POLICY NUMBER:  [VP999999990]

POLICY SPECIFICATIONS

BASE POLICY:	INDEXED FLEXIBLE PREMIUM VARIABLE UNIVERSAL LIFE INSURANCE
PREMIUMS:	PLANNED [ANNUAL] PREMIUM	=	[$2,747.25]
	7-PAY PREMIUM	=	[$4,197.83]

DEATH BENEFIT QUALIFICATION TEST:         [CASH VALUE ACCUMULATION TEST]

DEATH BENEFIT OPTION:                     [A]

MINIMUM GUARANTEED INTEREST RATE FOR FIXED OPTIONS: 2.00% ANNUALLY. ANY EXCESS INTEREST DECLARED BY US WILL BE GUARANTEED FOR ONE YEAR.

NET AMOUNT AT RISK FACTOR:         1.0016516

MONTHLY DEDUCTION END DATE:  POLICY ANNIVERSARY WHEN THE INSURED ATTAINS AGE 121

MAXIMUM PREMIUM LOAD RATE:  6.55%

ADMINISTRATIVE CHARGE PER MONTH:  $[7.50]

INDEXED ACCOUNT SEGMENT START DATES:     THE 15TH DAY OF EACH CALENDAR MONTH

(SEE INDEXED FIXED ACCOUNT OPTIONS SECTION FOR ADDITIONAL INFORMATION)

[STATE DEPARTMENT OF INSURANCE: (XXX) XXX-XXXX]

P12VUL Page.3.1

POLICY NUMBER:  [VP999999990]

POLICY SPECIFICATIONS

SUMMARY OF COVERAGES EFFECTIVE ON THE POLICY DATE

P12VUL	BASIC LIFE COVERAGE [GUARANTEED ISSUE]
	FACE AMOUNT:	[$25,000]
	INSURED:	[LELAND STANFORD]
	SEX AND AGE:	[MALE 35]
	RISK CLASS:	[STANDARD NONSMOKER]

P12VUL Page 3.0

POLICY NUMBER:  [VP999999990]

POLICY SPECIFICATIONS

SURRENDER CHARGE EFFECTIVE

AT BEGINNING OF COVERAGE YEAR

COVERAGE YEAR	SURRENDER CHARGE	REDUCTION FACTOR
[1	$243.00	$24.30
2	218.70	24.30
3	194.40	24.30
4	170.10	24.30
5	145.80	24.30
6	121.50	24.30
7	97.20	24.30
8	72.90	24.30
9	48.60	24.30
10	24.30	24.30
11+	0	0]

P12VUL Page 4.*

POLICY NUMBER:  [VP999999990]

POLICY SPECIFICATIONS

TERMINATION CREDIT

MONTHLY TERMINATION CREDIT CHARGE:	[$5.04]
TERMINATION CREDIT CHARGE PERIOD:	[5 YEARS]
MAXIMUM ANNUAL TERMINATION CREDIT BASIS:	[$4,197.83]

POLICY YEAR		TERMINATION CREDIT FACTOR
[1 – 5		0.12%
6+		0%]
POLICY YEAR	POLICY MONTH	TERMINATION CREDIT PERCENTAGE
[1	1	2.50%
1	2	3.00%
1	3	3.50%
1	4	4.00%
1	5	4.50%
1	6	5.00%
1	7	5.50%
1	8	6.00%
1	9	6.50%
1	10	7.00%
1	11	7.50%
1	12	8.00%
2	1 - 12	7.25%
3	1 - 12	6.75%
4	1 - 12	6.00%
5	1 - 12	5.25%
6	1 - 12	4.75%
7	1 - 12	4.00%
8	1 - 12	3.25%
9	1 - 12	2.75%
10	1 - 12	2.00%
11	1 - 12	1.25%
12	1 - 12	0.75%
13+	1 - 12	0.00%]

P12VUL Page 4.*

POLICY NUMBER:  [VP999999990]

POLICY SPECIFICATIONS

TABLE OF COST OF INSURANCE RATES

FOR BASIC LIFE COVERAGE [GUARANTEED ISSUE]

INSURED:                                 [LELAND STANFORD]

MAXIMUM MONTHLY COST OF INSURANCE RATES PER $1000.00 OF NET AMOUNT AT RISK APPLICABLE TO THIS COVERAGE.

POLICY YEAR	MONTHLY RATE
[1	0.10090
2	0.10670
3	0.11170
4	0.12010
5	0.12840
6	0.13760
7	0.14930
8	0.16350
9	0.17930
10	0.19940
11	0.22110
12	0.24200
13	0.26460
14	0.27790
15	0.29380
16	0.31390
17	0.33900
18	0.37330
19	0.41180
20	0.45950
21	0.51560
22	0.57510
23	0.63890
24	0.69180
25	0.75230
26	0.82540
27	0.91630
28	1.02660
29	1.14970
30	1.27900
31	1.41510
32	1.55240
33	1.68980
34	1.83930
35	1.99170
36	2.17330
37	2.37670
38	2.64820
39	2.93180
40	3.23010
41	3.56140
42	3.92360
43	4.34570
44	4.84010

P12VUL Page 4.*

POLICY NUMBER:  [VP999999990]

POLICY SPECIFICATIONS

TABLE OF COST OF INSURANCE RATES

FOR BASIC LIFE COVERAGE [GUARANTEED ISSUED]

CONTINUED

INSURED:                                 [LELAND STANFORD]

MAXIMUM MONTHLY COST OF INSURANCE RATES PER $1000.00 OF NET AMOUNT AT RISK APPLICABLE TO THIS COVERAGE.

POLICY YEAR	MONTHLY RATE
45	5.41330
46	6.04180
47	6.76170
48	7.51460
49	8.33040
50	9.24140
51	10.27540
52	11.43490
53	12.71510
54	14.10520
55	15.59360
56	17.17060
57	18.67330
58	20.26540
59	21.97380
60	23.81220
61	25.79270
62	27.64150
63	29.65380
64	31.85100
65	34.25960
66	36.90860
67	39.06360
68	41.41760
69	43.99540
70	46.82420
71	49.93700
72	53.37330
73	57.18460
74	61.42910
75	66.18210
76	71.53880
77	77.62690
78	83.33330
79	83.33330
80	83.33330
81	83.33330
82	83.33330
83	83.33330
84	83.33330
85	83.33330
86	83.33330
87+	0]

P12VUL Page 4.*

POLICY NUMBER:  [VP999999990]

POLICY SPECIFICATIONS

TABLE OF MAXIMUM MONTHLY COVERAGE CHARGES

FOR BASIC LIFE COVERAGE [GUARANTEED ISSUE]

INSURED:                                 [LELAND STANFORD]

POLICY YEAR	BASIC LIFE COVERAGE CHARGE
[1	$41.15
2	41.15
3	41.15
4	41.15
5	41.15
6	41.15
7	41.15
8	41.15
9	41.15
10	41.15
11	41.15
12	41.15
13	41.15
14	41.15
15	41.15
16	41.15
17	41.15
18	41.15
19	41.15
20	41.15
21	41.32
22	41.50
23	41.69
24	41.88
25	42.08
26	42.29
27	42.50
28	42.72
29	42.95
30	43.18
31	43.43
32	43.68
33	43.94
34	44.21
35	44.49
36	44.77
37	45.07
38	45.38
39	45.69
40	46.02
41	46.36
42	46.71
43	47.08
44	47.45

P12VUL Page 4.*

POLICY NUMBER:  [VP999999990]

POLICY SPECIFICATIONS

TABLE OF MAXIMUM MONTHLY COVERAGE CHARGES

FOR BASIC LIFE COVERAGE [GUARANTEED ISSUE]

CONTINUED

INSURED:                                 [LELAND STANFORD]

POLICY YEAR	BASIC LIFE COVERAGE CHARGE
45	$47.84
46	48.24
47	48.65
48	49.08
49	49.53
50	49.98
51	50.46
52	50.95
53	51.45
54	51.98
55	52.52
56	53.08
57	53.65
58	54.25
59	54.87
60	55.51
61	56.17
62	56.85
63	57.56
64	58.29
65	59.04
66	59.82
67	60.63
68	61.47
69	62.33
70	63.22
71	64.14
72	65.09
73	66.08
74	67.10
75	68.15
76	69.24
77	70.37
78	71.53
79	72.73
80	73.98
81	75.26
82	76.59
83	77.97
84	79.39
85	80.86
86	82.38
87+	0]

P12VUL Page 4.*