The commuted value of any unpaid instalments under Tabl or the commuted value of any unpaid instalments-certain Table B will be calculated by the Company at any time upon same basis (3% compound interest) as the instalments granted, and will be paid to the owner of the Policy, upon pr release. T XIII. INTEREST PRIVILEGE.-The proceeds of this Policy any designated fraction thereof, may at maturity, be allowed remain with the Company until the death of the beneficiary, du which period the Company will pay to the beneficiary yearly, t per cent. on the amount so held, the first payment being made year after the maturity of this Policy and the last payment to pro-rated to the date of the death of the beneficiary. The inte rate will be improved annually by such addition as may be awa by the Board of Trustees. At the time any such interest beco payable the beneficiary may withdraw the amount held by Company, thus terminating this feature. XIV. ASSIGNMENT.-Any assignment of this Policy shall furnished to the Company and a duplicate thereo1 attached her Any claim against the Company arising under any assignment this Policy shall be subject to proof of interest. No assignm shall impose any obligation on this Company until it has recei the original thereof, nor does the Company guarantee the sufficie or validity of any assignment. XV. PREMIUM LOANS.-After the third year if any premium or pr ums on this Policy, annual, semi-annual or quarterly, be not paid when or within the period of grace, the Company will charge against the value of this Policy such premium or premiums with 5 per cent. interest annum in advance, provided that such loan value is sufficient. The bala of value, if any, not thus used, shall be applied in accordance with the visions of Section VIII hereof, and any premium loans so made shall be ject to the terms of Section VII. This action of the Company is conting upon the request for such premium loans being filed by the owner of Policy at the Home Office after the Policy has acquired a loan value while there is no default in the payment of any premium, and such requ is revocable as to any future premium. XVI. NO ALTERATION OF THIS POLICY or waiver of any of conditions shall be valid unless endorsed hereon and signed by Officer of the Company. No agent is authorized to modify, alter enlarge this contract or to bind the Company by any promise undertaking as to distribution of surplus or any future award interest. APPLICATION. My statements and answers to the questions printed above, my statements and answers made and given to the Compar Medical Examiner, are full, complete and true. Upon them I b my application for insurance, and agree that they shall be garded as a part of the contract if and when issued. If the p mium on the insurance herein applied for is not paid at the time making this application, the contract of insurance shall not be force unless or until a policy shall be issued and deli.ered to and the first premium thereon actually paid during my lifeti and good health. If settlement is effected in accordance with attached receipt at the time of making this application, the pol shall be in force as of the date of such settlement, provided the plication is approved by the Company at the Home Office. policy if and when issued and delivered to me, shall be in the fo now in use by the Company. I understand that neither agents examiners have any authority to modify, alter or enlarge c tracts. The foregoing agreements and declarations are made behalf of myself and of any beneficiary under any policy on life issued by the Company upon this application. MEDICAL EXAMINER'S FORM. I hereby agree, that all the foregoing statements and answe made to the Company's Medical Examiner, are a part of my app cation for insurance, are declared to be true, and are offered to ompany as a consideration for the Contract. 20 PAYMENT (FIRST YEAR TERM AND 19 PREMIUMS) LIFE POLICY. No. 99,999. AGE, 35. PREMIUM, $355.80. PHILADELPHIA LIFE INSURANCE COMPANY OF PHILADELPHIA, PENNSYLVANIA In Consideration of the application for this policy, and of the payment of Three Hundred Fifty-five and 80-100 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-five and 80-100 Dollars, on or before the fourth day of March, 1913, 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. If the age of the insured has been misstated, the amount able hereunder shall be such a sum as the premium actually would have purchased at the correct age. Self-destruction v sane or insane, within one year of the date hereof, is a risk assumed by the Company under this policy. All statements r by the insured shall in the absence of fraud be deemed represe tions and not warranties. 1 PAYMENT OF PREMIUMS.-All premiums are payable in adv at the Home Office of the Company or to an agent of the Com upon delivery of a receipt signed by an executive officer of Company-the President, a Vice-President, Secretary, Treas Actuary or Comptroller-and countersigned by said agent. A grace of one month shall be granted for the paymen every premium after the first, during which time the insur shall continue in force. If death occurs within the days of g the unpaid portion of the premium for the then current policy shall be deducted from the amount payable hereunder. Except as herein provided, the payment of a premium or stalment thereof shall not maintain the policy in force beyond date when the next premium or instalment thereof is payable, failure to pay any premium or note when due will forfeit the p and all payments made thereon, Any unpaid portion of the rent year's premium and all indebtedness will be deducted 1 any settlement of this policy. PREMIUM LOANS.-In lieu of automatic extended insura and on satisfactory request from the insured prior to defaul the payment of any premium hereon, the Company shall first a any withdrawable surplus to pay the same; and the remainder if any, shall be charged against this policy as a loan at five centum interest, if the respective loan value specified below sufficient to cover such advance in addition to existing liens accrued interest; provided that if the credits be not sufficien cover the entire premium then due, the Company shall apply same, if sufficient, to pay the premium for a shorter period, not less than one month's premium. At any time while the p is thus sustained in force, the payment of premiums with inte may be resumed. When advances can no longer be made, balance then remaining shall be used to purchase term insura as stated below. No grace will be accorded under this provis LOANS. After three full years' premiums have been paid, Company at any time, while this policy is in force, will adva on proper assignment of this policy and on the sole security ther at a rate of interest not greater than five per centum per ann a sum equal to, or, at the option of the owner of the policy, than, the reserve at the end of the current policy year policy and on any dividend additions thereto, computed accor to the American Experience Table of Mortality, with interes three and one-half per centum per annum, less a sum not more t one per centum of the amount insured by this policy and of dividend additions thereto. The Company, however, will de from such loan value any existing indebtedness to the Comp on this policy and any unpaid balance of the premium for the rent policy year, and may collect interest in advance on the to the end of the current policy year. Failure to repay any s advance or to pay interest shall not avoid this policy unless total indebtedness hereon to the Company shall equal or such loan value at the time of such failure. on ex NON-FORFEITURE OPTIONS ON SURRENDER OR LAPSE.-In e of default in the payment of premiums after premiums have t paid for three years, the insured will be entitled, as provided the table of surrender values, to any one of the following optic 1. To automatic non-participating paid-up term insurance the amount insured by this policy, for such time as the surren value will purchase. The surrender value will be the entire rese on this policy and on any dividend additions thereto, compu according to the American Experience Table of Mortality with interest at three and one-half per centum, less a sum not more than one per centum of the amount insured by this policy and of any d.vidend additions thereto, and less any existing indebtedness to the Company on this policy. 2. To a non-participating paid-up life insurance policy, for an amount not less than may be purchased by the surrender value aforesaid, upon surrender within one month after default. 3. To a cash value not less than the surrender value aforesaid, upon surrender within one month after default. The surrender values stated will be increased correspondingly for any fractional portion of a year's premium which shall have been paid. Figures for later years will be furnished upon request. TABLE OF LOAN AND SURRENDER VALUES. THE CONTRACT.-A copy of the written and printed application this contract is attached hereto. This policy and application erefor, taken together, constitute the entire contract. No person, cept an executive officer of the Company as aforesaid, has power modify or in event of lapse to reinstate this policy, to extend the me for paying a premium, or to accept any note in payment ereof. ASSIGNMENT.-Any assignment of this contract shall be atched hereto, and a duplicate thereof shall be furnished the Comany at its Home Office. Any claim against the Company arising nder any assignment of this contract shall be subject to proof of terest. No assignment shall impose any obligation on this Comany until it has received the original or a duplicate thereof, nor pes the Company guarantee the legality of any assignment. REINSTATEMENT.-This policy may be reinstated on written apcation, subject to evidence of insurability satisfactory to the Comy and payment of arrears of premiums with interest thereon exceeding five per centum per annum. OPTIONS AT MATURITY.-The insured, by written notice to the ompany at its Home Office, and with the written consent of the signee and irrevocable beneficiary, if any, may elect to have the sum payable under this policy paid either in cash or as follows: 1. By the payment of interest thereon at three and one-quarter centum per annum, payable annually, to the payee under this licy at the end of each year during the life of the payee and by payment upon the death of the payee of the said net sum and crued interest to the executors, administrators or assigns of the yee, unless otherwise directed in said notice. 2. By the payment of equal annual instalments for a specified umber of years, the first instalment being payable immediately, in accordance with the following table for each $1,000 of said net sum. TABLE OF INSTALMENT VALUES FOR EACH $1,000 C INSURANCE. Sum of Instalments... $1428.50 $1331 60 $1314 04 $1295 28 $12 T 1 16 15 14 13 $78 62 $82 61 $87 22 $92 57 $9 $1257 92 $1239 15 $1221 08 $1203 41 311 11 10 9 8 $106 08 $114 94 $125 83 $139 35 $1 $1166 88 $1149 40 $1132 47 $1114 80 $10 3 6 5 4 $180 18 $212 99 $262 06 $344 00 $5 ...$1081 08 $1064 95 $1048 24 $1032 00 $10 3. By the payment of equal annual instalments payable at beginning of each year for a fixed period of twenty years and so many years longer as the payee shall survive in accordance the following table for each $1,000 of said net sum. TABLE OF CONTINUOUS INSTALMENT VALUES. Age last birthday of bene. ficiary at maturity.... 10 11 12 13 14 15 16 Each instalment per $1000 $10 02 340 20 $40 39 $40 59 $40 80 $41 01 $41 248 insurance..... Age last birthday of bene. ficiary at maturity 18 19 20 21 22 23 24 Each instalment per $1000 $41 72 $41 97 $42 24 342 51 $42 80 $43 11 $43 42$ insurance... Age last birthday of beneficiary at maturity... 26 27 28 29 9 | 30 | 31 | 32 Each instalment per $1000 $14 09 $44 45 844 82 $45 21 $45 62 $46 05 $46 49$ insurance.. Age last birthday of beneficiary at maturity 34 35 36 37 3839 40 Each instalment per $1000 $47 43 $47 93 $48 45 $48 99 $49 55 $50 14 850 748 insurance... Age last birthday of beneficiary at maturity. 42 43 44 45 46 47 48 Each instalment per $1000 $52 00 $52 65 $53 33 854 02 $54 72 $55 44 $56 165 insurance.... Age last birthday of bene- 50 51 52 53 54 55 56 ficiary at maturity Each instalment per $1000 $57 61 $58 34 359 05 359 76 $60 44 $61 11 $61 75 $6 insurance.... |