P08TRM PAC ART
Pacific Life Insurance Company • 45 Enterprise Drive • Aliso Viejo, CA 92656
READ YOUR POLICY CAREFULLY. This is a legal contract between you, the Owner, and us, Pacific
Life Insurance Company, a stock insurance company. We agree to pay the benefits of this policy
according to its provisions. The consideration for this policy is the application for it, a copy of which is
attached, and payment of the initial and subsequent premiums.
The method for determining the Death Benefit is described in the Death Benefit section of this
policy.
Required premium payments must be made in order to keep the policy In Force.
Signed for Pacific Life Insurance Company,
President and Chief Executive Officer Secretary
TERM LIFE INSURANCE
• Death Benefit Payable On The Death Of The Insured
• Premiums Payable as Provided Herein
• Coverage to Age 95
• Convertible
• Non-Participating
INSURED: LELAND STANFORD
SEX AND AGE: MALE 35 INITIAL
RISK CLASS: STANDARD NONSMOKER [MONTHLY] PREMIUM: $36.00
POLICY NUMBER: VF99999990 FACE AMOUNT: $500,000
POLICY DATE: MAY 1, 2008 OWNER: LELAND STANFORD
Free Look Right - You may return this policy within [20] days after you receive it. To do so, deliver it or
mail it to us or to the Producer/Representative who delivered it to you. This policy will then be deemed
void from the beginning and we will refund any premium paid.
Page 2
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POLICY SPECIFICATIONS
P08TRM Page 3.0 PAC ART
BASE POLICY: TERM LIFE INSURANCE
PREMIUMS INCREASE ANNUALLY AFTER THE FIRST
POLICY YEAR
CONVERSION PERIOD END DATE :
MAY 1,2018
REQUESTED PREMIUM PAYMENT INTERVAL:
MONTHLY
INITIAL MONTHLY PREMIUM:
$36.00
EXPIRATION DATE (ATTAINED AGE 95):
MAY 1, 2068
THE PREMIUMS SHOWN ON THE FOLLOWING PAGES ARE FOR ANNUAL PAYMENTS.
PREMIUMS CAN BE PAID MORE FREQUENTLY THAN ANNUALLY, BUT THE TOTAL AMOUNT PAID
EACH YEAR WILL BE GREATER THAN WHEN PAID ANNUALLY. TO CALCULATE THE PREMIUM
DUE FOR OTHER MODES OF PAYMENT, MULTIPLY THE BASIC COVERAGE PREMIUM PLUS THE
PREMIUM WAIVER RIDER PREMIUM BY THE APPROPRIATE FACTOR BELOW AND ROUND TO
THE NEAREST $0.01:
0.510 FOR SEMI-ANNUAL PREMIUMS
0.265 FOR QUARTERLY PREMIUMS
0.090 FOR THE MONTHLY PRE-AUTHORIZED CHECK PAYMENT PLAN
POLICY SPECIFICATIONS
P08TRM Page 3.1 PAC ART
SUMMARY OF COVERAGES EFFECTIVE ON THE POLICY DATE
________________________________________________________________________________
P08TRM
BASIC COVERAGE
FACE AMOUNT: $500,000
INSURED: LELAND STANFORD
SEX AND AGE: MALE 35
RISK CLASS: STANDARD NONSMOKER
________________________________________________________________________________
R08TPW PREMIUM WAIVER
INSURED: LELAND STANFORD
SEX AND AGE: MALE 35
RISK CLASS: STANDARD NONSMOKER
COVERAGE CEASE DATE: MAY 01, 2038
POLICY SPECIFICATIONS
P08TRM Page 4.0 PAC ART
TABLE OF PREMIUMS AT ANNUAL INTERVALS
FOR BASIC COVERAGE
INSURED: LELAND STANFORD
POLICY
YEAR
ANNUAL
PREMIUMS
1
$ 350.00
2
400.00
3 470.00
4 545.00
5 610.00
6 690.00
7 1,110.00
8 1,580.00
9 2,155.00
10 2,815.00
11 3,595.00
12 3,925.00
13 4,285.00
14 4,495.00
15 4,735.00
16 5,080.00
17 5,485.00
18 6,040.00
19 6,640.00
20 7,405.00
21 8,350.00
22 9,310.00
23 10,345.00
24 11,230.00
25 12,250.00
26 13,480.00
27 14,980.00
28 16,810.00
29 18,865.00
30 21,025.00
31 23,305.00
32 25,615.00
33 27,955.00
34 30,475.00
35 33,085.00
THE PREMIUMS SHOWN ABOVE INCLUDE A $100 POLICY FEE.
POLICY SPECIFICATIONS
P08TRM Page 4.1 PAC ART
TABLE OF PREMIUMS AT ANNUAL INTERVALS
FOR BASIC COVERAGE
CONTINUED
INSURED: LELAND STANFORD
POLICY
YEAR
ANNUAL
PREMIUMS
36 $ 36,250.00
37 39,790.00
38 44,440.00
39 49,345.00
40 54,505.00
41 60,145.00
42 66,295.00
43 73,435.00
44 81,775.00
45 91,405.00
46 101,905.00
47 113,860.00
48 126,310.00
49 139,735.00
50 154,600.00
51 171,205.00
52 189,610.00
53 209,710.00
54 231,250.00
55 253,975.00
56 277,690.00
57 299,995.00
58 323,245.00
59 347,770.00
60 373,675.00
THE PREMIUMS SHOWN ABOVE INCLUDE A $100 POLICY FEE.
POLICY SPECIFICATIONS
P08TRM Page 4.2 PAC ART
TABLE OF PREMIUMS AT ANNUAL INTERVALS
FOR PREMIUM WAIVER COVERAGE
INSURED: LELAND STANFORD
POLICY
YEAR
ANNUAL
PREMIUMS
1 $ 50.00
2 50.00
3 60.00
4 70.00
5 75.00
6 90.00
7 110.00
8 140.00
9 170.00
10 220.00
11 275.00
12 325.00
13 375.00
14 435.00
15 510.00
16 600.00
17 705.00
18 825.00
19 965.00
20 1,135.00
21 1,330.00
22 1,470.00
23 1,585.00
24 1,700.00
25 1,800.00
26 1,770.00
27 1,695.00
28 1,620.00
29 1,545.00
30 1,470.00
P08TRM Page 5
DEFINITIONS
In this section, we define certain terms used throughout this policy. Other terms may be defined in other
parts of the policy. Defined terms are usually capitalized to show emphasis.
Administrative Office – is the office that administers your policy. The address of the Administrative
Office at the time you applied for this policy is shown in the heading of the Application. If the address
changes, we will send you written notice of the new address.
Age – means the age as of the Insured’s birthday nearest to the Policy Date, increased by the number of
complete policy years elapsed.
Application – consists of the application for this policy, including any Certificate of Health, amendments,
or endorsements, and any application for reinstatement or increase in benefits.
Code – is the U.S. Internal Revenue Code of 1986, as amended, and the rules and regulations issued
thereunder.
Evidence of Insurability – is information, including medical information, satisfactory to us that is used to
determine insurability and the Insured’s Risk Class.
Face Amount – is the Face Amount of Basic Coverage as shown in the Policy Specifications.
Insured – is the person insured under this policy, as shown in the Policy Specifications.
In Force – means a policy is in effect and provides death benefit coverage on the Insured.
Owner, you, or your – refers to the Owner of this policy.
Policy Date – is shown in the Policy Specifications. Policy months, years and anniversaries are
measured from this date.
Policy Specifications – is a section of the policy that shows information specific to your policy.
Risk Class – is used in determining policy premiums and is determined by us during the underwriting
process. It depends on the Insured’s gender, health, tobacco use, and other factors. The Risk Class of
the Insured is shown in the Policy Specifications. Risk Class may also be referred to as Risk
Classification.
We, our, ours, and us – refer to Pacific Life Insurance Company.
Written Request – is your signed request in writing, or on a form we provide, and received by us at our
Administrative Office, containing information we need to act on the request.
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DEATH BENEFIT
When the Policy is In Force – This policy is In Force as of the Policy Date, subject to your acceptance of
the delivered policy and payment of the initial premium. The policy remains In Force until terminated as
provided in the Termination provision as long as premiums are paid when due or within the Grace Period.
Death Benefit – This policy provides a Death Benefit payable on the death of the Insured while this policy
is In Force. The Death Benefit is equal to the Face Amount shown in the Policy Specifications but may
be subject to adjustment as provided in the Misstatement provision or elsewhere in the policy.
Death Benefit Proceeds – The Death Benefit Proceeds (“Proceeds”) are the actual amount payable if
the Insured dies while this policy is In Force. The Proceeds are equal to the Death Benefit, as of the date
of death, plus the pro-rata portion of any premium paid beyond the end of the policy month of death, less
the amount of any premiums that are due but not yet paid at the time of death.
We will pay the Proceeds within two months after we receive, at our Administrative Office:
• due proof of the Insured’s death, consisting of a certified copy of the death certificate for the Insured
or other lawful evidence providing equivalent information;
• proof of the claimant’s legal interest in the proceeds; and
• sufficient evidence that any legal impediments to payment of Proceeds that depend on parties other
than us have been resolved. Legal impediments to payment include, but are not limited to (a) the
establishment of guardianships and conservatorships; (b) the appointment and qualification of
trustees, executors and administrators; (c) submission of information required to satisfy state and
federal reporting requirements; and (d) conflicting claims.
Proceeds paid are subject to the conditions and adjustments defined in other policy provisions, such as
General Provisions. We will pay interest on the Proceeds from the date of death at a rate not less than
the rate payable for funds left on deposit (see the Income Benefits section). If payment of Proceeds is
delayed more than 31 calendar days after we receive the above requirements needed to pay the claim,
we will pay additional interest at a rate of 10% annually beginning with the 31
st
calendar day referenced
above. Proceeds are paid as a lump sum unless you choose another payment method, as described in
the Income Benefits section.
PREMIUMS
Premium Payments – This policy will not be In Force until the initial premium is paid. The initial premium
is payable either at our Administrative Office or to our authorized representative. Subsequent premiums
are payable only at our Administrative Office. At your request, a premium receipt signed by one of our
officers will be given to you. We will notify you at your last known address if there is a change in this
mailing address. Any premium paid after the initial premium will be considered ‘received by us’ when it is
actually received at our Administrative Office. Except for the initial premium, Pacific Life bears no
responsibility for any premium unless the premium is received by us.
Guaranteed Premiums – There is a table of Premiums shown in the Policy Specifications. Those
premiums are guaranteed and cannot be changed by us.
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POLICY LAPSE AND REINSTATEMENT
Grace Period and Lapse – After the first premium, there is a Grace Period of 31 days from the premium
due date for you to pay each premium. The policy will continue In Force during the Grace Period. If any
premium is not paid by the end of its Grace Period, this policy will lapse. The date of lapse will be the due
date of the unpaid premium. Upon lapse, the policy will terminate with no value and no coverage will be
In Force.
Reinstatement – If this policy terminates due to lapse, it may be reinstated before the Expiration Date
shown in the Policy Specifications and within five years after the end of the Grace Period. To reinstate
this policy you must provide us with the following requirements:
• Your written Application;
• Evidence of Insurability satisfactory to us;
• Payment of all past due premiums, with interest at an effective annual rate of 6% from their due dates
to the reinstatement effective date.
The reinstatement effective date will be the beginning of the policy month that follows our receipt of the
above requirements and our approval of your Application.
TERMINATION
This policy will terminate and, except for the limited right to reinstate the policy, all rights of the owner will
end upon the earliest of the following events:
• The death of the Insured;
• The Expiration Date, as shown in the Policy Specifications;
• Conversion of this policy, as provided in the Conversion provision;
• Lapse of this policy, as provided in the Grace Period and Lapse provision;
• Successful contest of this policy as described in the Incontestability provision; and
• Our receipt of your Written Request to terminate the policy.
Upon termination we will refund to you the pro-rata portion of any premium you have paid that applies to a
period beyond the end of the policy month in which the policy terminates.
CONVERSION
While this policy is In Force, and subject to the conditions below, you may convert this policy to a new
policy at any time before the Conversion Period End Date shown on the Policy Specifications pages. The
Insured will not be required to provide Evidence of Insurability in order for you to exercise this conversion
right; however, conversion will not be allowed during a period of Total Disability as defined in any
Premium Waiver Rider that may be attached to this policy.
To convert this policy you must apply in writing on a form provided by us. This policy must be returned
with your request for conversion. Upon conversion, coverage under this policy will terminate. You should
consult your tax advisor before you exercise this Conversion right and before you make any other change
to your life insurance policy.
The effective date of the new policy will be the same as the date this policy terminates. The Insured must
be living for the new policy to take effect. The new policy may be issued on any plan of permanent
insurance that we make available for such purpose. The Insured’s Risk Class on the new policy will be
the same as the Insured’s Risk Class on this policy, if available. Otherwise, we will use the most
comparable Risk Class available for the new policy, as determined by us.
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The Face Amount of the new policy cannot exceed the Face Amount of this policy. You may select a
lesser Face Amount as long as it is not less than our regular minimum issue limit for the new policy form
at the time of conversion. Riders may be included on the new policy subject to our approval.
INCOME BENEFITS
Income Benefits – All or part of any policy proceeds may, instead of being paid in a lump sum, be left
with us under any one, or a combination of the income benefit plans available, subject to our minimum
amount requirements on the date of election. If the payee is not a natural person, the choice of a
payment option will be subject to our approval. We guarantee that the income benefit will not be less
than the income that would be provided by the immediate annuity purchase rates we offer at the time.
We guarantee that we will have at least the following income benefit plans available.
Fixed Income – Equal payments of the amount chosen with interest of not less than 2% per year until the
funds left on deposit are exhausted.
Life Income – Monthly income will automatically be guaranteed to continue for at least ten years. If the
payee dies before the end of the ten-year period, payments will continue to the end of the ten-year period
to a person designated in writing by that payee. The purchase rates for the monthly income for a male or
female income recipient bought by each $1,000 of benefits are shown below.
Age
Monthly
Income
Age
Monthly
Income
Age
Monthly
Income
Age
Monthly
Income
Age
Monthly
Income
0-30 2.38 40 2.63 50 3.00 60 3.60 70 4.63
32 2.42 42 2.69 52 3.10 62 3.76 72 4.92
34 2.47 44 2.76 54 3.20 64 3.94 74 5.26
36 2.52 46 2.83 56 3.32 66 4.14 75+ 5.45
38 2.57 48 2.91 58 3.45 68 4.37
Monthly income amounts for Ages not shown are halfway between the two amounts for the nearest two
Ages that are shown. Amounts shown are based on an annual interest rate of 2% and the Annuity 2000
female mortality table with five-year age setback. We may require evidence of survival for incomes that
last more than ten years.
OWNER AND BENEFICIARY
Owner – The Owner of this policy is as shown in the Policy Specifications or in a later Written Request. If
you change the Owner, the change is effective on the date the Written Request is signed, subject to our
receipt of it. If there are two or more Owners, they will own this contract as joint tenants with right of
survivorship, unless otherwise provided by Written Request.
Assignment – You may assign this policy by Written Request. An assignment will take place only when
recorded at our Administrative Office. When recorded, the assignment will take effect as of the date the
Written Request was signed. Any rights created by the assignment will be subject to any payments made
or actions taken by us before the change is recorded. We will not be responsible for the validity of any
assignment.
Beneficiary – The beneficiary is named by you in the Application to receive the Death Benefit proceeds.
You may name one or more beneficiaries. If you name more than one beneficiary, they will share the
Death Benefit proceeds equally or as you may otherwise specify by Written Request. If you have named
a contingent beneficiary, that person becomes the beneficiary if the beneficiary dies before the Insured.
A beneficiary may not, at or after the Insured’s death, assign, transfer or encumber any benefit payable.
To the extent allowed by law, policy benefits will not be subject to the claims of any creditor of any
beneficiary.
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You may make a change of beneficiary by Written Request on a form provided by us while the policy is In
Force. The change will take place as of the date the request is signed. Any rights created by the change
will be subject to any payments made or actions taken by us before we have received the Written
Request. You may designate a permanent beneficiary whose rights under the policy cannot be changed
without his or her written consent.
The interest of a beneficiary who does not outlive the Insured will be divided pro rata among the surviving
beneficiaries. If no beneficiaries survive to receive payment, the death proceeds will pass to the Owner,
or the Owner’s estate if the Owner does not survive to receive payment. In the event of a simultaneous
death of the Insured and a beneficiary such that it cannot be determined who died first, it will be assumed,
unless proof to the contrary is provided, that the beneficiary died last.
GENERAL PROVISIONS
Entire Contract – This policy is a contract between you and us. This policy, the attached copy of the
initial Application, including any amendments and endorsements to the Application, any applications for
reinstatement, any endorsements, benefits, or riders, and all additional policy information sections added
to this policy are the entire contract. Only our president, chief executive officer or secretary is authorized
to change this contract or extend the time for paying premiums. Any such change must be in writing.
All statements in the Application shall, in the absence of fraud, be deemed representations and not
warranties. We will not use any statement to contest this policy or defend a claim on grounds of
misrepresentation unless the statement is in an Application.
Incontestability – We will not contest this policy unless there was a material misrepresentation in the
Application. If we determine that the Application contains a material misrepresentation, we will rescind
the policy and return to you the premiums paid. No Death Benefit will be paid. Unless you fail to pay
required premiums, this policy cannot be contested, except as provided below, after it has been in force
for two years during the Insured’s lifetime.
If this policy lapses and is later reinstated, we will not contest the reinstated policy unless there was a
material misrepresentation in the Application required for reinstatement. If we determine that such
Application contains a material misrepresentation, we will rescind the reinstated policy as of the
reinstatement date and return to you the premiums paid after the reinstatement date. No Death Benefit
will be paid. We will not contest the reinstated policy after it has been in force for two years following
such reinstatement during the Insured’s lifetime.
Non-Participating – This policy will not share in any of our surplus earnings.
Suicide Exclusion – If the Insured dies by suicide, while sane or insane, within two years of the Policy
Date, the Death Benefit Proceeds will be limited to an amount equal to the sum of the premiums paid. If
this policy has been reinstated and the Insured dies by suicide, while sane or insane, within two years of
the latest reinstatement date, the Death Benefit Proceeds will be limited to an amount equal to the sum of
the premiums paid since such date.
Misstatement – If the Insured’s sex or birth date is misstated in the application, we will adjust all policy
benefits. The adjusted benefit amounts, end dates for benefits, and other features will be those that the
premiums paid would have purchased using the correct sex and birth date. The adjustment will occur
whether the misstatement is discovered before or after the death of the Insured.
Compliance – We reserve the right to make any change to the provisions of this policy to comply with, or
to give you the benefit of, any federal or state statute, rule, or regulation, including but not limited to
requirements for life insurance contracts under the Code. We will provide you with a copy of any such
change, and file such a change with the insurance supervisory official of the state in which this policy is
delivered. You have the right to refuse any such change.
P08TRM Page 10
INDEX
Subject Page Subject Page
Administrative Office 5
Age 5
Application 5
Assignment 8
Beneficiary 8
Code 5
Conversion 7
Death Benefit 6
Death Benefit Proceeds 6
Entire Contract 9
Evidence of Insurability 5
Face Amount 5
Grace Period 7
In Force 5, 6
Income Benefits 8
Incontestability 9
Insured 5
Lapse 7
Misstatement 9
Non-Participating 9
Owner 8
Policy Charges 7
Policy Date 5
Policy Specifications 5
Premiums 6
Reinstatement 7
Risk Class 5
Suicide Exclusion 9
Written Request 5
Pacific Life Insurance Company • 45 Enterprise Drive • Aliso Viejo, CA 92656
TERM LIFE INSURANCE
• Death Benefit Payable On The Death Of The Insured
• Premiums Payable as Provided Herein
• Coverage to Age 95
• Convertible
• Non-Participating
