EXHIBIT A(13)(y)
PRUCO LIFE INSURANCE COMPANY
| Insured | Rider for Policy No.
| |
| Xxxx Xxx | 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
| Xxxxxxxx X. Xxxxxxxx
| Secretary
|
|
|____________________________________________________
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PLI 76-82 Printed in U.S.A.
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II-204
