cash, or (b) to have the insurance continued in force from date of default, without future participation and without the right to loans, for its face amount, including any outstanding dividend additions, less any indebtedness to the Company hereon, or (c) to purchase non-participating paid-up insurance, payable at the same time and on the same conditions as this policy. The cash value will be the reserve at the date of default on this policy and on any dividend additions thereto, computed according to the American Experience Table of Mortality and interest at the rate of three and one-half per centum per annum, less not more than two and one-half per centum of the amount insured by this policy and of any dividend additions thereto, and less any existing indebtedness to the Company on this policy. The term for which the insurance will be continued or the amount of the paid-up policy will be such as the cash value will purchase as a net single premium at the attained age of the Insured according to the American Experience Table of Mortality and interest at the rate of three and one-half per centum per annum. If the owner shall not, within one month from default, surrender this policy to the Company at its Home Office for a cash surrender value or for paid-up insurance as provided in options (a) and (c), the insurance will be continued as provided in option (b). The figures in the following table are computed in accordance with the above provisions and upon the assumption that there is no indebtedness on the policy, and that there are no outstanding dividend additions.

NON-FORFEITURE TABLE.

The figures apply to a policy for $1000. As this contract is for $10,000 the loan, cash or paid-up insurance available in any year will be ten times the amount stated in the table for that year.

The first year's insurance under this policy is term insurance. All values for years subsequent to the twentieth will be equal to or equivalent to the entire reserve of the policy. Figures for later years will be furnished upon request.

ASSIGNMENT.-No assignment of this policy shall be binding upon the Company, until it be filed with the Company at its said Home Office. The Company assumes no responsibility as to the validity of any assignment.

REINSTATEMENT.-If default be made in premium payments and the policy has not been surrendered to the Company and cancelled, it may be reinstated at any time within three years, provided the Insured shall furnish evidence of good health satisfactory to the Company, and pay all overdue premiums to date of reinstatement, with interest thereon at five per centum per annum.

OPTIONS AT MATURITY.-The Insured, by written notice to the Company at its Home Office, and with the written consent of the assignee, if any, may elect to have the net sum payable under this policy paid either in cash or as follows:

(1) By the payment of interest thereon at three and one-half per centum per annum, payable annually, to the payee under this policy

at the end of each year during the life of the payee, and by the payment upon the death of the payee of the said net sum and accrued interest to the executors, administrators, or assigns of the payee, unless otherwise directed in said notice.

(2) By the payment of equal annual installments for a specified number of years, the first installment being payable immediately, in accordance with the following table for each $1,000 of said net sum.

(3) By the payment of equal annual installments payable at the beginning of each year for a fixed period of twenty years and for so many years longer as the payee shall survive in accordance with the following table for each $1,000 of said net sum.

Installments payable under options (2) or (3) which shall not have been paid prior to the death of the payee, shall be paid, unless otherwise directed in said notice, to the executors, administrators or assigns of the payee.

If the Insured shall not have directed otherwise the beneficiary may, after the death of the Insured, by like written notice, and with the written consent of the assignee, if any, select either of the above options.

Unless otherwise specified by the Insured the payee may on any interest date receive the amount yet due under option (1), and may at any time receive the commuted value of payments yet to be made, computed upon the same basis as option (2) in the following table, provided that no such commutation will be made under (3), except after the death of the payee occurring within the aforesaid twenty years.

TOTAL AND PERMANENT DISABILITY.-If the Insured has not attained the age of sixty years after one full annual premium has been paid and before a default in the payment of any subsequent premium, this policy will become fully paid up, requiring no further payment of premiums by the Insured, provided evidence, satisfactory to the Company, shall be furnished by the Insured that he has become totally and permanently disabled for life by bodily injury or disease, and is thereby prevented from performing any and every kind of duty pertaining to his occupation or any other occupation or gainful pursuit. On receipt of such evidence the Company will endorse the proper provision hereon. In such event the cash, loan and surrender values shall increase from year to year, and this policy shall participate in any distribution of surplus in its class in like manner as if the premiums had been regularly and duly paid by the Insured.

During the period of total and permanent disability, and at any time one year after the premium anniversary date first following

the date of such disability, the Company will, at the request of the insured and beneficiary or assignee, if any, pay a monthly income amounting to 1% of the face value of the policy, if there be no existing indebtedness, or if there be such indebtedness, 1% of the face value of the policy less such indebtedness; such payments to continue until the total amount of payments made shall equal the face of the policy, less all indebtedness, if any, at which time the Company's liability under this contract shail cease. In the event of the death of the Insured before the full amount of this policy has been paid to the Insured, beneficiary or assignee, the Company will pay the remaining amount due under this contract upon due proof of death. The cash, loan and surrender values will bear the same proportion to the full cash, loan and surrender values stated in table, on page 2, as the remaining amount of insurance under this contract bears to the original amount of insurance.

If, however, the Insured shall recover, so as to be able to engage in any occupation for wages or profit during the premium payment period, or before the full amount of the policy is paid, he shall then be required to pay all premiums becoming due under this contract after the date of recovery, and the liability of the Company will be limited to the face of the policy less all payments made to the Insured and less all indebtedness thereon. The........ ..Annual premium for this clause is $5.00 and is included in the whole premium charged for this policy, and this clause may be cancelled at any time by the Insured, and thereafter the Disability Insurance shall cease and the premium on this policy shall be reduced by the amount named herein, provided the policy be returned to the Company for proper endorsement.

Agents are not authorized to modify this policy or to extend the time for paying a premium.

APPLICATION.

I hereby declare and agree that all statements and answers written in this application marked Part I, and all those that I make to the Company's Medical Examiner marked Part II, are true, full and complete and are offered to the Company as a consideration for the contract of insurance, which I hereby agree to accept, and which shall not take effect until the first premium shall have been actually paid, while I am in good health, and the policy shall have been signed by the duly authorized officers of the Company and issued. I also agree that in any distribution of surplus, or apportionment of profits, the principles and methods which may then be in use by the Company for such distribution or apportionment, and its determination of the amount equitably belonging to any policy which may be issued under this application, shall be and are hereby ratified and accepted by all parties having or claiming any interest thereunder.

MEDICAL EXAMINER'S FORM.

I declare, on behalf of myself and of any person who shall have or claim any interest in any policy issued hereunder, each of the above answers to be full, complete and true, and that I have concealed nothing from the Examiner and that to the best of my knowledge and belief I am in good health and am a proper subject for life insurance.

I expressly waive, on behalf of myself and of any person who shall have or claim any interest in any policy issued hereunder, all provisions of law forbidding any physician or other person who has attended or examined me, or who may hereafter attend or examine me, from disclosing any knowledge or information which he thereby acquired.

20 PREMIUMS LIFE NONPARTICIPATING POLICY WITH DISABILITY BENEFITS.

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

AGE, 35.

ANNUAL PREMIUM, $309.40.

RESERVE LOAN LIFE INSURANCE COMPANY

INDIANAPOLIS, INDIANA

Hereby Promises and Agrees to Pay Ten Thousand Dollars, at the Home Office of the Company, to Mary Doe, Wife of the insured, within twenty-four hours after receipt of due proof of the death of John Doe (hereinafter called the Insured) of Indianapolis, County of Marion, State of Indiana.

This Policy is issued in consideration of the payment in advance of Three Hundred Nine and 40/100 Dollars. It will be continued as a limited payment life policy upon the further payment of a like amount on or before 12 o'clock, noon (Central Standard Time), of the Twentieth day of February in each year thereafter until Nineteen additional annual premiums have been paid or until the prior death of the insured.

This Policy shall not take effect unless the insured is alive and in good health at the time of its delivery; nor then unless the first premium has been paid.

All the conditions stated on the back of this Policy are hereby referred to and made a part of this contract as fully as if they were recited at length over the signatures hereto affixed. STATE OF INDIANA

OFFICE OF AUDITOR OF STATE
Seal

Indianapolis, February 1, 1914.

I, W. H. O'Brien, Auditor of the State of Indiana, do hereby certify that the Reserve Loan Life Insurance Company of Indianapolis, Indiana, has complied with the laws of the State of Indiana, and maintains with this Department a deposit of the legal reserve on its policies as required by law.

WM. H. O'BRIEN,
Auditor of State.

In Testimony Whereof, the Reserve Loan Life Insurance Company has caused this Policy to be signed by its President and Secretary, at Indianapolis, Indiana, this Twentieth day of February, One Thousand Nine Hundred and Fourteen. CHALMERS BROWN,

W. K. BELLIS,

Secretary.

For the Company..

President.

PRIVILEGES AND CONDITIONS.

This contract is absolutely free from conditions as to residence, occupation, travel or place of death, and no permit or extra premium will be required for military or naval service in time of war or in time of peace.

The reserve on this policy and all surrender values contained therein are based on the American Experience Table of Mortality with three and one-half per cent interest, and in no case does the surrender charge amount to more than two and one-half per cent of the amount insured hereby. The first year's insurance under this Policy is term insurance, purchased by the whole or part of the premium to be received during the first policy year, and the Policy shall be valued according to its terms and the laws of the State of Indiana.

In the event of no indebtedness hereon, the values in the above Table will apply. Any indebtedness may be paid in cash and the values in the Table will then apply, or if not so paid, the cash and loan values will be reduced by the amount of the indebtedness; the paid-up values will be reduced in the ratio of the indebtedness to the reserve on the Policy; and the extended insurance shall be for as long a term as the balance, left after deducting the indebtedness from the net value of the extended insurance as shown in the Table, will purchase as a net single premium. Premium payments for fractional parts of a year, if any, will proportionately increase the values in the Table. Values after twenty years shall be equivalent to the full reserve on this policy.

LOAN VALUE.-At any time after one year from the date hereof and while this Policy is in force, the Company will within ninety days after receipt of written request by the Insured, loan upon the sole security of this Policy up to the amount indicated in the Table of Guaranteed Values opposite the current policy year. The Company will require a satisfactory assignment of the Policy as security, and will deduct from the loan any existing indebtedness on or