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                                                                 EXHIBIT (10)(d)

                                                              AMERICAN
                                                                |GENERAL
                                                                |FINANCIAL GROUP
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JOINT AND LAST SURVIVOR
VARIABLE UNIVERSAL LIFE INSURANCE
SUPPLEMENTAL APPLICATION
AMERICAN GENERAL LIFE INSURANCE COMPANY, ("AGL")
Home Office: Houston, Texas

Member of American General Financial Group. American General Financial Group is the marketing name for American General Corporation
and its subsidiaries.

(This supplement must accompany the appropriate application for life insurance.)
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Applicant Information - Supplement to the application on the lives of
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Name of Proposed Contingent Insured            Name of Other Proposed Contingent Insured     Date of application for life insurance

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Initial Allocation Percentages
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Investment Options    In the "Premium Allocation" column, indicate how each premium received is to be allocated. In the "Deduction
                      Allocation" column, indicate which investment options are to be used for the deduction of monthly charges.
                      Total allocations in each column must equal 100%. Use whole percentages only.

                                           PREMIUM    DEDUCTION                                               PREMIUM    DEDUCTION
                                          ALLOCATION  ALLOCATION                                             ALLOCATION  ALLOCATION
                                          ----------  ----------                                             ----------  ----------
AGL Declared Fixed Interest Account (18)    _____%     _____%     NEUBERGER BERMAN ADVISERS MANAGEMENT TRUST
                                                                  Mid-Cap Growth Division (36)                     _____%     ____%
AIM VARIABLE INSURANCE FUNDS
AIM V.I. International Equity Division (1)  _____%     _____%     PIMCO VARIABLE INSURANCE TRUST
AIM V.I. Value Division (2)                 _____%     _____%     PIMCO Real Return Bond Division (101)            _____%     _____%
                                                                  PIMCO Short-Term Bond Division (37)              _____%     _____%
AMERICAN CENTURY VARIABLE PORTFOLIOS, INC.                        PIMCO Total Return Bond Division (102)           _____%     _____%
VP Value Division (19)                      _____%     _____%
                                                                  PUTNAM VARIABLE TRUST
AYCO SERIES TRUST                                                 Putnam VT Diversified Income Division (12)       _____%     _____%
Ayco Growth Division (23)                   _____%     _____%     Putnam VT Growth and Income Division (13)        _____%     _____%
                                                                  Putnam VT Int'l Growth and Income Division (14)  _____%     _____%
CREDIT SUISSE WARBURG PINCUS TRUST
Small Company Growth Division (105)         _____%     _____%     SAFECO RESOURCE SERIES TRUST
                                                                  Equity Division (15)                             _____%     _____%
DREYFUS INVESTMENT PORTFOLIOS                                     Growth Opportunities Division (16)               _____%     _____%
MidCap Stock Division (24)                  _____%     _____%
                                                                  THE UNIVERSAL INSTITUTIONAL FUNDS, INC.
DREYFUS VARIABLE INVESTMENT FUND                                  Equity Growth Division (10)                      _____%     _____%
Quality Bond Division (7)                   _____%     _____%     High Yield Division (11)                         _____%     _____%
Small Cap Division (8)                      _____%     _____%
                                                                  VALIC COMPANY I
FIDELITY VARIABLE INSURANCE PRODUCTS FUND                         International Equities Division (3)              _____%     _____%
VIP Asset Manager Division (28)             _____%     _____%     Mid Cap Index Division (4)                       _____%     _____%
VIP Contrafund Division (27)                _____%     _____%     Money Market I Division (5)                      _____%     _____%
VIP Equity-Income Division (25)             _____%     _____%     Nasdaq-100 Index Division (20)                   _____%     _____%
VIP Growth Division (26)                    _____%     _____%     Science & Technology Division (21)               _____%     _____%
                                                                  Small Cap Index Division (22)                    _____%     _____%
FRANKLIN TEMPLETON VARIABLE INSURANCE PRODUCTS TRUST              Stock Index Division (6)                         _____%     _____%
Franklin U.S. Government Division (106)     _____%     _____%
Mutual Shares Securities Division (107)     _____%     _____%     VANGUARD VARIABLE INSURANCE FUND
Templeton International Securities                                High Yield Bond Division (103)                   _____%     _____%
 Division(108)                              _____%     _____%     REIT Index Division (104)                        _____%     _____%

JANUS ASPEN SERIES                                                VAN KAMPEN LIFE INVESTMENT TRUST
Aggressive Growth Division (31)             _____%     _____%     Strategic Stock Division (17)                    _____%     _____%
International Growth Division (29)          _____%     _____%
Worldwide Growth Division (30)              _____%     _____%     OTHER:_____________________________              _____%     _____%
                                                                                                                    100%       100%
J.P. MORGAN SERIES TRUST II
J.P. Morgan Small Company Division (32)     _____%     _____%

MFS VARIABLE INSURANCE TRUST
MFS Capital Opportunities Division (34)     _____%     _____%
MFS Emerging Growth Division (9)            _____%     _____%
MFS New Discovery Division (35)             _____%     _____%
MFS Research Division (33)                  _____%     _____%
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AGLC 0093-99 REV 0800                                                                                                   Page  1 of 4
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Dollar Cost Averaging
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Dollar Cost    ($5,000 MINIMUM BEGINNING ACCUMULATION VALUE) An amount can be systematically transferred from the Money Market I
Averaging      Division and transferred to one or more of the investment options below. The AGL Declared Fixed Interest Account is
               not available for Dollar Cost Averaging. Please refer to the prospectus for more information on the Dollar Cost
               Averaging option.

               Day of the month for transfers: _____________________   (Choose a day of the month between 1-28.)

               Frequency of transfers:  [_] Monthly    [_] Quarterly    [_] Semiannually   [_] Annually

               Transfer $ ________________________________             ($100 MINIMUM, WHOLE DOLLARS ONLY)


AIM VARIABLE INSURANCE FUNDS                                    NEUBERGER BERMAN ADVISERS MANAGEMENT TRUST
AIM V.I. International Equity Division (1)  $__________         Mid-Cap Growth Division (36)                        $__________
AIM V.I. Value Division (2)                 $__________
                                                                PIMCO VARIABLE INSURANCE TRUST
AMERICAN CENTURY VARIABLE PORTFOLIOS, INC.                      PIMCO Real Return Bond Division (101)               $__________
VP Value Division (19)                      $__________         PIMCO Short-Term Bond Division (37)                 $__________
                                                                PIMCO Total Return Bond Division (102)              $__________
AYCO SERIES TRUST
Ayco Growth Division (23)                   $__________         PUTNAM VARIABLE TRUST
                                                                Putnam VT Diversified Income Division (12)          $__________
CREDIT SUISSE WARBURG PINCUS TRUST                              Putnam VT Growth and Income Division (13)           $__________
Small Company Growth Division (105)         $__________         Putnam VT Int'l Growth and Income Division (14)     $__________

DREYFUS INVESTMENT PORTFOLIOS                                   SAFECO RESOURCE SERIES TRUST
MidCap Stock Division (24)                  $__________         Equity Division (15)                                $__________
                                                                Growth Opportunities Division (16)                  $__________
DREYFUS VARIABLE INVESTMENT FUND
Quality Bond Division (7)                   $__________         THE UNIVERSAL INSTITUTIONAL FUNDS, INC.
Small Cap Division (8)                      $__________         Equity Growth Division (10)                         $__________
                                                                High Yield Division (11)                            $__________
FIDELITY VARIABLE INSURANCE PRODUCTS FUND
VIP Asset Manager Division (28)             $__________         VALIC COMPANY I
VIP Contrafund Division (27)                $__________         International Equities Division (3)                 $__________
VIP Equity-Income Division (25)             $__________         Mid Cap Index Division (4)                          $__________
VIP Growth Division (26)                    $__________         Nasdaq-100 Index Division (20)                      $__________
                                                                Science & Technology Division (21)                  $__________
FRANKLIN TEMPLETON VARIABLE INSURANCE PRODUCTS TRUST            Small Cap Index Division (22)                       $__________
Franklin U.S. Government Division (106)     $__________         Stock Index Division (6)                            $__________
Mutual Shares Securities Division (107)     $__________
Templeton International Securities                              VANGUARD VARIABLE INSURANCE FUND
 Division (108)                             $__________         High Yield Bond Division (103)                      $__________
                                                                REIT Index Division (104)                           $__________
JANUS ASPEN SERIES
Aggressive Growth Division (31)             $__________         VAN KAMPEN LIFE INVESTMENT TRUST
International Growth Division (29)          $__________         Strategic Stock Division (17)                       $__________
Worldwide Growth Division (30)              $__________
                                                                OTHER: ______________________________               $__________
J.P. MORGAN SERIES TRUST II
J.P Morgan Small Company Division (32)      $__________

MFS VARIABLE INSURANCE TRUST
MFS Capital Opportunities Division (34)     $__________
MFS Emerging Growth Division (9)            $__________
MFS New Discovery Division (35)             $__________
MFS Research Division (33)                  $__________
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Automatic Rebalancing
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AUTOMATIC      ($5,000 MINIMUM BEGINNING ACCUMULATION VALUE) Variable division assets will be automatically rebalanced based on the
REBALANCING    premium percentages designated on Page 1 of this form. If the AGL Declared Fixed Interest Account has been designated
               for premium allocation, the rebalancing will be based on the proportion allocated to the variable divisions. Please
               refer to the prospectus for more information on the Automatic Rebalancing option.

               CHECK HERE FOR AUTOMATIC REBALANCING FREQUENCY:  [_] Quarterly  [_] Semiannually  [_] Annually
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               NOTE: Automatic Rebalancing is not available if the Dollar Cost Averaging option has been chosen.

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Modified Endowment Contract
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CONTRACT       If any premium payment causes the policy to be classified as a modified endowment contract under Section 7702A of the
               Internal Revenue Code, there may be potentially adverse tax consequences. Such consequences include: (1) withdrawals
               or loans being taxed to the extent of gain; and (2) a 10% penalty tax on the taxable amount. In order to avoid
               modified endowment status, I request any excess premium that could cause such status to be refunded.
                                                                                                         [_] YES   [_] NO
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AGLC 0093-99 REV 0800                                                                                                    Page 2 of 4
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Death Benefit Compliance Test
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                           [_] Guideline Premium Test                           [_] Cash Value Accumulation Test
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Specified Amount
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Base Coverage $______________________plus Supplemental Coverage $ _________________________ = Total Specified Amount $ _____________

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Telephone Authorization
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                      I (or we, if Joint Owners), hereby authorize American General Life Insurance Company ("AGL") to act on
                      telephone instructions to transfer values among the variable divisions and the AGL Declared Fixed Interest
                      Account and to change allocations for future premium payments and monthly deductions given by:

Initial appropriate   [    ]  Policy Owner(s)- if Joint Owners, either of us acting independently.
box here:
                      [    ]  Policy Owner(s) or the Agent/Registered Representative who is appointed to represent AGL and the firm
                              authorized to service my policy.

                      AGL and any person designated by this authorization will not be responsible for any claim, loss or expense
                      based upon telephone instructions received and acted on in good faith, including losses due to telephone
                      instruction communication errors. AGL's liability for erroneous transfers and allocations, unless clearly
                      contrary to instructions received, will be limited to correction of the allocations on a current basis. If an
                      error, objection or other claim arises due to a telephone transaction, I will notify AGL in writing within
                      five working days from receipt of confirmation of the transaction from AGL. I understand that this
                      authorization is subject to the terms and provisions of my variable universal life insurance policy and its
                      related prospectus. This authorization will remain in effect until my written notice of its revocation is
                      received by AGL at its home office.
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Suitability
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ALL QUESTIONS MUST    1. Have you, the Proposed Insured(s) or Owner(s) (if different), received the variable universal life
BE ANSWERED.             insurance policy prospectus and the prospectuses describing the investment options?         [_] yes  [_] no
                         (IF "YES," PLEASE FURNISH THE PROSPECTUS DATES.)

                         Variable Universal Life Insurance Policy Prospectus:     __________

                         Supplements (if any):                                    __________

                      2. Do you understand and acknowledge:

                         a. THAT THE POLICY APPLIED FOR IS VARIABLE, EMPLOYS THE USE OF SEGREGATED ACCOUNTS WHICH
                            MEANS THAT YOU NEED TO RECEIVE AND UNDERSTAND CURRENT PROSPECTUSES FOR THE POLICY AND
                            THE UNDERLYING ACCOUNTS?                                                                 [_] yes  [_] no

                         b. THAT ANY BENEFITS, VALUES OR PAYMENTS BASED ON PERFORMANCE OF THE SEGREGATED
                            ACCOUNTS MAY VARY: AND                                                                   [_] yes  [_] no

                            (1)  ARE NOT GUARANTEED BY THE COMPANY, ANY OTHER INSURANCE COMPANY, THE U.S.
                                 GOVERNMENT OR ANY STATE GOVERNMENT?                                                 [_] yes  [_] no

                            (2)  ARE NOT FEDERALLY INSURED BY THE FDIC, THE FEDERAL RESERVE BOARD OR ANY
                                 OTHER AGENCY, FEDERAL OR STATE?                                                     [_] yes  [_] no

                         c. THAT IN ESSENCE, ALL RISK IS BORNE BY THE OWNER EXCEPT FOR FUNDS PLACED IN
                            THE AGL DECLARED FIXED INTEREST ACCOUNT?                                                 [_] yes  [_] no

                         d. THAT THE POLICY IS DESIGNED TO PROVIDE LIFE INSURANCE COVERAGE AND TO ALLOW FOR
                            THE ACCUMULATION OF VALUES IN THE SEGREGATED ACCOUNTS?                                   [_] yes  [_] no

                         e. THE AMOUNT OR DURATION OF THE DEATH BENEFIT MAY INCREASE OR DECREASE, DEPENDING
                            ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT?                                    [_] yes  [_] no

                         f. THE POLICY VALUES MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT
                            EXPERIENCE OF THE SEPARATE ACCOUNT, THE AGL DECLARED FIXED INTEREST ACCOUNT
                            ACCUMULATION, AND CERTAIN EXPENSE DEDUCTIONS?                                            [_] yes  [_] no

                      3. Do you believe the Policy you selected meets your insurance and investment
                         objectives and your anticipated financial needs?                                            [_] yes  [_] no

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AGLC 0093-99 REV 0800                                                                                                    Page 3 of 4
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Your Signature
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SIGNATURES   Signed at (city, state)
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             Print name of Broker/Dealer
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             X Registered Representative                                      State license #                   Date
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             X Proposed Contingent Insured                                                                      Date
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             X Other Proposed Contingent Insured                                                                Date
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             X Owner                                                                                            Date
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             (If different from Proposed Contingent Insured)

             X Additional Owner                                                                                 Date
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             (If different from Proposed Contingent Insured)
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AGLC 0093-99 REV 0800                                                                                                   Page 4 of 4
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