Long, Randi J. - Pruco Life Policy #V2 583 539

PROCESSING DATE: FEB 19, 2019

CONTRACT DATA

Insured's Information

RANDI J LONG Female, Issue Age 55

Rating Class

Nonsmoker

Basic Contract Information

Policy Number Contract Date Premium Period

V2 583 539

November 15, 2018

During the life of the Insured up to attained age 121

Beneficiary

GRAHAM W LONG, spouse

Preferred Loan Interest Rate Loan Interest Rate

1.25% 2.00%

Insurance Department Contact Information

Michigan Department of Insurance and Financial Services Telephone Number: 517-284-8800

Life Insurance on the Insured

Basic Insurance Amount

$500,000.00

Other Benefit(s) on the Insured (see appropriate form for details)

Rider ICC17 VL 145 B5 - Rider to Provide Acceleration of Death Benefit.

Minimum Initial Premium

The minimum initial premium due on the Contract Date is $725.41.

Contract Limitations

The minimum premium we will accept is $25.00.

The minimum Basic Insurance Amount is $100,000.00. The minimum decrease in Basic Insurance Amount is $5,000.00.

The minimum amount you may withdraw is $250.00.

CONTRACT DATA CONTINUED ON NEXT PAGE

ABC

ICC16 ULNLGA-2016

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