Customer Service, Bookkeeper, Cashier
Resume:
Return of Premium Term - **
Insured: Peace Date: August 19, 2014
Female, Age 44 Prepared by: GABRIELLA
RODRIGUEZ
Premium Mode: Special Monthly Agency: RICK DURAN AGENCY
MARLBORO, NJ 07746
License No: 1307764
Phone No: 848-***-****
This demonstration was produced to be used in New Jersey.
Summary of Coverages and Premium
Special Monthly Initial Premium
Base Plan
$100,000 Return of Premium Term - 30: $65.51
Premium Class: Super Preferred Non-Tobacco
Total Special Monthly Initial Premium $65.51
Description of Coverage
Plan This policy (Form Number ICC11 08025) is a level term to age 95 life insurance policy
with a Return of Premium Benefit. The initial premium is guaranteed for the first 30
policy years. After the first 30 policy years, premiums increase significantly. These
premiums continue to increase annually and are adjustable but will not exceed the
maximum premiums listed in the policy. This policy is convertible to the later of age 75
or the end of 5 policy years.
Definitions
Non-Tobacco Available for those who do not currently use tobacco or other nicotine products and have
not used tobacco or other nicotine products within the 12-month period prior to
application.
Preferred Non-Tobacco Available for those who can meet underwriting requirements more stringent than the
standard Non-Tobacco risk category.
Super Preferred Non-Tobacco Available for those who currently do not use tobacco or other nicotine products and have
not used tobacco or other nicotine products within the 36-month period prior to
application and can meet underwriting requirements more stringent than the Preferred
risk category.
Annualized Premium The actual cash outlay each year which includes benefits and riders.
Total Annualized Premium The sum of each year's Annualized Premium.
Cash Surrender Value The guaranteed cash surrender value payable at the surrender of the contract prior to the
30th policy year. If all premiums have been paid and the insured is still living at the end
of the 30th policy year, the Return of Premium Benefit will be paid and is equal to the
Cash Surrender Value. The Return of Premium Benefit is not taxable.
State Farm Life Insurance Company
TM022(07/2010) One State Farm Plaza, Bloomington, IL 61710 Page 1 of 2
Return of Premium Term - 30
Insured: Peace Date: August 19, 2014
Female, Age 44 Prepared by: GABRIELLA
RODRIGUEZ
Premium Mode: Special Monthly Agency: RICK DURAN AGENCY
9 S MAIN ST
MARLBORO, NJ 07746
License No: 1307764
Phone No: 848-***-****
Guaranteed Premiums and Values
End Total Cash
of Annualized Annualized Surrender
Year Premium Premium Value
5 787 3,931 851
10 787 7,862 3,482
15 787 11,792 6,848
20 787 15,723 11,078
30 787 23,584 23,584
35 11,610 72,244 0
50 49,989 496,965 0
51 56,491 553,456 0
This is a demonstration of policy guarantees; it is not a contract.
This demonstration should not be relied upon for tax advice. The tax status of this policy should be reviewed with the policyowner's legal and tax
advisors.
Not FDIC - No Bank Guarantee
Insured - May Lose Value
State Farm Life Insurance Company
TM022(07/2010) One State Farm Plaza, Bloomington, IL 61710 Page 2 of 2
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