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
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 Xxxx and the class 2 beneficiaries
are Xxxx and Xxxx. We owe Xxxx the proceeds if she is living at the Insured's
death. We owe Xxxx and Xxxx the proceeds if they are living then but Xxxx 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)
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
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 Xxxx and the class 2 beneficiaries
are Xxxx and Xxxx, We owe Xxxx the proceeds if she is living at the Insured's
death. We owe Xxxx and Xxxx the proceeds if they are living then but Xxxx 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
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 Xxxx and the class 2 beneficiaries
are Xxxx and Xxxx. We owe Xxxx the proceeds if she is living at the Insured's
death. We owe Xxxx and Xxxx the proceeds if they are living then but Xxxx 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
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/ XXXXXXXX X. XXXXXXXX /s/ XXXXXXX X. XXXXX
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
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
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/ XXXXXXXX X. XXXXXXXX
------------------------
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
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
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
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/ XXXXXXX X. LIGHT
-------------------------
Secretary
PLI 16-82
II-92
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
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/ XXXXXXXX X. XXXXXXXX
--------------------------
Secretary
PLI 18-82 Printed in the U.S.A.
II-94
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 XXXXXXXX X. XXXXXXXX
Secretary
PLI 21--82
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/ XXXXXXXX X. XXXXXXXX
Secretary
PLI 35--82
II-96
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/ XXXXXXXX X. XXXXXXXX
Secretary
PLI 47--82
II-97
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/ XXXXXXXX X. XXXXXXXX
Secretary
PLI 48--82
II-98
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/ XXXXXXXX X. XXXXXXXX
--------------------------
Secretary
PLI 50-82 Printed in U.S.A.
II-99
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/ XXXXXXXX X. XXXXXXXX
--------------------------
Secretary
PLI 28-82 Printed in U.S.A.
II-100
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
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/ XXXXX X. XXXXXXXX
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/ XXXXXXXX X. XXXXXXXX
------------------------
Secretary
PLI 86-82 Printed in U.S.A.
II-102
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
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-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
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/ XXXXXXXX X. XXXXXXXX
__________________________
Secretary
PLI 97--84 Printed in U.S.A.
II-105
