Document:

<PAGE>

                                                             EXHIBIT (10)(b)(ii)
<PAGE>

Part B                                                    AMERICAN
                                                            |GENERAL
           Multiple Insured                                  FINANCIAL GROUP
           Life Insurance Application

           [_] American General Life Insurance Company, Houston, TX
           [_] The Old Line Life Insurance Company of America, Milwaukee, WI
           [_] All American Life Insurance Company, Springfield, IL
           [_] The Franklin Life Insurance Company, Springfield, IL
           [_] The American Franklin Life Insurance Company, Springfield, IL

           Members of American General Financial Group. American General
           Financial Group is a marketing name for American General Corporation
           and its subsidiaries.

           In this application, the "Company" refers to the insurance company
           whose name is checked above.

           The insurance company checked above is SOLELY responsible for the
           obligation and payment of benefits under any policy that it may
           issue. No other company shown is responsible for such obligations or
           payments.

Personal and Employer Information

Primary proposed      Name
insured               --------------------------------------------------------
                      Social Security #                 Date of birth
                      --------------------------------  -----------------------
                      Employer
                      ---------------------------------------------------------
                      Employer address
                      ---------------------------------------------------------
                      Zip          Phone #             Length of employment
                      ------------ ------------------- ------------------------
                      Net worth $                Household income $
                      -------------------------- ------------------------------

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

Other proposed        Name
insured               ---------------------------------------------------------
                      Social Security #                  Date of birth
                      ---------------------------------- ----------------------
                      Employer
                      ---------------------------------------------------------
                      Employer address
                      ---------------------------------------------------------
                      Zip        Phone #            Length of employment
                      ---------- ------------------ ---------------------------
                      Net worth $               Household income $
                      ------------------------- -------------------------------

Background Information

Provide any additional details to "yes" answers for questions 1-6 in the
"Remarks" section on page  4.

  ----------------------------------    -----------------------------------
  Primary proposed insured              Other proposed insured

1. Do you intend to travel or reside outside of the United States or Canada
   within the next two years?

   [_]  yes   [_]  no                    [_]  yes   [_]  no

   Country, purpose, and date             Country, purpose, and date
   -----------------------------------    ----------------------------------
   -----------------------------------    ----------------------------------
   -----------------------------------    ----------------------------------

 2. In the past five years, have you participated in, or do you intend to
    participate in: any flights as a trainee, pilot or crew member; scuba
    diving; skydiving or parachuting; ultralight aviation; auto racing; cave
    exploration; hang gliding; boat racing; mountaineering; or other hazardous
    activities?

    [_]  yes   [_]  no                    [_] yes     [_] no
    If yes, complete the Aviation and/or  If yes, complete the Aviation and/or
    Avocation Questionnaire.              Avocation Questionnaire.

AGLC 8002-99
                                                                          Page 1
<PAGE>

Background Information continued

    ------------------------------------    ---------------------------------
    Primary proposed insured                Other proposed insured

3. Has any proposed insured:
   a) during the past 90 days submitted an application for life insurance to any
      other company or has any proposed insured begun the process of filling out
      an application?

      [_] yes   [_] no  If yes, explain.    [_] yes   [_] no  If yes, explain.

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

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

    b) ever had a life or disability insurance application modified, rated,
       declined, postponed, withdrawn, canceled, or refused for renewal?

      [_] yes   [_] no  If yes, explain.    [_] yes   [_] no  If yes, explain.

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

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

4. Have you ever filed for bankruptcy?

      [_] yes    [_] no                      [_]yes    [_] no

      Type of bankruptcy                     Type of bankruptcy
      ----------------------------------    ----------------------------------
      Date        Date of discharge         Date         Date of discharge
      ----------------------------------    ----------------------------------

5. In the past five years, have you been charged with or convicted of driving
   under the influence of alcohol or drugs, or had two or more driving
   violations?

      [_] yes   [_] no  If yes, explain.    [_] yes   [_] no  If yes, explain.

      State            License #            State        License #
      ----------------------------------    ----------------------------------

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

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

6. Have you ever been convicted of or pled guilty or "no contest" to a felony or
   do you have any such charge pending against you?

      [_] yes   [_] no  If yes, explain.    [_] yes   [_] no  If yes, explain.

      State             Date                State        Date
      ----------------------------------    ----------------------------------

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

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

Medical History

   Provide any additional details for answers to questions 7-9 in the "Remarks"
   section on page 4.

   Primary proposed insured                  Other proposed insured

7. Name and address of your personal physician(s). Write "none" if you don't
   have one.

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

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

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

      Date, reason, findings of last        Date, reason, findings of last
      visit                                 visit
      ----------------------------------    ----------------------------------

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

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

AGLC 8002-99

                                                                          Page 2
<PAGE>

Medical History continued

   -------------------------------------     ----------------------------------
   Primary proposed insured                  Other proposed insured

8. Height  and weight.
   ft.        in.        lbs.                ft.       in.         lbs.
   ---------- ---------- ----------------    --------- ----------- -------------

   Have you had any weight change in excess of 10 lbs. in the past year?

   [_]  yes   [_]  no   If yes, explain.     [_]  yes  [_] no  If yes, explain.
   ---------------------------------------   -----------------------------------

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

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

9. What is your family history?

                               Age if living   Age at death  Current condition
                                                             or cause of death
   Primary proposed insured
   Father                      -------------   -----------   -----------------

   Mother                      -------------   -----------   -----------------

   Other proposed insured
   Father                      -------------   -----------   -----------------

   Mother                      -------------   -----------   -----------------

For questions 10-16, provide additional information as requested in the
"Remarks" section on page 4.

<TABLE>
<CAPTION>

<S>                                                                   <C>                  <C>                 <C>
                                                                      ----------------     --------------      ------
                                                                      Primary proposed     Other proposed      Child
                                                                      insured              insured
10. Have you ever been diagnosed as having, been treated for,
    or consulted a licensed health care provider for:

   a) any heart disease, heart attack, chest pain,
      irregular heartbeat, high cholesterol, high blood pressure,
      or any other disorder of the heart or blood vessels?            [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

   b) any blood clot, aneurysm, stroke, or other disease, disorder,
      or blockage of the arteries or veins?                           [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

   c) any cancer, cysts, tumors, masses, or other such abnormalities? [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

   d) diabetes, disorder of the thyroid or other glands,
      immune system disorder, or blood or lymphatic system disorder?  [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

   e) any disorder of the stomach or liver, colitis, hepatitis, or
      any disorder of the digestive system or other such organs?      [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

   f) any disorder of the kidneys, prostate, urinary system, or
      reproductive organs?                                            [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

   g) any asthma, bronchitis, emphysema, sleep apnea, or other
      breathing or lung disorders?                                    [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

   h) any brain or spinal cord disorders, seizures, or other
      nervous system abnormalities including mental and
      nervous disorders?                                              [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

   i) arthritis, muscle disorders, or other bone or joint disorders?  [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

11. Are you currently taking any medication, treatment, or therapy,
    or are you under medical observation?                             [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

12. Have you in the past three years had:
    a) fainting spells, nervous disorder, headaches, convulsions, or
       paralysis?                                                     [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

    b) any pain or discomfort in the chest or shortness of breath?    [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

    c) disorders of the stomach, intestines, or rectum, or blood in
       the urine?                                                     [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

</TABLE>

AGLC 8002-99

                                                                          Page 3
<PAGE>

Medical History continued

<TABLE>
<CAPTION>

<S>                                                                   <C>                  <C>                 <C>
                                                                      ----------------     --------------      -----
                                                                      Primary proposed     Other proposed      Child
                                                                      insured              insured

13. Have you ever:
    a) sought or received advice, counseling, or treatment by
       a medical professional for the use of alcohol or drugs
       including prescription drugs?                                  [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

    b) used cocaine, marijuana, heroin, controlled substances, or any
       other drug except as legally prescribed by a physician?        [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no
       If "yes" answered to a or b, complete Drug/Alcohol
       Questionnaire.

14. Have you ever been diagnosed or treated by any member of the
    medical profession for AIDS Related Complex (ARC) or Acquired
    Immune Deficiency Syndrome (AIDS)?                                [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

15. In the past 10 years, have you:
    a) been hospitalized, consulted a health care provider, or had any
       illness, injury, or surgery?                                   [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

    b) had any laboratory tests, treatments, or diagnostic procedures,
       including x-rays, scans, or EKGs?                              [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

    c) been advised to have any diagnostic test, hospitalization, or
       treatment that was not completed?                              [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

    d) received or claimed disability or hospital indemnity
       benefits or a pension for any injury, sickness, disability,
       or impaired condition?                                         [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

16. Do you have any symptoms or knowledge of any other condition
    that is not disclosed above?                                      [_] yes   [_] no    [_] yes   [_] no     [_] yes   [_] no

</TABLE>

Remarks

Identify question number and name of proposed insured, and provide details to
any questions answered "yes" in the "Background Information" and
"Medical History" sections. Include such details as: date of first diagnosis;
name and address of doctor; tests performed; test results; medication(s) or
recommended treatment. If necessary, attach additional pages to record
responses.

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

AGLC 8002-99

                                                                          Page 4
<PAGE>

Your Signature

Statements by the proposed insured(s)

 I have read the above statements or they have been read to me. The above
 statements are true and complete to the best of my knowledge and belief. I
 understand that this application: (1) will consist of Part A, Part B, and,
 if applicable, Part C and related forms; and (2) shall be the basis for any
 policy issued on this application. I understand that any misrepresentation
 contained in this application and relied on by the Company may be used to:
 reduce or deny a claim or void the policy, if it is within its contestable
 period and if such misrepresentation materially affects the acceptance of
 the risk. Except as may be provided in a Limited Temporary Life Insurance
 Agreement (LTLIA) for which all eligibility requirements are met, I
 understand and agree that no insurance will be in effect pursuant to this
 application, or under any policy issued by the Company, unless or until: the
 policy has been delivered and accepted; the full first modal premium for the
 issued policy has been paid; and there has been no change in the health of
 any proposed insured that would change the answers to any questions in the
 application.

 I understand and agree that no agent is authorized to: accept risks or pass
 upon insurability; make or modify contracts; or waive any of the Company's
 rights or requirements.

 Insurance fraud

 Any person who, with intent to defraud or facilitate a fraud against an
 insurer, submits an application or files a claim containing a false or
 deceptive statement, may be guilty of insurance fraud.

Signatures     X Owner                                     Date
               ------------------------------------------- -------------------
               Signed at (city, state)
               ---------------------------------------------------------------
               X Witness                                   Date
               ------------------------------------------- -------------------
               X Primary proposed insured                  Date
               ------------------------------------------- -------------------
               (If under age 15, signature of parent or guardian)

               X Other proposed insured                    Date
               ------------------------------------------- -------------------

               I certify that I have truthfully and accurately recorded on the
               Part B application the information supplied by the proposed
               insured(s).

               Agent name (please print)
               ---------------------------------------------------------------
               Agent #                           State license #
               --------------------------------- -----------------------------
               X Agent                                     Date
               ------------------------------------------- -------------------

AGLC 8002-99

                                                                          Page 5<PAGE>

                                                             EXHIBIT (10)(c)(ii)

<PAGE>

Part C      Medical Exam Form
            Life Insurance Application

            [_]  American General Life Insurance Company, Houston, TX
            [_]  The Old Line Life Insurance Company of America, Milwaukee, WI
            [_]  All American Life Insurance Company, Springfield, IL
            [_]  The Franklin Life Insurance Company, Springfield, IL
            [_]  The American Franklin Life Insurance Company, Springfield, IL

            Members of American General Financial Group. American General
            Financial Group is a marketing name for American General Corporation
            and its subsidiaries.

            In this application, the "Company" refers to the insurance company
            whose name is checked above.

            The insurance company checked above is solely responsible for the
            obligation and payment of benefits under any policy that it may
            issue. No other company shown is responsible for such obligations or
            payments.

SECTION 1-STATEMENT TO MEDICAL EXAMINER

Proposed insured                             Date of birth
-------------------------------------------  ----------------------------------

1. Name of your personal physician
   ----------------------------------------------------------------------------

     Address
     --------------------------------------------------------------------------

     City, state, zip
     --------------------------------------------------------------------------

     Date and findings of last visit
     --------------------------------------------------------------------------

     Treatment given or medication prescribed
     --------------------------------------------------------------------------

2. Have you ever been diagnosed as having, been treated for, or consulted a
   licensed health care provider for:

   a. any heart disease, heart attack, chest pain, irregular
      heartbeat, high cholesterol, high blood pressure, or any
      other disorder of the heart or blood vessels?.............. [_] Yes [_] No

   b. any blood clot, aneurysm, stroke, or other disease,
      disorder, or blockage of the arteries or veins?............ [_] Yes [_] No

   c. any cancer, cysts, tumors, masses, or other such
      abnormalities?............................................. [_] Yes [_] No

   d. diabetes, disorder of the thyroid or other glands,
      immune system disorder, or blood or lymphatic
      system disorder?........................................... [_] Yes [_] No

   e. any disorder of the stomach or liver, colitis, hepatitis,
      or any disorder of the digestive system or other such
      organs?.................................................... [_] Yes [_] No

   f. any disorder of the kidneys, prostate, urinary system,
      or reproductive organs?.................................... [_] Yes [_] No

   g. any asthma, bronchitis, emphysema, sleep apnea, or other
      breathing or lung disorders?............................... [_] Yes [_] No

   h. any brain or spinal cord disorders, seizures, or other
      nervous system abnormalities including mental or nervous
      disorders?................................................. [_] Yes [_] No

   i. arthritis, muscle disorders, or other bone or joint
      disorders?................................................. [_] Yes [_] No

3. Are you currently taking any medication, treatment, or
   therapy, or are you under medical observation?................ [_] Yes [_] No

4. Have you in the past three years had:

   a. fainting spells, nervous disorders, headaches,
      convulsions, or paralysis?................................. [_] Yes [_] No

   b. any pain or discomfort in the chest or shortness
      of breath?................................................. [_] Yes [_] No

   c. disorders of the stomach, intestines, or rectum, or
      blood in the urine?........................................ [_] Yes [_] No

5. Have you ever:
   a. sought or received advice, counseling, or treatment by
      a medical professional for the use of alcohol or drugs,
      including prescription drugs?.............................. [_] Yes [_] No

   b. used cocaine, marijuana, heroin, controlled substances,
      or any other drug except as legally prescribed by a
      physician?................................................. [_] Yes [_] No

6. Have you ever been diagnosed or treated by any member of
   the medical profession for AIDS Related Complex (ARC) or
   Acquired Immune Deficiency Syndrome (AIDS)?................... [_] Yes [_] No

AGLC 8003-99                                                              Page 1
<PAGE>

________________________________________________________________________________
STATEMENT TO MEDICAL EXAMINER continued

7. In the past 10 years, have you:

   a. been hospitalized, consulted a health care provider, or
      had any illness, injury, or surgery?....................... [_] Yes [_] No

   b. had any laboratory tests, treatments, or diagnostic
      procedures, including x-rays, scans, or EKGs?.............. [_] Yes [_] No

   c. been advised to have any diagnostic test, hospitalization,
      or treatment that was not completed?....................... [_] Yes [_] No

   d. received or claimed disability or hospital indemnity
      benefits or a pension for any injury, sickness,
      disability, or impaired condition?......................... [_] Yes [_] No

8. Do you have any symptoms or knowledge of any other
   condition that is not disclosed above?........................ [_] Yes [_] No

9. Family history:

   Father: Age, if living                     Mother:  Age, if living
           ----------------------------------          -------------------------

           Age at death                                Age at death
           ----------------------------------          -------------------------

           Current condition or                        Current condition or
           cause of death                              cause of death
           ----------------------------------          -------------------------

10. Full details of any "yes" answers (please use additional sheet if
    necessary):

    Include such details as: date of first diagnosis; name and address of
    doctor; tests performed; test results; medication(s) or recommended
    treatment.

--------------------------------------------------------------------------------
I have read the above statements or they have been read to me. The above
statements are true and complete to the best of my knowledge and belief. I
understand that this application: (1) will consist of Part A, Part B, Part C,
and, if applicable, any related forms; and (2) shall be the basis for any policy
issued on this application. I understand that any misrepresentation contained in
this application and relied on by the Company may be used to: reduce or deny a
claim or void the policy, if it is within its contestable period and if such
misrepresentation materially affects the acceptance of the risk. Except as may
be provided in a Limited Temporary Life Insurance Agreement (LTLIA) for which
all eligibility requirements are met. I understand and agree that no insurance
will be in effect pursuant to this application, or under any policy issued by
the Company, unless or until: the policy has been delivered and accepted; the
full first modal premium for the issued policy has been paid; and there has been
no change in the health of any proposed insured that would change the answers to
any questions in the application.

In order to determine eligibility for insurance coverage, I hereby give my
consent to any of the entities listed below to give to the Company or its legal
representative, all information they have pertaining to: my medical
consultations, treatments, or surgeries; hospital confinements, which concern
the physical and mental condition of me, my spouse, or my minor children; my use
of drugs or alcohol; or any other non-medical information. Non-medical
information could include items such as: personal finances; habits; hazardous
avocations; motor vehicle or court records; or foreign travel, etc. The list of
entities for which I give my consent to provide the information above is as
follows: any physician or medical practitioner; any hospital, clinic or other
health care facility; any insurance or reinsurance company; any consumer
reporting agency or insurance support organization; my employer; or the Medical
Information Bureau (MIB).

I, as well as any person authorized to act on my behalf, may upon written
request, obtain a copy of this consent from the Company.

This consent will be valid for 30 months from the date of this application. I
agree that a photocopy of this consent will be as valid as the original.

I understand and agree that no agent is authorized to: accept risks or pass upon
insurability; make or modify contracts; or waive any of the Company's rights or
requirements.

Any person who, with intent to defraud or facilitate a fraud against an insurer,
submits an application or files a claim containing a false or deceptive
statement may be guilty of insurance fraud.

Signature of proposed insured

--------------------------------------------------------------------------------
(If under age 15, signature of parent or guardian)

Signed at (city)                      (state)                  date
------------------------------------  ----------------------   -----------------
Signature of examiner
--------------------------------------------------------------------------------

AGLC 8003-99                                                              Page 2
<PAGE>

SECTION 2-REPORT BY MEDICAL EXAMINER

Proposed insured                                 Date of birth
-----------------------------------------------  -------------------------------

Instructions to Examiner:

To be completed in private by Examiner only. This report is confidential between
the Company and the Examiner. Examination of heart and lungs must be with
stethoscope against bare skin.

1. Build
   a. Did you weigh proposed insured?............................ [_] Yes [_] No

   b. Is appearance unhealthy or older than stated age?.......... [_] Yes [_] No

      Height (in shoes)       ft.        in.     Weight (clothed)        lbs.
      ---------------------------   --------     ----------------------------

2. Blood pressure (Record all readings.)

   If blood pressure exceeds 140/90, please repeat determination at end of
   examination and record in space provided.

     Treated       [_] Yes    [_] No      Rx
                                          --------------------------------------

<TABLE>
<CAPTION>

<S>                             <C>                 <C>                     <C>                    <C>
                                At rest             After exercise          3 minutes later        Repeat B.P.

                 Systolic
      Diastolic 5th phase
               Pulse rate
   Irregularities per min.
</TABLE>

3. Heart
   a. Is there any cyanosis, dyspnea,edema, arteriosclerosis,
      peripheral vascular, or other cardiovascular
      disorder?.................................................. [_] Yes [_] No

   b. Is heart enlarged? (If Yes, describe.)..................... [_] Yes [_] No

   c. Is murmur present? (If Yes, complete 3.d.)................. [_] Yes [_] No

   d. Before exercise, murmur is:

      [_] Constant                 Transmitted to where
                                   ------------------------------------------
      [_] Inconstant               Localized at:  [_] Apex [_] Base [_]Elsewhere
      [_] Systolic (give details)  ------------------------------------------
      [_] Diastolic                Murmur grade: 1/6   2/6   3/6  4/6
                                                 5/6   6/6   (please circle)
   After exercise, murmur is:
                [_] Unchanged   [_]Decreased    [_] Increased    [_] Absent

   Your impression:
   ----------------------------------------------------------------------------

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

4. Has this examination revealed abnormality of any of the following: (circle
   applicable items)

   a. Eyes, ears, nose, mouth, pharynx? (If vision or hearing
      markedly impaired, indicate degree and correction.)........ [_] Yes [_] No

   b. Endocrine system (including thyroid and breasts)?.......... [_] Yes [_] No

   c. Nervous system (including reflexes, gait, paralysis)?...... [_] Yes [_] No

   d. Respiratory system?........................................ [_] Yes [_] No

   e. Abdomen (including scars)?................................. [_] Yes [_] No

   f. Genito-urinary system (including prostate)?................ [_] Yes [_] No

   g. Skin (including scars), lymph nodes, blood vessels
      (including varicose veins)?................................ [_] Yes [_] No

   h. Musculoskeletal system (including spine, joints,
      amputations, deformities)?................................. [_] Yes [_] No

AGLC 8003-99                                                             Page 3
<PAGE>

_______________________________________________________________________________
REPORT BY MEDICAL EXAMINER continued

5. Have any of the following been completed in conjunction
   with this exam?............................................... [_] Yes [_] No

            [_] EKG   [_] Chest x-ray   [_] Blood drawn   [_] Urine

6. Do you have any pertinent information not disclosed above?.... [_] Yes [_] No

7. Specimen kit

   Please indicate where and when specimen kit was sent

              [_]  CRL  [_]  Other
                                  --------------------------------------------

              Date mailed
              ----------------------------------------------------------------

8. Details of "yes" answers to Questions 1 - 6. (Identify items. Please use
   additional sheet if necessary.)

9. Examiner

   Are you related to the proposed insured by blood or
   marriage or do you have any business or professional
   relationship with the proposed insured?....................... [_] Yes [_] No

   If yes, explain.

10. Please send this completed examination form directly to:

                            Underwriting Department
                                 P.O. Box 2764
                           Houston, Texas 77252-2764

I certify that this exam was conducted the         day of,              , at
                                           --------------  -----------------

                                                  [ ] a.m.  [ ]  p.m.
                                           --------------------------

Location of exam
-------------------------------------------------------------------------------

Authorized by
-------------------------------------------------------------------------------

Examiner's signature
-------------------------------------------------------------------------------

Examiner's name
-------------------------------------------------------------------------------

Examiner's Social Security # or tax I.D. #
-------------------------------------------------------------------------------

(must be furnished under authority of law)
-------------------------------------------------------------------------------

Examiner's address
-------------------------------------------------------------------------------

Examiner's phone #
-------------------------------------------------------------------------------

AGLC 8003-99                                                              Page 4

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