Common use of UNDERSTOOD AND AGREED THAT Clause in Contracts

UNDERSTOOD AND AGREED THAT. If the Owner is a Trustee or successor Trustee under a tax qualified plan or the employer under a tax qualified non-trusteed plan, Northwestern Mutual Life will be fully discharged of liability for any action taken by the Owner in the exercise of any contract right and for all amounts paid to, or at the direction of, the Owner and will have no obligation as to the use of the amounts. In all dealings with the Owner, Northwestern Mutual Life will be fully protected against the claims of every other person. The premium will be credited the date both the entire premium and the application are received at the Home Office. Receipt of the premium at a payment facility designated by Northwestern Mutual Life will be considered the same as receipt at the Home Office. If a Tax Qualified Employee Plan, an IRA or TDA is applied for, the Applicant and/or Annuitant have received and reviewed the appropriate ERISA, IRA or TDA disclosure statements. FIXED ANNUITY - SINGLE PREMIUM RETIREMENT ANNUITY POLICIES HAVE PROVISIONS FOR THE ASSESSMENT OF SURRENDER CHARGES ON CASH WITHDRAWAL. No agent is authorized to make or alter contracts or to waive the rights or requirements of Northwestern Mutual Life. X__________________________________________________________________ X_______________________________________________ Signature of Applicant (Indicate relationship below if applicable) Signature of Annuitant (if other than Applicant) [ ] Trustee [ ] Employer X_______________________________________________ Signature of Licensed Agent Date Signed at: City County State | | | | | | | | ___________________________________________________________________________________________________________________________ 49 -------------------------------------------------------------------------------- AGENT'S CERTIFICATE -------------------------------------------------------------------------------- Annuitant Name: First, MI, Last A | |_____________________________________________________________________

Appears in 2 contracts

Samples: NML Variable Annuity Account A, NML Variable Annuity Account A

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UNDERSTOOD AND AGREED THAT. If the Owner is a Trustee or successor Trustee under a tax qualified plan or the employer under a tax qualified non-trusteed plan, Northwestern Mutual Life will be fully discharged of liability for any action taken by the Owner in the exercise of any contract right and for all amounts paid to, or at the direction of, the Owner and will have no obligation as to the use of the amounts. In all dealings with the Owner, Northwestern Mutual Life will be fully protected against the claims of every other person. The premium will be credited the date both the entire premium and the application are received at the Home Office. Receipt of the premium at a payment facility designated by Northwestern Mutual Life will be considered the same as receipt at the Home Office. If a Tax Qualified Employee Plan, an IRA or TDA is applied for, the Applicant and/or Annuitant have received and reviewed the appropriate ERISA, IRA or TDA disclosure statements. FIXED ANNUITY - SINGLE PREMIUM RETIREMENT ANNUITY POLICIES HAVE PROVISIONS FOR THE ASSESSMENT OF SURRENDER CHARGES ON CASH WITHDRAWAL. No agent is authorized to make or alter contracts or to waive the rights or requirements of Northwestern Mutual Life. X__________________________________________________________________ X_______________________________________________ Signature of Applicant (Indicate relationship below if applicable) Signature of Annuitant (if other than Applicant) [ ] Trustee [ ] Employer X_______________________________________________ Signature of Licensed Agent Date Signed at: City County State | | | | | | | | ___________________________________________________________________________________________________________________________ 49 50 -------------------------------------------------------------------------------- AGENT'S CERTIFICATE -------------------------------------------------------------------------------- Annuitant Name: First, MI, Last A | |_____________________________________________________________________

Appears in 2 contracts

Samples: NML Variable Annuity Account B, NML Variable Annuity Account A

UNDERSTOOD AND AGREED THAT. If (1) The application consists of this application form and the Owner medical questionnaire; (2) The representations are true and complete to the best of my knowledge and belief; (3) No liability exists and the insurance applied for will not take effect until the policy is delivered and the payment is made during the lifetime of the proposed Insured(s) and then only if the proposed Insured(s) has (have) not consulted or been treated by any physician or practitioner of any healing art or had any tests listed in the application since its completion; but if the payment is paid prior to delivery of the policy and a Trustee or successor Trustee under a tax qualified plan or conditional receipt is delivered by the employer under a tax qualified non-trusteed planregistered representative, Northwestern Mutual Life insurance will be fully discharged of liability for any action taken by the Owner in the exercise of any contract right and for all amounts paid to, or at the direction of, the Owner and will have no obligation as effective subject to the use terms of the amounts. In all dealings with the Owner, Northwestern Mutual Life will be fully protected against the claims of every other person. The premium will be credited the date both the entire premium conditional receipt; and the application are received at the Home Office. Receipt of the premium at a payment facility designated by Northwestern Mutual Life will be considered the same as receipt at the Home Office. If a Tax Qualified Employee Plan, an IRA (4) No registered representative or TDA is applied for, the Applicant and/or Annuitant have received and reviewed the appropriate ERISA, IRA or TDA disclosure statements. FIXED ANNUITY - SINGLE PREMIUM RETIREMENT ANNUITY POLICIES HAVE PROVISIONS FOR THE ASSESSMENT OF SURRENDER CHARGES ON CASH WITHDRAWAL. No agent broker is authorized to make amend, alter, or alter contracts or to waive modify the rights or requirements terms of Northwestern Mutual Lifethis agreement. X__________________________________________________________________ X______________________________________ Signature of Insured Date Signature of Spouse Date (if application is for Other Insured Rider) ______________________________________ Signature _______________________________________ Print Name of Applicant (Indicate relationship below if applicable) Signature Insured Print Name of Annuitant (if other than Applicant) [ ] Trustee [ ] Employer Spouse X_____________________________________ _______________________________________ Signature of Licensed Agent 2nd Insured Date Signed at: at City County State | | | | | | | | ___________________________________________________________________________________________________________________________ 49 -------------------------------------------------------------------------------- AGENT'S CERTIFICATE -------------------------------------------------------------------------------- Annuitant Name: First, MI, Last A | |Print Name of 2nd Insured X_____________________________________ Signature of Owner Date (if other than Insured) ______________________________________________________________________ Print Name of Owner Agent's Report -------------------------------------------------------------------------------- 15. REPLACEMENT Agents are required to complete this section. -------------------------------------------------------------------------------- Is the insurance being applied for considered a replacement according to its definition in the replacement regulations (if any) of the state in which the business was written? (send Replacement and/or 1035 Exchange forms where applicable) |_| Yes |_| No Indicate any replacement in the chart below. -------------------------------------------------------------------------------- 16. LIFE INSURANCE IN EFFECT Agents are required to complete this section. -------------------------------------------------------------------------------- Please list all life insurance currently in effect; indicate if insurance being applied for will replace any of the listed policies: --------------------------------------------------------------------------------------------- Company/Policy # Year Amount Accidental Waiver Replacing Other Personal Business Death Benefit Policies?* --------------------------------------------------------------------------------------------- $ $ $ |_| Yes |_| No |_| Yes |_| No --------------------------------------------------------------------------------------------- |_| Yes |_| No |_| Yes |_| No --------------------------------------------------------------------------------------------- |_| Yes |_| No |_| Yes |_| No --------------------------------------------------------------------------------------------- |_| Yes |_| No |_| Yes |_| No --------------------------------------------------------------------------------------------- |_| Yes |_| No |_| Yes |_| No --------------------------------------------------------------------------------------------- Total $ $ $ -------------------------------------------------------------------- *If life insurance applied for is replacing existing policy -------------------------------------------------------------------------------- 17. BUSINESS INSURANCE Please complete this section if business insurance is applied for. --------------------------------------------------------------------------------

Appears in 2 contracts

Samples: Inheritage Account of Allmeric Financial Life Ins & Ann Co, Vel Ii Account of Allmerica Financial Life Ins & Ann Co

UNDERSTOOD AND AGREED THAT. If the Owner is a Trustee or successor Trustee under a tax qualified plan or the employer under a tax qualified non-trusteed plan, Northwestern Mutual Life will be fully discharged of liability for any action taken by the Owner in the exercise of any contract right and for all amounts paid to, or at the direction of, the Owner and will have no obligation as to the use of the amounts. In all dealings with the Owner, Northwestern Mutual Life will be fully protected against the claims of every other person. The premium will be credited the date both the entire premium and the application are received at the Home Office. Receipt of the premium at a payment facility designated by Northwestern Mutual Life will be considered the same as receipt at the Home Office. If a Tax Qualified Employee Plan, an IRA or TDA is applied for, the Applicant and/or Annuitant have received and reviewed the appropriate ERISA, IRA or TDA disclosure statements. FIXED ANNUITY - SINGLE PREMIUM RETIREMENT ANNUITY POLICIES HAVE PROVISIONS FOR THE ASSESSMENT OF SURRENDER CHARGES ON CASH WITHDRAWAL. No agent is authorized to make or alter contracts or to waive the rights or requirements of Northwestern Mutual Life. X__________________________________________________________________ X_______________________________________________ Signature of Applicant (Indicate relationship below if applicable) Signature of Annuitant (if other than Applicant) [ ] Trustee [ ] Employer X_______________________________________________ Signature of Licensed Agent Date Signed at: City County State | | | | | | | | ___________________________________________________________________________________________________________________________ 49 44 -------------------------------------------------------------------------------- AGENT'S CERTIFICATE -------------------------------------------------------------------------------- Annuitant Name: First, MI, Last A | |_____________________________________________________________________

Appears in 1 contract

Samples: NML Variable Annuity Account A

UNDERSTOOD AND AGREED THAT. If the Owner is a Trustee or successor Trustee under a tax qualified plan or the employer under a tax qualified non-trusteed plan, Northwestern Mutual Life will be fully discharged of liability for any action taken by the Owner in the exercise of any contract right and for all amounts paid to, or at the direction of, the Owner and will have no obligation as to the use of the amounts. In all dealings with the Owner, Northwestern Mutual Life will be fully protected against the claims of every other person. The premium will be credited the date both the entire premium and the application are received at the Home Office. Receipt of the premium at a payment facility designated by Northwestern Mutual Life will be considered the same as receipt at the Home Office. If a Tax Qualified Employee Plan, an IRA or TDA is applied for, the Applicant and/or Annuitant have received and reviewed the appropriate ERISA, IRA or TDA disclosure statements. FIXED ANNUITY - SINGLE PREMIUM RETIREMENT ANNUITY POLICIES HAVE PROVISIONS FOR THE ASSESSMENT OF SURRENDER CHARGES ON CASH WITHDRAWAL. No agent is authorized to make or alter contracts or to waive the rights or requirements of Northwestern Mutual Life. X__________________________________________________________________ X_______________________________________________ Signature of Applicant (Indicate relationship below if applicable) Signature of Annuitant (if other than Applicant) [ ] Trustee [ ] Employer X_______________________________________________ Signature of Licensed Agent Date Signed at: City County State | | | | | | | | ___________________________________________________________________________________________________________________________ 49 87 -------------------------------------------------------------------------------- AGENT'S CERTIFICATE -------------------------------------------------------------------------------- Annuitant Name: First, MI, Last A | |_____________________________________________________________________

Appears in 1 contract

Samples: NML Variable Annuity Account B

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UNDERSTOOD AND AGREED THAT. If the Owner is a Trustee or successor Trustee under a tax qualified plan or the employer under a tax qualified non-trusteed plan, Northwestern Mutual Life will be fully discharged of liability for any action taken by the Owner in the exercise of any contract right and for all amounts paid to, or at the direction of, the Owner and will have no obligation as to the use of the amounts. In all dealings with the Owner, Northwestern Mutual Life will be fully protected against the claims of every other person. The premium will be credited the date both the entire premium and the application are received at the Home Office. Receipt of the premium at a payment facility designated by Northwestern Mutual Life will be considered the same as receipt at the Home Office. If a Tax Qualified Employee Plan, an IRA or TDA is applied for, the Applicant and/or Annuitant have received and reviewed the appropriate ERISA, IRA or TDA disclosure statements. FIXED ANNUITY - SINGLE PREMIUM RETIREMENT ANNUITY POLICIES HAVE PROVISIONS FOR THE ASSESSMENT OF SURRENDER CHARGES ON CASH WITHDRAWAL. No agent is authorized to make or alter contracts or to waive the rights or requirements of Northwestern Mutual Life. X__________________________________________________________________ X_______________________________________________ Signature of Applicant (Indicate relationship below if applicable) Signature of Annuitant (if other than Applicant) [ ] Trustee [ ] Employer X_______________________________________________ Signature of Licensed Agent Date Signed at: City County State | | | | | | | | ___________________________________________________________________________________________________________________________ 49 52 -------------------------------------------------------------------------------- AGENT'S CERTIFICATE -------------------------------------------------------------------------------- Annuitant Name: First, MI, Last A | |_____________________________________________________________________

Appears in 1 contract

Samples: NML Variable Annuity Account B

UNDERSTOOD AND AGREED THAT. If the Owner is a Trustee or successor Trustee under a tax qualified plan or the employer under a tax qualified non-trusteed plan, Northwestern Mutual Life will be fully discharged of liability for any action taken by the Owner in the exercise of any contract right and for all amounts paid to, or at the direction of, the Owner and will have no obligation as to the use of the amounts. In all dealings with the Owner, Northwestern Mutual Life will be fully protected against the claims of every other person. The premium first purchase payment will be credited the valuation date coincident with or next following the date both the entire premium application and the application purchase payment are received at the Home Office. Receipt of the premium at a payment facility designated by Northwestern Mutual Life will be considered the same as receipt at the Home OfficeLife. If a Tax Qualified Employee Plan, an IRA or TDA is applied for, the Applicant and/or Annuitant have received and reviewed the appropriate ERISA, IRA or TDA disclosure statements. FIXED ANNUITY - SINGLE PREMIUM RETIREMENT ANNUITY POLICIES HAVE PROVISIONS FOR THE ASSESSMENT OF SURRENDER CHARGES ON CASH WITHDRAWAL. No agent is authorized to make or alter contracts or to waive the rights or requirements of Northwestern Mutual Life. X__________________________________________________________________ X_______________________________________________ I acknowledge receipt of the Prospectus and I understand that all payments and values provided by this contract, when based on the investment experience of a separate account, are variable and are not guaranteed as to amount. X -------------------------------------------------------------------- Signature of Applicant (Indicate relationship below if applicable) [ ] Trustee X -------------------------------------------------------------------- Signature of Annuitant (if other than Applicant) [ ] Trustee [ ] Employer X_______________________________________________ X -------------------------------------------------------------------- Signature of Licensed Agent Date Signed at: City County State | | | | | | | | ___________________________________________________________________________________________________________________________ 49 -------------------------------------------------------------------------------- ================================================================================ AGENT'S CERTIFICATE -------------------------------------------------------------------------------- ================================================================================ Annuitant Name: First, MI, Last A | |_____________________________________________________________________Last

Appears in 1 contract

Samples: NML Variable Annuity Account B

UNDERSTOOD AND AGREED THAT. If the Owner is a Trustee or successor Trustee under a tax qualified plan or the employer under a tax qualified non-trusteed plan, Northwestern Mutual Life will be fully discharged of liability for any action taken by the Owner in the exercise of any contract right and for all amounts paid to, or at the direction of, the Owner and will have no obligation as to the use of the amounts. In all dealings with the Owner, Northwestern Mutual Life will be fully protected against the claims of every other person. The premium will be credited the date both the entire premium and the application are received at the Home Office. Receipt of the premium at a payment facility designated by Northwestern Mutual Life will be considered the same as receipt at the Home Office. If a Tax Qualified Employee Plan, an IRA or TDA is applied for, the Applicant and/or Annuitant have received and reviewed the appropriate ERISA, IRA or TDA disclosure statements. FIXED ANNUITY - SINGLE PREMIUM RETIREMENT ANNUITY POLICIES HAVE PROVISIONS FOR THE ASSESSMENT OF SURRENDER CHARGES ON CASH WITHDRAWAL. No agent is authorized to make or alter contracts or to waive the rights or requirements of Northwestern Mutual Life. X__________________________________________________________________ X_______________________________________________ Signature of Applicant (Indicate relationship below if applicable) Signature of Annuitant (if other than Applicant) [ ] Trustee [ ] Employer X_______________________________________________ Signature of Licensed Agent Date Signed at: City County State | | | | | | | | ___________________________________________________________________________________________________________________________ 49 -------------------------------------------------------------------------------- AGENT'S CERTIFICATE -------------------------------------------------------------------------------- Annuitant Name: First, MI, Last A | |_____________________________________________________________________

Appears in 1 contract

Samples: NML Variable Annuity Account B

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