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Partial Surrender/Partial Withdrawal
LOB: Variable Life II
Contract #: 004408143
Inforce agency code: 999
Insured name: SALLY MOUSE
Policy status: Premium Paying
Partial Surrender/Partial Withdrawal:
Amount (Refer to Account Value Quote Screen):
Effective date: 03/23/1999
Surrender charge (Refer to Quote Screen):
Contract Information Before After
Base policy face amount: 60,000.00
Base annual standard premium: 778.80
Base annual substandard premium: 0.00
Base annual disability premium: 47.04
Death benefit option: 3 3
Cash surrender value: 2,634.10 614.10
*Fund account balance: 2,634.10 614.10
Loan amount: 0.00 0.00
Loan interest: 0.00 0.00
Loan asset credit: 0.00 0.00
Accumulated surrender charge: 0.00 20.00
Tax Information Before After
Cost basis: 4,545.41 2,545.41
Gain: 0.00 0.00
MEC status: None Irrevocable
Total 7-pay premium: 2,992.46 345.62
Guideline single premium: 0.00 0.00
Accumulated guideline level: 0.00 0.00
Premiums paid for guideline: 0.00 0.00
Current year guideline premium margin: 0.00 0.00
Excess guideline amount paid: 0.00 0
Total distribution amount: 0.00 2,000.00
Taxable distribution amount: 0.00 0.00
Corridor death benefit: 0.00 0.00
Recapture ceiling amount: 0 0
Penalty tax indicator: No No
Distribution code: None None
Alerts: Contract fails benefit reduction test
*Fund Account Balance represents values as of 03/22/1999.
This does not reflect actual values as of the transaction date due to fund performance.

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