 842 833
7 871 867 862 857 852 846 840 833 826 818 810 800 789 778
8 839 833 828 821 815 808 800 792 783 773 762 750 737 722
9 806 800 793 786 778 769 760 750 739 727 714 700 684 667
10 774 767 759 750 741 731 720 708 696 682 667 650 632 611
11 742 733 724 714 704 692 680 667 652 636 619 600 579 556
12 710 700 690 679 667 654 640 625 609 591 571 550 526 500
13 677 667 655 643 630 615 600 583 565 546 524 500 474 444
14 645 633 621 607 593 577 560 542 522 500 476 450 421 389
15 613 600 586 571 556 538 520 500 478 455 429 400 368 333
16 581 567 552 536 518 500 480 458 435 409 381 350 316 278
17 548 533 517 500 481 462 440 417 391 364 333 300 263 222
18 516 500 483 464 444 423 400 375 348 318 286 250 211 200
19 484 467 448 429 407 385 360 333 304 273 238 200 200 200
20 452 433 414 393 370 346 320 292 261 227 200 200 200 200
21 419 400 379 357 333 308 280 250 217 200 200 200 200 *
22 387 367 345 322 296 269 240 208 200 200 200 200 *
23 355 333 310 286 259 231 200 200 200 200 200 *
24 323 300 276 250 222 200 200 200 200 200 *
25 290 267 241 214 200 200 200 200 200 *
26 258 233 207 200 200 200 200 200 *
27 226 200 200 200 200 200 200 *
28 200 200 200 200 200 200 *
29 200 200 200 200 200 *
30 200 200 200 200 *
31 200 200 200 *
32 200 200 *
33 200 *
34 *
*NO AMOUNT PAYABLE IF DEATH OCCURS IN THIS CONTRACT YEAR OR ANY LATER CONTRACT YEAR.
- -----------------------------------------------------------------------------------------------------------------------
</TABLE>
(Table Continued on Next Page)
VL 181
II-251
<PAGE>
(Table Continued from Preceding Page)
<TABLE>
<CAPTION>
- ---------------------------------------------------------------------------------------
ISSUE AGE
- ---------------------------------------------------------------------------------------
ANNIVER-
SARY 46 47 48 49 50 51 52 53 54 55
- ---------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000
2 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
3 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
4 941 938 933 929 923 917 909 900 889 875
5 882 875 867 857 846 833 818 800 778 750
6 824 813 800 786 769 750 727 700 667 625
7 765 750 733 714 692 667 636 600 556 500
8 706 688 667 643 615 583 545 500 444 375
9 647 625 600 571 538 500 455 400 333 250
10 588 563 533 500 462 417 364 300 222 200
11 529 500 467 429 385 333 273 200 200 *
12 471 438 400 357 308 250 200 200 *
13 412 375 333 286 231 200 200 *
14 353 313 267 214 200 200 *
15 294 250 200 200 200 *
16 235 200 200 200 *
17 200 200 200 *
18 200 200 *
19 200 *
20 *
*NO AMOUNT PAYABLE IF DEATH OCCURS
IN THIS CONTRACT YEAR OR ANY LATER CONTRACT YEAR.
- ---------------------------------------------------------------------------------------
</TABLE>
(Continued from Preceding Page)
PAID-UP INSURANCE
Paid-up Insurance on Life of Insured Spouse.--The Insured might die: (1) in the
term period for this Benefit; (2) while this contract is in force with no
premium in default past its days of grace; and (3) while the insured spouse is
living. In this case, the insurance on the life of the insured spouse under the
Benefit will become paid-up term insurance for decreasing amounts. We will
compute these amounts from the Table of Amounts of Insurance. While the paid-up
insurance is in effect, the contract will remain in force until the end of the
term period for the Benefit. The paid-up insurance will have cash values but no
loan value.
If this Benefit becomes paid-up, it may be surrendered for its net cash value.
This will be the net value on the date of surrender of the paid-up insurance.
But, within 30 days after a contract anniversary, the net cash value will not be
less than it was on that anniversary. We base this net cash value on the insured
spouse's age and sex. The insured spouse's age at any time will be his or her
age last birthday on the contract date plus the length of time since that date.
We use the Commissioners 1980 Standard Ordinary Mortality Table. We use
continuous functions based on age last birthday. We use an effective interest
rate of 4% a year
We will usually pay any cash value promptly. But we have the right to postpone
paying it for up to six months. If we do so for more than 30 days, we will pay
interest at the rate of 3% a year. If we are asked for the values which apply,
we will furnish them.
VL 181
(Continued on Next Page)
II-252
<PAGE>
(Continued from Preceding Page)
CONVERSION TO ANOTHER PLAN OF INSURANCE
Right to Convert.--While the Insured is living, you may be able to exchange this
Benefit for a new contract of life insurance on the life of the insured spouse
in either this company or The Prudential Insurance Company of America. In any of
these paragraphs, when we use the phrase the company we mean whichever of these
companies may issue the new contract. And where we use the phrase new contract
we mean the contract for which the Benefit may be exchanged. You will not have
to prove that the insured spouse is insurable.
Conditions.--Your right to make this exchange is subject to all these
conditions: (1) The amount we would have paid under this Benefit if the insured
spouse had died just before the contract date of the new contract must be large
enough to meet the minimum for a new contract, as we describe under Contract
Specifications. (2) You must ask for the exchange in writing and in a form that
meets our needs. (3) You must send this contract to us to be endorsed. (4) We
must have your request and the contract at our Service Office while the Benefit
is in force and at least five years before the end of its term period.
The new contract will not take effect unless the premium for it is paid while
the insured spouse is living and within 31 days after its contract date. If the
premium is paid as we state, it will be deemed that: (1) the insurance under the
new contract took effect on its contract date; and (2) this Benefit ended just
before that contract date. We will return that part, if any, of the last premium
paid for the Benefit that is more than was needed to pay premiums to that
contract date.
Contract Date.--The date of the new contract will be the date you ask for in
your request. But it may not be after the date to which premiums are paid for
this Benefit. It may not be less than five years before the end of the term
period for the Benefit. And it may not be more than 31 days before we have your
request at our Service Office.
Contract Specifications.--The new contract will be in the standard rating class.
The company will set the issue age and the premiums for the new contract in
accord with its regular rules in use on the date of the new contract.
The new contract may call for annual premiums. If the company agrees, you will
be able to have premiums fall due more often.
The contract may be either one of the following:
1. A Life Paid Up at Age 85 plan. In this case the new contract will be issued
by The Prudential Insurance Company of America. Its face amount will be the
amount you ask for in your request. But it cannot be less than $10,000 or more
than 80% of the amount we would have paid under this Benefit if the insured
spouse had died just before the contract date of the new contract. (Since
$10,000 is 80% of $12,500, the amount we would have paid must be at least
$12,500 for this exchange to be possible.)
2. A contract like the one to which this Benefit is attached. Its face amount
will be the amount you ask for in your request. But it cannot be less than
$25,000 or more than 80% of the amount we would have paid under the Benefit if
the insured spouse had died just before the contract date of the new contract.
(Since $25,000 is 80% of $31,250, the amount we would have paid must be at least
$31,250 for this exchange to be possible.)
(Continued on Next Page)
VL 181
II-253
<PAGE>
(Continued from Preceding Page)
3. An Appreciable Life or Variable Appreciable Life Contract, if Pruco Life
Insurance Company is regularly issuing such contracts at that time. Its face
amount will be the amount you ask for in your request. But it cannot be less
than $50,000 or more than 80% of the amount we would have paid under the Benefit
if the insured spouse had died just before the contract date of the new
contract. (Since $50,000 is 80% of $62,500, the amount we would have paid must
be at least $62,500 for this exchange to be possible.)
The new contract will not have Supplementary Benefits other than as we describe
in this and in the next paragraph. If the company would include in other
contracts like the new contract a benefit for waiving premiums in the event of
disability, here is what the company will do. Even though this contract does not
have that benefit on the life of the insured spouse, the company will put it in
the new contract on his or her life. The benefit, if any, in the new contract
will be the same one, with the same provisions, that the company puts in other
contracts like it on its contract date. In this paragraph, when we use the
phrase other contracts like it, we mean contracts the company would regularly
issue on the same plan and for the same rating class, amount, issue age and sex.
No premium will be waived under the new contract unless the disability started
on or after its contract date. And no premium will be waived under a new
contract unless it has a benefit for waiving premiums in the event of
disability. This will be so even if premiums have been waived under this
contract.
Changes.--You may be able to have this Benefit changed to a new contract of life
insurance other than in accord with the requirements for exchange that we state
above. But any change may be made only if the company consents, and will be
subject to conditions and charges that are then determined.
MISCELLANEOUS PROVISIONS
Ownership and Control.--Unless we endorse this contract to say otherwise, while
the Insured is living the owner alone may exercise all ownership and control of
this contract. This includes, but is not limited to, these rights: (1) to assign
the contract; and (2) to change any subsequent owner. A request for such a
change must be in writing to us at our Service Office and in a form that meets
our needs. The change will take effect only when we endorse the contract to show
it.
Unless we endorse this contract to say otherwise: (1) while any insurance is in
force after the Insured's death, the owner of the contract will be the insured
spouse; and (2) the owner alone will be entitled to (a) any contract benefit and
value, and (b) the exercise of any right and privilege granted by the contract
or by us. But any insurance payable upon the Insured's death will be payable to
the beneficiary for that insurance.
Beneficiary.--The word beneficiary where we use it in this contract without
qualification means the beneficiary for insurance payable upon the death of the
Insured.
Unless we endorse this contract to say otherwise, the beneficiary for insurance
payable upon the death of the insured spouse will be the Insured if living,
otherwise the estate of the insured spouse.
The beneficiary for insurance payable upon the death of the insured spouse may
be changed. The request must be in writing and in a form that meets our needs.
It will take effect only when we file it at our Service Office; this will be
after the contract is sent to us to be endorsed, if we ask for it. Then any
previous beneficiary's interest in such insurance will end as of the date of the
request. It will end then even if the insured spouse is not living when we file
the request. Any beneficiary's interest is subject to the rights of any assignee
of whom we know.
When a beneficiary is designated, any relationship shown is to the Insured,
unless otherwise stated.
Misstatement of Age or Sex.--If the insured spouse's stated age or sex or both
are not correct, we will change each benefit and any amount payable to what the
premium would have bought for the correct age and sex.
The Schedule of Premiums may show that premiums change or stop on a certain
date. We may have used that date because the insured spouse would attain a
certain age on that date. If we find that the issue age for the insured spouse
was wrong, we will correct that date.
Suicide Exclusion.--If the insured spouse, whether sane or insane, dies by
suicide within the period which we state in the Suicide Exclusion under General
Provisions, we will not pay the amount we describe under Benefit above. Instead,
we will pay no more than the sum of the premiums paid for this Benefit. We will
make that payment in one sum.
VL 181
(Continued on Next Page)
II-254
<PAGE>
(Continued from Preceding Page)
Reinstatement.--If this contract is reinstated, it will not include the
insurance that we provide under this Benefit on the life of the insured spouse
unless we are given any facts we need to satisfy us that the insured spouse is
insurable for the Benefit.
Contract Value Options.--If this contract has a Contract Value Options
provision, it will apply only during the Insured's lifetime. Any extended or
reduced paid-up insurance that may be described there is on the life of the
Insured only.
Contract Loans.--If this contract has a Loans provision, we will not consider
any contract debt when we determine the amount payable, if any, at the death of
the insured spouse.
Incontestability.--Except for non-payment of premium, we will not contest this
Benefit after is has been in force during the insured spouse's lifetime for two
years from the issue date.
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the earliest of (1) the death of the Insured, (2) the
death of the insured spouse, and (3) the contract anniversary at the end of the
term period for the Benefit.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the last day before the contract date of any other contract (a)
for which the Benefit is exchanged, or (b) to which the Benefit is changed;
3. the date the contract is surrendered under its Cash Value Option, if it has
one, or the paid-up insurance, if any, under the Benefit is surrendered; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
This Supplementary Benefit rider
attached to this contract on the Contract Date
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
Secretary
VL 181
II-255
EXHIBIT 1.A(13)(ddd)
- --------------------------------------------------------------------------------
RIDER FOR
TERM INSURANCE BENEFIT ON LIFE OF INSURED SPOUSE
DECREASING AMOUNT AFTER THREE YEARS
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
Benefit.--We will pay an amount under this Benefit if we receive due proof that
the insured spouse died (1) in the term period for the Benefit; and (2) while
this contract is in force with no premium in default past its days of grace. We
will pay this amount to the beneficiary for insurance payable upon the insured
spouse's death. But our payment is subject to all the provisions of the Benefit
and of the rest of this contract. The phrase insured spouse means the Insured's
spouse named in the application for this contract.
We will use the table below to compute the amount we will pay. We show the
Initial Amount of Term Insurance under this Benefit on the Contract Data
page(s). We also show the term period for the Benefit there. It starts on the
contract date, which we show on the first page. The anniversary at the end of
the term period is part of that period.
TABLE OF AMOUNTS OF INSURANCE
Amounts Payable.--We show here the amount we will pay, based on the insured
spouse's issue age, for each $1,000 of Initial Amount of Term Insurance if death
occurs in the contract year ending with the anniversary shown.
<TABLE>
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------------
ISSUE AGE
- ------------------------------------------------------------------------------------------------------------------------
ANNIVER-
SARY 18 19 20 21 22 23 24 25 26 27 28 29 30 31
- ------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000
2 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
3 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
4 978 977 977 976 976 975 974 974 973 972 971 971 970 969
5 956 955 953 952 951 950 949 947 946 944 943 941 939 938
6 933 932 930 929 927 925 923 921 919 917 914 912 909 906
7 911 909 907 905 902 900 897 895 892 889 886 882 879 875
8 889 886 884 881 878 875 872 868 865 861 857 853 849 844
9 867 864 860 857 854 850 846 842 838 833 829 824 818 813
10 844 841 837 833 829 825 821 816 811 806 800 794 788 781
11 822 818 814 810 805 800 795 789 784 778 771 765 758 750
12 800 795 791 786 780 775 769 763 757 750 743 735 727 719
13 778 773 767 762 756 750 744 737 730 722 714 706 697 688
14 756 750 744 738 732 725 718 710 703 694 686 676 667 656
15 733 727 721 714 707 700 692 684 676 667 657 647 636 625
16 711 705 698 690 683 675 667 658 649 639 629 618 606 594
17 689 682 674 667 659 650 641 632 622 611 600 588 576 563
18 667 659 651 643 634 625 615 605 595 583 571 559 546 531
19 644 636 628 619 610 600 590 579 568 556 543 529 515 500
20 622 614 605 595 585 575 564 553 540 528 514 500 485 469
21 600 591 581 571 561 550 538 526 513 500 486 471 455 438
22 578 568 558 548 537 525 513 500 486 472 457 441 424 406
23 556 545 535 524 512 500 487 474 459 444 429 412 394 375
24 533 523 512 500 488 475 462 447 432 417 400 382 364 344
25 511 500 488 476 463 450 436 421 405 389 371 353 333 313
26 489 477 465 452 439 425 410 395 378 361 343 324 303 281
27 467 454 442 429 415 400 385 368 351 333 314 294 273 250
28 445 432 419 405 390 375 359 342 324 306 286 265 243 219
29 422 409 395 381 366 350 333 316 297 278 257 235 212 200
30 400 386 372 357 341 325 308 289 270 250 229 206 200 200
- ------------------------------------------------------------------------------------------------------------------------
</TABLE>
(Table Continued on Next Page)
VL 181 S
II-256
<PAGE>
(Table Continued from Preceding Page)
<TABLE>
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------------
ISSUE AGE
- ------------------------------------------------------------------------------------------------------------------------
ANNIVER-
SARY 18 19 20 21 22 23 24 25 26 27 28 29 30 31
- ------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
31 $378 $364 $349 $333 $317 $300 $282 $263 $243 $222 $200 $200 $200 $200
32 356 341 325 310 293 275 256 237 216 200 200 200 200 200
33 333 318 302 286 268 250 231 210 200 200 200 200 200 200
34 311 295 279 262 244 225 205 200 200 200 200 200 200 200
35 289 273 256 238 220 200 200 200 200 200 200 200 200 *
36 267 250 232 214 200 200 200 200 200 200 200 200 *
37 245 227 209 200 200 200 200 200 200 200 200 *
38 222 204 200 200 200 200 200 200 200 200 *
39 200 200 200 200 200 200 200 200 200 *
40 200 200 200 200 200 200 200 200 *
41 200 200 200 200 200 200 200 *
42 200 200 200 200 200 200 *
43 200 200 200 200 200 *
44 200 200 200 200 *
45 200 200 200 *
46 200 200 *
47 200 *
48 *
*NO AMOUNT PAYABLE IF DEATH OCCURS IN THIS CONTRACT YEAR OR ANY LATER CONTRACT YEAR.
- ------------------------------------------------------------------------------------------------------------------------
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------------
ISSUE AGE
- ------------------------------------------------------------------------------------------------------------------------
ANNIVER-
SARY 32 33 34 35 36 37 38 39 40 41 42 43 44 45
- ------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000
2 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
3 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
4 968 967 966 964 963 962 960 958 957 955 952 950 947 944
5 935 933 931 929 926 923 920 917 913 909 905 900 895 889
6 903 900 897 893 889 885 880 875 870 864 857 850 842 833
7 871 867 862 857 852 846 840 833 826 818 810 800 789 778
8 839 833 828 821 815 808 800 792 783 773 762 750 737 722
9 806 800 793 786 778 769 760 750 739 727 714 700 684 667
10 774 767 759 750 741 731 720 708 696 682 667 650 632 611
11 742 733 724 714 704 692 680 667 652 636 619 600 579 556
12 710 700 690 679 667 654 640 625 609 591 571 550 526 500
13 677 667 655 643 630 615 600 583 565 546 524 500 474 444
14 645 633 621 607 593 577 560 542 522 500 476 450 421 389
15 613 600 586 571 556 538 520 500 478 455 429 400 368 333
16 581 567 552 536 518 500 480 458 435 409 381 350 316 278
17 548 533 517 500 481 462 440 417 391 364 333 300 263 222
18 516 500 483 464 444 423 400 375 348 318 286 250 211 200
19 484 467 448 429 407 385 360 333 304 273 238 200 200 200
20 452 433 414 393 370 346 320 292 261 227 200 200 200 200
21 419 400 379 357 333 308 280 250 217 200 200 200 200 *
22 387 367 345 322 296 269 240 208 200 200 200 200 *
23 355 333 310 286 259 231 200 200 200 200 200 *
24 323 300 276 250 222 200 200 200 200 200 *
25 290 267 241 214 200 200 200 200 200 *
26 258 233 207 200 200 200 200 200 *
27 226 200 200 200 200 200 200 *
28 200 200 200 200 200 200 *
29 200 200 200 200 200 *
30 200 200 200 200 *
31 200 200 200 *
32 200 200 *
33 200 *
34 *
*NO AMOUNT PAYABLE IF DEATH OCCURS IN THIS CONTRACT YEAR OR ANY LATER CONTRACT YEAR.
- -----------------------------------------------------------------------------------------------------------------------
</TABLE>
(Table Continued on Next Page)
AL 181 S
II-257
<PAGE>
(Table Continued from Preceding Page)
<TABLE>
<CAPTION>
- ---------------------------------------------------------------------------------------
ISSUE AGE
- ---------------------------------------------------------------------------------------
ANNIVER-
SARY 46 47 48 49 50 51 52 53 54 55
- ---------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000
2 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
3 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
4 941 938 933 929 923 917 909 900 889 875
5 882 875 867 857 846 833 818 800 778 750
6 824 813 800 786 769 750 727 700 667 625
7 765 750 733 714 692 667 636 600 556 500
8 706 688 667 643 615 583 545 500 444 375
9 647 625 600 571 538 500 455 400 333 250
10 588 563 533 500 462 417 364 300 222 200
11 529 500 467 429 385 333 273 200 200 *
12 471 438 400 357 308 250 200 200 *
13 412 375 333 286 231 200 200 *
14 353 313 267 214 200 200 *
15 294 250 200 200 200 *
16 235 200 200 200 *
17 200 200 200 *
18 200 200 *
19 200 *
20 *
*NO AMOUNT PAYABLE IF DEATH OCCURS
IN THIS CONTRACT YEAR OR ANY LATER CONTRACT YEAR.
- ---------------------------------------------------------------------------------------
</TABLE>
(Continued from Preceding Page)
PAID-UP INSURANCE
Paid-up Insurance on Life of Insured Spouse.--The Insured might die (1) in the
term period for this Benefit; (2) while this contract is in force with no
premium in default past its days of grace; and (3) while the insured spouse is
living. In this case, the insurance on the life of the insured spouse under the
Benefit will become paid-up term insurance for decreasing amounts. We will
compute these amounts from the Table of Amounts of Insurance. While the paid-up
insurance is in effect, the contract will remain in force until the end of the
term period for the Benefit. The paid-up insurance will have cash values but no
loan value.
If this Benefit becomes paid-up, it may be surrendered for its net cash value.
This will be the net value on the date of surrender of the paid-up insurance.
But, within 30 days after a contract anniversary, the net cash value will not be
less than it was on that anniversary. We base this net cash value on the insured
spouse's age and sex. The insured spouse's age at any time will be his or her
age last birthday on the contract date plus the length of time since that date.
We use the Commissioners 1980 Standard Ordinary Mortality Table. We use
continuous functions based on age last birthday. We use an effective interest
rate of 4% a year.
We will usually pay any cash value promptly. But we have the right to postpone
paying it for up to six months. If we do so for more than 30 days, we will pay
interest at the rate of 3% a year. If we are asked for the values which apply,
we will furnish them.
VL 181 S
(Continued on Next Page)
II-258
<PAGE>
(Continued from Preceding Page)
CONVERSION TO ANOTHER PLAN OF INSURANCE
Right to Convert.--While the Insured is living, you may be able to exchange this
Benefit for a new contract of life insurance on the life of the insured spouse
in either this company or The Prudential Insurance Company of America. In any of
these paragraphs, when we use the phrase the company we mean whichever of these
companies may issue the new contract. And where we use the phrase new contract
we mean the contract for which the Benefit may be exchanged. You will not have
to prove that the insured spouse is insurable.
Conditions.--Your right to make this exchange is subject to all these
conditions: (1) The amount we would have paid under this Benefit if the insured
spouse had died just before the contract date of the new contract must be large
enough to meet the minimum for a new contract, as we describe under Contract
Specifications. (2) You must ask for the exchange in writing and in a form that
meets our needs. (3) You must send this contract to us to be endorsed. (4) We
must have your request and the contract at our Service Office while the Benefit
is in force and at least five years before the end of its term period.
The new contract will not take effect unless the premium for it is paid while
the insured spouse is living and within 31 days after its contract date. If the
premium is paid as we state, it will be deemed that: (1) the insurance under the
new contract took effect on its contract date; and (2) this Benefit ended just
before that contract date. We will return that part, if any, of the last premium
paid for the Benefit that is more than as needed to pay premiums to that
contract date.
Contract Date.--The date of the new contract will be the date you ask for in
your request. But it may not be after the date to which premiums are paid for
this Benefit. It may not be less than five years before the end of the term
period for the Benefit. And it may not be more than 31 days before we have your
request at our Service Office.
Contract Specifications.--The new contract will be in the standard rating class.
The company will set the issue age and the premiums for the new contract in
accord with regular rules in use on the date of the new contract.
The new contract may call for annual premiums. If the company agrees, you will
be able to have premiums fall due more often.
The contract may be either one of the following:
1. A Life Paid Up at Age 85 plan. In this case the new contract will be issued
by The Prudential Insurance Company of America. Its face amount will be the
amount you ask for in your request. But it cannot be less than $10,000 or more
than 80% of the amount we would have paid under this Benefit if the insured
spouse had died just before the contract date of the new contract. (Since
$10,000 is 80% of $12,500, the amount we would have paid must be at least
$12,500 for this exchange to be possible.)
2. A contract like the one to which this Benefit is attached. Its face amount
will be the amount you ask for in your request. But it cannot be less than
$25,000 or more than 80% of the amount we would have paid under the Benefit if
the insured spouse had died just before the contract date of the new contract.
(Since $25,000 is 80% of $31,250, the amount we would have paid must be at least
$31,250 for this exchange to be possible.)
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VL 181 S
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<PAGE>
(Continued from Preceding Page)
3. An Appreciable Life or Variable Appreciable Life Contract, if Pruco Life
Insurance Company is regularly issuing such contracts at that time. Its face
amount will be the amount you ask for in your request. But it cannot be less
than $50,000 or more than 80% of the amount we would have paid under the Benefit
if the insured spouse had died just before the contract date of the new
contract. (Since $50,000 is 80% of $62,500, the amount we would have paid must
be at least $62,500 for this exchange to be possible.)
The new contract will not have Supplementary Benefits other than as we describe
in this and in the next paragraph. If the company would include in other
contracts like the new contract a benefit for waiving premiums in the event of
disability, here is what the company will do. Even though this contract does not
have that benefit on the life of the insured spouse, the company will put it in
the new contract on his or her life. The benefit, if any, in the new contract
will be the same one, with the same provisions, that the company puts in other
contracts like it on its contract date. In this paragraph, when we use the
phrase other contracts like it, we mean contracts the company would regularly
issue on the same plan and for the same rating class, amount, issue age and sex.
No premium will be waived under the new contract unless the disability started
on or after its contract date. And no premium will be waived under a new
contract unless it has a benefit for waiving premiums in the event of
disability. This will be so even if premiums have been waived under this
contract.
Changes.--You may be able to have this Benefit changed to a new contract of life
insurance other than in accord with the requirements for exchange that we state
above. But any change may be made only if the company consents, and will be
subject to conditions and charges that are then determined.
MISCELLANEOUS PROVISIONS
Ownership and Control.--Unless we endorse this contract to say otherwise, while
the Insured is living the owner alone may exercise all ownership and control of
this contract. This includes, but is not limited to, these rights: (1) to assign
the contract; and (2) to change any subsequent owner. A request for such a
change must be in writing to us at our Service Office and in a form that meets
our needs. The change will take effect only when we endorse the contract to show
it.
Unless we endorse this contract to say otherwise: (1) while any insurance is in
force after the Insured's death, the owner of the contract will be the insured
spouse; and (2) the owner alone will be entitled to (a) any contract benefit and
value, and (b) the exercise of any right and privilege granted by the contract
or by us. But any insurance payable upon the Insured's death will be payable to
the beneficiary for that insurance.
Beneficiary.--The word beneficiary where we use it in this contract without
qualification means the beneficiary for insurance payable upon the death of the
Insured.
Unless we endorse this contract to say otherwise, the beneficiary for insurance
payable upon the death of the insured spouse will be the Insured if living,
otherwise the estate of the insured spouse.
The beneficiary for insurance payable upon the death of the insured spouse may
be changed. The request must be in writing and in a form that meets our needs.
It will take effect only when we file it at our Service Office; this will be
after the contract is sent to us to be endorsed, if we ask for it. Then any
previous beneficiary's interest in such insurance will end as of the date of the
request. It will end then even if the insured spouse is not living when we file
the request. Any beneficiary's interest is subject to the rights of any assignee
of whom we know.
When a beneficiary is designated, any relationship shown is to the Insured,
unless otherwise stated.
Misstatement of Age or Sex.--If the insured spouse's stated age or sex or both
are not correct, we will change each benefit and any amount payable to what the
premium would have bought for the correct age and sex.
The Schedule of Premiums may show that premiums change or stop on a certain
date. We may have used that date because the insured spouse would attain a
certain age on that date. If we find that the issue age for the insured spouse
was wrong, we will correct that date.
Suicide Exclusion.--If the insured spouse, whether sane or insane, dies by
suicide within the period which we state in the Suicide Exclusion under General
Provisions, we will not pay the amount we describe under Benefit above. Instead,
we will pay no more than the sum of the premiums paid for this Benefit. We will
make that payment in one sum.
VL 181 S
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II-260
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(Continued from Preceding Page)
Reinstatement.--If this contract is reinstated, it will not include the
insurance that we provide under this Benefit on the life of the insured spouse
unless we are given any facts we need to satisfy us that the insured spouse is
insurable for the Benefit.
Contract Value Options.--If this contract has a Contract Value Options
provision, it will apply only during the Insured's lifetime. Any extended or
reduced paid-up insurance that may be described there is on the life of the
Insured only.
Contract Loans.--If this contract has a Loans provision, we will not consider
any contract debt when we determine the amount payable, if any, at the death of
the insured spouse.
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the earliest of (1) the death of the Insured, (2) the
death of the insured spouse, and (3) the contract anniversary at the end of the
term period for the Benefit.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the last day before the contract date of any other contract (a)
for which the Benefit is exchanged, or (b) to which the Benefit is changed;
3. the date the contract is surrendered under its Cash Value Option, if it has
one, or the paid-up insurance, if any, under the Benefit is surrendered; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
This Supplementary Benefit rider attached to this contract on the Contract Date
Pruco Life Insurance Company,
By /s ISABELLE L. KIRCHER
- ------------------------------
Secretary
VL 181 S
II-261
EXHIBIT 1.A.(13)(eee)
- --------------------------------------------------------------------------------
RIDER FOR
TERM INSURANCE BENEFIT ON LIFE OF INSURED SPOUSE
DECREASING AMOUNT AFTER THREE YEARS
Read the list of Supplementary Benefits on the Contract Data page(s).
This Benefit is a part of this contract only if it is listed there.
Benefit.--We will pay an amount under this Benefit if we receive due proof that
the insured spouse died (1) in the term period for the Benefit; and (2) while
this contract is in force with no premium in default past its days of grace. We
will pay this amount to the beneficiary for insurance payable upon the insured
spouse's death. But our payment is subject to all the provisions of the Benefit
and of the rest of this contract. The phrase insured spouse means the Insured's
spouse named in the application for this contract.
We will use the table below to compute the amount we will pay. We show the
Initial Amount of Term Insurance under this Benefit on the Contract Data
page(s). We also show the term period for the Benefit there. It starts on the
contract date, which we show on the first page. The anniversary at the end of
the term period is part of that period.
TABLE OF AMOUNTS OF INSURANCE
Amounts Payable.--We show here the amount we will pay, based on the insured
spouse's issue age, for each $1,000 of Initial Amount of Term Insurance if death
occurs in the contract year ending with the anniversary shown.
<TABLE>
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------------
ISSUE AGE
- ------------------------------------------------------------------------------------------------------------------------
ANNIVER-
SARY 18 19 20 21 22 23 24 25 26 27 28 29 30 31
- ------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000
2 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
3 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
4 978 977 977 976 976 975 974 974 973 972 971 971 970 969
5 956 955 953 952 951 950 949 947 946 944 943 941 939 938
6 933 932 930 929 927 925 923 921 919 917 914 912 909 906
7 911 909 907 905 902 900 897 895 892 889 886 882 879 875
8 889 886 884 881 878 875 872 868 865 861 857 853 849 844
9 867 864 860 857 854 850 846 842 838 833 829 824 818 813
10 844 841 837 833 829 825 821 816 811 806 800 794 788 781
11 822 818 814 810 805 800 795 789 784 778 771 765 758 750
12 800 795 791 786 780 775 769 763 757 750 743 735 727 719
13 778 773 767 762 756 750 744 737 730 722 714 706 697 688
14 756 750 744 738 732 725 718 710 703 694 686 676 667 656
15 733 727 721 714 707 700 692 684 676 667 657 647 636 625
16 711 705 698 690 683 675 667 658 649 639 629 618 606 594
17 689 682 674 667 659 650 641 632 622 611 600 588 576 563
18 667 659 651 643 634 625 615 605 595 583 571 559 546 531
19 644 636 628 619 610 600 590 579 568 556 543 529 515 500
20 622 614 605 595 585 575 564 553 540 528 514 500 485 469
21 600 591 581 571 561 550 538 526 513 500 486 471 455 438
22 578 568 558 548 537 525 513 500 486 472 457 441 424 406
23 556 545 535 524 512 500 487 474 459 444 429 412 394 375
24 533 523 512 500 488 475 462 447 432 417 400 382 364 344
25 511 500 488 476 463 450 436 421 405 389 371 353 333 313
26 489 477 465 452 439 425 410 395 378 361 343 324 303 281
27 467 454 442 429 415 400 385 368 351 333 314 294 273 250
28 445 432 419 405 390 375 359 342 324 306 286 265 243 219
29 422 409 395 381 366 350 333 316 297 278 257 235 212 200
30 400 386 372 357 341 325 308 289 270 250 229 206 200 200
- ------------------------------------------------------------------------------------------------------------------------
</TABLE>
(Table Continued on Next Page)
VL 181 W
II-262
<PAGE>
(Table Continued from Preceding Page)
<TABLE>
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------------
ISSUE AGE
- ------------------------------------------------------------------------------------------------------------------------
ANNIVER-
SARY 18 19 20 21 22 23 24 25 26 27 28 29 30 31
- ------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
31 $378 $364 $349 $333 $317 $300 $282 $263 $243 $222 $200 $200 $200 $200
32 356 341 325 310 293 275 256 237 216 200 200 200 200 200
33 333 318 302 286 268 250 231 210 200 200 200 200 200 200
34 311 295 279 262 244 225 205 200 200 200 200 200 200 200
35 289 273 256 238 220 200 200 200 200 200 200 200 200 *
36 267 250 232 214 200 200 200 200 200 200 200 200 *
37 245 227 209 200 200 200 200 200 200 200 200 *
38 222 204 200 200 200 200 200 200 200 200 *
39 200 200 200 200 200 200 200 200 200 *
40 200 200 200 200 200 200 200 200 *
41 200 200 200 200 200 200 200 *
42 200 200 200 200 200 200 *
43 200 200 200 200 200 *
44 200 200 200 200 *
45 200 200 200 *
46 200 200 *
47 200 *
48 *
*NO AMOUNT PAYABLE IF DEATH OCCURS IN THIS CONTRACT YEAR OR ANY LATER CONTRACT YEAR.
- ------------------------------------------------------------------------------------------------------------------------
<CAPTION>
- ------------------------------------------------------------------------------------------------------------------------
ISSUE AGE
- ------------------------------------------------------------------------------------------------------------------------
ANNIVER-
SARY 32 33 34 35 36 37 38 39 40 41 42 43 44 45
- ------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000
2 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
3 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
4 968 967 966 964 963 962 960 958 957 955 952 950 947 944
5 935 933 931 929 926 923 920 917 913 909 905 900 895 889
6 903 900 897 893 889 885 880 875 870 864 857 850 842 833
7 871 867 862 857 852 846 840 833 826 818 810 800 789 778
8 839 833 828 821 815 808 800 792 783 773 762 750 737 722
9 806 800 793 786 778 769 760 750 739 727 714 700 684 667
10 774 767 759 750 741 731 720 708 696 682 667 650 632 611
11 742 733 724 714 704 692 680 667 652 636 619 600 579 556
12 710 700 690 679 667 654 640 625 609 591 571 550 526 500
13 677 667 655 643 630 615 600 583 565 546 524 500 474 444
14 645 633 621 607 593 577 560 542 522 500 476 450 421 389
15 613 600 586 571 556 538 520 500 478 455 429 400 368 333
16 581 567 552 536 518 500 480 458 435 409 381 350 316 278
17 548 533 517 500 481 462 440 417 391 364 333 300 263 222
18 516 500 483 464 444 423 400 375 348 318 286 250 211 200
19 484 467 448 429 407 385 360 333 304 273 238 200 200 200
20 452 433 414 393 370 346 320 292 261 227 200 200 200 200
21 419 400 379 357 333 308 280 250 217 200 200 200 200 *
22 387 367 345 322 296 269 240 208 200 200 200 200 *
23 355 333 310 286 259 231 200 200 200 200 200 *
24 323 300 276 250 222 200 200 200 200 200 *
25 290 267 241 214 200 200 200 200 200 *
26 258 233 207 200 200 200 200 200 *
27 226 200 200 200 200 200 200 *
28 200 200 200 200 200 200 *
29 200 200 200 200 200 *
30 200 200 200 200 *
31 200 200 200 *
32 200 200 *
33 200 *
34 *
*NO AMOUNT PAYABLE IF DEATH OCCURS IN THIS CONTRACT YEAR OR ANY LATER CONTRACT YEAR.
- -----------------------------------------------------------------------------------------------------------------------
</TABLE>
(Table Continued on Next Page)
VL 181 W
II-263
<PAGE>
(Table Continued from Preceding Page)
<TABLE>
<CAPTION>
- ---------------------------------------------------------------------------------------
ISSUE AGE
- ---------------------------------------------------------------------------------------
ANNIVER-
SARY 46 47 48 49 50 51 52 53 54 55
- ---------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
1 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000 $1000
2 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
3 1000 1000 1000 1000 1000 1000 1000 1000 1000 1000
4 941 938 933 929 923 917 909 900 889 875
5 882 875 867 857 846 833 818 800 778 750
6 824 813 800 786 769 750 727 700 667 625
7 765 750 733 714 692 667 636 600 556 500
8 706 688 667 643 615 583 545 500 444 375
9 647 625 600 571 538 500 455 400 333 250
10 588 563 533 500 462 417 364 300 222 200
11 529 500 467 429 385 333 273 200 200 *
12 471 438 400 357 308 250 200 200 *
13 412 375 333 286 231 200 200 *
14 353 313 267 214 200 200 *
15 294 250 200 200 200 *
16 235 200 200 200 *
17 200 200 200 *
18 200 200 *
19 200 *
20 *
*NO AMOUNT PAYABLE IF DEATH OCCURS
IN THIS CONTRACT YEAR OR ANY LATER CONTRACT YEAR.
- ---------------------------------------------------------------------------------------
</TABLE>
PAID-UP INSURANCE
Paid-up Insurance on Life of Insured Spouse.--The Insured might die: (1) in the
term period for this Benefit; (2) while this contract is in force with no
premium in default past its days of grace; and (3) while the insured spouse is
living. In this case, the insurance on the life of the insured spouse under the
Benefit will become paid-up term insurance for decreasing amounts. We will
compute these amounts from the Table of Amounts of Insurance. While the paid-up
insurance is in effect, the contract will remain in force until the end of the
term period for the Benefit. The paid-up insurance will have cash values but no
loan value.
If this Benefit becomes paid-up, it may be surrendered for its net cash value.
This will be the net value on the date of surrender of the paid-up insurance.
But, within 30 days after a contract anniversary, the net cash value will not be
less than it was on that anniversary. We base this net cash value on the insured
spouse's age and sex. The insured spouse's age at any time will be his or her
age last birthday on the contract date plus the length of time since that date.
We use the Commissioners 1980 Standard Ordinary Mortality Table. We use
continuous functions based on age last birthday. We use an effective interest
rate of 4% a year
We will usually pay any cash value promptly. But we have the right to postpone
paying it for up to 30 days. If we are asked for the values which apply, we will
furnish them.
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II-264
<PAGE>
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CONVERSION TO ANOTHER PLAN OF INSURANCE
Right to Convert.--While the Insured is living, you may be able to exchange this
Benefit for a new contract of life insurance on the life of the insured spouse
in either this company or The Prudential Insurance Company of America. In any of
these paragraphs, when we use the phrase the company we mean whichever of these
companies may issue the new contract. And where we use the phrase new contract
we mean the contract for which the Benefit may be exchanged. You will not have
to prove that the insured spouse is insurable.
Conditions.--Your right to make this exchange is subject to all these
conditions: (1) The amount we would have paid under this Benefit if the insured
spouse had died just before the contract date of the new contract must be large
enough to meet the minimum for a new contract, as we describe under Contract
Specifications. (2) You must ask for the exchange in writing and in a form that
meets our needs. (3) You must send this contract to us to be endorsed. (4) We
must have your request and the contract at our Service Office while the Benefit
is in force and at least five years before the end of its term period.
The new contract will not take effect unless the premium for it is paid while
the insured spouse is living and within 31 days after its contract date. If the
premium is paid as we state, it will be deemed that: (1) the insurance under the
new contract took effect on its contract date; and (2) this Benefit ended just
before that contract date. We will return that part, if any, of the last premium
paid for the Benefit that is more than as needed to pay premiums to that
contract date.
Contract Date.--The date of the new contract will be the date you ask for in
your request. But it may not be after the date to which premiums are paid for
this Benefit. It may not be less than five years before the end of the term
period for the Benefit. And it may not be more than 31 days before we have your
request at our Service Office.
Contract Specifications.--The new contract will be in the standard rating class.
The company will set the issue age and the premiums for the new contract in
accord with regular rules in use on the date of the new contract.
We will endorse the new contract to show that the period we state in its
incontestability provision will start on the issue date of this contract. But if
this contract was reinstated before the date of the new contract, that period
will start on the date of the reinstatement. We will have the right to use the
statements that were made to us as the basis for reinstatement to contest the
new contract. The period during which we will have that right will be the period
we state in the incontestability provision of the new contract.
We will endorse the new contract to show that the period we state in its Suicide
Exclusion provision will start on the issue date of this contract.
The new contract may call for annual premiums. If the company agrees, you will
be able to have premiums fall due more often.
The contract may be either one of the following:
1. A Life Paid Up at Age 85 plan. In this case the new contract will be issued
by The Prudential Insurance Company of America. Its face amount will be the
amount you ask for in your request. But it cannot be less than
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VL 181 W
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<PAGE>
(Continued from Preceding Page)
$10,000 or more than 80% of the amount we would have paid under this Benefit if
the insured spouse had died just before the contract date of the new contract.
(Since $10,000 is 80% of $12,500, the amount we would have paid must be at least
$12,500 for this exchange to be possible.)
2. A contract like the one to which this Benefit is attached. Its face amount
will be the amount you ask for in your request. But is cannot be less than
$25,000 or more than 80% of the amount we would have paid under the Benefit if
the insured spouse had died just before the contract date of the new contract.
(Since $25,000 is 80% of $31,250, the amount we would have paid must be at least
$31,250 for this exchange to be possible.)
3. An Appreciable Life or Variable Appreciable Life Contract, if Pruco Life
Insurance Company is regularly issuing such contracts at that time. Its face
amount will be the amount you ask for in your request. But it cannot be less
than $50,000 or more than 80% of the amount we would have paid under the Benefit
if the insured spouse had died just before the contract date of the new
contract. (Since $50,000 is 80% of $62,500, the amount we would have paid must
be at least $62,500 for this exchange to be possible.)
The new contract will not have Supplementary Benefits other than as we describe
in this and in the next paragraph. If the company would include in other
contracts like the new contract a benefit for waiving premiums in the event of
disability, here is what the company will do. Even though this contract does not
have that benefit on the life of the insured spouse, the company will put it in
the new contract on his or her life. The benefit, if any, in the new contract
will be the same one, with the same provisions, that the company puts in other
contracts like it on its contract date. In this paragraph, when we use the
phrase other contracts like it, we mean contracts the company would regularly
issue on the same plan and for the same rating class, amount, issue age and sex.
No premium will be waived under the new contract unless the disability started
on or after its contract date. And no premium will be waived under a new
contract unless it has a benefit for waiving premiums in the event of
disability. This will be so even if premiums have been waived under this
contract.
Changes.--You may be able to have this Benefit changed to a new contract of life
insurance other than in accord with the requirements for exchange that we state
above. But any change may be made only if the company consents, and will be
subject to conditions and charges that are then determined.
MISCELLANEOUS PROVISIONS
Ownership and Control.--Unless we endorse this contract to say otherwise, while
the Insured is living the owner alone may exercise all ownership and control of
this contract. This includes, but is not limited to, these rights: (1) to assign
the contract; and (2) to change any subsequent owner. A request for such a
change must be in writing to us at our Service Office and in a form that meets
our needs. The change will take effect only when we endorse the contract to show
it.
Unless we endorse this contract to say otherwise: (1) while any insurance is in
force after the Insured's death, the owner of the contract will be the insured
spouse; and (2) the owner alone will be entitled to (a) any contract benefit and
value, and (b) the exercise of any right and privilege granted by the contract
or by us. But any insurance payable upon the Insured's death will be payable to
the beneficiary for that insurance.
Beneficiary.--The word beneficiary where we use it in this contract without
qualification means the beneficiary for insurance payable upon the death of the
Insured.
Unless we endorse this contract to say otherwise, the beneficiary for insurance
payable upon the death of the insured spouse will be the Insured if living,
otherwise the estate of the insured spouse.
The beneficiary for insurance payable upon the death of the insured spouse may
be changed. The request must be in writing and in a form that meets our needs.
It will take effect only when we file it at our Service Office; this will be
after the contract is sent to us to be endorsed, if we ask for it. Then any
previous beneficiary's interest in such insurance will end as of the date of the
request. It will end then even if the insured spouse is not living when we file
the request. Any beneficiary's interest is subject to the rights of any assignee
of whom we know.
When a beneficiary is designated, any relationship shown is to the Insured,
unless otherwise stated.
Misstatement of Age or Sex.--If the insured spouse's stated age or sex or both
are not correct, we will change each benefit and any amount payable to what the
premium would have bought for the correct age and sex.
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II-266
<PAGE>
(Continued from Preceding Page)
The Schedule of Premiums may show that premiums change or stop on a certain
date. We may have used that date because the insured spouse would attain a
certain age on that date. If we find that the issue age for the insured spouse
was wrong, we will correct that date.
Suicide Exclusion.--If the insured spouse, whether sane or insane, dies by
suicide within the period which we state in the Suicide Exclusion under General
Provisions, we will not pay the amount we describe under Benefit above. Instead,
we will pay no more than the sum of the premiums paid for this Benefit. We will
make that payment in one sum.
Reinstatement.--If this contract is reinstated, it will not include the
insurance that we provide under this Benefit on the life of the insured spouse
unless we are given any facts we need to satisfy us that the insured spouse is
insurable for the Benefit.
Contract Value Options.--If this contract has a Contract Value Options
provision, it will apply only during the Insured's lifetime. Any extended or
reduced paid-up insurance that may be described there is on the life of the
Insured only.
Contract Loans.--If this contract has a Loans provision, we will not consider
any contract debt when we determine the amount payable, if any, at the death of
the insured spouse.
Incontestability.--Except for non-payment of premium, we will not contest this
Benefit after it has been in force during the insured spouse's lifetime for two
years from the issue date.
Benefit Premiums.--We show the premiums for this Benefit on the Contract Data
page(s). They stop on the earliest of (1) the death of the Insured, (2) the
death of the insured spouse, and (3) the contract anniversary at the end of the
term period for the Benefit.
Termination.--This Benefit will end on the earliest of:
1. the end of the last day of grace of a premium in default; it will not
continue if a benefit takes effect under any contract value options provision
that may be in the contract;
2. the end of the last day before the contract date of any other contract (a)
for which the Benefit is exchanged, or (b) to which the Benefit is changed;
3. the date the contract is surrendered under its Cash Value Option, if it has
one, or the paid-up insurance, if any, under the Benefit is surrendered; and
4. the date the contract ends for any other reason.
Further, if you ask us in writing in the premium period, we will cancel the
Benefit as of the date to which premiums are paid. Contract premiums due then
and later will be reduced accordingly.
This Supplementary Benefit rider attached to this contract on the Contract Date
Pruco Life Insurance Company,
By /s/ ISABELLE L. KIRCHNER
Secretary
VL 181 W
II-267
EXHIBIT 1A(13)(fff)
Pruco Life Insurance Company
| Insured | Rider for Policy No.
| |
|_______________________________________ |___________________________________
ALTERATION OF TEXT
The provisions of this policy entitled "Loan Value", "Interest Charge" and
"Effect of a Loan" are replaced by the following:
LOAN VALUE.--During the first contract year the loan value is zero. After the
first contract year, it is 90% of the sum of the net cash value and any existing
contract debt.
If the difference between the loan value and any existing contract debt is $500
or more, you may borrow any amount from $500 up to that difference. If the
difference is less than $500, you may not borrow any amount unless it is to pay
premiums on this contract.
Example 1: Suppose the net cash value is $8,000. You borrowed $1,500 a few
months ago. Suppose also that now there is interest of $40 charged but not yet
due. The contract debt is now $1,540, which is made up of the $1,500 loan and
the $40 interest.
Example 2: Suppose, in example 1, you want to borrow all that you can. The loan
value is $8,586; to compute it we add the net cash value ($8,000) to the
contract debt ($1,540) and take 90% of the sum. We will lend you $7,046 which is
the difference between the $8,586 loan value and the $1,540 contract debt. This
will increase the contract debt to $8,586. We will add the new amount borrowed
to the existing loan and will charge interest on it, too.
There are three exceptions to the above definition of loan value. The first is
that in the days of grace of a premium in default, the loan value is what it was
on the due date of that premium, plus 90% of the excess investment return since
that date. The second is that if the contract is in force as reduced paid-up
insurance we use anniversaries and not premium due dates to find the loan value
since there are no more of those due dates. The third is that if the contract is
in force as reduced paid-up insurance, the loan value is the amount that would
grow with interest to equal the net single premium on the next anniversary.
INTEREST CHARGE.--We will charge interest daily on any loan. Interest is due on
each contract anniversary, or when the loan is paid back if that comes first. If
interest is not paid when due, it will become part of the loan. Then we will
start to charge interest on it, too.
The loan interest rate is the annual rate we set from time to time. The rate
will never be greater than is permitted by law, 18%. It will change only on a
contract anniversary.
Before the start of each contract year, we will determine the loan interest rate
we can charge for that contract year.
To do this, we will first find the rate that is the greater of (1) The Published
Monthly Average (which we describe below) for the calendar month ending two
months before the calendar month of the contract anniversary; and (2) the
assumed rate of return for this contract, plus 1%.
If that greater rate is at least 1/2% more than the loan interest rate we had
set for the current contract year, we have the right to increase the loan
interest rate by at least 1/2%, up to the lesser of 18% and that greater rate.
If it is at least 1/2% less, we will decrease the loan interest rate to be no
more than the greater rate. We will not change the loan interest rate by less
than 1/2%.
When you make a loan we will tell you the initial interest rate for the loan. We
will send you a notice if there is to be an increase in the rate.
The Published Monthly Average means:
1. Moody's Corporate Bond Yield Average--Monthly Average Corporates, as
published by Moody's Investors Service, Inc. or any successor to that service;
or
2. If that average is no longer published, a substantially similar average,
established by the insurance regulator where this contract is delivered.
Example 3: Suppose the contract date is in 1987. Six months before the
anniversary in 1996 you borrow $1,000 out of a $4,000 loan value. Assume we
charge 8% a year. Three months later, but still three months before the
anniversary, we will have charged about $20 interest. This amount will be a few
cents more or less than $20 since some months have more days than others. The
interest will not be due until the anniversary unless the loan is paid back
sooner. The loan will still be $1,000. The contract debt will be $1,020, since
contract debt includes interest charged but not yet due. On the anniversary in
1996 we will have charged about $40 interest. The interest will then be due.
(Continued on Next Page)
- -----------
PLI 158--85
- -----------
II-268
<PAGE>
ALTERATION OF TEXT (Continued)
Example 4: Suppose the $40 interest in example 3 is paid on the anniversary. The
loan and contract debt will each become $1,000 right after the payment.
Example 5: Suppose the $40 interest in example 3 is not paid on the anniversary.
The interest will become part of the loan, and we will begin to charge interest
on it, too. The loan and contract debt will each become $1,040.
Effect of a Loan.--When you take a loan, we will reduce the investment base by
the amount you borrow. We will also reduce the investment base by interest that
becomes part of the loan because it is not paid when due. When you repay part or
all of a loan we will increase the investment base by the amount you repay. We
will not increase the investment base by interest that is paid before we make it
part of the loan. We will allocate loans and repayments among the subaccounts in
proportion to the investment base in each subaccount as of the date of the loan
or repayment. Only the amount of the investment base will reflect the investment
results of the subaccounts. The amount of the loan will be credited with a rate
which is 1% less than the loan interest rate for the contract year. Since the
amount you borrow is removed from the investment base, a loan will have a
permanent effect on the death benefit and net cash value of this contract. The
longer the loan is outstanding, the greater this effect is likely to be.
Example 6: Suppose the contract's investment base is $15,000 and that $10,000 is
in subaccount A and $5,000 is in subaccount B. If you make a $9,000 loan we will
reduce the amount in subaccount A by $6,000 and the amount in subaccount B by
$3,000.
Suppose that sometime later, when the investment base in each of the two
subaccounts is the same, you choose to repay the $9,000 loan. We will add $4,500
to the amount in each subaccount.
This endorsement is in effect because we were asked to make it so. You have the
right to decide whether or not you want it to be in effect at any time. If you
change your mind, you must ask us in writing; your new request will take effect
as soon as we have it at our Service Office.
|Rider attached to and made a part of this Contract
|
|
|Signed for the Company,
|
|
|By /s/ ISABELLE L. KIRCHNER
| Secretary
|
|Date Attest
|____________________________________________________
- -----------
PLI 158--85 Printed in U.S.A.
- -----------
II-269
EXHIBIT 1A(13)(ggg)
Pruco Life Insurance Company
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
ALTERATION OF TEXT
The provisions of this policy entitled "Loan Value", "Interest Charge" and
"Effect of a Loan" are replaced by the following:
LOAN VALUE.--During the first contract year the loan value is zero. After the
first contract year, it is 90% of the sum of the net cash value and any existing
contract debt.
If the difference between the loan value and any existing contract debt is $500
or more, you may borrow any amount from $500 up to that difference. If the
difference is less than $500, you may not borrow any amount unless it is to pay
premiums on this contract.
Example 1: Suppose the net cash value is $8,000. You borrowed $1,500 a few
months ago. Suppose also that now there is interest of $40 charged but not yet
due. The contract debt is now $1,540, which is made up of the $1,500 loan and
the $40 interest.
Example 2: Suppose, in example 1, you want to borrow all that you can. The loan
value is $8,586; to compute it we add the net cash value ($8,000) to the
contract debt ($1,540) and take 90% of the sum. We will lend you $7,046 which is
the difference between the $8,586 loan value and the $1,540 contract debt. This
will increase the contract debt to $8,586. We will add the new amount borrowed
to the existing loan and will charge interest on it, too.
There are three exceptions to the above definition of loan value. The first is
that in the days of grace of a premium in default, the loan value is what it was
on the due date of that premium, plus 90% of the excess investment return since
that date. The second is that if the contract is in force as reduced paid-up
insurance we use anniversaries and not premium due dates to find the loan value
since there are no more of those due dates. The third is that if the contract is
in force as reduced paid-up insurance, the loan value is the amount that would
grow with interest to equal the net single premium on the next anniversary.
INTEREST CHARGE.--We will charge interest daily on any loan. Interest is due on
each contract anniversary, or when the loan is paid back if that comes first. If
interest is not paid when due, it will become part of the loan. Then we will
start to charge interest on it, too.
The loan interest rate is the annual rate we set from time to time. The rate
will never be greater than is permitted by law. It will change only on a
contract anniversary.
On each January 1st and on each July 1st, we will determine the loan interest
rate we can charge for each contract year that starts on or after that January
1st or that July 1st, respectively.
To do this, we will first find the rate that is the greater of (1) The Published
Monthly Average (which we describe below) for the calendar month ending two
months before the date as of which we are making the determination; and (2) the
assumed rate of return for this contract, plus 1%.
If that greater rate is at least 1/2% more than the loan interest rate we had
set for the prior contract year, we have the right to increase the loan interest
rate by at least 1/2%, up to that greater rate. If it is at least 1/2% less, we
will decrease the loan interest rate to be no more than the greater rate. We
will not change the loan interest rate by less than 1/2%.
When you make a loan, we will tell you the initial interest rate for the loan.
We will send you a notice at least 30 days in advance if there is to be a change
in the rate.
The Published Monthly Average means:
1. Moody's Corporate Bond Yield Average--Monthly Average Corporates, as
published by Moody's Investors Service, Inc. or any successor to that service;
or
2. If that average is no longer published, a substantially similar average,
established by the insurance regulator where this contract is delivered.
Example 3: Suppose the contract date is in 1987. Six months before the
anniversarv in 1996 you borrow $1,000 out of a $4,000 loan value. Assume we
charge 8% a year. Three months later, but still three months before the
anniversary, we will have charged about $20 interest. This amount will be a few
cents more or less than $20 since some months have more days than others. The
interest will not be due until the anniversary unless the loan is paid back
sooner. The loan will still be $1,000. The contract debt will be $1,020, since
contract debt includes interest charged but not yet due. On the anniversary in
1996 we will have charged about $40 interest. The interest will then be due.
(Continued on Next Page)
- -----------
PLI 185--85
- -----------
II-270
<PAGE>
ALTERATION OF TEXT (Continued)
Example 4: Suppose the $40 interest in example 1 is paid on the anniversary. The
loan and contract debt will each become $1,000 right after the payment.
Example 5: Suppose the $40 interest in example 1 is not paid on the anniversary.
The interest will become part of the loan, and we will begin to charge interest
on it, too. The loan and contract debt will each become $1,040.
EFFECT OF A LOAN.--When you take a loan, we will reduce the investment base by
the amount you borrow. We will also reduce the investment base by interest that
becomes part of the loan because it is not paid when due. When you repay part or
all of a loan we will increase the investment base by the amount you repay. We
will not increase the investment base by interest that is paid before we make it
part of the loan. We will allocate loans and repayments among the subaccounts in
proportion to the investment base in each subaccount as of the date of the loan
or repayment. Only the amount of the investment base will reflect the investment
results of the subaccounts. The amount of the loan will be credited with a rate
which is 1% less than the loan interest rate for the contract year. Since the
amount you borrow is removed from the investment base, a loan will have a
permanent effect on the death benefit and net cash value of this contract. The
longer the loan is outstanding, the greater this effect is likely to be.
Example 6: Suppose the contract's investment base is $15,000 and that $10,000 is
in subaccount A and $5,000 is in subaccount B. If you make a $9,000 loan we will
reduce the amount in subaccount A by $6,000 and the amount in subaccount B by
$3,000.
Suppose that sometime later, when the investment base in each of the two
subaccounts is the same, you choose to repay the $9,000 loan. We will add $4,500
to the amount in each subaccount.
This endorsement is in effect because we were asked to make it so. You have the
right to decide whether or not you want it to be in effect at any time. If you
change your mind, you must ask us in writing; your new request will take effect
as soon as we have it at our Service Office.
|RIDER ATTACHED TO AND MADE A PART OF THIS CONTRACT
|
|
|Signed for the Company,
|
|
| By /s/ ISABELLE L. KIRCHNER
| Secretary
|
|
| Date Attest
|____________________________________________________
- -----------
PLI 185--85
- -----------
II-271
EXHIBIT 1A(13)(hhh)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
|_____________________________________ |___________________________________
ALTERATION OF TEXT
The provisions of this policy entitled "Loan Value", "Interest Charge" and
"Effect of a Loan" are replaced by the following:
Loan Value.--During the first contract year the loan value is zero. After the
first contract year, it is 90% of the sum of the net cash value and any existing
contract debt.
If the difference between the loan value and any existing contract debt is $500
or more, you may borrow any amount from $500 up to that difference. If the
difference is less than $500, you may not borrow any amount unless it is to pay
premiums on this contract.
Example 1: Suppose the net cash value is $8,000. You borrowed $1,500 a few
months ago. Suppose also that now there is interest of $40 charged but not yet
due. The contract debt is now $1,540, which is made up of the $1,500 loan and
the $40 interest.
Example 2: Suppose, in example 1, you want to borrow all that you can. The loan
value is $8,586; to compute it we add the net cash value ($8,000) to the
contract debt ($1,540) and take 90% of the sum. We will lend you $7,046 which is
the difference between the $8,586 loan value and the $1,540 contract debt. This
will increase the contract debt to $8,586. We will add the new amount borrowed
to the existing loan and will charge interest on it, too.
There are three exceptions to the above definition of loan value. The first is
that in the days of grace of a premium in default, the loan value is what it was
on the due date of that premium, plus 90% of the excess investment return since
that date. The second is that if the contract is in force as reduced paid-up
insurance we use anniversaries and not premium due dates to find the loan value
since there are no more of those due dates. The third is that if the contract is
in force as reduced paid-up insurance, the loan value is the amount that would
grow with interest to equal the net single premium on the next anniversary.
Interest Charge.--We will charge interest daily on any loan. Interest is due on
each contract anniversary, or when the loan is paid back if that comes first. If
interest is not paid when due, it will become part of the loan. Then we will
start to charge interest on it, too.
The loan interest rate is the annual rate we set from time to time. The rate
will never be greater than is permitted by law. It will change only on a
contract anniversary.
Before the start of each contract year, we will determine the loan interest rate
we can charge for that contract year.
To do this, we will first find the rate that is the greater of (1) The Published
Monthly Average (which we describe below) for the calendar month ending two
months before the calendar month of the contract anniversary; and (2) the
assumed rate of return for this contract, plus 1%.
If that greater rate is at least 1/2% more than the loan interest rate we had
set for the current contract year, we have the right to increase the loan
interest rate by at least 1/2%, up to that greater rate. If it is at least 1/2%
less, we will decrease the loan interest rate to be no more than the greater
rate. We will not change the loan interest rate by less than 1/2%.
When you make a loan we will tell you the initial interest rate for the loan. We
will send you a notice if there is to be an increase in the rate.
The Published Monthly Average means:
1. Moody's Corporate Bond Yield Average--Monthly Average Corporates, as
published by Moody's Investors Service, Inc. or any successor to that service;
or
2. If that average is no longer published, a substantially similar average,
established by the insurance regulator where this contract is delivered.
Example 3: Suppose the contract date is in 1987. Six months before the
anniversary in 1996 you borrow $1,000 out of a $4,000 loan value. Assume we
charge 8% a year. Three months later, but still three months before the
anniversary, we will have charged about $20 interest. This amount will be a few
cents more or less than $20 since some months have more days than others. The
interest will not be due until the anniversary unless the loan is paid back
sooner. The loan will still be $1,000. The contract debt will be $1,020, since
contract debt includes interest charged but not yet due. On the anniversary in
1996 we will have charged about $40 interest. The interest will then be due.
(Continued on Next Page)
- -----------
PLI 157--85
- -----------
II-272
<PAGE>
ALTERATION OF TEXT (Continued)
Example 4: Suppose the $40 interest in example 3 is paid on the anniversary. The
loan and contract debt will each become $1,000 right after the payment.
Example 5: Suppose the $40 interest in example 3 is not paid on the anniversary.
The interest will become part of the loan, and we will begin to charge interest
on it, too. The loan and contract debt will each become $1,040.
Effect of a Loan.--When you take a loan, we will reduce the investment base by
the amount you borrow. We will also reduce the investment base by interest that
becomes part of the loan because it is not paid when due. When you repay part or
all of a loan we will increase the investment base by the amount you repay. We
will not increase the investment base by interest that is paid before we make it
part of the loan. We will allocate loans and repayments among the subaccounts in
proportion to the investment base in each subaccount as of the date of the loan
or repayment. Only the amount of the investment base will reflect the investment
results of the subaccounts. The amount of the loan will be credited with a rate
which is 1% less than the loan interest rate for the contract year. Since the
amount you borrow is removed from the investment base, a loan will have a
permanent effect on the death benefit and net cash value of this contract. The
longer the loan is outstanding, the greater this effect is likely to be.
Example 6: Suppose the contract's investment base is $15,000 and that $10,000 is
in subaccount A and $5,000 is in subaccount B. If you make a $9,000 loan we will
reduce the amount in subaccount A by $6,000 and the amount in subaccount B by
$3,000.
Suppose that sometime later, when the investment base in each of the two
subaccounts is the same, you choose to repay the $9,000 loan. We will add $4,500
to the amount in each subaccount.
This endorsement is in effect because we were asked to make it so. You have the
right to decide whether or not you want it to be in effect at any time. If you
change your mind, you must ask us in writing; your new request will take effect
as soon as we have it at our Service Office.
|Rider attached to and made a part of this Contract
|
|
|Signed for the Company,
|
|
|By /s/ DOROTHY K. LIGHT
| ------------------------------
| Secretary
|
|
| Date Attest
|___________________________________________________
- -----------
PLI 157--85
- -----------
II-273
EXHIBIT 1A(13)(iii)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| JOHN DOE | XX XXX XXX
|_____________________________________ |___________________________________
ALTERATION OF TEXT
The provision of this policy entitled "CONTRACT VALUE OPTIONS" is replaced by
the following:
Benefit After the Grace Period.--If a premium is in default past its days of
grace and if the net cash value (which we describe under Cash Value Option) is
more than zero, we will use that value to keep the contract in force as one of
three kinds of insurance. One kind is extended insurance; another kind is
reduced paid-up insurance; and the third kind is variable reduced paid-up
insurance. We describe them below. You will find under Automatic Benefit which
kind it will be. Any extra benefit(s) will, of course, end as soon as a premium
is in default past its days of grace unless the form that describes it states
otherwise.
Extended Insurance.--This will be term insurance on the Insured's life. We will
pay the amount of term insurance if the Insured dies in the term we describe
below. Before the end of the term there wili be cash values but no loan value.
The amount of term insurance will be equal to the insurance amount on the due
date of the premium in default, minus any contract debt. The amount of the
insurance will not vary. The term is a period of time that will start on the due
date of the premium in default. The length of the term will be what is provided
when we use the net cash value as a net single premium for extended term
insurance. The length of the term will depend on the net cash value, the amount
of insurance, the Insured's issue age and sex, and on the length of time since
the contract date. (The net single premiums that we refer to here are not those
we show on the Contract Data page(s). The ones we show there are used to compute
the variable insurance amount.)
Example: Suppose the face amount is $50,000. On the day a premium is due, the
variable insurance amount is $5,140. There is contract debt of $1,300. If the
premium due is not paid at the end of its days of grace, the amount of term
insurance will be $53,840. This comes from the insurance amount of $55,140 (the
face amount of $50,000 plus the variable insurance amount $5,140) minus the
$1,300 contract debt. The term insurance will last as long as the net cash value
will provide it.
There may be extra days of term insurance. This will occur if, on the due date
of the premium in default, the term of extended insurance provided by the net
cash value does not exceed 90 days, or the number of days for which premiums
have been paid, if less. The number of extra days will be, (1) 90 or the number
of days for which premiums have been paid, if less, minus (2) the number of days
of extended insurance that would be provided by the net cash value, if there
were no contract debt. The extra days, if any, start on the day after the last
day of term insurance provided by the net cash value, if any. If there is no
such term insurance, they start on the due date of the premium in default. The
term insurance for the extra days has no cash value. There will be no extra days
if you replace the extended insurance with reduced paid-up insurance or variable
reduced paid-up insurance or if you surrender the contract before the extra days
start.
Reduced Paid-up Insurance.--This will be paid-up life insurance on the Insured's
life. We will pay the amount of this insurance when the Insured dies. There will
be cash values and loan values. The amount of this insurance will be what is
provided when we use the net cash value at the net single premium rate. This
rate depends on the Insured's issue age and sex and on the length of time since
the contract date. The amount of this insurance will not vary.
Variable Reduced Paid-up Insurance.--This will be paid-up variable life
insurance on the Insured's life. The death benefit may change from day to day,
as we explain below, but if there is no contract debt, it will not be less than
a minimum guaranteed amount determined as of the day when the contract went into
default. There will be cash values and loan values.
The minimum guaranteed amount of insurance will be computed by using the net
cash value at the net single premium rate. The net single premium rate depends
on the Insured's issue age and sex and on the length of time since the contract
date. The amount payable in event of death thereafter will be the greater of (a)
the minimum guaranteed amount and (b) the investment base divided by the net
single premium at the Insured's attained age. In either case the amount will be
adjusted for any contract debt.
Except when it is provided as the automatic benefit, (see below) the Variable
Reduced Paid-Up Insurance Option will be available only when the guaranteed
death benefit under the option will be $5,000 or more.
(Continued on Next Page)
- -----------
PLI 169--85
- -----------
II-274
<PAGE>
ALTERATION OF TEXT (Continued)
Computations.--We will make all computations for any of these benefits as of the
due date of the premium in default. But we will consider any loan you take out
or pay back in the days of grace of that premium.
Automatic Benefit.--When a premium is in default past its days of grace, the
contract will stay in force as extended insurance. But it will stay in force as
variable reduced paid-up insurance if either of these statements applies: (1) We
issued the contract in a rating class for which we do not provide extended
insurance; in this case the phrase No Extended Insurance is in the Rating Class
on page 3. (2) The amount of variable reduced paid-up insurance would be at
least as great as the amount of extended insurance.
Optional Benefit.--You may choose to replace any extended insurance that has a
cash value by either variable reduced paid-up insurance or reduced paid-up
insurance. To make this choice, you must do so in writing to us and in a form
that meets our needs, not more than three months after the due date of the
premium in default. You must also send the contract to us to be endorsed.
Cash Value Option.--You may surrender this contract for its net cash value, if
this value is more than zero. If this value is less than zero, the proceeds on
surrender will be equal to zero. To do so, you must ask us in writing and in a
form that meets our needs. You must also send the contract to us. Here is how we
will compute the net cash value:
1. On a Monthly Date if no premium is in default: The net cash value on a
Monthly Date will be equal to (a) the tabular cash value on that date; plus (b)
the net single premium at the Insured's then attained age for the variable
insurance amount that applies on that date; minus (c) if that date is a premium
due date, and the premium has not been paid, the net premium that applies on
that date; minus (d) any contract debt; minus (e) in the first contract year,
any issue charge instalments that have not yet been paid. The amount of (b) will
be less than zero if the variable insurance amount is less than zero.
2. On any other date if no premium is in default: The net cash value on a date
other than a Monthly Date will be equal to (a) the tabular cash value on that
date; plus (b) the net single premium at the Insured's then attained age for the
variable insurance amount that applies on that date; plus (c) the excess
investment return since the last Monthly Date; minus (d) any contract debt;
minus (e) in the first contract year, any issue charge instalments that have not
yet been paid. The amount of (b) will be less than zero if the variable
insurance amount is less than zero.
3. During the days of grace of a premium in default: The net cash value on any
date will be the net cash value as of the due date of the first unpaid premium
plus the excess investment return since that due date. But we will adjust this
value for any loan you took out or paid back since that due date.
4. After the days of grace of a premium in default: The net cash value as of any
date will be the net value on that date of whichever of these benefits is then
in force: extended insurance; reduced paid-up insurance; or variable reduced
paid-up insurance, less any contract debt. However, within 30 days after an
anniversary, the net cash value will not be less than it was on that
anniversary. We will, of course, adjust it for any loan you took out or paid
back since that anniversary.
If the due date of a paid premium is on or after the date a contract value
option takes effect, we will pay that premium to you in cash.
If all due premiums have been paid, or during the days of grace of a premium in
default, or if the contract is in force as variable reduced paid-up insurance,
we will usually pay any cash value within 7 days after we receive your request
and the contract at our Service Office. But we have the right to defer payment
if (1) the New York Stock Exchange is closed; or (2) the SEC requires that
trading be restricted or declares an emergency; or (3) the SEC lets us defer
payments to protect our contract owners.
If a premium is in default past its days of grace, we have the right to postpone
paying a cash value for up to six months. If we do so for more than 30 days, we
will pay interest at the rate of 3% a year.
Tabular Values.--ln the table on page 4 we show tabular values at the ends of
contract years. The tabular value at the beginning of the first contract year is
the net premium then due. If we need to compute tabular values at some time
during a contract year, we will count the time since the start of the year and
any premiums paid for the year. We will let you know the tabular values for
other durations if you ask for them.
|RIDER ATTACHED TO AND MADE A PART OF THIS CONTRACT
|
|
|Signed for the Company,
|
|
| By /s/ ISABELLE L. KIRCHNER
| -----------------------------
| Secretary
|
|
| Date July 25, 1985 Attest M. Smith
|____________________________________________________
- -----------
PLI 169--85
- -----------
II-275
EXHIBIT 1A(13)(jjj)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| JOHN DOE | XX XXX XXX
|_____________________________________ |___________________________________
VARIABLE REDUCED PAID-UP INSURANCE
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.
The new amount of insurance and its effective date are shown in the attached
Table of Values. Unless otherwise stated in the Table, any contract debt was
deducted when we computed the net cash value that was used to provide the
variable reduced paid-up insurance.
The cash value of the variable reduced paid-up insurance will continue to vary
according to the investment results in the separate account. There is no
guaranteed minimum cash value under this option.
The death benefit under this option may change from day to day, but it will
never be less than the amount determined as of the day of default. The death
benefit will increase if investment results are in excess of the assumed rate or
mortality charges lower than the maximum rate. The death benefit will decrease
if investment results are less than the assumed rate, but it will not decrease
below the amount determined on the day of default.
As of the effective date shown in the Table each of these items no longer
applies: (1) the Tabular Cash Values shown on page 4 in the contract; (2) any
Supplementary Benefits or other extra benefits that were made a part of the
contract by rider or endorsement; and (3) any provisions of the contract that do
not apply to the variable reduced paid-up insurance.
If this contract is reinstated, the net cash value that applies upon
reinstatement is as we state under Premium Payment and Reinstatement.
The attached Table shows values at the ends of contract years. If we need to
compute values at some time during a contract year, we will count the time since
the start of the year. We will let you know the values for other durations if
you ask for them.
|RIDER ATTACHED TO AND MADE A PART OF THIS CONTRACT
|
|
|Pruco Life Insurance Company,
|
|
| By /s/ ISABELLE L. KIRCHNER
| -----------------------------
| Secretary
|
|
| Date July 25, 1988 Attest M. Smith
|____________________________________________________
- -----------
PLI 164--85
- -----------
II-276
Exhibit 3
April 25, 1997
Pruco Life Insurance Company
213 Washington Street
Newark, New Jersey 07102-2992
Gentlemen:
In my capacity as Chief Counsel of Pruco Life Insurance Company ("Pruco Life"),
I have reviewed the establishment of Pruco Life Variable Insurance Account (the
"Account") on November 10, 1982 by the Executive Committee of the Board of
Directors of Pruco Life as a separate account for assets applicable to certain
variable life insurance contracts, pursuant to the provisions of Section 20-651
of the Arizona Insurance Code. I was responsible for oversight of the
preparation and review of the Registration Statement on Form S-6, as amended,
filed by Pruco Life with the Securities and Exchange Commission (Registration
No. 2-80513) under the Securities Act of 1933 for the registration of certain
variable life insurance contracts issued with respect to the Account.
I am of the following opinion:
(1) Pruco Life was duly organized under the laws of Arizona and is a
validly existing corporation.
(2) The Account has been duly created and is validly existing as a
separate account pursuant to the aforesaid provisions of Arizona law.
(3) The portion of the assets held in the Account equal to the reserve and
other liabilities for variable benefits under the variable life
insurance contracts is not chargeable with liabilities arising out of
any other business Pruco Life may conduct.
(4) The variable life insurance contracts are legal and binding
obligations of Pruco Life in accordance with their terms.
In arriving at the foregoing opinion, I have made such examination of law and
examined such records and other documents as I judged to be necessary or
appropriate.
I hereby consent to the filing of this opinion as an exhibit to the Registration
Statement.
Very truly yours,
/s/
- ---------------------------
Clifford E. Kirsch
II-277
Exhibit 6
April 25, 1997
Pruco Life Insurance Company
213 Washington Street
Newark, New Jersey 07102-2992
To Pruco Life Insurance Company of New Jersey:
This opinion is furnished in connection with the registration by Pruco Life
Insurance Company of variable life insurance contracts
("Contracts") under the Securities Act of 1933. The prospectus included in
Post-Effective Amendment No. 24 to Registration Statement No. 2-80513 on Form
S-6 describes the Contracts. I have reviewed the Contract form and I have
participated in the preparation and review of the Registration Statement and
Exhibits thereto. In my opinion:
(1) The illustrations of death benefits included in the prospectus section
entitled "How a Contract's Death Benefit Will Vary", based on the
assumptions stated in the illustrations, are consistent with the
provisions of the Contract.
(2) The illustrations of cash values included in the prospectus section
entitled "How a Contract's Cash Value Will Vary", based on the
assumptions stated in the illustrations, are consistent with the
provisions of the Contract.
(3) The illustrations of cash values and death benefits included in the
section entitled "Illustrations" and in the Appendix of the
prospectus, based on the assumptions stated in the illustrations, are
consistent with the provisions of the Contract. The rate structure of
the Contract has not been designed so as to make the relationship
between premiums and benefits, as shown in the illustrations, appear
more favorable to a prospective purchaser of a Contract for male age
25 or male age 40, than to prospective purchasers of Contracts on
males of other ages or on females.
(4) The illustration of the effect of a Contract loan on the death benefit
and cash value included in the prospectus section entitled "Contract
Loans", based on the assumptions stated in the illustration, is
consistent with the provisions of the Contract.
(5) The illustrations (with respect to a lapsed Contract) of cash values,
extended term insurance and reduced paid-up insurance which are
included in the prospectus section entitled "Options on Lapse", based
on the assumptions stated in the illustrations, are consistent with
the Contract.
I hereby consent to the use of this opinion as an exhibit to the Registration
Statement and to the reference to my name under the heading "Experts" in the
prospectus.
Very truly yours,
/s/
- -------------------------------------------
Nancy D. Davis, FSA, MAAA
Vice President and Assistant Actuary
The Prudential Insurance Company of America
II-278
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