Universal Life Illustration

CLIENT

Sex -Select Sex- Male Female

Class -Select Class- Smoker(Cigarette,Betel Nut,Vape) Non-Smoker

State -Select State- CH GU KO MJ PA PH RO SP TI YA

RATED

TableAmount Table Amount 0% 25% 50% 75% 100% 125% 150% 175% 200%

RIDERS

Waiver of Target Waiver of Target Yes No

Add Other Insured

-Select Relationship- -Select Relationship- Self Family

Class

Sex

ILLUSTRATION

Guideline Premiums All Tests Single/Level No Tests

Calculation Basic Premium Coverage Amount

Premium Mode Bi-Weekly Quarterly Semi Monthly Semi Annual Monthly Annual

Premium Method Group Bill Payroll Deduction B-O-M CWA Other

Plan Premium Band Band 1 Band 2 Band 3

Policy Date:

1035 Exchange-In:

1035 Exchange-In:

Face Amount:

Current Interest:

Years to Show:

Years to Pay:

Policy Age:

Initial Coverage:

Min 1st Yr Ann Prem:

Planned Ann Prem:

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