0001209286-18-000481 Sample Contracts

FUND/SERV AGREEMENT
Fund/Serv Agreement • August 13th, 2018 • MEMBERS Horizon Variable Separate Account • New York

AGREEMENT entered into as of the 2nd day of October, 2015 by and between Northern Lights Distributors, LLC, a Nebraska limited liability company (“Fund Agent), and MEMBERS Life Insurance Company (“Trust Entity”).

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CONTRACT NUMBER: [123456789]
MEMBERS Horizon Variable Separate Account • August 13th, 2018

This contract is issued to the Owner in consideration of the application and the initial Purchase Payment. MEMBERS Life Insurance Company will pay the benefits of this contract, subject to its terms and conditions, which will never be less than the amount required by the state law in which the contract is delivered.

CONTRACT NUMBER: [123456789]
MEMBERS Horizon Variable Separate Account • August 13th, 2018

This contract is issued to the Owner in consideration of the application and the initial Purchase Payment. MEMBERS Life Insurance Company will pay the benefits of this contract, subject to its terms and conditions, which will never be less than the amount required by the state law in which the contract is delivered.

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