tality, with interest at 3 per cent., less any existing indebtedness to the Company on the Policy. At the end of the third and succeeding years the cash value is the full reserve, and the paidup and extension values are the equivalents thereof. The stipulated values of this Policy shall be correspondingly increased for any fractional portion of a year's premium which has been paid. This non-forfeiture value shall be secured to the owner of the Policy through one of the following provisions:

First:-The automatic extension of the net amount insured by this Policy for the number of years and days stated below, at the expiration of which time the insurance shall cease; or,

Second:-The issue of paid-up participating insurance payable at death for the sum provided for below upon written application therefor by the owner of the Policy and the legal surrender of all claims hereunder to the Company at its Home Office within one month after lapse; or,

Third: The payment in accordance with Section IX hereof, of the cash surrender value provided for below on surrender of the Policy and all claims hereunder to the Company within one month from the date of lapse.

IX. Table of Extension, Paid-up, and Loan or Cash Values provided for by this Policy. Loan Value available during policy year.

Should any indebtedness exist it shall be deducted from the Cash Value of the Policy, and the other Values shall be correspondingly reduced.

The cash value of any paid-up or extension granted upon the lapse of this Policy will be the full reserve at the time of surrender, less any indebtedness to the Company under the Policy, and will be paid to the owner thereof, upon proper release.

X. REINSTATEMENT.-In the event of default in premium payments, unless the cash value has been duly paid, it is agreed that this Policy may be reinstated at any time upon evidence of insurability satisfactory to the Company and the payment of all overdue premiums and the payment or reinstatement of any other indebtedness to the Company upon said Policy, with interest at the rate of not exceeding six per cent. per annum.

XI. DEATH CLAIM.-When this Policy shall become a claim by the death of the insured, settlement less any indebtedness on the Policy, will be made upon receipt of due proof of death.

XII. INSTALMENT TABLES.-The amount of this Policy when it becomes a claim may be made payable at the option of the beneficiary, in such number of instalments, two to thirty, as may be chosen in accordance with Table A of Instalment Values printed below.

These options can only be exercised in cases where the beneficiary is an individual. They are not available when an association, firm or corporation is named as beneficiary or assignee.

Similarly, the amount of this Policy when it becomes a claim may be made payable in annual instalments for twenty years guaranteed and as much longer thereafter as the beneficiary may live, in accordance with Table B of Instalment Values printed below.

These tables are based upon a Policy, the proceeds of which are one thousand dollars, and apply pro rata to this Policy.

The instalments under Table A, or the instalments-certain under Table B, after the first year, will be increased annually by such surplus as may be awarded by the Board of Trustees.

The commuted value of any unpaid instalments under Table A or the commuted value of any unpaid instalments-certain under Table B will be calculated by the Company at any time upon the same basis (3% compound interest) as the instalments were granted, and will be paid to the owner of the Policy, upon proper release.

XIII. INTEREST PRIVILEGE.-The proceeds of this Policy or any designated fraction thereof, may at maturity, be allowed to remain with the Company until the death of the beneficiary, during which period the Company will pay to the beneficiary yearly, three per cent. on the amount so held, the first payment being made one year after the maturity of this Policy and the last payment to be pro-rated to the date of the death of the beneficiary. The interest rate will be improved annually by such addition as may be awarded by the Board of Trustees. Unless otherwise directed by the insured in writing filed with the Company, the balance remaining unpaid may be withdrawn at any interest period.

XIV. ASSIGNMENT.-Any assignment of this Policy shall be furnished to the Company and a duplicate thereof attached hereto. Any claim against the Company arising under any assignment of this Policy shall be subject to proof of interest. No assignment shall impose any obligation on this Company until it has received the original thereof, nor does the Company guarantee the sufficiency or validity of any assignment.

XV. PREMIUM LOANS.-After the third year if any premium or premiums on this Policy, annual, semi-annual or quarterly, be not paid when due or within the period of grace, the Company will charge against the loan value of this Policy such premium or premiums with 5 per cent. interest per annum in advance, provided that such loan value is sufficient. The balance of value, if any, not thus used, shall be applied in accordance with the provisions of Section VIII hereof, and any premium loans so made shall be subject to the terms of Section VII. This action of the Company is contingent upon the request for such premium loans being filed by the owner of the Policy at the Home Office after the Policy has acquired a loan value and while there is no default in the payment of any premium, and such request is revocable as to any future premium.

XVI. NO ALTERATION OF THIS POLICY or waiver of any of its conditions shall be valid unless endorsed hereon and signed by an Officer of the Company. No agent is authorized to modify, alter or enlarge this contract or to bind the Company by any promise or undertaking as to distribution of surplus or any future award of interest.

XVII. DISABILITY BENEFITS.

A. WAIVER OF PREMIUM.-If after one full year's premium shall have been paid upon this Policy and before default in payment of any subsequent premium, the insured shall, during his lifetime and before attaining the age of sixty, furnish due proof to the Company that he has become wholly disabled by bodily injury or disease so that he is and will be thereby permanently and continuously prevented from engaging in any occupation whatever for remuneration or profit, and that such disability has existed continuously for not less than sixty days, the Company, by endorsement hereon, shall waive the payment of the premiums which may thereafter become due under this Policy, during the continuane of the insured's said total disability. In making any settlement under this Policy, the Company shall not deduct any part of the premiums so waived and the values provided for under the nonforfeiture provisions of this Policy shall increase from year to

year in the same manner as though the premiums so waived had been paid in cash.

B. RECOVERY FROM DISABILITY.-Should the Company accept under this Policy proofs of permanent total disability it may nevertheless at any time thereafter, but not oftener than once a year, demand of the insured due proof of the continuance of such total disability, and upon failure to furnish such proof, or if it appears that the insured has engaged or become able to engage in any occupation whatever for remuneration or profit, no further premiums shall be waived.

Without prejudice to any other cause of total disability, the entire and irrecoverable loss of the sight of both eyes, or the severance of both hands at or above the wrists, or of both feet at or above the ankles, or of one entire hand and one entire foot, shall be considered as total and permanent disability.

Upon written request by the insured accompanied by the Policy for endorsement the disability benefit may be discontinued; if so discontinued or if the insured attain age sixty, premiums thereafter will be reduced by Two and 20/100 Dollars yearly, being the additional premium for such benefit. Non-payment of said additional premium will void this provision and the benefits secured thereby.

APPLICATION.

My statements and answers to the questions printed above, and my statements and answers made and given to the Company's Medical Examiner, are full, complete and true. Upon them I base my application for insurance, and agree that they shall be regarded as a part of the contract if and when issued. If the premium on the insurance herein applied for is not paid at the time of making this application, the contract of insurance shall not be in force unless or until a policy shall be issued and delivered to me and the first premium thereon actually paid during my lifetime and good health. If settlement is effected in accordance with the attached receipt at the time of making this application, the policy shall be in force as of the date of such settlement, provided the application is approved by the Company at the Home Office. policy if and when issued and delivered to me, shall be in the form now in use by the Company. I understand that neither agents nor examiners have any authority to modify, alter or enlarge_contracts. The foregoing agreements and declarations are made on behalf of myself and of any beneficiary under any policy on my life issued by the Company upon this application.

MEDICAL EXAMINER'S FORM.

The

I hereby agree, that all the foregoing statements and answers, made to the Company's Medical Examiner, are a part of my application for insurance, are declared to be true, and are offered to the Company as a consideration for the Contract.

20 PAYMENT LIFE POLICY WITH PREMIUM
INSURANCE RIDER.

No. 99,999.
AMOUNT, $10,000.

PHILADELPHIA LIFE INSURANCE

AGE, 35. PREMIUM, $359.30.

COMPANY OF

PHILADELPHIA, PENNSYLVANIA.

In Consideration of the application for this policy, and of the payment of Three Hundred Fifty-nine and 30/100 Dollars in advance, hereby insures the life of John Doe, hereinafter called the insured, for one year.

Upon the payment of an annual premium of Three Hundred Fifty-nine and 30-100 Dollars, on or before the fourth day of March, 1914, this policy will become a Limited Payment Life policy and the insurance will be continued by the payment of a like sum on or before the fourth day of March in each year thereafter during the life of the insured for eighteen years or until prior death of the insured.

Upon receipt of due proofs of the_death of the insured, provided this policy is in force, the Company will pay Ten Thousand Dollars at its Home Office in the City of Philadelphia to Jane Doe, wife of the insured, if living, otherwise to the executors, administrators or assigns of the insured.

The insured may, while this policy is in force and unassigned, change the beneficiary. Written request must be made and the change will take effect when endorsement is made by the Company upon the policy. The right is reserved to the insured, without the consent of the beneficiary, to receive every benefit, exercise every right and enjoy every privilege conferred upon the insured by this policy.

DIVIDENDS.-The surplus accruing upon this policy shall be ascertained and distributed annually, and at the option of the insured may then be allowed to remain with the Company with interest at a rate not less than three and one-half per centum; used to purchase paid-up additions; or withdrawn in cash, but if so withdrawn the value of the following provisions would thereby be reduced. If no other option is selected, dividends may be withdrawn in cash.

REDUCING PREMIUM PAYING PERIOD.-Whenever, at the end of any policy year, the accumulations of surplus shall be sufficient to prepay future premiums hereon, no further premiums shall be required; but at the option of the insured the payment of premiums may be continued in order to increase accumulations.

MATURING THE POLICY AS AN ENDOWMENT.-Whenever, at the end of any policy year, the accumulated surplus and reserve together shall equal or exceed the amount insured hereunder, this policy shall mature as an endowment, and shall be payable at once to the insured during his lifetime.

SURPLUS PAYABLE WITH SUM INSURED.-If this policy becomes a claim by death, the sum insured hereunder, together with any surplus withdrawable at the end of the previous policy year, shall be paid the beneficiary.

INCONTESTABILITY.-This policy shall be incontestable, except for non-payment of premiums, after one year from its date.

From date of issue this policy shall be without any restrictions as to travel, residence or occupation.