existing indebtedness) as participating paid-up insurance for such an amount as the said reserve will purchase at the premium named.

CHANGE OF PLAN.-While this Policy is in full force it may be changed at any time, without medical examination to any other form of Life or Endowment Policy in use by the Company at the time this Policy was issued, provided the rate of premium is not thereby diminished. For any such change the Company will require the payment of such an amount as is determined by it under its then existing rules and the new Policy shall be of the same number, age at issue, date of issue and amount as this Policy.

OPTIONS ON SURRENDER OR LAPSE.-After premiums have been paid hereon for three full years, this Policy will have a value equal to the full reserve on the Policy and on any paid-up dividend additions, computed as of the date to which premiums have been paid, and based upon the American Experience Table of Mortality with interest at three and one-half per centum per annum, less any existing indebtedness to the Company on this Policy.

Said value may be used at the option of the Insured in any one of the following three ways: (1) Applied to the purchase of extended insurance, commencing from the date to which premiums have been paid, without future participation, and without the right to loans or cash values, for the face amount of the Policy, plus any outstanding paid-up dividend additions and less any indebtedness hereon, and for such a term of years and months as said value taken as a single premium at the Insured's then attained age will provide according to the American Experience Table of Mortality with interest at three and one-half per centum per annum. Any outstanding dividends which have been left to accumulate at interest will be then paid in cash, or, if the Insured so elects before the expiration of the days of grace they may be left at interest but withdrawable on any subsequent anniversary of the Policy or at the expiration of the term of extension. (2) Applied to the purchase of non-participating paid-up insurance, payable at the same time and on the same conditions as this Policy, but without the right to loans or cash values, for such an amount as said value taken as a single premium at the Insured's then attained age, will provide according to the American Experience Table of Mortality with interest at three and one-half per centum per annum. Written request must be made for this option accompanied by this Policy for surrender or endorsement at the Home Office before the expiration of the days of grace. Any dividends which have been left to accumulate at interest will be then paid in cash or if the Insured so elects before the expiration of the days of grace they may be left at interest but withdrawable on any subsequent anniversary of the Policy, or on payment of the paid-up insurance as a death claim. (3) Collected in cash on written request and proper surrender of this Policy before the expiration of the days of grace. The amount of any outstanding dividends which have been left to accumulate at interest will also be paid in cash in that event. Payment may be deferred by the Company for a period not exceeding ninety days.

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 cutstanding dividends or dividend additions. Figures for years not shown will be furnished upon request and will be upon the same basis;

After premiums for three full years shall have been paid, if default occurs in payment of any subsequent premium, and if the Insured shall not elect before the expiration of the days of grace to have the value of the Policy applied under Option (2) or Option (3), the value will be applied as provided in Option (1). If default occurs before premiums for three full years have been paid this Policy will have no value and the insurance will cease and determine.

REINSTATEMENT.-Unless surrendered for cash, this Policy may be reinstated at any time after default upon evidence of insurability satisfactory to the Company, and by payment of arrears of premiums with interest at six per centum per annum; any indebtedness which existed at date of default together with interest to the date of reinstatement, to be at the option of the Insured on application for reinstatement, either repaid in cash or continued as an indebtedness against the Policy.

CONDITIONS AND PRIVILEGES.-The Insured is privileged to travel or reside in any part of the world and may engage in any occupation. This Policy does not insure against the death of the Insured caused by his or her own hand or act, while sane or insane, during the first year from the date hereof, and in the event of such death the liability of the Company shall be the amount of the premiums paid.

This Policy and the application therefor, a copy of which is hereto attached and made a part hereof, constitute the entire contract between the parties and shall be incontestable after one year from the date hereof except for non-payment of premiums and except as otherwise provided in the Policy. All statments made by the Insured shall in the absence of fraud be deemed representations and not warranties, and no such statement shall avoid this Policy unless it is contained in the written application herefor.

If the age of the Insured has been misstated, the amount payable hereunder shall be such as the premium paid would have purchased at the correct age.

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 or effect of any assignment, and any claim made by reason of any such assignment shall be subject to proof of interest and extent thereof.

LOANS. After three full years' premiums have been paid and while this Policy is in full force by the payment of premiums, the Company will loan on the sole security of the Policy and on proper assignment thereof, an amount not exceeding its cash value at the end of the then current Policy year. Interest on loans will be at a rate not exceeding six per centum per annum, which if not paid annually shall be added to the principal and bear interest at the

same rate. The Company will deduct from such loan any existing indebtedness or previous advances on the Policy and any unpaid balance of premium for the current Policy year, and may collect interest in advance on the loan to the end of the current Policy year. Failure to repay any such advance, or to pay interest, shall not avoid this Policy unless the total indebtedness hereon to the Company shall equal or exceed the cash value of the Policy at the time of such failure, and until one month after notice shall have been mailed to the last known address of the Insured and of the assignee, if any. Consummation of loans may be deferred by the Company for a period not exceeding ninety days. No condition other than as herein provided shall be exacted as a prerequisite to any such advance.

VALUATION. The first year's insurance under this policy is Term Insurance.

CHANGE OF BENEFICIARY.-When the right of revocation has been reserved, or in case of the death of any beneficiary under either a revocable or irrevocable designation, the Insured subject to any existing assignment of the Policy may at any time, and from time to time, nominate a new beneficiary or beneficiaries by filing with the Company a written request duly acknowledged, accompanied by this Policy for endorsement. Such change shall not take effect, however, until it has been endorsed upon the Policy by the Company. When the right of revocation has not been reserved such right may be resumed by the Insured at any time by filing with the Company a written request signed by the Insured and the then irrevocable beneficiary or beneficiaries and duly acknowledged. The resumption of such right of change shall be operative when so acknowledged by the Company. If the beneficiary or beneficiaries named hereunder shall die before the Insured, and the Insured shall not have named a new beneficiary, the proceeds of this Policy shall be payable to the Insured's executors, administrators or assigns.

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

(1) By the payment of interest thereon at three and onehalf 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, assigns of the payee, unless otherwise directed in said notice.

or

(2) By the payment of equal annual instalments for a specified number of years, the first instalment being payable immediately, in accordance with the following table for each One Thousand Dollars of said net sum.

(3) By the payment of equal annual instalments payable at the beginning of each year for a fixed period of twenty years or for so many years longer as the payee shall survive, in accordance with the following table for each One Thousand Dollars of said net sum. This option cannot be selected if there be more

than one payee.

Instalments 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.

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.

No change in mode of payment or revocation of any change shall take effect until endorsed on the Policy by the Company at its Home Office.

The above modes of settlement are based upon an interest earning of 3 per centum, and may be increased by such additional rate of interest as may be declared by the Company in any year on funds held under such modes of settlement.

i

AGENTS ARE NOT AUTHORIZED to modify this Policy or

to extend the time for paying premiums.

In Witness Whereof, the Company has caused this policy to be executed this First day of June, Nineteen hundred and Seventeen.

T. A. PHILLIPS,

Secretary.

E. W. RANDALL,

President.

APPLICATION.

I agree to be examined by the Company's regularly appointed Medical Examiner and that my statements herein and to the Examiner are made for the purpose of obtaining this Insurance.

MEDICAL EXAMINER'S FORM. 1

I HEREBY DECLARE that my answers to the questions on Part I and Part II of my application for Life Insurance are full, complete and true, and I agree that they shall be a part of any policy issued on my life.. I do further hereby agree that any Policy issued upon this application shall be dated as of the date of approval by the Company of this application, unless such date would increase my rated age, in which case said Policy shall bear the same date as the first part of this application; and that in determining the due date of any Premium the reckoning shall be from the date of the Policy.

During the first ten years of this policy military or naval service in time of war is a risk not assumed by the Company, unless within thirty-one days after entering upon such service, notice thereof shall be given to the Company by the insured or on his behalf, and unless there shall be paid such extra premiums as the Company may fix for such service. In event of the insured's entering upon such service and failing to give such notice or failing to pay such extra premiums at the times and in the manner required, the liability of the Company for subsequent death of the insured while engaged in or as a result of such service shall be limited to the regular policy premiums paid on this policy without interest, less any indebtedness hereon to the Company. All disability benefits contained in or conferred by the policy shall immediately cease upon the insured's entering or engaging in such military or naval service, and the policy premiums shall be thereafter reduced by the amount charged for said disability benefits. Any provision of this policy in conflict herewith is hereby elim inated and declared of no effect.