EXHIBIT 10(jj)

[LOGO APPEARS HERE]

 

Pacific Life Insurance Company

  §  700 Newport Center Drive   §  Newport Beach, CA 92660

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FLEXIBLE

PREMIUM

ADJUSTABLE LIFE

INSURANCE

POLICY

  

We, Pacific Life Insurance Company, agree with you, the Owner,

to pay the benefits of this policy according to its provisions.

 

Right To Cancel Policy Within 20 Days – You may return this policy within 20
days after you receive it. To do so, deliver or mail it to us or our agent. We
will then cancel this policy as of the policy date and refund any premium paid.

 

Signed at our Home Office, 700 Newport Center Drive, Newport Beach, California
92660

§  Flexible Premiums Payable to Age 95

 

SIGNATURE APPEARS HERE

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SIGNATURE APPEARS HERE

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§  Adjustable Face Amount

  Chairman and Chief Executive Officer   Secretary

§  Participating

       

 

FORM: 92-45

 

    

This is not an original contract, but merely evidences the terms

and conditions, effective as of 2/9/2005

of the original policy of the same number which has been lost

mutilated or accidentally destroyed.

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IMPORTANT NOTICE

 

WE ARE REQUIRED BY STATE LAW TO PROVIDE YOU WITH THE FOLLOWING INFORMATION.

 

AT PACIFIC LIFE, WE ALWAYS STRIVE TO PROVIDE OUR POLICYOWNERS WITH THE BEST
PRODUCTS AND SERVICES. SHOULD YOU HAVE A PROBLEM, YOUR LOCAL AGENT AND AGENCY
WILL BE GLAD TO HELP YOU.

 

HOWEVER, YOU MAY ALSO CONTACT THE CALIFORNIA DEPARTMENT OF INSURANCE IF THE
CONTACTS BETWEEN YOU AND OUR COMPANY OR OUR AGENT HAVE FAILED TO PRODUCE A
SATISFACTORY SOLUTION TO THE PROBLEM.

 

PACIFIC LIFE CUSTOMER SERVICE

700 NEWPORT CENTER DRIVE

NEWPORT BEACH, CA 92660

 

(800) 800-7681

 

OR

 

CALIFORNIA DEPARTMENT OF INSURANCE

CONSUMER AFFAIRS DIVISION

300 SOUTH SPRING STREET

SOUTH TOWER

LOS ANGELES, CA 90013

 

CALIFORNIA ONLY (800) 927-HELP

OUTSIDE CALIFORNIA: (213) 736-3582

 

2

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POLICY SPECIFICATIONS

 

PREMIUMS:

  PLANNED ANNUAL PREMIUM = $31,083.00

INTEREST:

  IN ADDITION TO GUARANTEED INTEREST DESCRIBED IN THE INTEREST PROVISION OF THIS
POLICY, WE MAY CREDIT EXCESS INTEREST ON THE UNLOANED PORTION OF THE ACCUMULATED
VALUE. THIS EXCESS INTEREST WILL BE GUARANTEED FOR THE FIRST POLICY YEAR SUCH
THAT, TOGETHER WITH GUARANTEED INTEREST, THE INTEREST RATE ON THE UNLOANED
PORTION OF THE ACCUMULATED VALUE WILL BE .506483% PER MONTH WHICH IS EQUIVALENT
TO 6.25% ANNUALLY.

DEATH BENEFIT

QUALIFICATION

TEST:

  CASH VALUE ACCUMULATION TEST (THIS ELECTION IS IRREVOCABLE FOR LIFE OF THE
CONTRACT.)

OWNER:

  LITTON INDUSTRIES INC

BENEFICIARY:

  AS STATED ON THE APPLICATION UNLESS SUBSEQUENTLY CHANGED.     This is not an
original contract, but merely evidences the terms and conditions, effective as
of 2/9/2005 of the original policy of the same number which has been lost
mutilated or accidentally destroyed.

BASIC POLICY:

  FLEXIBLE PREMIUM ADJUSTABLE LIFE

POLICY NUMBER:

 

1A23867640

   INSURED’S NAME: RONALD D SUGAR

FIRST YEAR

TOTAL COVERAGE:

 

$2,406,083.00

   RISK CLASSIFICATION:  MALE         NONSMOKER

POLICY DATE:

 

JUN 01, 2000

   AGE ON POLICY DATE:    52

MATURITY DATE:

 

JUN 01, 2043

   NOTE: THIS POLICY MAY NOT REMAIN IN FORCE TO THE INDICATED MATURITY DATE IF
THE PAYMENTS ARE INSUFFICIENT TO MAINTAIN THE CASH VALUE UNTIL THAT DATE.

MONTHLY PAYMENT DATE IS

THE 1ST DAY OF THE MONTH.

  

 

3

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POLICY NUMBER: 1A2386764-0

 

POLICY SPECIFICATIONS

 

SUMMARY OF COVERAGES EFFECTIVE ON THE POLICY DATE

 

92-45:

   BASIC COVERAGE GUARANTEED ISSUE

FACE AMOUNT:

   $481,217.00 INITIAL SURRENDER CHARGE : $2,011.49

RISK CLASSIFICATION:

   MALE            NONSMOKER

 

SEE POLICY PAGE 10 FOR ADDITIONAL DETAILS REGARDING THE SURRENDER CHARGE.

 

ADMINISTRATIVE

CHARGE:

   $6.00 PER MONTH

INSURANCE

CHARGE:

   AN AMOUNT PER $1000 OF FACE AMOUNT WILL BE DEDUCTED FROM THE ACCUMULATED
VALUE EACH MONTH FOR THE FIRST 60 POLICY MONTHS ACCORDING TO THE FOLLOWING
SCHEDULE:     

POLICY

MONTH

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AMOUNT PER

$1,000 OF FACE

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     1 – 15   $0.38      16 – 30   $0.64      31 – 45   $0.90      46 – 60  
$1.16

R90-APB2:

   ADDED PROTECTION BENEFIT GUARANTEED ISSUE     

TARGET AMOUNT:

 

$1,924,866.00 VARYING

SEE ATTACHED SCHEDULE

    

AGE AT ISSUE:

  52     

RISK CLASSIFICATION:

  MALE NONSMOKER     

COVERAGE CEASE DATE:

  JUN 01, 2043

PERSON COVERED: RONALD D SUGAR

R86-E1: EXCHANGE OF INSURED RIDER

 

4

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POLICY NUMBER: 1A2386764-0

 

POLICY SPECIFICATIONS (CONT’D)

 

SUMMARY OF COVERAGES EFFECTIVE ON THE POLICY DATE

 

ADDED PROTECTION BENEFIT

 

VARYING SCHEDULE

 

AGE AT ISSUE: 52

 

RISK CLASSIFICATION: MALE            NONSMOKER

 

COVERAGE CEASE DATE: JUN 1, 2043

PERSON COVERED: RONALD D SUGAR

 

ATTAINED AGE

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   TARGET AMOUNT

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   ATTAINED AGE

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   TARGET AMOUNT

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52    $ 1,924,866.00    90    $ 47,862.00 53    $ 2,075,949.00    91    $
47,862.00 54    $ 2,233,032.00    92    $ 47,862.00 55    $ 2,397,115.00    93
   $ 47,862.00 56    $ 2,567,198.00    94    $ 47,862.00 57    $ 2,744,281.00   
         58    $ 2,928,364.00             59    $ 3,120,447.00             60   
$ 3,319,530.00             61    $ 3,528,613.00             62    $ 3,745,696.00
            63    $ 3,971,779.00             64    $ 4,208,863.00             65
   $ 1,025,862.00             66    $ 1,025,862.00             67    $
1,025,862.00             68    $ 1,025,862.00             69    $ 1,025,862.00
            70    $ 47,862.00             71    $ 47,862.00             72    $
47,862.00             73    $ 47,862.00             74    $ 47,862.00          
  75    $ 47,862.00             76    $ 47,862.00             77    $ 47,862.00
            78    $ 47,862.00             79    $ 47,862.00             80    $
47,862.00             81    $ 47,862.00             82    $ 47,862.00          
  83    $ 47,862.00             84    $ 47,862.00             85    $ 47,862.00
            86    $ 47,862.00             87    $ 47,862.00             88    $
47,862.00             89    $ 47,862.00            

 

5

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POLICY NUMBER: 1A2386764-0

 

POLICY SPECIFICATIONS

 

TABLE OF COST OF INSURANCE RATES

 

GUARANTEED MAXIMUM MONTHLY COST OF INSURANCE RATES PER $1.00 APPLICABLE TO BASIC
POLICY COVERING THE INSURED.

 

AGE

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MONTHLY

CHARGE

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   AGE

--------------------------------------------------------------------------------

  

MONTHLY

CHARGE

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52

   0.00066576          

53

   0.00072874          

54

   0.00080017          

55

   0.00087671          

56

   0.00096005          

57

   0.00104684          

58

   0.00113961          

59

   0.00123924          

60

   0.00134997          

61

   0.00147355          

62

   0.00161340          

63

   0.00177217          

64

   0.00194909          

65

   0.00214342          

66

   0.00235099          

67

   0.00257276          

68

   0.00280882          

69

   0.00306532          

70

   0.00335367          

71

   0.00368198          

72

   0.00406029          

73

   0.00449620          

74

   0.00498351          

75

   0.00551331          

76

   0.00607652          

77

   0.00666569          

78

   0.00727588          

79

   0.00792387          

80

   0.00863520          

81

   0.00943077          

82

   0.01033895          

83

   0.01137349          

84

   0.01251384          

85

   0.01373772          

86

   0.01502184          

87

   0.01635661          

88

   0.01773798          

89

   0.01917198          

90

   0.02067765          

91

   0.02228714          

92

   0.02406346          

93

   0.02611992          

94

   0.02881299          

 

6

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POLICY NUMBER: 1A2386764-0

 

POLICY SPECIFICATIONS

 

TABLE OF COST OF INSURANCE RATES

 

GUARANTEED MAXIMUM MONTHLY COST OF INSURANCE RATES PER $1.00 APPLICABLE TO THE
ADDED PROTECTION BENEFIT COVERING RONALD D SUGAR

 

AGE

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MONTHLY

CHARGE

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   AGE

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MONTHLY

CHARGE

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52

   0.00066576          

53

   0.00072874          

54

   0.00080017          

55

   0.00087671          

56

   0.00096005          

57

   0.00104684          

58

   0.00113961          

59

   0.00123924          

60

   0.00134997          

61

   0.00147355          

62

   0.00161340          

63

   0.00177217          

64

   0.00194909          

65

   0.00214342          

66

   0.00235099          

67

   0.00257276          

68

   0.00280882          

69

   0.00306532          

70

   0.00335367          

71

   0.00368198          

72

   0.00406029          

73

   0.00449620          

74

   0.00498351          

75

   0.00551331          

76

   0.00607652          

77

   0.00666569          

78

   0.00727588          

79

   0.00792387          

80

   0.00863520          

81

   0.00943077          

82

   0.01033895          

83

   0.01137349          

84

   0.01251384          

85

   0.01373772          

86

   0.01502184          

87

   0.01635661          

88

   0.01773798          

89

   0.01917198          

90

   0.02067765          

91

   0.02228714          

92

   0.02406346          

93

   0.02611992          

94

   0.02881299          

 

7

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Company or PL or we or us refers to Pacific Life Insurance Company.

 

Monthly payment date is the day each month on which Mortality Charges,
Administrative Charges, Insurance Charges, Rider Charges, and Benefit Charges,
if any, are deducted from the Accumulated Value. This day is shown on page 3.
The first monthly payment date is the Policy Date.

 

Home Office means the Company’s office located at 700 Newport Center Drive,
Newport Beach, California 92660.

 

You, your or owner refers to the owner of this policy.

 

Policy Date is shown on page 3. Policy months, years and anniversaries are
measured from this date.

 

Age means age nearest birthday as of the policy date, increased by the number of
complete policy years elapsed. With respect to any increases in face amount,
riders, or other policy benefits which have an effective date not falling on a
policy date anniversary, “age” means age nearest birthday as of the effective
date increased by the number of complete years elapsed since the effective date.

 

Evidence of Insurability is information, including medical information,
satisfactory to the Company that is used to determine the insured’s class of
risk.

 

Debt means all unpaid policy loans plus accrued interest on such loans.

 

Written request is a request in writing satisfactory to PL and filed at its Home
Office.

 

Maturity date is the policy anniversary nearest the insured’s 95th birthday.

 

Premiums

 

Premiums – This policy will not be inforce until the first premium is paid. No
premium may be less than $25. Premiums may be paid at any time prior to the
maturity date while this policy is in force either at the Home Office of the
Company or to an agent of the Company, subject to the premium limitations and
the Reinstatement provision shown below. On written request we will give you a
premium receipt signed by a Company officer.

 

We reserve the right to require evidence of insurability, satisfactory to us,
for any premium payment that would result in an immediate increase in the
difference between the death benefit and the Accumulated Value. If satisfactory
evidence of insurability is not provided before such premium is paid, we reserve
the right to refund the premium.

 

Premium Limitation – This section applies only to policies where the Guideline
Premium Test has been elected as the Death Benefit Qualification method. In
order for this policy to be treated as life insurance under the Internal Revenue
Code, the sum of the premiums paid less any dividends paid in cash and less any
partial withdrawals may not exceed the greater of:

 

  §   the Guideline Single Premium; or

 

  §   the sum of the Guideline Level Premiums to the date of payment.

 

The amounts of the Guideline Premiums are shown in the Policy Specifications
pages. The Guideline Premiums will change whenever there is a change in the face
amount of insurance or in other policy benefits. Such change will be shown in
the supplemental schedule of coverage. This premium limitation does not apply to
payment of a premium necessary to prevent lapse of the policy.

 

The Guideline Premiums are determined according to the rules applicable to this
policy set forth in the Internal Revenue Code. The Guideline Premiums will be
adjusted to conform to any changes in the Internal Revenue Code.

 

8

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In the event that a premium payment would exceed these limits, the Company
reserves the right to refund the excess payment with interest to the owner.

 

Grace Period and Lapse – The Company will determine on each monthly payment date
if a premium payment will be necessary as of the next monthly payment date to
keep the policy in force. A premium will be due on the next monthly payment date
if, at that time, the Mortality Charges, Administrative Charges, Insurance
Charges, Rider Charges, Benefit Charges and loan interest accrued to the end of
the next month are greater than the Accumulated Value less debt.

 

At such time as we determine that a premium is due, a notice will be sent to
your last known address and to the last known address of any assignee. The
notice will state the due date and the amount of premium required to keep the
policy in force. If this premium is not paid by its due date, the policy will be
in default. The premium may be paid during a grace period of 61 days beginning
on the premium due date. The policy will remain in force during this grace
period. A lapse occurs if the amount shown in the notice remains unpaid at the
end of the grace period. Upon lapse, the policy terminates and no coverage is in
force. We will send you written notice of lapse at your last known address at
least 30 days prior to termination of coverage.

 

Reinstatement – If it has not been surrendered, this policy may be reinstated
not more than five years after the date of premium default. To reinstate the
policy you must provide us with:

 

  §   evidence of insurability satisfactory to us; and

 

  §   payment of a premium sufficient to continue the policy in force for the
two-month period following the next monthly payment date.

 

You may pay or reinstate any debt outstanding on the date of default. Any loan
paid or reinstated will cause an increase in Accumulated Value of an equal
amount to also be reinstated. The reinstatement will become effective at such
time as the two conditions have been met.

 

Policy Benefits

 

Death Proceeds – When we receive proof that the insured’s death occurred while
this policy was in force, we will pay the death benefit under either the Cash
Value Accumulation Test or the Guideline Premium Test as elected by you and
shown in the Policy Specifications pages. These tests are described below. Any
debt, Mortality Charges, Administrative Charges, Insurance Charges, Rider
Charges and Benefit Charges due and unpaid through the policy month in which the
insured dies will be deducted from the death proceeds. We will also pay interest
on the resulting amount from the date of death to the date of payment at a rate
not less than the guaranteed rate or the legal rate required by the state in
which this policy is issued, if higher.

 

Death Benefit Qualification

 

The owner elects the method for Death Benefit Qualification in the application.
Once elected, this method may not be changed for the life of the contract. The
owner must choose one of the following methods:

 

  1.   Cash Value Accumulation Test – The death benefit will be the greater of
the face amount or the amount required for this policy to be deemed life
insurance according to the Internal Revenue Code. Such required amount will be
determined based on the Accumulated Value (defined on Page 8) and the Cash Value
Accumulation Test defined in the Internal Revenue Code Section 7702(b). We
reserve the right to amend this policy to comply with future regulations or
changes in the Internal Revenue Code. We will provide you with a copy of any
such amendment.

 

  2.   Guideline Premium Test – The death benefit will be determined as
described below under the Guideline Premium Test Death Benefit Options and the
Guideline Minimum Death Benefit provisions.

 

Guideline Premium Test Death Benefit Options There are two Death Benefit Options
available. The owner elects Option A or Option B in the application. If no
option is elected, Option A is the automatic option.

 

9

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Option A – The death benefit is the greater of:

 

  §   the face amount; or

 

  §   the Guideline Minimum Death Benefit.

 

Option B – The death benefit is the greater of:

 

  §   the face amount plus the Accumulated Value on the date of death; or

 

  §   the Guideline Minimum Death Benefit.

 

The Death Benefit Option may be changed on written request. After any such
change, the face amount will be that amount which results in the death benefit
after the change being equal to the death benefit before the change. The Death
Benefit Option may not be changed more than once in any policy year.

 

Guideline Minimum Death Benefit – The Guideline Minimum Death Benefit is the
product of the Accumulated Value and the Death Benefit Factor shown below for
the then current age of the insured:

 

Age

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   Factor

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   Age

--------------------------------------------------------------------------------

   Factor

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0-40

   2.50    60    1.30

41

   2.43    61    1.28

42

   2.36    62    1.26

43

   2.29    63    1.24

44

   2.22    64    1.22

45

   2.15    65    1.20

46

   2.09    66    1.19

47

   2.03    67    1.18

48

   1.97    68    1.17

49

   1.91    69    1.16

50

   1.85    70    1.15

51

   1.78    71    1.13

52

   1.71    72    1.11

53

   1.64    73    1.09

54

   1.57    74    1.07

55

   1.50    75-90    1.05

56

   1.46    91    1.04

57

   1.42    92    1.03

58

   1.38    93    1.02

59

   1.34    94    1.01

 

Benefit Change Provision – Subject to PL’s approval, the owner may change the
face amount of insurance if such request is made:

 

  §   during the lifetime of the insured;

 

  §   after the first policy year if the change is an increase;

 

  §   after the fifth policy year following the later of the policy date or the
most recent increase in face amount, if the change is a decrease;

 

  §   no more often than once in any policy year; and

 

  §   on written request while this policy is in force.

 

Increase – The following must occur before the effective date of any increase in
the face amount:

 

  §   evidence of insurability satisfactory to us must be provided to the
Company;

 

  §   consent of the insured, if the owner is not the insured.

 

10

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The effective date of the increased face amount will be the first monthly
payment date on or following the date all the conditions are met. A supplemental
schedule of coverage will be issued. This schedule will include the following
information for the additional face amount of insurance:

 

  §   the effective date of the increased face amount;

 

  §   the amount of the increase in the face amount;

 

  §   the class of risk;

 

  §   the monthly Insurance Charge;

 

  §   the surrender charge; and

 

  §   the new Guideline Premiums.

 

  §   An increase in the face amount will be allowed only if it results in a
death benefit increase of at least $10,000.

 

An administrative charge of $100 will be deducted from the Accumulated Value on
the effective date of the increase.

 

Decrease – A request to decrease the face amount will be effective on the
monthly payment date following the date of the written request. Existing
insurance will be decreased or eliminated in the following order:

 

  §   first, the most recent increase;

 

  §   second, the next most recent increases successively; and

 

  §   finally, the original face amount.

 

A supplemental schedule of coverage will be issued. This schedule will include
the following information:

 

  §   the effective date of the decrease in the face amount;

 

  §   the amount of the decrease in the face amount and the benefit remaining in
force; and

 

  §   the new Guideline Premiums.

 

The face amount of this policy may not be reduced to less than $10,000. Any
decrease in the face amount must result in a death benefit decrease of not less
than $10,000.

 

A decrease in the face amount will not be allowed if such decrease causes the
Guideline Level Premium to become negative.

 

Accumulated Value

 

Accumulated Value – The Accumulated Value on the policy date is 90.25% of the
first premium minus the Mortality Charges, Administrative Charges, Insurance
Charges, Rider Charges, and Benefit Charges, if any, for the first policy month.

 

The Accumulated Value on each subsequent monthly payment date is:

 

  §   the Accumulated Value on the last monthly payment date increased by one
month’s interest on such amount;

 

  §   plus, not less than 90.25% of any premiums paid since the last monthly
payment date increased by interest on such amount from the date the payment was
received at the Home Office;

 

  §   plus any Dividend credited;

 

  §   minus any Mortality Charges;

 

11

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  §   minus any Administrative Charges;

 

  §   minus any Insurance Charges;

 

  §   minus any Rider Charges;

 

  §   minus any Benefit Charges; and

 

  §   minus the amount of any Partial Withdrawal since the last monthly payment
date and interest on such amount from the date of withdrawal.

 

During any policy month the Accumulated Value is:

 

  §   the Accumulated Value on the last monthly payment date increased by
interest on such amount from such date;

 

  §   plus, not less than 90.25% of any premiums paid since the last monthly
payment date increased by interest on such amount from the date the payment was
received at the Home Office;

 

  §   minus the amount of any Partial Withdrawal since the last monthly payment
date and interest on such amount from the date of withdrawal.

 

Interest – We will credit interest on the Accumulated Value at a rate not less
than the Guaranteed Interest rate of .327374% per month, compounded monthly.
This is equivalent to 4% annually. In addition, we may credit excess interest to
the portion of the Accumulated Value in excess of existing debt.

 

This policy will be eligible for additional interest at the end of each of the
tenth and twentieth policy years if the policy is then in force. At each time of
eligibility, the Accumulated Value will be recalculated by increasing the
monthly rates of interest credited to the unloaned portion of the Accumulated
Value for each month from the Policy Date to the time of eligibility by the
smaller of (1) or (2), where:

 

  §   (1) is 0.25 multiplied by the monthly rate of interest credited to the
unloaned portion of the Accumulated Value in excess of the Guaranteed Interest
Rate of .327374%; and

 

  §   (2) is .041571%, which is the monthly equivalent of 0.5% annually.

 

We will not recompute the Dividends, Mortality Charges, Administrative Charges,
Insurance Charges, Rider Charges, or Benefit Charges when we recalculate the
Accumulated Value. The additional interest credit resulting from the
recalculation will be added to the Accumulated Value at the time of eligibility.
The eligibility for, and crediting of, additional interest will not be affected
by lapse, if followed by reinstatement.

 

Mortality Charges – Beginning on the policy date and monthly thereafter, there
will be a deduction from the Accumulated Value equal to the sum of the Mortality
Charges applicable to the following:

 

  §   the initial face amount; plus

 

  §   each increase in the face amount.

 

The monthly Mortality Charge for the death benefit payable under this policy is
(1) multiplied by the result of (2) minus (3), where:

 

  §   (1) is the applicable monthly Cost of Insurance Rate;

 

  §   (2) is the death benefit at the beginning of the policy month divided by
1.00327374; and

 

  §   (3) is the Accumulated Value at the beginning of the policy month before
deduction of Mortality Charges.

 

If the Cash Value Accumulation Test or Guideline Premium Test Death Benefit
Option A is elected and there have been increases in the face amount, then, for
purposes of calculating the Mortality Charges, the Accumulated

 

12

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Value will be first considered applicable to the initial face amount. If the
Accumulated Value exceeds the initial face amount, the excess will then be
considered applicable to any additional face amount resulting from increases in
the order of the increases.

 

The Mortality Charges will be adjusted for any decreases in the face amount
according to the Benefit Change Provision.

 

Cost of Insurance Rates – The Cost of Insurance Rates are based on the insured’s
attained age and risk classification, and the policy duration. The nonguaranteed
monthly Cost of Insurance Rates will be determined by the Company. These rates
will not exceed the Guaranteed Maximum Monthly Cost of Insurance Rates shown in
the Policy Specifications pages. Any change in the Cost of Insurance Rates will
apply uniformly for all insureds of the same risk classification on this policy
form.

 

We will use the initial risk classification and the duration measured from the
policy date: (i) for the initial face amount if the Cash Value Accumulation Test
or Guideline Premium Test Death Benefit. Option A is elected; or (ii) for the
initial face amount plus the Accumulated Value if Guideline Premium Test Death
Benefit Option B is elected. For each increase in face amount, we will use the
risk classification and the duration applicable to the increase.

 

If the death benefit: (i) equals the Guideline Minimum Death Benefit under the
Guideline Premium Test; or (ii) is greater than the face amount under the Cash
Value Accumulation Test, then any increase in Accumulated Value will cause an
automatic increase in the death benefit. The risk classification and duration
for such increase will be the same as that used for the most recent increase in
the face amount.

 

Administrative Charges – There will be an Administrative Charge withdrawn from
the Accumulated Value on each monthly payment date. The amount of this charge is
shown in the Policy Specifications pages. There will also be an Administrative
Charge of $100 withdrawn from the Accumulated Value on the effective date for
any increase in the face amount and $25 for any Partial Withdrawal of Cash
Surrender Value.

 

Insurance Charges – There are separate Insurance Charges for the original face
amount and each increase in the face amount. These charges are withdrawn monthly
from the Accumulated Value, for a period of 60 policy months starting on the
Policy Date or the effective date of any increase in the face amount as
applicable. Insurance Charges per $1,000 of initial face amount are shown in the
Policy Specifications pages. Insurance Charges for any increase in the face
amount are based on the insured’s attained age on the effective date of the
increase.

 

Dividends

 

Participating – At the end of the first and each following year, we will
determine your dividend, if any.

 

If there would have been a dividend payable at the end of the policy year in
which the insured dies, we will pay part of that dividend to the beneficiary.
The dividend will be for that part of the policy year during which the insured
lived.

 

Dividend Options – You may choose one of the following options:

 

  §   (1) Cash. Dividends will be paid in cash; or

 

  §   (2) Increased Accumulated Value. Dividends will be added to the policy’s
Accumulated Value on the date of the dividend payment. The Accumulated Value
will increase by exactly the amount of the dividend.

 

You may choose a dividend option within 31 days after a dividend is credited. If
you do not choose an option, Option (2) will be in effect until such time as you
request a different option. Any option you choose will remain in effect until
you change it.

 

13

--------------------------------------------------------------------------------

Maturity, Surrender and Partial Withdrawal

 

Maturity – If the insured is living on the maturity date, this policy will then
terminate. We will pay to you the Cash Surrender Value as a final settlement.

 

Surrender – Upon written request while the insured is living you may surrender
this policy for its Cash Surrender Value. The policy will terminate on the date
of the request.

 

Cash Surrender Value – The Cash Surrender Value is the Accumulated Value less
the sum of any debt and the applicable surrender charge.

 

Partial Withdrawal – Upon written request and after the first policy year while
the insured is living, you may withdraw a portion of the Cash Surrender Value of
this policy. A maximum of one withdrawal may be made in each policy year. The
amount of each Partial Withdrawal must be not less than $500 and the Cash
Surrender Value remaining after the withdrawal must be at least $500. The
Accumulated Value will be reduced by the amount of the Partial Withdrawal plus
an administrative charge of $25.

 

A Partial Withdrawal may cause a decrease in the face amount under the Cash
Value Accumulation Test or under Guideline Premium Test Death Benefit Option A.
During the first 15 policy years, the face amount will be reduced only to the
extent that the amount withdrawn exceeds the lesser of $10,000 or 10% of the
Cash Surrender Value. After the 15th anniversary, there will be a decrease in
the face amount equal to the Partial Withdrawal amount.

 

Any decrease in the face amount resulting from a Partial Withdrawal will be
subject to the Benefit Change provision of this policy.

 

Surrender Charge – There is a separate Surrender Charge for the original face
amount and each increase in the face amount. Surrender Charges begin on the
policy date and on the effective date of each increase in the face amount, and
reduce each month thereafter by 9.09% until the 12th month. The Surrender Charge
for the original face amount is shown on page 4. Surrender Charges for any
increase in the face amount are based on the insured’s attained age on the
effective date of the increase.

 

General – The Company may postpone payment of the Cash Surrender Value for up to
six months from the date you apply for it. If payment is postponed for 30 days
or more, the Cash Surrender Value will earn interest during the period of
postponement at a rate not less than 4% per year. However, we will not postpone
payment of the Cash Surrender Value if it is used to pay a premium on any other
policy you own that is issued by the Company and is then in force.

 

You may receive the Cash Surrender Value in a lump sum or you may apply it to
purchase income benefits.

 

If a surrender request is received within 30 days after a policy anniversary,
the Surrender Value will not be less than the Cash Surrender Value on such
anniversary minus any loans or partial withdrawals made after the anniversary.

 

Benefits – Maturity, surrender or withdrawal benefits may be used to buy a
monthly income for the lifetime of the insured. Death benefits may be used to
buy a monthly income for the lifetime of the beneficiary. Payments are
guaranteed for ten years. If the beneficiary dies before the end of the ten-year
period, payments will continue to the end of the ten-year period to a person
designated by the beneficiary.

 

14

--------------------------------------------------------------------------------

The purchase rates for the monthly income will be set periodically by the
Company. However, the income bought by each $1,000 will always be at least as
large as that shown below:

 

Age

--------------------------------------------------------------------------------

   Monthly Income

--------------------------------------------------------------------------------

   Age

--------------------------------------------------------------------------------

   Monthly Income

--------------------------------------------------------------------------------

30

   $ 3.76    54    $ 4.73

32

     3.81    56      4.87

34

     3.86    58      5.04

36

     3.91    60      5.22

38

     3.97    62      5.42

40

     4.03    64      5.65

42

     4.10    66      5.91

44

     4.18    68      6.19

46

     4.27    70      6.50

48

     4.37    72      6.85

50

     4.48    74      7.22

52

     4.59    75      7.41

 

Monthly income amounts for ages not shown are halfway between the two amounts
for the nearest two ages which are shown.

 

Guaranteed amounts for ages under 30 are the same as those for age 30;
guaranteed amounts for ages over 75 are the same as those for age 75. Amounts
shown are based on the 1983 Table a with interest at 4% annually.

 

This benefit is not available if the income would be less than $100 a month. We
may require evidence of survival for incomes which last more than ten years.
Optional forms of monthly income benefits are available upon request.

 

Policy Loans

 

Policy Loans – Loans may be obtained upon written request to the Company on the
sole security of this policy.

 

When Available – Loans are available only if the policy has a loan value
available. PL may delay granting a loan for up to six months from the date of
the request unless the loan is used to pay a premium on any other policy you own
that is issued by the Company and is then in force.

 

Amount Available – A loan may be for any amount up to the loan value. The loan
value is the Cash Surrender Value reduced by the following amounts:

 

  §   loan interest accrued to the next policy anniversary; and

 

  §   Mortality Charges, Administrative Charges, Insurance Charges, Rider
Charges and Benefit Charges, if any, for not more than 12 months following the
loan date.

 

Loan Interest – Interest is payable in arrears at the annual rate of:

 

  §   (i) 5.00% for policy years one through ten;

 

  §   (ii) 4.50% for policy years eleven through twenty; and

 

  §   (iii) 4.25% for policy years twenty-one and after.

 

Interest not paid when due will be added to the loan principal and bear interest
at the same rate of interest.

 

Repayment – Loans may be repaid at any time prior to the lapse of this policy.

 

15

--------------------------------------------------------------------------------

All funds received will be credited to this policy as a premium unless clearly
marked as a loan repayment.

 

Termination – If the debt exceeds the Accumulated Value less the Surrender
Charge of this policy, the policy will terminate with no value unless the excess
debt is repaid before the end of the Grace period. We will give you and any
assignee on record at our Home Office at least 30 days written notice before we
terminate the policy.

 

Owner and Beneficiary

 

Owner – The owner of this policy is as shown on page 3 or in a later written
change. If there are two or more owners, they will own this contract as joint
tenants with right of survivorship unless otherwise stated.

 

Assignment – This policy may be assigned upon written request. An assignment
will take place only when recorded at our Home Office. When recorded, the
assignment will take effect as of the date the written request was signed. Any
rights created by the assignment will be subject to any payments made or actions
taken by PL before the change is recorded. PL will not be responsible for the
validity of any assignment.

 

Beneficiary – The beneficiary is named by you in the application to receive the
death proceeds. The interest of any beneficiary will be subject to any
assignment.

 

A change of beneficiary may be made upon written request on forms provided by PL
while the insured is living. The change will take place as of the date the
request is signed. Any rights created by the change will be subject to any
payments made or actions taken by PL before the written request is received.

 

The interest of a beneficiary who does not survive to receive payment will pass
to the surviving beneficiaries in proportion to their share in the proceeds
unless otherwise provided. If no beneficiaries survive to receive payment, the
death proceeds will pass to the owner, or the owner’s estate if the owner does
not survive to receive payment.

 

General Provisions

 

Entire Contract – This policy is a contract between the Owner and PL. This
policy, the attached copy of the initial application, any applications for
reinstatement, all subsequent applications to change the policy and any
endorsements, riders or benefits are the entire contract. No statement will be
used in defense of a claim unless such statement is contained in the
application(s).

 

All statements contained in the application(s) shall, in the absence of fraud,
be deemed representations and not warranties.

 

Only an authorized officer of PL is permitted to change this contract or waive
any of its terms. The change must be made in writing.

 

Annual Report – An annual report will be mailed to you at your last known
address. This report will show the following information as of the policy
anniversary:

 

  §   the Accumulated Value;

 

  §   the Cash Surrender Value;

 

  §   premiums paid and charges made during the policy year;

 

  §   any dividend earned during the policy year;

 

  §   interest earned during the policy year;

 

16

--------------------------------------------------------------------------------

  §   existing debt;

 

  §   changes in the Guideline Premiums; and

 

  §   any information required by law.

 

Illustrative Report – An Illustrative Report will be sent to you upon request.
This report will show a projection of the future policy value as of the date of
the report. Any information required by law will be included. We will charge you
a reasonable fee for providing the report, but not more than $25.

 

Incontestability – Except for failure to pay premiums, this policy cannot be
contested by the Company after the expiration of the following time periods:

 

  §   the initial face amount cannot be contested after the policy has been in
force during the insured’s lifetime for two years from the policy date; and

 

  §   an increase in the face amount cannot be contested after the increased
amount has been in force during the insured’s lifetime for two years from its
effective date.

 

If this policy has been reinstated, it cannot be contested after it has been in
force during the insured’s lifetime for two years from the date of
reinstatement.

 

Suicide Exclusion – If the insured dies by suicide, while sane or insane, within
two years of the policy date, no death benefit will be paid. Instead, we will
return the sum of the premiums paid, less the sum of any debt, any dividends
paid in cash, and any Partial Withdrawal amounts. If the insured dies by
suicide, while sane or insane, within two years of the effective date of any
increase in the face amount, no death benefit will be paid with respect to that
increase. Instead, we will refund the Mortality Charges made with respect to
that increase.

 

Misstatement of Age or Sex – If there is a misstatement of age or sex in the
application, the amount of the death benefit shall be that which would be
purchased by the most recent Mortality Charge for the correct age and sex.

 

For all policy years after the policy year in which the misstatement is
discovered, the Accumulated Value will be calculated using Mortality Charges
based on the correct age and sex. The Accumulated Value for the year in which
the misstatement is discovered will not be recalculated. Surrender Charges will
not be recalculated.

 

Juvenile Risk Classification – If an insured’s age on the policy date is less
than 20, you will be notified at the last known address at least 60 days prior
to attainment of age 20 of the option to apply for “Nonsmoker” risk status. This
option must be requested in writing and accompanied by satisfactory evidence of
nonsmoking.

 

Basis of Values – A detailed statement showing how values are determined has
been filed with the state insurance department. All values are not less than the
minimums required by the law in the state in which this policy is delivered and
the Standard Nonforfeiture Law. All Guaranteed Values and the Guaranteed Maximum
Monthly Cost of Insurance Rates are based on the 1980 CSO Mortality Table (ANB)
and interest at the rate of 4% per year. For policies that are issued on a
unisex basis, the 1980 CSO Table B applies. For both sex distinct and unisex
issues, the Guaranteed Monthly Cost of Insurance Rates are the same for
nonsmoker and smoker classifications.

 

17

--------------------------------------------------------------------------------

Index

 

     Page

--------------------------------------------------------------------------------

Accumulated Value

   8

Administrative Charges

   3,10

Age

   3,6

Annual Report

   12

Assignment

   12

Basis of Values

   13

Beneficiary

   3,12

Benefit Change Provision

   8

Cash Surrender Value

   10

Cost of Insurance Rates

   9

Death Benefit Options

   7

Death Benefit Qualification

   7

Death Proceeds

   7

Definitions

   6

Dividends

   10

Entire Contract

   12

Face Amount

   3

General

   11

Grace Period

   6

Guideline Minimum Death Benefit

   7

Illustrative Report

   12

Income Benefits

   11

Incontestability

   12

Insurance Charges

   4,10

Interest

   3,9

Juvenile Risk Classification

   13

Lapse

   6

Loan Interest

   11

Maturity

   10

Misstatement

   12

Mortality Charges

   9

Owner

   3,11

Partial Withdrawal

   10

Policy Benefits

   7

Policy Date

   3,6

Policy Loans

   11

Policy Specifications

   3,4,5

Premiums

   3,6

Premium Limitation

   6

Reinstatement

   7

Repayment

   11

Suicide Exclusion

   12

Surrender

   10

Surrender Charge

   10

Termination

   11

 

18

--------------------------------------------------------------------------------

Exchange of Insured Rider

 

Benefit – You may exchange the named insured on this policy for a new insured,
subject to this rider’s terms.

 

Exchange Conditions – Exercise of this exchange will be subject to the following
conditions:

 

  §   the new insured must submit evidence of insurability satisfactory to us;

 

  §   you must make written application for the exchange, return this policy for
reissue and pay any costs or charges as determined by us.

 

Exchange Date – The exchange date is the first monthly payment date on or after
the date the exchange conditions are met.

 

Coverage on New Insured – Coverage on the new insured will become effective on
the exchange date. Coverage on the current insured will terminate on the day
before the exchange date.

 

This policy’s policy date will not be changed unless the new insured was born
after the policy date. In that case, the new policy date will be the anniversary
of this policy next following the birthdate of the new insured.

 

The cost of insurance rates for the new insured will be those applicable for the
new insured’s attained age and risk classification. Riders on the new insured
will be added only with our consent and subject to our requirements.

 

The face amount will not be affected by the exchange. If a different face amount
is desired on the new insured, the Increase or Decrease provision of the policy
can be exercised.

 

Suicide Exclusion – If the new insured dies by suicide, while sane or insane,
within two years of the exchange date, no death benefit will be paid. Instead,
we will return the cash value as of the exchange date, plus the sum of the
premiums paid since the exchange date, less the sum of any debt, partial
withdrawal amounts, and any dividends paid in cash.

 

Incontestability – Except for failure to pay premiums, this policy cannot be
contested after it has been in force during the new insured’s lifetime for two
years from the exchange date.

 

Effective Date – This rider is effective on the policy date unless otherwise
stated hereon. This rider will terminate:

 

  §   on termination or lapse of this policy; or

 

  §   if the option provided by this rider is exercised.

 

General Conditions – Any indebtedness or assignment outstanding against this
policy will not be affected by the exchange. This rider is a part of the policy
to which it is attached. All terms of this policy which do not conflict with the
rider’s terms apply to this rider.

 

Pacific Life Insurance Company

 

[SIGNATURE APPEARS HERE]

--------------------------------------------------------------------------------

  

[SIGNATURE APPEARS HERE]

--------------------------------------------------------------------------------

Chairman and Chief Executive Officer

   Secretary

 

19

--------------------------------------------------------------------------------

ADDED PROTECTION BENEFIT

 

Covered Person – As used in this benefit, “Covered Person” means any of the
individuals covered under this benefit on the Policy Date. Covered Persons may
be deleted from or, with evidence of insurability, added to this benefit. When
this occurs, we will send you revised Policy Specifications pages.

 

Coverage – When we receive proof that a Covered Person’s death occurred while
this benefit was in force, we will pay the Coverage Amount in effect, if any, on
that Covered Person under this benefit on the date of that Covered Person’s
death.

 

Coverage Amount – The Coverage Amount on any Covered Person provided by this
benefit in any policy year is equal to the greater of zero or the result of (1)
minus (2) shown below where the Covered Person is also the insured in the base
policy, and is otherwise equal to (1) below.

 

  (1)   is the Target Amount you specified in the application for that Covered
Person and for that policy year. This Target Amount is also shown separately for
each Covered Person in the Policy Specifications pages; such amount may be level
or varying by policy year.

 

         Subject to our approval, you may change the Target Amount for any
Covered Person and for any policy year, if you request such change in writing
during the lifetime of the Covered Person. Such change requests may be made not
more than once per policy year. You must provide evidence of insurability
satisfactory to us before any request for an increase in Target Amount becomes
effective. An administrative charge of $100 will be deducted from the base
policy Accumulated Value on the effective date of any increase in Target Amount.
Any decrease in Target Amount which you request for any policy year may require
associated decreases in Target Amounts for future policy years. You will be
informed of such associated future decreases, and your consent will be obtained
before your requested decrease becomes effective. Any decrease will first be
applied against the most recent increase, if any, and then against successively
earlier increases, if any, and finally against the original Target Amounts.

 

  (2)   is any increase in the base policy death benefit payable in that policy
year which results from either the Guideline Premium Test or the Cash Value
Accumulation Test defined in the Internal Revenue Code. The applicable test is
described in the base policy.

 

Mortality Charges – The Mortality Charges for this benefit are calculated
separately for each Covered Person. The Mortality Charge for any Covered Person
in any policy year is equal to the product of the applicable monthly Cost of
Insurance Rate times the Coverage Amount divided by the sum of one plus the
monthly Guaranteed Interest Rate shown in the base policy. The Cost of Insurance
Rates vary by age, duration, and risk classification and are subject to change
by us at any time, but will not exceed the Guaranteed Maximum Monthly Cost of
Insurance Rates for this benefit shown in the Policy Specifications pages. Any
such change will be made without regard to any change in health of any Covered
Person.

 

Conversion – While this benefit is in force, the Coverage Amount under this
benefit on any Covered Person may be converted at your request, without evidence
of insurability, to a new policy on that Covered Person’s life at any time
before that Covered Person is age 65. This benefit may be converted during the
first two years it is in force regardless of that Covered Person’s age. The
Coverage Amount on that Covered Person under this benefit will be cancelled on
the new policy’s Policy Date. The new policy’s Policy Date and the conversion
date will be the monthly payment date which next follows the date of our receipt
of your written request for conversion.

 

The amount of insurance under the new policy may not exceed the lesser, of the
Coverage Amount provided under this benefit on that Covered Person on the
conversion date, or the smallest Target Amount for that Covered Person for the
five-year period following the new policy’s Policy Date. If the Target Amount
you specified for that Covered Person is level for all policy years, then the
smallest Target Amount shall mean the level Target Amount. A lesser amount may
be selected as long as it is not less than our regular minimum limit at the time
of conversion.

 

20

--------------------------------------------------------------------------------

The new policy may be on any life insurance plan, other than term insurance,
that we regularly issue at the time of conversion. It will be issued in the same
risk classification and contain the same restrictions, if any, as this benefit.
It will be issued at our published rates which apply at that Covered Person’s
age on the new policy’s Policy Date.

 

Additional benefits or riders will not be included in the new policy without our
consent at the time of conversion.

 

Effective Date – This benefit is effective on the Policy Date unless otherwise
stated.

 

Termination – This benefit will terminate on the earliest of:

 

  §   your written request; or

 

  §   lapse of this policy; or

 

  §   conversion of the entire Coverage Amount; or

 

  §   termination of this policy.

 

General Conditions – This benefit is part of the policy to which it is attached.
As applied to this benefit, the periods stated in this policy’s Incontestability
and Suicide provisions will start with this benefit’s effective date. All terms
of this policy which do not conflict with this benefit’s terms apply to this
benefit.

 

Pacific Life Insurance Company

 

[SIGNATURE APPEARS HERE]

--------------------------------------------------------------------------------

 

[SIGNATURE APPEARS HERE]

--------------------------------------------------------------------------------

Chairman and Chief Executive Officer   Secretary

 

21

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CALIFORNIA LIFE and HEALTH INSURANCE GUARANTEE ASSOCIATION ACT

 

SUMMARY DOCUMENT AND DISCLAIMER

 

Residents of California who purchase life insurance, and annuities should know
that the insurance companies licensed in this state to write these types of
insurance are members of the California Life Insurance Guarantee Association
(“CLHIGA”). The purpose of this association is to assure that policyholders will
be protected, within limits, in the unlikely event that a member insurer becomes
financially unable to meet its obligations. If this should happen, the Guarantee
Association will assess its other member insurance companies for the money to
pay the claims of insured persons who live in this state and, in some cases, to
keep coverage in force. The valuable extra protection through the Association is
not unlimited, as noted in the box below, and is not a substitute for consumers’
care in selecting insurers.

 

The California Life and Health Insurance Guarantee Association may not provide
coverage for this policy. If coverage is provided, it may be subject to
substantial limitations or exclusions, and require continued residency in
California. You should not rely on coverage by the California Life Insurance
Guarantee Association in selecting an insurance company or in selecting an
insurance policy.

 

Coverage is NOT provided for your policy or any portion of it that is not
guaranteed by the insurer or for which you have assumed the risk, such as a
variable contract sold by prospectus.

 

Insurance companies or their agents are required by law to give or send you this
notice. However, insurance companies and their agents are prohibited by law from
using the existence of the guarantee association to induce you to purchase any
kind of insurance policy.

 

Policyholders with additional questions should first contact their insurer or
agent or may then contact:

 

California Life and Health Insurance Guarantee Association

P.O. Box 17319

Beverly Hills, California 90209-3319

or

Consumer Service Division

California Department of Insurance

300 South Spring Street

Los Angeles, California 90013

 

Below is a brief summary of this law’s coverages, exclusions and limits. This
summary does not cover all provisions of the law; nor does it in any way change
anyone’s rights or obligations under the act or the rights or obligations of the
Association.

 

COVERAGE

 

Generally, individuals will be protected by the California Life and Health
Insurance Guarantee Association if they live in this state and hold a life
insurance contract, or an annuity, or if they are insured under a group
insurance contract issued by a member insurer. The beneficiaries, payees or
assignees of insured persons are protected as well, even if they live in another
state.

 

22

--------------------------------------------------------------------------------

EXCLUSIONS FROM COVERAGE

 

However, persons holding such policies are not protected by this Guarantee
Association if:

 

  §   their insurer was not authorized to do business in this state when it
issued the policy or contract;

 

  §   their policy was issued by a health care service plan (HMO, Blue Cross,
Blue Shield), charitable organization, a fraternal benefit society, a mandatory
state pooling plan, a mutual assessment company, an insurance exchange, or a
grants and annuities society;

 

  §   they are eligible for protection under the laws of another state. This may
occur when the insolvent insurer was incorporated in another state whose
guaranty association protects insureds who live outside that state;

 

The Guarantee Association also does not provide coverage for:

 

  §   unallocated annuity contracts, that is, contracts which are not issued to
and owned by an individual and which guarantee rights to group contract holders,
not individuals;

 

  §   Employer or association plans to the extent the plan is self-funded or
uninsured;

 

  §   Synthetic guaranteed interest contracts;

 

  §   any policy or portion of a policy which is not guaranteed by the insurer
or for which the individual has assumed the risk, such as a variable contract
sold by prospectus;

 

  §   any policy of reinsurance unless an assumption certificate was issued;

 

  §   interest rate yields that exceed an average rate;

 

  §   any portion of a contract that provides dividends or experience rating
credits.

 

LIMITS ON AMOUNT OF COVERAGE

 

The Act limits the Association to pay benefits as follows:

 

LIFE AND ANNUITY BENEFITS

 

  §   80% of what the life insurance company would owe under a life policy or
annuity contract up to

 

  §   $100,000 in cash surrender values,

 

  §   $100,000 in present value of annuities, or

 

  §   $250,000 in life insurance death benefits.

 

  §   a maximum of $250,000 for any one insured life no matter how many policies
and contracts there were with the same company, even if the policies provided
different types of coverages.

 

HEALTH BENEFITS

 

  §   A maximum of $200,000 of the contractual obligations that the health
insurance company would owe were it not insolvent. The maximum may increase or
decrease annually based upon changes in health care cost component of the
consumer price index.

 

PREMIUM SURCHARGE

 

Member insurers are required to recoup assessments paid to the Association by
way of a surcharge on premiums charged for health insurance policies to which
the Act applies.

 

23

--------------------------------------------------------------------------------

HOME OFFICE ENDORSEMENT

 

INSURED: RONALD D SUGAR

POLICY NO: 1A2386764-0

 

THIS POLICY IS AMENDED IN ACCORDANCE WITH THE POLICY CHANGE REQUEST. THIS
ENDORSEMENT IS PART OF THE POLICY AND SHOULD BE ATTACHED.

 

RIDER TYPE ADDED PROTECTION BENEFIT

--------------------------------------------------------------------------------

        

AMOUNT OF INCREASE

       $ 87,083.00

AMOUNT OF RIDER AFTER INCREASE

       $ 2,011,949.00

EFFECTIVE DATE OF INCREASE

  JUN 1, 2001       

CEASE DATE OF INCREASE

  JUN 1, 2043       

PERSON COVERED

  RONALD D SUGAR       

AGE AT INCREASE

  53       

RISK CLASSIFICATION

  MALE            NONSMOKER       

TOTAL COVERAGE

       $ 2,493,166.00

 

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[LOGO APPEARS HERE]

 

Pacific Life Insurance Company   

§  700 Newport Center Drive

  

§  Newport Beach, CA 92660

--------------------------------------------------------------------------------

 

FLEXIBLE PREMIUM ADJUSTABLE

LIFE INSURANCE POLICY

 

§   Flexible Premiums Payable to Age 95

 

§   Adjustable Face Amount

 

§   Participating

 

FORM: 92-45

 

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STATEMENT DATE: DEC 13, 2000

POLICY NUMBER: 1A2386764-0

 

STATEMENT OF POLICY COST AND BENEFIT INFORMATION

FLEXIBLE PREMIUM ADJUSTABLE LIFE

 

PACIFIC LIFE INSURANCE COMPANY

   MC INSURANCE SERVICES INC

P.O. BOX 6390

   P W M INSURANCE

NEWPORT BEACH, CA 92658-6390

   ENGINE CO BLDG #28      644 S FIGUEROA      LOS ANGELES CA 90017

 

THIS INFORMATION IS PROVIDED TO ASSIST YOU IN BETTER UNDERSTANDING YOUR POLICY.
THE BASIC BENEFIT COVERAGE IS SHOWN BELOW. YOUR POLICY IS THE ENTIRE CONTRACT,
WHICH FULLY DESCRIBES YOUR BENEFITS.

 

OWNER NAME: LITTON INDUSTRIES INC      AGE ON POLICY DATE: 52 INSURED NAME:
RONALD D SUGAR      RISK CLASS: MALE         NONSMOKER FORM: 92-45       

 

         

GUARANTEED INTEREST

AND MORTALITY CHARGES

--------------------------------------------------------------------------------

   NON-GUARANTEED CURRENT
INTEREST AND MORTALITY
CHARGES

--------------------------------------------------------------------------------

POLICY YEAR

--------------------------------------------------------------------------------

   ANNUAL
PREMIUM

--------------------------------------------------------------------------------

   DEATH
BENEFIT

--------------------------------------------------------------------------------

   SURRENDER
VALUE

--------------------------------------------------------------------------------

   DEATH
BENEFIT

--------------------------------------------------------------------------------

   SURRENDER
VALUE

--------------------------------------------------------------------------------

1

   $ 31,083.00    $ 2,406,083    $ 7,849    $ 2,406,083    $ 18,356

2

   $ 31,083.00    $ 2,557,166    $ 11,329    $ 2,557,166    $ 36,074

3

   $ 31,083.00    $ 2,714,249    $ 10,066    $ 2,714,249    $ 53,049

4

   $ 31,083.00    $ 2,878,332    $ 3,287    $ 2,878,332    $ 69,160

5

   $ 31,083.00    $ 0    $ 0    $ 3,048,415    $ 84,282

6

   $ 31,083.00    $ 0    $ 0    $ 3,225,498    $ 105,258

7

   $ 31,083.00    $ 0    $ 0    $ 3,409,581    $ 124,985

8

   $ 31,083.00    $ 0    $ 0    $ 3,601,664    $ 142,806

9

   $ 31,083.00    $ 0    $ 0    $ 3,800,747    $ 157,964

10

   $ 31,083.00    $ 0    $ 0    $ 4,009,830    $ 176,031

11

   $ 31,083.00    $ 0    $ 0    $ 4,226,913    $ 184,003

12

   $ 31,083.00    $ 0    $ 0    $ 4,452,996    $ 185,722

13

   $ 31,083.00    $ 0    $ 0    $ 4,690,080    $ 179,736

14

   $ 0.00    $ 0    $ 0    $ 1,507,079    $ 176,649

15

   $ 0.00    $ 0    $ 0    $ 1,507,079    $ 172,951

16

   $ 0.00    $ 0    $ 0    $ 1,507,079    $ 168,870

17

   $ 0.00    $ 0    $ 0    $ 1,507,079    $ 162,702

18

   $ 0.00    $ 0    $ 0    $ 1,507,079    $ 153,938

19

   $ 0.00    $ 0    $ 0    $ 529,079    $ 158,467

20

   $ 0.00    $ 0    $ 0    $ 529,079    $ 189,703

AGE 65

   $ 31,083.00    $ 0    $ 0    $ 4,690,080    $ 179,736

 

DIVIDENDS ARE BASED ON THE COMPANY’S CURRENT DIVIDEND SCALE AND ARE NOT
GUARANTEED.

 

26

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STATEMENT DATE: DEC 13, 2000

POLICY NUMBER: 1A2386764-0

 

STATEMENT OF POLICY COST AND BENEFIT INFORMATION

SUMMARY OF COVERAGE AND PREMIUMS

 

     LIFE INSURANCE COST INFORMATION

--------------------------------------------------------------------------------

     GUARANTEED

--------------------------------------------------------------------------------

   CURRENT

--------------------------------------------------------------------------------

COST INDEX

--------------------------------------------------------------------------------

   5 YEAR

--------------------------------------------------------------------------------

   10 YEAR

--------------------------------------------------------------------------------

   20 YEAR

--------------------------------------------------------------------------------

   5 YEAR

--------------------------------------------------------------------------------

   10 YEAR

--------------------------------------------------------------------------------

   20 YEAR

--------------------------------------------------------------------------------

SURRENDER @ 5%

        11.82    11.82         5.74    6.36

NET PAYMENT

   11.82    11.82    11.82    11.49    10.05    8.30

EQUIVALENT LEVEL

                             

ANNUAL DIVIDEND

        0.00    0.00         0.00    0.00

 

AN EXPLANATION OF THE INTENDED USE OF THESE INDICES AND OF THE EQUIVALENT LEVEL
ANNUAL DIVIDEND IS PROVIDED IN THE LIFE INSURANCE BUYER’S GUIDE.

 

**** IMPORTANT NOTICE ****

 

ACTUAL RESULTS WILL DIFFER FROM THE PROJECTIONS SHOWN ON THE PREVIOUS PAGE IF
THERE IS A CHANGE IN THE INTEREST RATES, MORTALITY CHARGES OR THE TIMING AND
AMOUNT OF YOUR PREMIUM PAYMENTS. THE NON-GUARANTEED AMOUNTS SHOWN ARE BASED ON
OUR CURRENT UNLOANED INTEREST RATE OF 6.45%. WE MAY CHANGE THE CURRENT INTEREST
RATE AT ANY TIME BUT MAY NOT CREDIT LESS THAN THE GUARANTEED ANNUAL RATE OF
4.00%. WE MAY CHANGE THE CURRENT MORTALITY CHARGES AT ANY TIME BUT MAY NOT
CHARGE MORE THAN THE GUARANTEED CHARGES. FURTHER, THE TAX STATUS OF THIS
CONTRACT SHOULD BE REVIEWED EACH YEAR. FOR FURTHER INFORMATION, CONTACT THE
INSURANCE COMPANY OR YOUR AGENT SHOWN AT THE TOP OF PAGE 1.

 

*** THE PROJECTED VALUES ON THE PREVIOUS PAGE INCLUDE THE***

***            COSTS AND BENEFITS OF THE BASIC COVERAGE                      ***

***         AND ANY ADDITIONAL INSURANCE OR PREMIUM RIDERS.  ***

 

TYPE OF COVERAGE

--------------------------------------------------------------------------------

   BENEFIT
AMOUNT

--------------------------------------------------------------------------------

BASIC COVERAGE:

      

FLEXIBLE PREMIUM ADJUSTABLE LIFE

   $ 481,217.00

CASH VALUE VERSION

      

ADDITIONAL INSURANCE RIDERS:

      

ADDED PROTECTION BENEFIT

     1,924,866.00

OTHER RIDERS:

      

 

EXCHANGE OF INSURED RIDER

 

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