Document:

<PAGE>

<TABLE>
<S>                                    <C>
                                                                                                                       EXHIBIT 10(c)

 Complete and return this request to:        American General Life Insurance Company ("AGL")
      Corporate Markets Group                            CORPORATE MARKETS GROUP
            PO BOX 4647                                       Houston, Texas
       Houston, TX 77210-4647
 (888) 222-4943 . Fax (713) 831-4622         VARIABLE UNIVERSAL LIFE INSURANCE SERVICE REQUEST
------------------------------------------------------------------------------------------------------------------------------------
  [_]  CONTRACT                1. | CONTRACT #: __________________________________________INSURED:__________________________________
       IDENTIFICATION             | ADDRESS:________________________________________________________________ New Address (yes) (no)
    COMPLETE THIS SECTION FOR     | Primary Owner (if other than an insured):_______________________________
          ALL REQUESTS.           | Address:________________________________________________________________ New Address (yes) (no)
                                  | Primary Owner's S.S. No. or Tax I.D. No._____________ Phone Number:(   )_____-_________________
                                  | Joint Owner (if applicable):___________________________________________________________________
                                  | Address:________________________________________________________________ New Address (yes) (no)
-----------------------------------------------------------------------------------------------------------------------------------
  [_]  NAME                    2. | Change Name Of: (Circle One)  Insured  Owner  Payor   Beneficiary
       CHANGE                     | Change Name From: (First, Middle, Last)               Change Name To: (First, Middle, Last)
Complete this section if the name |
      of the Insured, Owner,      | __________________________________________________    __________________________________________
     Payor or Beneficiary has     |
 changed. (Please note, this does | Reason for Change: (Circle One)   Marriage   Divorce   Correction   Other
 not change the Insured, Owner,   |                                   (Attach copy of legal proof)
       Payor or Beneficiary       |
          designation)            |
------------------------------------------------------------------------------------------------------------------------------------
  [_]  MODE OF PREMIUM         3. | Indicate frequency and premium amount desired: $_____Annual  $____Semi-Annual  $_____Quarterly
       PAYMENT/BILLING CHANGE     |
  Use this section to change the  | Start Date: _______/_________/__________
 billing frequency and/or method  |
   of premium payment. Refer to   |
  your contract and its related   |
      prospectus for further      |
 information concerning minimum   |
  premiums and billing options.   |
------------------------------------------------------------------------------------------------------------------------------------
 [_]  LOST CONTRACT            4. | I/we hereby certify that the contract of insurance for the listed contract has been
      CERTIFICATE                 | __________LOST   ______DESTROYED   _________OTHER.
Complete this section if applying | Unless I/we have directed cancellation of the contract, I/we request that a:
for a Certificate of Insurance or |              ________________Certificate of Insurance at no charge
 duplicate contract to replace a  |              ________________Full duplicate contract at a charge of $25
lost or misplaced contract. If a  | be issued to me/us. If the original contract is located, I/we will return the Certificate or
 full duplicate contract is being | duplicate contract to AGL for cancellation.
   requested, a check or money    |
order for $25 payable to AGL must |
 be submitted with this request.  |
------------------------------------------------------------------------------------------------------------------------------------
  [_]  DOLLAR COST             5. | Designate the day of the month for transfers: ____________(choose a day from 1-28)
       AVERAGING                  | Frequency of transfers (check one): _____Monthly _____Quarterly ____Semi-Annually _____Annually
    ($5,000 minimum initial       | I want:  $___________ ($100 minimum) taken from the Money Market Division and transferred to the
  accumulation value) An amount   | following Divisions:
  may be deducted periodically    | AIM VARIABLE INSURANCE FUNDS                     NEUBERGER BERMAN ADVISERS MANAGEMENT TRUST
 from the Money Market Division   | $_______AIM V.I. International Equity Division   $_______Mid-Cap Growth Portfolio
  and placed in one or more of    | $_______AIM V.I Value Division                   NORTH AMERICAN FUNDS VARIABLE PRODUCT SERIES I
      the Divisions listed.       | AMERICAN CENTURY VARIABLE PORTFOLIOS, INC.       $_______Small Cap Index Fund
  The Declared Fixed Interest     | $_______VP Value Fund                            $_______Science & Technology Fund
  Account is not available for    | AYCO SERIES TRUST                                $_______Nasdaq-100 Index Fund
 Dollar Cost Averaging. Please    | $_______Ayco Large Cap Growth Fund I             $_______International Equities Fund
refer to the prospectus for more  | DREYFUS INVESTMENT PORTFOLIOS                    $_______MidCap Index Fund
 information in the Dollar Cost   | $_______MidCap Stock Portfolio                   $_______Money Market Fund
      Averaging Option.           | DREYFUS VARIABLE INVESTMENT FUND                 $_______Stock Index Fund
                                  | $_______Quality Bond Portfolio                   PIMCO VARIABLE INSURANCE TRUST
                                  | $_______Small Cap Portfolio                      $_______PIMCO Short-Term Bond Portfolio
                                  | FIDELITY VARIABLE INSURANCE PRODUCTS FUND        $_______PIMCO Real Return Bond Portfolio
                                  | $_______VIP Equity-Income Fund                   $_______PIMCO Total Return Bond Portfolio
                                  | $_______VIP Growth Fund                          PUTNAM VARIABLE TRUST
                                  | $_______VIP Contrafund Fund                      $_______Putnam VT Diversified Income Fund
                                  | $_______VIP Asset Manager Fund                   $_______Putnam VT Growth and Income Fund
                                  | J.P. MORGAN SERIES TRUST II                      $_______Putnam VT Int'l Growth and Income Fund
                                  | $_______J.P. Morgan Small Company Portfolio      SAFECO RESOURCE SERIES TRUST
                                  | JANUS ASPEN SERIES                               $_______Equity Portfolio
                                  | $_______International Growth Portfolio           $_______Growth Opportunities Portfolio
                                  | $_______Worldwide Growth Portfolio               THE UNIVERSAL INSTITUTIONAL FUND, INC.
                                  | $_______Aggressive Growth Portfolio              $_______Equity Growth Portfolio
                                  | MFS VARIABLE INSURANCE TRUST                     $_______High Yield Portfolio
                                  | $_______MFS Research Series                      VAN KAMPEN LIFE INVESTMENT TRUST
                                  | $_______MFS Capital Opportunities Series         $_______Strategic Stock Division
                                  | $_______MFS New Discovery Series                 VANGUARD VARIABLE INSURANCE FUND
                                  | $_______MFS Emerging Growth Series               $_______High Yield Bond Portfolio
                                  |                                                  $_______REIT Index Portfolio
                                  |                                                  WARBURG PINCUS TRUST
                                  |                                                  $_______Small Company Growth Portfolio
                                  |                                                  OTHER:_________________________________________
                                  | ________INITIAL HERE TO REVOKE DOLLAR COST AVERAGING ELECTION.
------------------------------------------------------------------------------------------------------------------------------------
CM 1010 REV 0900                                               PAGE 1 OF 3
</TABLE>

<PAGE>

<TABLE>
<S>                                    <C>
------------------------------------------------------------------------------------------------------------------------------------
  [_]  TELEPHONE PRIVILEGE     6. | I(/we if Multiple Owners) hereby authorize AGL to act on telephone instructions to transfer
       AUTHORIZATION              | values among the Variable Divisions and Declared Fixed Interest Account and to change
Complete this section if you are  | allocations for future purchase payments and monthly deductions.
applying for or revoking current  | Initial the designation you prefer:
     telephone privileges.        | _____________Contract Owner(s) ONLY--If Multiple Owners, either one acting independently.
                                  | _____________Contract Owner(s) AND Agent/Registered Representative who is appointed to represent
                                  |              AGL and the firm authorized to service my contract.
                                  |
                                  | AGL and any person designated by this authorization will not be responsible for any claim, loss
                                  | or expense based upon telephone transfer or allocation instructions received and acted upon in
                                  | good faith, including losses due to telephone instruction communication errors. AGL's liability
                                  | for erroneous transfers or 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 the receipt of the confirmation of the transaction from AGL. I understand that this
                                  | authorization is subject to the terms and provisions of my contract and its related prospectus.
                                  | This authorization will remain in effect until my written notice of its revocation is received
                                  | by AGL at the address printed on the top of this service request form.
                                  | ______________INITIAL HERE TO REVOKE TELEPHONE PRIVILEGE AUTHORIZATION.
-----------------------------------------------------------------------------------------------------------------------------------
  [_]  CORRECT AGE             7. | Name of Insured for whom this correction is submitted:_________________________________________
 Use this section to correct the  |
 age of any person covered under  | Correct DOB: _________/_________/_________
   this contract. Proof of the    |
   correct date of birth must     |
     accompany this request.      |
-----------------------------------------------------------------------------------------------------------------------------------
  [_]  TRANSFER OF             8. |                                         (DIVISION NAME)                      (DIVISION NAME)
       ACCUMULATED VALUES         | Transfer $_______ or % ________ from _________________________ to _____________________________
   Use this section if you want   | Transfer $_______ or % ________ from _________________________ to _____________________________
to move money between divisions.  | Transfer $_______ or % ________ from _________________________ to _____________________________
See the Transfer Provision in your| Transfer $_______ or % ________ from _________________________ to _____________________________
 contract for description of and  | Transfer $_______ or % ________ from _________________________ to _____________________________
   restrictions to transfer of    | Transfer $_______ or % ________ from _________________________ to _____________________________
accumulated values. Amounts to be | Transfer $_______ or % ________ from _________________________ to _____________________________
 transferred should be indicated  | Transfer $_______ or % ________ from _________________________ to _____________________________
in dollar or percentage amounts,  | Transfer $_______ or % ________ from _________________________ to _____________________________
    maintaining consistency       | Transfer $_______ or % ________ from _________________________ to _____________________________
         throughout.              |
------------------------------------------------------------------------------------------------------------------------------------
  [_]  CHANGE IN               9. |                                   PREM %  DED %                                   PREM %  DED %
       ALLOCATION                 | AGL DECLARED FIXED-INTEREST ACCOUNT               NORTH AMERICAN FUNDS VARIABLE PRODUCT SERIES I
       PERCENTAGES                | AIM VARIABLE INSURANCE FUNDS      _____% _____%   Small Cap Index Fund            _____%  _____%
  Use this section to indicate    | AIM V.I. International Equity                     Science & Technology Fund       _____%  _____%
     how premiums or monthly      |   Division                        _____% _____%   Nasdaq-100 Index Fund           _____%  _____%
 deductions are to be allocated.  | AIM V.I. Value Division           _____% _____%   International Equities Fund     _____%  _____%
 Total allocation in each column  | AMERICAN CENTURY VARIABLE PORTFOLIOS, INC.        MidCap Index Fund               _____%  _____%
     must equal 100%; whole       | VP Value Fund                     _____% _____%   Money Market Fund               _____%  _____%
         numbers only.            | AYCO SERIES TRUST                                 Stock Index Fund                _____%  _____%
                                  | Ayco Large Cap Growth Fund I      _____% _____%   PIMCO VARIABLE INSURANCE TRUST
                                  | DREYFUS INVESTMENT PORTFOLIOS                     PIMCO Short-Term Bond Portfolio _____%  _____%
                                  | MidCap Stock Portfolio            _____% _____%   PIMCO Real Return Bond Portfolio_____%  _____%
                                  | DREYFUS VARIABLE INVESTMENT FUND                  PIMCO Total Return Bond
                                  | Quality Bond Portfolio            _____% _____%     Portfolio                     _____%  _____%
                                  | Small Cap Portfolio               _____% _____%   PUTNAM VARIABLE TRUST
                                  | FIDELITY VARIABLE INSURANCE PRODUCTS FUND         Putnam VT Diversified Income
                                  | VIP Equity-Income Fund            _____% _____%     Fund                          _____%  _____%
                                  | VIP Growth Fund                   _____% _____%   Putnam VT Growth and Income
                                  | VIP Contrafund Fund               _____% _____%     Fund                          _____%  _____%
                                  | VIP Asset Manager Fund            _____% _____%   Putnam VT Int'l Growth and
                                  | J.P. MORGAN SERIES TRUST II                       Income Fund                     _____%  _____%
                                  | J.P. Morgan Small Company                         SAFECO RESOURCE SERIES TRUST
                                  | Portfolio                         _____% _____%   Equity Portfolio                _____%  _____%
                                  | JANUS ASPEN SERIES                                Growth Opportunities Portfolio  _____%  _____%
                                  | International Growth Portfolio    _____% _____%   THE UNIVERSAL INSTITUTIONAL FUND, INC.
                                  | Worldwide Growth Portfolio        _____% _____%   Equity Growth Portfolio         _____%  _____%
                                  | Aggressive Growth Portfolio       _____% _____%   High Yield Portfolio            _____%  _____%
                                  | MFS VARIABLE INSURANCE TRUST                      VAN KAMPEN LIFE INVESTMENT TRUST_____%  _____%
                                  | MFS Research Series               _____% _____%   Strategic Stock Division        _____%  _____%
                                  | MFS Capital Opportunities Series  _____% _____%   VANGUARD VARIABLE INSURANCE FUND
                                  | MFS New Discovery Series          _____% _____%   High Yield Bond Portfolio       _____%  _____%
                                  | MFS Emerging Growth Series        _____% _____%   REIT Index  Portfolio           _____%  _____%
                                  | NEUBERGER BERMAN ADVISERS MANAGEMENT TRUST        WARBURG PINCUS TRUST
                                  | Mid-Cap Growth Portfolio          _____% _____%   Small Company Growth Portfolio  _____%  _____%
                                  |                                                   OTHER:_______________________   _____%  _____%
------------------------------------------------------------------------------------------------------------------------------------
CM 1010 REV 0900                                               PAGE 2 OF 3
</TABLE>
<PAGE>

<TABLE>
<S>                                 <C>
------------------------------------------------------------------------------------------------------------------------------------
  [_]  AUTOMATIC              10. |
       REBALANCING                | Indicate frequency: ________Quarterly ________Semi-Annually ________Annually
   ($5,000 minimum accumulation   |
 value) Use this section to apply |                    (DIVISION NAME)                                   (DIVISION NAME)
      for or make changes to      |
   Automatic Rebalancing of the   | _______% : ___________________________________     _______%  : ________________________________
 variable divisions. Please refer | _______% : ___________________________________     _______%  : ________________________________
    to the prospectus for more    | _______% : ___________________________________     _______%  : ________________________________
   information on the Automatic   | _______% : ___________________________________     _______%  : ________________________________
       Rebalancing Option.        | _______% : ___________________________________     _______%  : ________________________________
  This option is not available    | _______% : ___________________________________     _______%  : ________________________________
while the Dollar Cost Averaging   |
       Option is in use.          | ________  INITIAL HERE TO REVOKE AUTOMATIC REBALANCING ELECTION.
------------------------------------------------------------------------------------------------------------------------------------
 [_]  REQUEST FOR             11. |
      PARTIAL                     | ______I request a partial surrender of $_____ or _____% of the net cash surrender value.
      SURRENDER/                  | ______I request a loan in the amount of $_____.
      CONTRACT LOAN               | ______I request the maximum loan amount available from my contract.
 Use this section to apply for a  |
partial surrender from or contract|
loan against contract values. For | Unless you direct otherwise below, proceeds are allocated according to the deduction allocation
detailed information concerning   | percentages in effect, if available; otherwise they are taken pro-rata from the Declared Fixed
these two options please refer to | Interest Account and Variable Divisions in use.
  your contract and its related   |
  prospectus. If applying for a   | ________________________________________________________________________________________________
  partial surrender be sure to    |
complete the Notice of Withholding| ________________________________________________________________________________________________
 section of this Service Request  |
  in addition to this section.    | ________________________________________________________________________________________________
                                  |
                                  | ________________________________________________________________________________________________
------------------------------------------------------------------------------------------------------------------------------------
 [_]  NOTICE OF               12. | The taxable portion of the distribution you receive from your variable universal life insurance
      WITHHOLDING                 | contract is subject to federal income tax withholding unless you elect not to have withholding
Complete this section it you have | apply. Withholding of state income tax may also be required by your state of residence. You may
 applied for a partial surrender  | elect not to have withholding apply by checking the appropriate box below. If you elect not to
        in Section 11.            | have withholding apply to your distribution or if you do not have enough income tax withheld,
                                  | you may be responsible for payment of estimated tax. You may incur penalties under the
                                  | estimated tax rules, if your withholding and estimated tax are not sufficient.
                                  |
                                  | Check one: ________I DO want income tax withheld from this distribution.
                                  |
                                  |            ________I DO NOT want income tax withheld from this distribution.
------------------------------------------------------------------------------------------------------------------------------------
 [_]  AFFIRMATION/            13. | CERTIFICATION: UNDER PENALTIES OF PERJURY, I CERTIFY: (1) THAT THE NUMBER SHOWN ON THIS FORM IS
      SIGNATURE                   | MY CORRECT TAXPAYER IDENTIFICATION NUMBER AND; (2) THAT I AM NOT SUBJECT TO BACKUP WITHHOLDING
   Complete this section for      | UNDER SECTION 3406(a)(1)(C) OF THE INTERNAL REVENUE CODE.
         ALL requests.            |
                                  | THE INTERNAL REVENUE SERVICE DOES NOT REQUIRE YOUR CONSENT TO ANY PROVISION OF THIS DOCUMENT
                                  | OTHER THAN THE CERTIFICATION REQUIRED TO AVOID BACKUP WITHHOLDING.
                                  |
                                  | Dated at_______________this___________day of______________________________________,__________
                                  |
                                  | X______________________________________________   X__________________________________________
                                  |  SIGNATURE OF OWNER                                SIGNATURE OF WITNESS
                                  |
                                  | X______________________________________________   X__________________________________________
                                  |  SIGNATURE OF JOINT OWNER                          SIGNATURE OF WITNESS
                                  |
                                  | X______________________________________________   X__________________________________________
                                  |  SIGNATURE OF ASSIGNEE                             SIGNATURE OF WITNESS
                                  |
------------------------------------------------------------------------------------------------------------------------------------
CM 1010 REV 0900                                               PAGE 3 OF 3
</TABLE><PAGE>

<TABLE>
<CAPTION>

                                                                                                                       EXHIBIT 10(e)

                                          AMERICAN GENERAL LIFE INSURANCE COMPANY ("AGL")
                                                     Corporate Markets Group
                                                    Home Office: Houston, Texas

                                    VARIABLE UNIVERSAL LIFE INSURANCE SUPPLEMENTAL APPLICATION

                         (This supplement must accompany the appropriate application for life insurance.)

<S>                                            <C>                                           <C>
-----------------------------------------------------------------------------------------------------------------------------------
                                                   PART 1. APPLICANT INFORMATION
-----------------------------------------------------------------------------------------------------------------------------------

Supplement to the application on the life or lives of ________________________________________, dated ____________________________

-----------------------------------------------------------------------------------------------------------------------------------
                                              PART 2. INITIAL ALLOCATION PERCENTAGES
-----------------------------------------------------------------------------------------------------------------------------------
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 account 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         _____%     _____%     NEUBERGER BERMAN ADVISERS MANAGEMENT TRUST
AIM VARIABLE INSURANCE FUNDS                                      Mid-Cap Growth Portfolio                         _____%     ____%
AIM V.I. International Equity Division      _____%     _____%     NORTH AMERICAN FUNDS VARIABLE PRODUCT SERIES I
AIM V.I. Value Division                     _____%     _____%     Small Cap Index Fund                             _____%     _____%
AMERICAN CENTURY VARIABLE PORTFOLIOS, INC.                        Science & Technology Fund                        _____%     _____%
VP Value Fund                               _____%     _____%     Nasdaq-100 Index Fund                            _____%     _____%
AYCO SERIES TRUST                                                 International Equities Fund                      _____%     _____%
Ayco Large Cap Growth Fund I                _____%     _____%     MidCap Index Fund                                _____%     _____%
DREYFUS INVESTMENT PORTFOLIOS                                     Money Market Fund                                _____%     _____%
MidCap Stock Portfolio                      _____%     _____%     Stock Index Fund                                 _____%     _____%
DREYFUS VARIABLE INVESTMENT FUND                                  PIMCO VARIABLE INSURANCE TRUST
Quality Bond Portfolio                      _____%     _____%     PIMCO Short-Term Bond Portfolio                  _____%     _____%
Small Cap Portfolio                         _____%     _____%     PIMCO Real Return Bond Portfolio                 _____%     _____%
FIDELITY VARIABLE INSURANCE PRODUCTS FUND                         PIMCO Total Return Bond Portfolio                _____%     _____%
VIP Equity-Income Fund                      _____%     _____%     PUTNAM VARIABLE TRUST
VIP Growth Fund                             _____%     _____%     Putnam VT Diversified Income Fund                _____%     _____%
VIP Contrafund Fund                         _____%     _____%     Putnam VT Growth and Income Fund                 _____%     _____%
VIP Asset Manager Fund                      _____%     _____%     Putnam VT Int'l Growth and Income Fund           _____%     _____%
J.P. MORGAN SERIES TRUST II                                       SAFECO RESOURCE SERIES TRUST
J.P. Morgan Small Company Portfolio         _____%     _____%     Equity Portfolio                                 _____%     _____%
JANUS ASPEN SERIES                                                Growth Opportunities Portfolio                   _____%     _____%
International Growth Portfolio              _____%     _____%     THE UNIVERSAL INSTITUTIONAL FUND, INC.
Worldwide Growth Portfolio                  _____%     _____%     Equity Growth Portfolio                          _____%     _____%
Aggressive Growth Portfolio                 _____%     _____%     High Yield Portfolio                             _____%     _____%
MFS VARIABLE INSURANCE TRUST                                      VAN KAMPEN LIFE INVESTMENT TRUST
MFS Research Series                         _____%     _____%     Strategic Stock Division                         _____%     _____%
MFS Capital Opportunities Series            _____%     _____%     VANGUARD VARIABLE INSURANCE FUND
MFS New Discovery Division                  _____%     _____%     High Yield Bond Portfolio                        _____%     _____%
MFS Emerging Growth Series                  _____%     _____%     REIT Index Portfolio                             _____%     _____%
                                                                  WARBURG PINCUS TRUST
                                                                  Small Company Growth Portfolio                   _____%     _____%
                                                                  OTHER:_____________________________              _____%     _____%
------------------------------------------------------------------------------------------------------------------------------------
CM 1001-99 REV0699                                        PAGE 1 OF 3
</TABLE>

<PAGE>

<TABLE>
<CAPTION>

                                              AMERICAN GENERAL LIFE INSURANCE COMPANY
                                                      Corporate Markets Group
                                                    Home Office: Houston, Texas

<S>                                                   <C>                                                    <C>
------------------------------------------------------------------------------------------------------------------------------------
                                                   PART 3. DOLLAR COST AVERAGING
------------------------------------------------------------------------------------------------------------------------------------
DOLLAR COST AVERAGING: ($5,000 MINIMUM BEGINNING ACCUMULATION VALUE) An amount can be systematically transferred from the Money
Market 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) from the AGSPC Money Market Division to the
                                                following division(s)

AIM VARIABLE INSURANCE FUNDS                                    NORTH AMERICAN FUNDS VARIABLE PRODUCT SERIES I
AIM V.I. International Equity Division      $__________         Small Cap Index Fund                                $__________
AIM V.I. Value Division                     $__________         Science & Technology Fund                           $__________
AMERICAN CENTURY VARIABLE PORTFOLIOS, INC.                      Nasdaq-100 Index Fund                               $__________
VP Value Fund                               $__________         International Equities Fund                         $__________
AYCO SERIES TRUST                                               MidCap Index Fund                                   $__________
Ayco Large Cap Growth Fund I                $__________         Money Market Fund                                   $__________
DREYFUS INVESTMENT PORTFOLIOS                                   Stock Index Fund                                    $__________
MidCap Stock Portfolio                      $__________         PIMCO VARIABLE INSURANCE TRUST
DREYFUS VARIABLE INVESTMENT FUND                                PIMCO Short-Term Bond Portfolio                     $__________
Quality Bond Portfolio                      $__________         PIMCO Real Return Bond Portfolio                    $__________
Small Cap Portfolio                         $__________         PIMCO Total Return Bond Portfolio                   $__________
FIDELITY VARIABLE INSURANCE PRODUCTS FUND                       PUTNAM VARIABLE TRUST
VIP Equity-Income Fund                      $__________         Putnam VT Diversified Income Fund                   $__________
VIP Growth Fund                             $__________         Putnam VT Growth and Income Fund                    $__________
VIP Contrafund Fund                         $__________         Putnam VT Int'l Growth and Income Fund              $__________
VIP Asset Manager Fund                      $__________         SAFECO RESOURCE SERIES TRUST
J.P. MORGAN SERIES TRUST II                                     Equity Portfolio                                    $__________
J.P Morgan Small Company Portfolio          $__________         Growth Opportunities Portfolio                      $__________
JANUS ASPEN SERIES                                              THE UNIVERSAL INSTITUTIONAL FUNDS, INC.
International Growth Portfolio              $__________         Equity Growth Portfolio                             $__________
Worldwide Growth Portfolio                  $__________         High Yield Portfolio                                $__________
Aggressive Growth Portfolio                 $__________         VAN KAMPEN LIFE INVESTMENT TRUST
MFS VARIABLE INSURANCE TRUST                                    Strategic Stock Division                            $__________
MFS Research Series                         $__________         VANGUARD VARIABLE INSURANCE FUND
MFS Capital Opportunities Series            $__________         High Yield Bond Portfolio                           $__________
MFS New Discovery Series                    $__________         REIT Index Portfolio                                $__________
MFS Emerging Growth Series                  $__________         WARBURG PINCUS TRUST
NEUBERGER BERMAN ADVISERS MANAGEMENT TRUST                      Small Company Growth Portfolio                      $__________
Mid-Cap Growth Portfolio                    $__________         OTHER _______________________________               $__________

------------------------------------------------------------------------------------------------------------------------------------
                                                   PART 4. AUTOMATIC REBALANCING
------------------------------------------------------------------------------------------------------------------------------------
AUTOMATIC REBALANCING:  ($5,000 MINIMUM BEGINNING ACCUMULATION VALUE) Variable division assets will be automatically rebalanced
based on the premium percentages designated in Part 2. If the AGL Declared Fixed Interest Account has been designated for premium
allocation in Part 2, 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

NOTE: Automatic Rebalancing is not available if the Dollar Cost Averaging option has been chosen

CM 1001-99 REV0699                                    PAGE 2 OF 3
</TABLE>

<PAGE>

<TABLE>
<CAPTION>

                                              AMERICAN GENERAL LIFE INSURANCE COMPANY
                                                      Corporate Markets Group
                                                    Home Office: Houston, Texas

<S>                                                    <C>                                                       <C>
------------------------------------------------------------------------------------------------------------------------------------
                                                  PART 5. TELEPHONE AUTHORIZATION
------------------------------------------------------------------------------------------------------------------------------------
I (or we, if Multiple 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
purchase payments and monthly deductions given by: (INITIAL APPROPRIATE BOX BELOW.)

[    ]  Contract Owner(s)- if Multiple Owners, either of us acting independently.

[    ]  Contract 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/we will notify
AGL in writing within five working days from receipt of confirmation of the transaction from AGL. I/we 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/our written notice of its revocation is received by AGL at its home office.

[    ]  INITIAL HERE TO DECLINE THE ABOVE TELEPHONE AUTHORIZATION.

------------------------------------------------------------------------------------------------------------------------------------
                                      PART 6. SUITABILITY (ALL QUESTIONS MUST BE ANSWERED.)
------------------------------------------------------------------------------------------------------------------------------------
                                                                                                            YES        N0
1. Have you received the variable universal life insurance contract prospectus and the prospectuses
   describing the investment options?                                                                       [_]        [_]
   (IF "yes," please furnish the Prospectus dates.)

           Variable Universal Life Insurance Contract Prospectus:   __________

           Supplements (if any):                                    __________

2. Do you understand and acknowledge:

   a. THAT THE CONTRACT APPLIED FOR IS VARIABLE, EMPLOYS THE USE OF SEGREGATED ACCOUNTS WHICH MEANS
      THAT YOU NEED TO RECEIVE AND UNDERSTAND CURRENT PROSPECTUSES FOR THE CONTRACT AND THE
      UNDERLYING ACCOUNTS?                                                                                  [_]        [_]

   b. THAT ANY BENEFITS, VALUES OR PAYMENTS BASED ON PERFORMANCE OF THE SEGREGATED ACCOUNTS MAY
      VARY: AND                                                                                             [_]        [_]

      (1)  ARE NOT GUARANTEED BY THE COMPANY, ANY OTHER INSURANCE COMPANY, THE U.S. GOVERNMENT
           OR ANY STATE GOVERNMENT?                                                                         [_]        [_]
      (2)  ARE NOT FEDERALLY INSURED BY THE FDIC, THE FEDERAL RESERVE BOARD OR ANY OTHER AGENCY,
           FEDERAL OR STATE?                                                                                [_]        [_]

   c. THAT IN ESSENCE, ALL RISK IS BORNE BY THE OWNER EXCEPT FOR FUNDS PLACED IN THE AGL DECLARED
      FIXED INTEREST ACCOUNT?                                                                               [_]        [_]

   d. THAT THE CONTRACT IS DESIGNED TO PROVIDE LIFE INSURANCE COVERAGE AND TO ALLOW FOR THE
      ACCUMULATION OF VALUES IN THE SEGREGATED ACCOUNTS?                                                    [_]        [_]

   e. THE AMOUNT OR DURATION OF THE DEATH BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE
      INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT?                                                        [_]        [_]

   f. THE CONTRACT 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?                                                                                   [_]        [_]

3. Do you believe the Policy you selected meets your insurance and investment objectives and your
   anticipated financial needs?                                                                             [_]        [_]
------------------------------------------------------------------------------------------------------------------------------------

Signed at:________________________________________________________________________________ Date:____________________________________
          CITY                                                                       STATE

  X____________________________________________________________      X________________________________________________________
   SIGNATURE OF OWNER                                                 SIGNATURE OF REGISTERED REPRESENTATIVE

  X_____________________________________________________________      ________________________________________________________
   SIGNATURE OF MULTIPLE OWNER (if applicable)                        PRINT NAME OF BROKER/DEALER

------------------------------------------------------------------------------------------------------------------------------------
CM 1001-99 REV0699                                         PAGE 3 OF 3
</TABLE>

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00024-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00024-of-00352.parquet"}]]