Anchor Life Insurance Company. TWENTY-PAYMENT LIFE POLICY-Guaranteed PremIUM AMOUNT, $10,000. REDUCTION. ANNUAL PREMIUM, $383.50. AGE, 35. The Anchor Life Insurance Company by this contract of insurance agrees to pay ten thousand dollars and in addition thereto the cash value of any coupons due and unpaid, at the home office of the company, in Indianapolis, Ind., as follows: To the beneficiary, Mary Doe, wife of the insured, immediately upon receipt of due proofs of the death of the insured and of the interest of the claimant, during the continuance of this contract The insured, William Doe, of Indianapolis, county of Marion, State of Indiana. GUARANTEED ANNUAL REDUCTION IN PREMIUMS.-Upon the payment of the second and each succeeding annual premium, the company guarantees to credit to this policy an amount as evidenced by the attached coupons. These amounts may, as they fall due, be used in accordance with any one of the following options: (1) Withdrawn in cash. (2) Used in the payment of premiums. (3) Used to purchase paid-up additions to this policy. This option is subject to evidence of good health satisfactory to the company for any paid-up additions which will cause the amount payable at death to exceed the face of this policy. (4) Remain attached to this policy. In which case they shall improve at three and one-half per cent interest for each full year compounded annually and shall be withdrawable on demand. After the payment of fifteen full years' premiums in cash, the company guarantees, upon surrender of this policy, to deliver to the insured a fully paid-up policy for an amount equal to the face of this policy, provided all coupons remain attached under option four and are surrendered with the policy. PREMIUMS ON THIS POLICY WILL BE PAID BY THE COMPANY IF THE INSURED IS PERMANENTLY DISABLED.-After one full annual payment shall have been made, and before a default in the payment of any subsequent premium, if the insured, prior to attaining the age of sixty, shall furnish satisfactory proof that he has been wholly and permanently disabled by bodily injuries or disease, and will be permanently, continuously and wholly prevented thereby for life from pursuing any and all gainful occupations, the company, by an endorsement in writing upon this contract, will agree to pay for the insured the premiums, if any, which shall thereafter become payable during the continuance of such disability. In any such case, premiums so paid shall not be a lien on this contract, and the cash, loan and other values of this contract in the schedule as given hereinafter shall increase in the same manner as if the premiums were paid by the insured. In the event of total and permanent disability, as above, the insured may elect, in lieu of the option above mentioned, to receive one year from the receipt of satisfactory proofs of such total and permanent disability, one twentieth of the face of this contract in cash, and the further payment of a like amout upon each succeeding anniversary, until twentyannual instalments shall have been paid. Should the insured die during the period men tioned, the remainder of the instalments shall be payable in like manner to the beneficiary named herein. If, however, the insured shall recover so as to be able to engage in any gainful occupation, the company's obligation to pay the premiums or the remainder of the annual instalments of the face of this contract shall cease, and the insured shall resume the payment of premiums on the first premium due date following such recovery. I, STATE OF INDIANA.-OFFICE OF AUDITOR Of State. auditor of State of the State of Indiana, do hereby certify that the Anchor Life Insurance Company, with principal office at Indianapolis Ind., has fully complie with the provisions of an act of the general assembly of the State of Indiana, entitled 'an act for the incorporation of life insurance companies on either the stock or mutual plan***" approved March 10, 1899, and is duly incorporated under said act, as a stock company with $100,000 capital stock. I further certify that said company has now on deposit with my office, securities as prescribed by said act for the security and benefit of its policyholders. I further certify that said company is authorized to transact the business of life insurance in this State. This policy contains the standard provisions required by the law of the State of Indiana GUARANTEED BENEFITS OF THIS CONTRACT. GRACE IN PAYMENT OF PREMIUMS.-A grace of thirty-one days, during which this contract shall remain in force, will be allowed in the payment of all premiums except the first. INCONTESTABILITY.-This policy, which, with the application therefor, constitutes the entire contract between the parties hereto, shall be incontestable after one year from date of issue for the amount due, provided premiums have been duly paid, and there has been no violation of provisions relating to suicide or military and naval service in time of war. If the age of the insured has been misstated, the amount payable hereunder shall be that which the premium paid would have purchased at the correct age of the insured. AUTOMATICALLY NON-FORFEITABLE.-Should the insured fail to pay the second or any subsequent premium hereon without having exercised any of the several options set forth below, the company will, without any action on the part of the insured, gran the third option (extended insurance) as set forth below. REINSTATEMENT.This policy may be reinstated at any time upon application of the insured, accompanied by evidence of insurability satisfactory to the company, the approval of the president, and the payment of all arrears due, with interest at the rate of five (5) per cent per annum. CHANGE OF BENEFICIARY.-Provided this policy is not assigned, the insured may at any time, and from time to time during its continuance, change the beneficiary, to take effect only when such change and the written consent of the company thereto are endorsed upon the policy, at the home office of the company, whereupon all rights of the former beneficiary shall cease. If there be no beneficiary living at the death of the insured, the proceeds of this policy shall be paid to the executors, administrators, or assigns of the insured. LOANS.-After this policy shall have been in force one full year, the company will, within six months after written request, loan up to the amount stated in the cash loan column of the table endorsed hereon for the end of the last preceding year for which complete annual premiums have been paid, with interest in advance at the rate of five (5) per cent per annum; provided: (1) That this policy be duly assigned to the company as collateral security for such loan; (2) that the amount of loan availableshall include any previous loan or other unpaid indebtedness; (3) that the premiums must be fully paid to the end of the current policy year; (4) failure to repay such loan or interest thereon shall not void this policy unless the total indebtedness hereon to the company shall equal or exceed the loan value at the time of such default nor until thirty days after notice shall have been mailed by the company to the last known address of the insured and of the assignees, if any. YEARLY SURRENDER OPTIONS.-All premiums having been fully paid in cash, and this policy being free from indebtedness, the insured, upon surrender and cancellation thereof within thirty days after the second or any subsequent anniversary of its date of issue, will be entitled to one of the following options, the respective values and extensions thereof being shown in the table of values given below. The cash values shown herein are at least equal to the amount available for the purchase of extended insurance. Provided: That in any settlement hereunder any indebtedness to the company on account of this policy shall first be deducted from the net value of the option selected and the balance paid in cash or applied as a net single premium upon the American Experience Table of Mortality and three and one-half per cent interest, to purchase paid-up or extended insurance. First option: Cash. Second option: Paid-up insurance. Third opiton: Extended insurance. The election of the second or third option will be evidenced by the issuance of a new policy in lieu of this policy. This policy is based upon the American Experience Table of Mortality and three and one-half per cent interest, and the reserve computed upon that basis. Values for years subsequent to the twentieth shall be the full reserve. 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. SETTLEMENT OPTIONS.-If this policy is in full force twenty years from date hereof, the insured may take in settlement thereof any one of the following options: If all coupons remain attached under option four: (1) A paid-up policy for $13,480, or (2) a cash payment of $7,638 10/100, or (3) an annuity of $594 70/100, 0 (4) a paid-up policy for $10,000, and a cash payment of $1,978 10/100. The first option is subject to evidence of good health satisfactory to the company. If coupons have been withdrawn: (1) A paid-up policy for $10,000, or (2) a cash payment of $5,660, or (3) an annuity of $441 30/100. If a part of the coupons remain attached and a part are withdrawn, the above values will be proportionately increased. INSTALMENT OPTIONS.-The insured, by written request on the company's form, may change the mode of payment of the proceeds of this policy as a death claim, provided ་ the policy is in force and has not been assigned, from payment in one sum as provided on the first page hereof, to payment by annual instalments as provided in the following table: For each $1000 payable in one sum, $1,059.95 will be paid in 5 instalments of $211.99 each, or $1,138.20 will be paid in 10 instalments of $113.82 each, or $1.219.95 will be paid in 15 instalments of $81.33 each, or $1,305.20 will be paid in 20 instalments of $65.26 each, or $1,394 will be paid in 25 instalments of $55.76 each, or any of the above annual instalments will be paid in monthly instalments if desired. GENERAL PROVISIONS. (1) Premiums are due and payable annually in advance, but after the first year may be paid semi-annually or quarterly, at the home office of the company, or may be paid to an agent of the company upon delivery of receipt: signed by the president or secretary, and countersigned by the agent. If any premium. cash loan or interest thereon be not paid when due, this policy shall be void and all premiums forfeited to the company except as herein provided. (2) Proof of the fact and cause of death must be furnished to the company at its home office not later than three years after the death of the insured, on the company's blanks furnished for that purpose, which proofs shall comprise satisfactory statements establishing the claim. (3) In case of death from service in war without permission from the company, the full reserve for this policy at the time of such death only will be paid. (4) Any indebtedness to the company, including any balance of premium for the insurance year remaining unpaid, will be deducted in any settlement of this policy or any benefit thereunder. (5) This policy may be assigned upon written approval of the president or secretary, but the company will not assume any responsibility for the validity of an assignment. (6) Only the president, vice-president or secretary has power on behalf of the company to make or modify this or any contract of insurance, or to extend the time of paying any premium, and the company shall not be bound by any promise or representation heretofore or hereafter given by any agent or person other than the above. (7) All statements made by the insured in the application herefor shall, in the absence of fraud, be deemed representations and not warranties.] This policy is issued in consideration of the printed and written application therefor, a copy of which is hereto attached and made a part hereof, and the payment in advance of three hundred eighty-three and 50/100 dollars, for one year's term insurance, and will be renewed upon the further payment of a like amount at the home office of the company, on or before the nineteenth day of December in every year thereafter, until twenty full annual premiums shall have been paid. In witness whereof, the Anchor Life Insurance Company has caused this policy to be signed by its duly authorized officers, at its home office in the city of Indianapolis, Ind., this nineteenth day of December, 1910. Coupons provide for reduction of premiums in successive years as follows: $39.10; $13.20; $47.40; $51.60; $55.80; $60; $64.20; $68.40; $72.60; $76.80; $81; $85.10; $89.30; $93.50; $97.70; $101.90; $106.10; $110.30 and $114.50. AGREEMENT IN APPLICATION. As a further consideration for the issuance of this insurance, I represent and agree that the statements, answers and agreements stated herein, and the statements, answers and agreements made in Part 2 of this application, all of which shall be a part of the contract of insurance hereby applied for, are full, true and complete, otherwise this insurance shall be void. For myself and all persons who shall have any interest therein, I agree that the policy shall be construed as a contract made and to be performed in the State of Indiana; that there shall be no contract of insurance until a policy shall have been issued and delivered to me when in good health, and the first premium then paid to said company; that engaging in handling electric wires or dynamos, making or using explosives, blasting, mining, submarine labor, aeronautic ascensions, coupling or switching cars, employment on any steam or sailing vessel, or railroad train or engine, except as passenger or sleepingcar conductor, within one year from the date of the policy, without the written consent of the company, shall work a forfeiture of all rights under the policy issued hereon; that all premiums due on the policy are payable annually in advance, but may be paid in semiannual or quarterly instalments in advance, according to the company's rate therefor; that self-destruction sane or insane, or death in the violation of a law, within one year from date of policy, are risks not assumed by the company in the contract, but in such cases the company will pay the amount of the premium actually paid hereon; that the delivery and acceptance of the policy herein applied for, and the payment of the first premium thereon, shall constitute an acceptance of the contract and of all its conditions. Atlantic Life Insurance Company. HEAD OFFICE, RICHMOND, Va. ANNUAL PREMIUM RATES PER $1000 OF INSURANCE.† (Reserve at 312%.) *Premiums payable until age 75. † Adopted September 25th, 1908. Atlantic Life Insurance Company. TWENTY-PAYMENT LIFE POLICY-ANNUAL DIVIDENDS. AMOUNT, $10,000. ANNUAL PREMIUM, $373. AGE, 35. Atlantic Life Insurance Company, Richmond, Va., agrees to pay (amount) ten thousand dollars to (beneficiary) Mary Doe, wife of the insured, or to any substituted beneficiary, at its home office, Richmond, Va., immediately upon receipt and approval of proofs of the death of (insured) John Doe, of Richmond, Va. INVESTMENT AND INSTALMENT OPTIONS. At the written request of the insured, the company will provide by endorsement on this contract that the amount payable hereunder, or any portion thereof, when the same matures as a death claim, shall be left with the company as a trust fund for such period as the insured may direct, the beneficiary to receive semi-annually interest at the rate earned by the company (after deducting losses on investments) on its admitted assets during the preceding calendar year, less one-eighth of one per cent of the amount of said trust fund for investment expenses. The principal sum left in trust under this provision shall be payable in cash to the beneficiary or to the estate of the beneficiary on the expiry of the period stipulated by the insured. The insured may also stipulate in said request that no assignment or hypothecation of this contract, or any part thereof, or any income therefrom, shall be made by the beneficiary. In lieu of the above, the insured may also exercise any one of the instalment options provided on the fourth page hereof. ANNUAL DIVIDENDS.-The company will determine at the end of each year the amount of surplus to be allotted to this contract. Upon payment in cash of the second and each succeeding premium, the surplus allotted to this contract shall, at the option of the insured, be either (1) Paid in cash; or, (2) Applied toward the payment of any premium or premiums; or, (3) Applied without re-examination to the purchase of non-forfeitable additional paid-up participating insurance payable at the same time and in the same manner as the principal sum herein provided, or, (4) Left with the company to accumulate to the credit of this contract with interest at three and one-half per centum compounded annually. When the reserve on this contract, together with such accumulations, shall equal the net single premium required to purchase a paid-up contract for the principal sum herein provided at the attained age of the insured, said contract shall then become paid-up for its full amount, and no further premiums shall be required. The amount of surplus on deposit may be withdrawn by the insured at any time. Unless the insured shall elect otherwise, within three months after the mailing by the company of a written notice requesting such election, it shall be construed as an election on the part of the insured to continue this contract under option (3). After all premiums required by this contract shall have been paid, it shall participate annually in the surplus as herein provided. Should the premium be paid otherwise than annually, the surplus shall be applied in the manner in which premiums are paid. PERMANENT DISABILITY BENEFITS.—If, prior to attaining age sixty, while this contract is in full force by the payment of premiums, the insured shall furnish proof satisfactory to the company that from causes originating after the delivery of this contract, he has become totally and permanently disabled, and will by such disablement be prevented for life from engaging in any gainful occupation, the company will by endorsement hereon waive the payment of premiums falling due during the continuance of such disability, and the right of the insured to dividends or surrender values shall continue as if the premiums were duly paid by the insured. OPTIONAL BENEFITS.-In lieu of the benefit aforesaid, the company will on like proof of disability and on surrender and cancellation of this contract issue a supplementary contract providing for the payment in twenty equal annual instalments of the sum due in event of death, the first instalment to be payable on approval of the aforesaid proof and surrender of this contract, and subsequent instalments annually thereafter. Any indebtedness to the company against this contract shall reduce the amount of each instalment by the proportion that said indebtedness bears to the commuted value of said instalments. SPECIFIC CAUSES OF DISABILITY.-The company will consider the entire and irrevocable loss by accident or disease of the sight of both eyes, or the total and permanent loss by accident or disease of the use of both hands or both feet, or of one hand and one foot, as total and permanent disability within the meaning of this provision. GRACE. A grace of one month, during which time this contract will remain in full force, will be allowed in payment of all premiums except the first, subject to interest at six per cent per annum for the days past due. PREMIUM. This contract is issued in consideration of the written and printed application, a copy of which is attached hereto and made a part of this contract, and of the payment of three hundred and seventy-three dollars in advance, before this contract shall take effect, as the premium for an insurance terminating one year from the date hereof, and will be renewed and extended thereafter as a limited payment life contract upon the further payment of a like amount due one year from the date hereof and on the same anniversary day in every year thereafter and payable on said date annually or within the grace period as above |