Red Section 9-2020

AGENT RESOURCE SECTION THE AGENT-CLIENT RELATIONSHIP Steps to Successful Selling Meeting with Your Client

Needs Analysis Selling

Matching Insurance Products with Customer Needs

Application Specifics

New Members and Lodge Assignments

Certificate Provisions

Annuity Information ETIQUETTE AND ETHICS The Hermann Sons Life Agent – A Definition

Duties & Responsibilities

Licensed Agent Agreement

Unlicensed Agent Agreement FIC Code of Ethics Becoming a Licensed Agent Becoming an FIC AGENT RESOURCES Agent Training New Hire Training Regional Workshops Continuing Education Seminars Quick References

The Home Office Staff & Marketing Staff

Sales Agent Commission Schedule

Cash Bonuses and Awards

The Illustration Program

Glossary of Insurance Terms FORMS & BROCHURES Index of available forms and sales materials

Steps to Successful Selling Anyone with the right skill set and motivation can become a successful Hermann Sons Life insurance and annuities agent. Life insurance and annuities sometimes may be difficult to understand, but with the proper training, agents can earn a lucrative income selling for Hermann Sons Life. Here are some steps to help you become a successful Hermann Sons Life sales agent.

Prospecting – Coming Soon Meeting With Your Client The Agent’s Role – Coming Soon Needs Analysis Selling Matching Insurance Products with Customer Needs Application Specifics New Members and Lodge Assignments Certificate Provisions Annuity Information Delivering the Certificate – Coming Soon The Post Sale Relationship – Coming Soon

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Meeting With Your Client Needs Analysis Selling Most people are not so financially sound that they could stop working tomorrow and be able to have enough resources to support their family for a long time into the future. However, this is precisely what happens when the primary bread winner of a family dies. For this reason, life insurance is a critical piece of a family’s financial profile. But how does a family determine the proper amount of insurance? – The answer is a Needs Analysis!

The inherent problems associated with analyzing needs are understood. Needs analysis can be quite uncomfortable for the client and the agent. What are some of the negative issues associated with obtaining a complete needs analysis?

Clients are uncomfortable sharing information.

Clients don’t feel it is an important step in purchasing a small Hermann Sons Life product.

They know exactly what they want.

Agents feel uncomfortable asking the questions.

What if the analysis recommends more insurance than they can afford?

It is hopeful that information in this section will help agents feel more comfortable when assisting clients complete the needs analysis process.

Why is needs analysis important?

Why do we need to complete a needs analysis for our clients?

It’s the Law! Documented needs analysis protects the consumer and the agent.

Life insurance sales should be needs based. And when the client knows what they need it helps them plan for the future. You may have heard the old joke that “everybody talks about the weather, but nobody does anything about it.” Through proper needs analysis we have the opportunity to help our clients not just talk about their future but to understand and plan for their needs.

Needs analysis is the most reliable approach to determining the proper level of insurance. This type of analysis determines the amount of money needed to support the family and pay down outstanding liabilities, reduced by current asset holdings and future receipts of income.

When we do this we increase customer satisfaction. When customers are pleased with your service and recognize your planning professionalism they are more inclined to tell others. This will increase client referrals. Even if they do not take the coverage recommended by needs analysis, they are at least aware of their needs which may lead to future contacts.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

As you prepare for the needs analysis process, it is important that you help your client to feel comfortable with you and what you can offer to them.

Today’s consumer has more accessibility to information than ever before. Yet when considering a major financial obligation like life insurance or annuities they often don’t do any investigation. Maybe it’s because of the complexity of the product or the lack of desire to consider their own mortality, but for whatever reason they will rely on the agent to take the first step.

Your ability to best serve your client and the promise of a potential sale will essentially depend on your ability to put your clients at ease and teach them about the products you sell.

Remember, you are the professional! Help the client to understand how you can help them.

Show confidence and knowledge. Use special words and phrases like needs-based selling, confidentiality and trust to help clients feel more comfortable.

Conducting the needs analysis interview There are four basic steps to needs analysis: Fact finding Determining client objectives Analyzing customer needs and amounts Helping with product selection

Following these steps will allow you to identify and discuss: Information which will determine your client’s potential for life insurance or annuities. (job, health, other insurance) Financial problems that might arise or goals for when your client dies or retires. (debt) Your client’s objectives and motivation to purchase. (children, college, new home, change in job, retirement, desired estate) The specific form we use to record gathered information is the Needs Analysis Form. Plan to carry at least three copies to each appointment. You can start completing the form (or take notes) as you conduct the needs analysis interview. One will be used to complete information, sign and send to the Home Office. Another can be left with the client to use for a spouse or at a future date.

Step #1 – Fact finding This first step includes the typical data gathering.

What is their current financial situation?

Do they have other insurance in force?

Why are they interested in Hermann Sons Life? (Camp or dance, annuity vs. SAFE, etc.)

During the fact finding phase you often get a strong indication whether your client needs insurance and the first indicators of how much.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Step #2 – Determining Client Objectives The next step involves discovering what the client’s overall objective is for purchasing life insurance or an annuity.

What percentage of income would you like your family to have when you die?

What bills or expenses would you want liquidated?

At what age do you want to retire?

What do you need for retirement income?

Does your family have a history of longevity?

Many clients have never thought of these questions.

You may have to help them with some objectives (e.g., mortgage, college).

Remember, these objectives become the motivation for their purchase today and future purchases.

Step #3 – Analyzing Customer Needs and Amounts By determining the client’s objectives you know where they are and where they want to go. Now it’s time to determine how they can get there from here.

To apply suitability standards to your needs analysis you must analyze the objectives your customer indicated to determine the appropriate amount and type of coverage.

Typically, customers need insurance to cover these six needs: Income – Most people’s main source of income comes from employment. The money they make from work generally meets their needs. Death, however, brings an end to that source of income. A family that loses an income-earner as a result of premature death will face financial hardships unless another source of income has been provided for in advance. Life insurance can meet this need because it is designed to create dollars when an individual dies.

Mortgage – The most important legacy an income-earner should want to leave their family is a roof over their heads, especially when there are children involved. Life insurance can guarantee that survivors will keep their home or have the available funds for rent. At the least, estimate the actual cost for 120 months.

Debt Repayment – Debts create another cash need when a family member dies. Having a lump sum to liquidate these obligations will allow the surviving family to use other income for current living expenses rather than paying for past purchases.

Final Expenses – Cost associated with a funeral, probate and legal fees, possible medical bills and other associated expenses can cause great indebtedness. These costs are traditionally estimated between $15,000 and $20,000.

Child Care and Education – Children need to be cared for, especially after the death of a parent. Loss of wages can be a hardship unless covered by insurance. Plan on $8,000-$14,000 per year per child for child care and associated needs. (The number of years calculated will depend on the age of the child.) For college, plan on $20,000 to $40,000 per year per child. It will be more if it is a private university or if children fail to qualify for grants.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Emergency Funds – The death of a wage-earner doesn’t affect the possibility of other emergencies occurring. Major home, auto or health expenses could still occur. Plan to set aside funds equaling one-half of your annual income for emergencies.

Also, look at the funds which will be available at death. This will include other life insurance and annuities (from Hermann Sons Life and others, including employer group), cash on hand, and other income.

Step #4 – Helping Your Client to Choose a Product Once your client agrees that they have a life insurance or annuity need, you can present product choices and options. Explain to customers how the features of the product will solve their financial needs. By carefully reviewing appropriate amounts and explaining how they solve financial needs, you will meet suitability standards.

Knowing the Certificate Features

It is very important that agents are fully aware of our products and product features. Our clients look to you as the professional. You must have thorough knowledge of the products so you will know which plan(s) will do the best job for the client.

Unfortunately, choosing suitable products for clients is not as easy as drawing numbers out of a hat. It’s a precise science, but not a perfect one, and it takes considerable product knowledge and practice. Once you learn about the products, you must then learn to match them to the right customers.

Solid product training, like we provide during CE sessions, will help you to put customers at ease and make them more willing to listen to your ideas about their financial situations.

Putting It All Together

Earning the customers’ trust while discovering their needs will make your job of describing a product and presenting the results much easier. Be sure you have analyzed each detail carefully. Not every product may be suitable for a person’s needs. Our CE courses, regional workshops, and your professional experience will give you the ability and confidence you need to make good decisions.

Trust is earned through knowledge and professionalism.

Now, let’s talk more generally about the needs analysis process and our form.

We all understand the benefits of needs analysis, the importance of completing the form, the hurdles associated with it, and general solutions.

So let’s talk specifics!

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

What if the client is hesitant or doesn’t want to complete a needs analysis?

Be prepared to steer them in the right direction. Use phrases that will help them understand the importance of needs analysis.

“Your personalized needs will best be met if I may ask you a few questions.”

What are some phrases that have helped you in the past?

“You mentioned ___ tell me more about ___.”

“What specific benefits are important to you when selecting a life insurance certificate?”

“What this means to you is (state unique benefit).”

Try using estimates. This will give you usable numbers which can still be helpful in defining need.

Do as much needs analysis as you can (through questions) without completing the form. The client will feel less pressured but you will still gain some knowledge to help with recommendations.

Leave a blank form for them to complete later on their own. Even if you don’t have all of the information, at least they will have a better idea of their needs when they complete the form on their own.

Although there are certain “rules of thumb” which may be used in order to estimate the insurance need, they are very simplistic and often do not consider such important factors as the family’s current net worth or the ages of the family members. Such rules of thumb can provide a wide disparity of solutions. Without looking at a family’s entire financial profile, it is difficult, if not impossible, to accurately determine the proper amount of life insurance. Proper needs analysis is always the best path.

When the needs analysis states they need more coverage than the family is willing to pay or able to afford that is OK – at least they are aware of what their needs are.

Any method used to determine a family’s insurance need will be an estimate. Circumstances will change almost on a daily basis. Therefore, it is important to review the insurance need regularly and make any necessary adjustments.

This gives you future opportunities to meet with your clients.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

Matching Insurance Products with Customer Needs Life insurance can be used to meet client needs by helping them to appropriately manage their risk. Insurance agents must learn to design an insurance portfolio that meets the client’s needs and those of his/her family and other dependents.

Life brings many changes and surprises because it is a continual process of beginnings and endings. We can offer our customers peace of mind for today and for tomorrow by knowing how to help them adjust their financial needs for the many changes and surprises that come with living life – what we call Life Events.

What is a “Life Event?” A life event occurs when life circumstances change and affect planning for the future.

The Most Common Life Events: Getting out on your own/entering college Establishing a career Getting married Buying a home Becoming parents/newborn Starting a business Planning for dependents with special needs Retirement Divorce Death Getting out on your own/entering college – Getting out on your own can be exciting and a little scary. It is the time when young adults begin taking responsibility. It is important that no matter where life takes these young people we are there to support them. It is at this point when they may begin to think about owning their own life insurance plans and we should be available to assist them.

Establishing a career – Pursuing a career can be a rewarding experience. It may be the first time to manage money without the help of their parents. Undoubtedly, they will be full of questions and uncertainties. Taxes, insurance, retirement, it may be more than they can handle alone. We have watched them grow up and now they are beginning their lives and making their own choices. When they are uncomfortable discussing financial issues with their parents, you can be there to help them make wise choices about their employer benefits and possibly a Hermann Sons Life product to supplement their portfolio.

Getting married – Getting married is a big step. When planning a wedding, other decisions and plans may be put on hold. However, as soon as possible after the wedding, you should schedule an appointment with the new couple to update names, addresses and beneficiaries.

In addition, this is a perfect time to discuss their life insurance and other insurance planning.

Also, discuss their need to change beneficiaries with their employer benefits and supplement with Hermann Sons Life products if necessary.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Buying a home – Because home ownership is a substantial investment and a long-term commitment, most people want to protect this asset for their family. One of the methods is protecting against premature death through life insurance. When discussing coverage always remember to review coverage for all income contributors.

Parenting – Once the first child is born, financial planning for the future becomes even more essential. Should the child have life insurance? Should the life insurance coverage on parents be increased? Knowing what to expect will allow your customers to plan for the future and to increase their chances that they will not fall short of their financial goals. Indeed, this is the time to review and update their goals.

Starting a business – Business owners have the same need for insurance as families or individuals. The principal use of life insurance by business owners is Key Person Insurance.

Retirement – The number of people who are financially unprepared for retirement is staggering. One study revealed that more than half of adults in the U.S. were planning to depend solely on Social Security for retirement income. It’s never too late to start or improve a retirement plan. Basically there are three steps to retirement planning: 1. Estimating retirement income 2. Estimating retirement needs 3. Deciding on investments Planning for dependents with special needs – Some clients may have dependents with special needs, such as a disabled child, spouse or sibling. There may come a time when they can no longer provide the vital physical and financial support that is needed for their special person to remain safe and secure. What happens next depends largely on the quality of their planning for this time. You can help your customers by informing them of life insurance and annuities that are specific to their unique situations.

Divorce – Those who have recently changed their marital status may have important financial and legal decisions to make. These decisions might deal with changes in property ownership and providing for children’s welfare. As the family insurance agent your assistance with these matters is crucial. Divorce is sometimes the flip side of marriage and often the bridge between marriage and remarriage so some of the same assistance you offer to married couples may be appropriate at this stage as well.

Death – The death of a spouse or loved one is a difficult time. Yet, during this period, many decisions need to be made and actions must be taken in the first few months after death. You can be a strong shoulder for your customer to lean on during this time. Read up on ways to help your customers handle these details. This may be a great time to suggest an annuity for the death proceeds that are not needed for current living expenses. Some of the decisions that must be made may include: employee/retirement/survivor benefits, veteran benefits, change of ownership, change of beneficiaries, etc.

Back to Table of Contents

AGENT RESOURCE SECTION

Matching Products With Needs Gather Information Gathering appropriate information is crucial to matching needs. The Needs Analysis form provides the questions you should have answered to make a professional recommendation. However, knowing your customer also includes building a rapport. You will find out more useful information by engaging your customers in casual conversation during the interview.

Analyze Information Now you must analyze the information you have gathered to see what product(s) may be most suited to your client’s needs. Remember, temporary needs are typically covered with Term Life and permanent needs with Whole Life. A temporary need is generally 1-30 years but that really depends on the age of the client. For example: If a client is 50 years old then 30 years would be a permanent need. However, if your client is 20 years old then a 30 year need would be temporary.

Some clients may not be able to afford the premiums for all of the permanent insurance they may need in their portfolios. In these cases you can recommend Term with the understanding that they should convert to Whole Life as soon as they can afford it. You can even set up a strategy where they convert small portions at specific intervals to make it more convenient and affordable. Or maybe the best plan is a combination of Whole and Term Life.

Present Recommendations There are a couple of approaches you may take.

One-option Recommendation – when you are very secure in your solution for the customer’s needs, offer only one option. Always tell the customer why this is the best option.

Two-option Recommendation – if it appears that two different plans of action could be appropriate, then present both. Be sure to explain how each will provide the RESULTS they identified earlier.

Back to Table of Contents

AGENT RESOURCE SECTION

Application Specifics Applicant’s Full Name

We know it requests middle initial only, but the Underwriting Department would like the full and complete name.

Premium, Supplemental Contract, Lodge Dues

Check your math. If paying monthly, collect one month of lodge dues; if paying yearly, collect one year of lodge dues, etc.

Life Insurance: The Impact of Ownership Who is the Owner?

The certificate owner is the person named in the insurance contract who has control of the certificate including all rights stipulated in the contract. Usually, this is the person whose life is insured, but it can be a parent (in the case of a junior member), or a beneficiary, such as the spouse.

The certificate owner has certain important rights to the certificate, including: •• paying the premium; •• naming beneficiaries; •• determining the various options within the life insurance certificate, such as settlement options; •• changing owners of the certificate in the future; •• borrowing from a cash buildup in the certificate; and changing any other feature in the insurance certificate.

Why is ownership important?

Many parents, especially those who pay the premiums for the certificate, feel that ownership goes hand in hand. It does not! When the junior holder turns 18 he or she becomes the owner if there is no named owner. Not only does the 18-year-old member have control of all rights of the certificate, but parents cannot seek information from the Home Office because of contract privacy laws.

Ownership has greater impact when major life events, such as divorce, occur.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

Medical Information

Our agents are our field underwriters. This section must be completed in its entirety. Have the client follow along as you read the questions. Don’t paraphrase the questions. Always put the name of the primary family physician even if no adverse medical details exist.

Designating a Life Insurance Beneficiary ben’e·fi’ci·ar’y n.

A beneficiary is the person or entity named (designated) to receive the death benefits of a life insurance certificate or annuity.

Choosing a life insurance beneficiary is an important part of enacting a new certificate. While many life insurance shoppers approach designating a beneficiary as an arduous task, general certificates have few rules on who can be a beneficiary, how the beneficiary must file claims and how the claims are paid.

Hermann Sons Life beneficiary rules are covered under Title 11 in the Charter and Laws of Hermann Sons Life.

The designation of a beneficiary is required.

Who may be a beneficiary?

A life insurance beneficiary is someone who receives death benefits when the insurance certificate holder dies. When an individual privately purchases a life insurance plan, he may designate anyone, regardless of relation, as a beneficiary. Some certificateholders elect to designate two or more beneficiaries.

Even though some life insurance owners leave their insurance benefits to a non-profit organization or some small business, owners choose to designate the business as a beneficiary, allowing the business to survive even if the owner passes away, Hermann Sons Life prefers a person be named as beneficiary.

Primary and Secondary Beneficiaries Our insurance certificates provide for certificate holders to designate not only primary beneficiaries, but also contingent or secondary beneficiaries who may receive benefits if the primary designee is deceased. Life insurance is a long term arrangement, and beneficiaries may change over time. If a certificate holder designates a spouse, for example, the beneficiary may pass away before the certificate holder, leaving the benefits to be dispersed according to Article 80. In such cases, a contingent beneficiary would receive the insurance payout if the primary beneficiary is deceased.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

Hermann Sons Life does not offer an Irrevocable Beneficiary option.

An irrevocable beneficiary is one that cannot be changed. Hermann Sons Life does not offer this.

Right to Change Beneficiaries Every certificate owner has the right to change their beneficiaries according to Hermann Sons Life Laws. Every change must be applied for using the proper application form. The effective date of the change is the date it was signed by the certificate holder provided the application is in compliance with Hermann Sons Life Laws and approved.

Certificate vs. Will All beneficiaries and changes to such are designated according to the certificate laws and are not affected by stated beneficiaries in a will.

Payment to Beneficiaries and Co-Beneficiaries In the event two or more beneficiaries are designated and one or more pre-decease the member that portion of the benefit will be paid to the surviving beneficiary or beneficiaries, share and share alike. But should the pre-deceased beneficiary be a child of the member then that portion will be paid to the beneficiaries’ surviving child or children, share and share alike. Adopted children share equally with natural children.

This per stirpes-like distribution method is only used when children are beneficiaries.

If all beneficiaries pre-decease the member or if all the designated beneficiaries are unauthorized by Hermann Sons Life Laws, the proceeds of the certificate will be paid in the following manner: • Surviving spouse • Children of the member, share and share alike and if one child is deceased, to their children (share and share alike) • Surviving parents, share and share alike • Surviving brothers and sisters, share and share alike • Children of the brothers and sisters, in that portion and share that the brothers and sisters would have received if alive • Estate of the Insured Adopted children and half blood children share equally with full blood children.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

Divorced Spouse as a Beneficiary The divorced spouse of a member is not eligible as a beneficiary unless the member has redesignated such after the divorce becomes final. (ie., Jane Doe, ex-wife) A beneficiary forfeits their interest if they bring about the death of the member.

Spouses must give written consent on provided forms before you can designate anyone else as the beneficiary of a retirement plan.

Common law spouses are not entitled to benefits unless expressly designated as a beneficiary.

Minors as Beneficiaries If the beneficiary is a minor, then the proceeds will be paid to the legally appointed and qualified guardian of the minor’s estate after required proof. When there is no legal guardian, Hermann Sons Life may hold the proceeds in trust until the child’s 18th birthday.

We cannot accept children, under the age of 18, as beneficiaries of annuities.

Payment to beneficiaries of unsound mind are similar.

Lack of Proof for Claim If no proof of claim is made within the required time as stipulated by the State of Texas, the funds will be forwarded to the State of Texas under the applicable laws.

Avoid complications. Always encourage your clients to review and update their beneficiaries periodically.

The APPLICATION is a legal document and one of the most important parts of the insurance transaction. Take sufficient time to verify that all information is accurate and complete. Print legibly to avoid misinterpretations.

Back to Table of Contents

AGENT RESOURCE SECTION

New Members and Lodge Assignments Helping the new member to choose a lodge is an important part in the total sales process.

Membership and the feeling of belonging to a group is a big part of who we are. Members who are active or who have a connection to their lodge are more likely to retain membership.

Lodge placement is the choice of the member.

It is the job of the agent to educate each new member about the lodge system and help them to decide which lodge is best for them. Most often new members will end up being placed in the same lodge of the agent but this is not always the case. Most new members will not know or really care about lodge placement. Your job will be to help them decide what lodge is best for them and their family. All agents want to see their lodge grow, but what is best for the member should trump any desire for personal lodge growth.

The following are guidelines that agents should discuss as clients are deciding on a lodge: Tell your client about the Hermann Sons Lodge system.

Hermann Sons Life operates under a lodge system. When a person joins Hermann Sons Life they also join a local lodge. Lodges have business meetings, social events, and support their members and the community in many ways. Dues charged by local lodges help support the lodge in all they do.

Tell your client specific details about lodges in their area.

Helpful lodge placement criteria.

Lodge placement is the choice of the member.

Often the new member wants to belong to the lodge to which other family members belong(ed). Their personal choices should always be honored.

Traditionally, it is best if members are placed in the lodge closest to them.

We want members to participate in their lodge. There is a better chance this will happen if the lodge is close.

Is the member going to participate in a school of dance?

It is always good if the junior is a member of the lodge that sponsors the dance class; although, if their parents are members of another lodge the child should be placed with the parents. Juniors from any lodge can participate in any school of dance.

A member can always change their lodge membership.

If a member discovers they would like to belong to a different lodge they can transfer their membership at any time.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Certificate Provisions A life insurance certificate is a legal contract between the insurance company and the certificate owner. It sets forth the terms of the agreement between the two parties of the contract: The certificate owner sends in premium payments and in return the insurance company agrees to pay at certificate maturity as a death benefit or agrees to pay a death benefit at the death of the insured.

Here are some important provisions of Hermann Sons Life certificates and contracts: Free Look – All Hermann Sons Life certificates or contracts provide a 30-day free look period to the certificate owner. Once the certificate or contract is approved, issued and delivered to the certificate owner, they have 30 days to review their purchase. We must refund all premiums paid to the certificate owner if they decide to exercise this provision.

All Hermann Sons Life certificates and contracts have this provision including the Annuity contracts.

Incontestability – Once a certificate has been in force for two years, Hermann Sons Life can no longer contest a certificate or revoke it. However, if there is a discovery of fraud, Hermann Sons Life can contest any claims and possibly pursue criminal charges.

Grace Period – If the certificate owner fails to make the premium payments, Hermann Sons Life will not cancel the certificate immediately. The certificate holder has a 31-day grace period.

APL (Automatic Premium Loan) – If any premiums are not paid when due or within the grace period, the premium along with lodge dues will be taken from the cash value of the certificate.

If this loan balance exceeds the cash surrender value of the certificate the certificate will become null and void. APL balances can be repaid in any amount or frequency that the certificate owner desires.

Reinstatement – A Hermann Sons Life certificate owner can reinstate a certificate within three years of its lapse date provided that they pay all back premiums due plus interest. Other requirements may include providing evidence of insurability and paying any certificate loan balances.

Nonforfeiture Options – These are options in a permanent insurance certificate that must be made available to the certificate owner if they stop paying the premiums. These options are: Cash surrender value – The certificate owner can receive the full amount of the cash accumulation as cash less any premium and lodge dues, interest and loan balances due.

Reduced Paid Up Insurance – The certificate owner can use the cash value to purchase a single premium paid up certificate at the attained age of the certificate owner.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

Certificate Loans – When a certificate owner takes out a certificate loan, as long as the premiums are paid regularly, the cash values in the certificate will generally rise faster than the loan plus the loan’s interest. However, if the certificate loan and the interest on it become greater than the total cash value of the certificate, the certificate will lapse. To avoid cancellation of the certificate, the certificate owner should either pay enough of the loan and interest to reduce the total outstanding amount to a figure lower than the total cash value of the certificate, or pay off the entire loan plus interest.

Refund Options – An insurance company can declare certificate refunds annually, but these refunds cannot be guaranteed. There are several options available to certificate owners regarding refunds.

Paid Up Additions – The certificate owner can use the refunds to buy additional, paid up insurance at the insured’s attained age.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

Annuity Information Some of the best products we have available to our members are our annuity products.

We offer the following Annuities: Non-Qualified Annuities • 5-Year Annuity • Prefer 2000 – 9-Year Annuity Qualified Annuities • Traditional IRA - 5 or 9 Year Annuity • Roth IRA - 5 or 9 Year Annuity • SEP IRA - 5 or 9 Year Annuity • Inherited IRA - 5 or 9 Year Annuity What is an annuity?

An annuity is an investment designed to accumulate private retirement funds.

Under current tax laws annuities are tax-deferred. No tax is due until you actually take the money out. (The only exception is with the ROTH IRA.) Only interest gain is taxable for nonqualified annuities.

The money you invest in an annuity can grow three ways: • Your premium earns interest.

• Your interest earns interest.

• The money you would have paid in taxes remains in your account to earn interest.

Interest Rates Hermann Sons Life’s current rates are listed in the quarterly interest rate information report.

Guaranteed rates are specified by contract.

Withdrawals and Surrender Fees After one year, up to a 10% withdrawal can be made per contract year without a surrender fee.

Up to three partial withdrawals of at least $100 per certificate year are allowed as long as the total amount does not exceed 10% of the accumulation value at the beginning of that year.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 4/1/2012

Surrender Fees All annuities have a surrender charge if more than 10% of the accumulation value is taken.

Here are the charges per year for the 5-Year Annuity: Year Surrender Charge 1 7% 2 5% 3 3% 4 2% 5 1% 6 and over 0% Here are the charges per year for the 9-Year Annuity: Year Surrender Charge 1 9% 2 8% 3 7% 4 6% 5 5% 6 4% 7 3% 8 2% 9 1% Thereafter 0% Miscellaneous Information • Under IRS Regulation 1035, non-qualified tax-deferred annuities can be exchanged without taxation.

• A variety of asset types can be rolled over and combined into one fixed annuity.

• Additional deposits can be made into the same annuity without starting a new surrender period.

• Annuities in the form of life insurance avoid probate if the beneficiary is set up properly.

Qualified Retirement Accounts • Contributions based on an individual’s income are given special income tax treatment in a traditional IRA or Roth IRA. • A traditional IRA requires mandatory withdrawals when you reach age 70 ½. A Roth IRA does not.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

The Hermann Sons Life Agent – A Definition Who are Hermann Sons Life agents and why are they so vital to the success of our company?

This question can be answered very simply by saying: They are the face of Hermann Sons Life.

They are the voice of Hermann Sons Life.

Their success translates into Hermann Sons Life’s success.

Hermann Sons Life agents may vary in age, level of experience, background, sex and area of residence, but two common feelings unite them all – first, the desire, commitment and determination to ensure that Hermann Sons Life remains a vital and thriving part of the fraternal insurance industry, and second, the satisfaction that is gained from delivering products that offer protection and enrichment for the lives of their members.

It is our agents that bring Hermann Sons Life to the families of Texas. For this we are truly indebted.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Duties And Responsibilities The agent is in most cases the first and most influential contact that our members will have with our company. With this realization comes responsibility.

The Hermann Sons Life Agent‌ works to increase membership and keep Hermann Sons Life strong focuses on the needs of the client and member abides by the rules of our company and the laws of the Texas Department of Insurance protects the confidentiality of their clients understands the importance of education protects and guards all property entrusted to them is always growing and striving to be better is supportive of other agents and the Home Office is always ethical and conducts all business with the highest standards The duties of the agent are expanded upon in the Letter of Agreement and this manual. Familiarize yourself with all aspects of the job and represent Hermann Sons Life and its members with respect and pride.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

LICENSED AND UNLICENSED AGENT AGREEMENTS Both agreements are currently being revised.

The new agreements will be forwarded to you as soon as they are available.

This space is reserved for the revised Agent Agreement.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 01/01/2020

Fraternal Insurance Counselor Code of Ethics Preamble: As a fraternal life underwriter, I will maintain the utmost professional standards toward my members and at the same time maintain a position of trust and loyalty to my Society.

I believe it to be my responsibility: To conduct my fraternal business according to high standards of honesty and fairness and to render that service to my members which, in the same circumstances, I would apply to or demand for myself. I will develop my ability and improve my knowledge through regular continuing education.

To provide competent and member-focused sales and service based on my members’ concerns, needs and input. I will present accurately and completely the facts essential to my members’ decisions and always place their best interest and welfare above any personal considerations. I will submit complete and accurate applications for membership and insurance on only those persons whom I believe to have the proper requirements that conform with my Society’s underwriting rules.

To engage in active and fair competition. I will refuse any person or persons any part of my commissions or earnings as an inducement to purchase an insurance or annuity product. I will follow applicable regulations as well as guidelines developed by my Society whenever a sale involves replacement of insurance.

To only use advertising and sales materials approved by my Society and the applicable regulatory authorities.

To respect my members’ confidences and hold in trust personal information.

To fairly and expeditiously handle member complaints or disputes.

To cooperate in a system of supervision and review that is designed to achieve compliance with this Code of Ethics and Principles of Ethical Conduct.

As a Fraternal Insurance Counselor, I pledge myself to uphold and maintain these principles and responsibilities.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 01/01/2020

Becoming A Licensed Agent All Hermann Sons Life agents must become state licensed within one year of their hire date.

Instructions on becoming licensed are located in the Agent Only section of the Hermann Sons Life website under Other Important Information. The Agent Only part of the site is accessed by going to hermannsonslife.org/agent-staff.

The Sales Department will reimburse agents 50 percent of expenses incurred in becoming licensed, including exam fees, fingerprinting fees and classroom fees. Please turn in your receipts for licensing expenses to Ana Vasquez.

If you have any questions regarding how to become licensed, please contact Ana Vasquez at ext. 235.

Becoming A Fraternal Insurance Counselor (FIC) All agents are strongly encouraged to enroll in the Fraternal Insurance Counselor (FIC) designation program. Enrolling in the FIC program must be initiated by the Hermann Sons Life Sales Department as Hermann Sons Life must be listed as your sponsor. Hermann Sons Life will contact the training company for you.

The FIC program requires that you complete four main courses: FIC Basic – Part A - Introduction to Life Insurance FIC Basic – Part B - Ethics for the Insurance Professional FIC Intermediate – Needs Analysis FIC Advanced – Introduction to Advanced Markets The cost for the online textbook is $49 and includes the exam cost.

You must complete all four courses within three years of your initial enrollment date. A passing score is 70 or greater. You will receive immediate test results with the online exam.

Contact Ana Vasquez at ext. 235 for further information.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 01/01/2020

Agent Training Hermann Sons Life sales agents receive training on a regular basis. Classroom instruction for agents is held at the time of hire, twice a year at regional workshops and once a year for licensed agents at the continuing education weekend.

New Hire Training Newly hired agents receive a three-day intense new hire training and orientation. Training consists of reviewing sales techniques, introducing sales agents to forms needed in order to complete a sale, immersion in the history of our company and its culture, company mission and company benefits. Orientation consists of company policies and procedures, a tour of the Home Office campus and the Camp and Retirement Home campuses.

Regional Workshops Designed to educate agents on pertinent sales topics, sales policies and procedures, and requested training topics, these workshops are held in a public setting located within a reasonable distance of an agent’s home. Workshops traditionally begin at 4 p.m. and last until 7 p.m. Agents are encouraged to share their sales experiences related to the topic of discussion.

Workshops are a great training resource for all agents and sessions are typically held during the months of February and August. In addition to receiving three hours of training, agents also are treated to a complimentary dinner. All agents are required to attend local workshop training sessions, unless excused.

Continuing Education Seminars During the Continuing Education weekend, licensed agents receive two days of classroom instruction. Traditionally held at the Hermann Sons Life Camp in Comfort, Texas, this educational weekend is conducted in the month of October. The continuing education weekend is one of the easiest ways for licensed agents to complete their 12 hours of annually required continuing education. Classes are conducted in cooperation with a single designated instructor or a group of instructors who are approved by the Texas Department of Insurance. At times, classes are taught by Hermann Sons Life staff .

Agents pay a nominal fee to participate in this event. This fee offsets housing and food costs for the entire weekend. All licensed agents should plan to attend; otherwise please contact the Sales Department for your CE options.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 01/01/2020

Home Office Staff Name

Ext.

Title

Eugene Zollinger

277

President and Chief Executive Officer

Marketing Letricia Rodriguez

231

Marketing Manager

Kathie Ninneman Elaine Soto

273 279

Communications Director Assistant Communications Director

Kolbe, Tim

272

Vice President of Sales

Ana Vasquez Gladys Rowley

235 225

Compliance Director Administrative Assistant

Eulla Krueger Teresa Saathoff

283 281

Regional Sales Manager Regional Sales Manager

Schulmeier, Samantha

233

Vice President of Operations and COO

Public Relations

Sales Agents

Beth Williams Alice Golla

282 0 or 220

Administrative Assistant Receptionist

Member Services Steve Flandro Darla Howell Carol Swan

288 268 258

Member Services Representative Member Services Representative Member Services Representative

264 229

Underwriting Director Underwriting Representative

Underwriting Tiffany Sanchez Debbie Payne

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 05/01/2020

Matt Walker

261

Vice President of Information Technology

Letty Fragoso Rebecca Henley Jon Thompson Tyson Wilber

267 243 269 263

Desktop/Agent Support, Operations Senior Programmer Associate Vice President of Information Technology Systems/Network/Security Administrator

*Note – requests for membership lists should be made to the Sales Department.

Mary Pruitt

231

Vice President of Finance and CFO

Melisa Haecker Cindy Ledwig Sara Sanchez

284 234 247

Financial Controller HR/Payroll Specialist Accounts Payable

Maintenance Terry Haecker LaWanda Gibbons James Smith

260 251 251

Director Maintenance Maintenance

Cecily Kelly

257

Vice President of Member Benefits

238 239

Member Benefits Representative Events Coordinator

Controller’s Office

Member Benefits Jacqueline Klein Tammi Sutherland Home Office - San Antonio, Texas

210-226-9261

Toll Free

800-234-4124

Sales Department – Toll Free

888-839-7667 877-437-6266

Sales Fax

210-475-9071

Underwriting Fax

210-226-3055

Member Services Fax

210-892-0299

Tim Kolbe Cell Phone

830-660-3713

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 05/01/2020

Sales Department Staff HOME OFFICE PHONES: 210-527-9113 877-437-6266 888-839-7667 VICE PRESIDENT OF SALES TIM KOLBE, ext. 272

PHONE 830-660-3713 EMAIL timk@hermannsonslife.org

REGIONAL SALES MANAGERS EULLA KRUEGER, ext. 283

PHONE 210-863-0546 (cell) 830-985-3643 (home)

EMAIL eullak@hermannsonslife.org

TERESA SAATHOFF, ext. 281

PHONE 210-422-6996 (cell) 210-276-0361 (home)

EMAIL teresas@hermannsonslife.org

OFFICE STAFF COMPLIANCE DIRECTOR ANA VASQUEZ , FLMI, AIRC, FIC, ext. 235

EMAIL anav@hermannsonslife.org

ADMINISTRATIVE ASSISTANT GLADYS ROWLEY, FIC, ext. 225

EMAIL gladysr@hermannsonslife.org

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 05/01/2020

Sales Sales Agent’s Agent Commission Schedule Schedule Life Insurance

First Year

Traditional Life

Life Insurance H and J Plan

Traditional Life

70%

Interest Sensitive Life

* Single Premium - FL and JFL Interest Sensitive Life Flex Annual - FLA and and JFLA Flex Annual - FLA and JFLA * SAFE Plan - Differential by Age * SAFE Plan - Differential by Age Age 50-60 Age 50-60 Age 61-70 Age 61-70 Age 71-80 Age 71-80 Age 81-90

2%

Term Insurance *

Term Insurance *

10 Year Renewable, CT-10 20 Year Level, CLT-20 20 Year Level, CLT-20 Coverage to age 70, CT-70

Renewable to age 120, RT-120 * Annual $60 certificate fee will not apply

Issued prior to Oct. 1, 1996 Issued between Oct. 1, 1996 - Dec. 31, 2001 Issued after Dec. 31, 2001: Flexible Premium Deferred Annuity * Issued after Dec. 31, 2001: Preferred 2000 AnnuityDeferred * Flexible Premium Annuity * Preferred 2000 Annuity * * No more commissions after Year 1 * No more commissions after Year 1 Riders

10%

0% 0% 0% 0%

1% of all deposits

3% of initial deposit only

70% 70%

Waiver of Premium WP

Please refer to the Agent Contract Agreement or the Glossary of Terms for commission specifics including PleaseConversions, refer to the Agent Contract Agreement for Rollovers, Chargebacks, Premium Deducincludinginformation.

Rollovers, Conversions, tioncommission Options, andspecifics other commission

0% 10%

0% 0% 0% 0%

50%

50% 50%

10%

50% 50%

50%

10% 10% 10% 10%

50%

50%

70%

50%

50%

1% of all deposits 3% of initial deposit only

3% of all 1st yr. deposits

3% of all 1st yr. deposits 3% of all first year deposits 3% of all first year deposits

70% 70%

10% 10% 10% 10%

10%

Waiver of Premium WP Insurability Protection Rider IPR

10%

10%

Insurability Protection IPRADB Accidental Death Rider Benefit

Back to Table of Contents

70%

Premium Deduction Options, and other commission information.

50%

Accidental Death Benefit ADB Riders

10%

50%

towards commissions. * Annual $48.00 policy fee for term certificates will Annuity not applyPlans towards commissions.

Issued prior to Oct. 1, 1996 Issued between Oct. 1, 1996 - Dec. 31, 2001

50% 50% 50% 50%

50%

10 Year Renewable, CT-10

back First Year

7%

70% 70%

12% 12% 9% 9% 6% 6% 2%

Age 81-90

* Modified Endowment Contract. Cash withdrawal * Modified Endowment Cash withdrawal or loan may cause taxcontract. consequences. or loan may cause tax consequences.

Annuity Plans

70%

Years 2-7

First Year

H and J Plan

Years 2-7Charge-

50% 50%

10%

Revised 05/01/2020

Cash Bonuses and Awards In addition to insurance and annuity sales commissions, Hermann Sons Life sales agents are eligible for the following Cash Bonuses and Awards: Quarterly Sales Bonus Special Campaigns Agent’s Award Banquet Bonus and Awards NAFIC Awards Other Production Awards and Bonuses

Please review the following pages for details of each program

Back to Table of Contents

AGENT RESOURCE SECTION

All Agents Quarterly Bonus APPLICATIONS 8 16 24 36 50+

APPLICATIONS BONUS $100 $200 $300 $400 $500

PREMIUM INCOME $4,000 $6,000 $10,000 $14,000 $20,000

PREMIUM INCOME BONUS $100 $200 $300 $400 $500

All agents are eligible for the bonuses listed above (annuity applications do not count towards the application bonus) if they meet either the Applications minimum OR the Premium Income minimums.

Agents are not competing against each other or in regions. They will only be striving to achieve the above required amounts to attain a bonus.

APPLICATIONS APPLICATIONS

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 01/01/2020

Special Campaigns Throughout the year, the Vice President of Sales will announce campaigns that focus on sales of a specific product or a specific sales goal.

Cash bonuses and/or awards are announced at the beginning of each campaign.

Agents are encouraged to participate throughout the year in these campaigns. Participation helps to supplement their commission income, and shows interest in helping the Hermann Sons Life message reach as many new and current members as possible.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 01/01/2020

Agent’s Award Banquet Bonus and Awards Agents are eligible to attend an all-expenses paid Awards Recognition Event courtesy of Hermann Sons Life. In addition, agents receive the following awards and cash bonuses.

Category

Qualifications

President’s Club

$30,000 1st Year PI – Entry Level 12 applications minimum 70% Persistency

Past PC Winners

$30,000 PI

Additional bonus for additional Premium Income

$60,000 PI – Bronze Level $90,000 PI – Silver Level $120,000 PI – Gold Level $150,000 PI – Platinum Level $180,000 PI – Emerald Level $200,000 PI – Diamond Level

Executive Club

$12,000 1st year PI 12 applications minimum 70% Persistency

Award Ring or Jacket or Tote Bag and Plaque

Mobile Office Case and Plaque

$200 cash

$200 cash $1,000,000 face amount 12 applications minimum 70% Persistency

Plaque

$100 cash

$100

Past MDC Winners

Club Membership Persistency

$300 cash $400 cash $500 cash $600 cash $700 cash $800 cash $1,000 cash

Past EC Winners

Million Dollar Club

Cash Bonus $300 cash

10,15,or 20 years in any combination of clubs

Lapel pin

All clubs and banquet awards are based on new business issued for one (1) contest year from January 1 through December 31 (the first and last business day of the year will determine the actual contest year).

Annuity and matured annuity applications do not count towards these awards.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

AGENT CLUB GIFTS First-time President’s Club qualifiers may choose one of 3 gifts

Picture Coming Soon

Jacket

Tote Bag

with initials embossed on tag

Ring

First-time Executive Club qualifiers receive a mobile office case

Mobile Office Case

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

NAFIC Awards All Hermann Sons Life agents who have earned the FIC designation are eligible for National Association of Fraternal Insurance Counselor (NAFIC) awards. The qualifications for each award are listed below. Award period is January 1 through December 31.

FIC Service Award Qualifications • $2,000,000 in Sales Production

• 30 applications minimum • 90% persistency Award

• Certificate of recognition from NAFIC • FIC dues paid for 1 year • Plaque for 10, 20, 25 or 30 years of award eligibility

FIC Production Award Qualifications

• Bronze -$30,000 First Year Commissions and 30 Applications • Silver - $40,000 First Year Commissions and 30 Applications • Gold - $50,000 First Year Commissions and 30 Applications • Platinum - $65,000 First Year Commissions and 30 Applications

Award

• Certificate of recognition from NAFIC for each category

NAFIC President’s Award Qualifications

• $90,000 First Year Commissions and 30 Applications

Award

• NAFIC Plaque

NAFIC Chairman’s Council Members earn a seat on the Chairman’s Council for achieving $125,000 or more in earned first-year commissions.

Rising Star Award Awarded to those agents who in their first four years of having their FIC designation meet the following: i. 50 new life applications OR ii. 75 total new applications OR iii. 25 new insurance members Back to Table of Contents

AGENT RESOURCE SECTION

Revised 01/01/2020

Other Production Awards and Bonuses E & O Premium Payment A $20 bonus will be credited to an agent’s E&O premium for each approved and issued application (up to 12 applications). This credit will be given to each agent between January 1 and December 31 of the current year. Matured annuity applications will not be credited toward your E&O. Note: This payment is a credit towards your E & O insurance payment of $240 and is not reflected as a cash award.

Newborn Bonus Program A Newborn bonus of $25 per newborn contract delivered will be paid. In addition, a bonus of $25 will be paid for a permanent whole life contract that is issued while the newborn contract is active. This bonus program is in addition to any commissions paid as part of the Sales Agent’s Commission Schedule. The agent must complete both the Newborn Bonus Request Form and the Additional Coverage Bonus Request Form and submit them to the Sales Department in order to receive the bonus.

Most New Adult Members A cash bonus of $200 is awarded to the agent with the most submitted and approved new adult member applications. Award period is January 1 through December 31.

Most 100% Families A cash bonus of $300 is awarded to the agent with the most submitted and approved 100% Family life certificates or annuity contracts (a minimum of six is required). A family can only be awarded a 100% Family Pin once. A 100% Family consists of the primary social group – parents and children. A single individual is not eligible. Award period is January 1 through December 31.

Last Agent Standing A cash bonus of $300 is awarded to agents who have at least one application submitted for each month. Award period is January 1 through December 31. Additional recognition includes agent’s name on a poster that remains in the Sales Department.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 01/01/2020

Family Builder Bonus Program A $50 bonus will be paid if an adult application is written and approved within six months of writing a junior application in the same household. The adult application can be a Whole Life, a Term Life or an Annuity of at least $10,000 face value. The six months is calculated by the Junior Issue Date and the Adult Application Date.

Multi Product Bonus Program A $100 bonus will be paid if multiple products are written at the same time for the same adult.

Minimums that apply include: $100,000 Term $25,000 Whole Life $10,000 Single Premium $10,000 Annuity Multiple products means two or more products written at the same time. Conversions do not apply. Rollovers do not apply.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 11/01/2018

The Illustration Program The illustration program is located online in the Agent Only section of the Hermann Sons Life website.

If you have installation problems, please contact the Sales Department. If we cannot help with your installation problems, we will refer your call to the Information Technology Department.

Agents are reminded that they may access the illustration software via the Internet from any mobile device. This capability empowers the agent to provide insurance plan quotes whenever they have mobile connectivity. Quotes can be sent to the client from the mobile device via email.

Website: viscalc.com/app/invite/5s22xj Sign in and create your own username and password.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

Glossary of Insurance Terms Accelerated Death Benefits - This feature allows you, under certain circumstances, to receive the proceeds of your life insurance certificate before you die. Such circumstances include terminal or catastrophic illness, the need for long-term care, or confinement to a nursing home.

Accidental Death Benefit - In a life insurance certificate, a benefit in addition to the death benefit paid to the beneficiary, should death occur due to an accident. There can be certain exclusions as well as time and age limits.

Actuary - A specialist in the mathematics of insurance who calculates rates, reserves, dividends and other statistics.

Adjustable Rate - An interest rate that changes based on changes in a published market-rate index.

Admitted Assets - Assets permitted by state law to be included in an insurance company’s annual statement. These assets are an important factor when regulators measure insurance company solvency. They include mortgages, stocks, bonds and real estate.

Agent - An individual who sells and services insurance certificates.

Annuitization - Process by which you convert part or all of the money in a qualified retirement plan or nonqualified annuity contract into a stream of regular income payments, either for your lifetime or the lifetimes of you and your joint annuitant. Once you choose to annuitize, the payment schedule and the amount is generally fixed and cannot be altered.

Annuitization Options - Choices in the way to annuitize. For example, life with a 10-year period certain means payouts will last a lifetime, but should the annuitant die during the first 10 years, the payments will continue to beneficiaries through the 10th year. Selection of such an option reduces the amount of the periodic payment.

Annuity - An agreement by an insurer to make periodic payments that continue during the survival of the annuitant(s) or for a specified period from a capital investment and the gain from that investment.

Assets - Assets refer to “all the available properties of every kind or possession of an insurance company that might be used to pay its debts.” There are three classifications of assets: invested assets, all other assets, and total admitted assets. Invested assets refer to things such as bonds, stocks, cash and income-producing real estate. All other assets refer to non-income producing possessions such as the building the company occupies, office furniture, and debts owed, usually in the form of deferred and unpaid premiums. Total admitted assets refer to everything a company owns. All other plus invested assets equal total admitted assets. By law, some states don’t permit insurance companies to claim certain goods and possessions, such as deferred and unpaid premiums, in the all other assets category, declaring them “non-admissible.”

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

Attained Age - The insured’s age at a particular time. For example, many term life insurance certificates allow an insured to convert to permanent insurance without a physical examination at the insured’s then attained age. Upon conversion, the premium usually rises substantially to reflect the insured’s age and diminished life expectancy.

Captive Agent - Representative of a single insurer or fleet of insurers who is obliged to submit business only to that company, or at the very minimum, give that company first refusal rights on a sale. In exchange, that insurer usually provides its captive agents with an allowance for office expenses as well as an extensive list of employee benefits such as pensions, life insurance, health insurance, and credit unions.

Chargeback – A reversal of commissions originally paid to an agent. Reversals are due to lapses or surrenders that occur within the first 12 months of the certificate issue date. Currently, chargebacks are calculated at 50 percent. Commissions from certificates that are returned within the 30-day Free Look Period will be charged at a rate of 100%. Chargeback commissions and/or amounts may be changed without notice. Agents will be notified as soon as possible of changes to this policy.

Churning – An illegal and unethical practice whereby an insurance agent unnecessarily replaces existing life insurance for the purpose of earning additional commissions.

Claim - A demand made by the insured, or the insured’s beneficiary, for payment of the benefits as provided by the certificate.

Commission - Fee paid to an agent or insurance salesperson as a percentage of the certificate premium. The percentage varies widely depending on coverage, the insurer and the marketing methods.

Coverage - The scope of protection provided under an insurance certificate.

Convertible - Term Life insurance coverage that can be converted into permanent insurance regardless of an insured’s physical condition and without a medical examination. The individual cannot be denied coverage or charged an additional premium for any health problems.

Death Benefit - The limit of insurance or the amount of benefit that will be paid in the event of the death of a covered person.

Dividend - The return of part of the certificate’s premium for a certificate issued on a participating basis by either a mutual or stock insurer. A portion of the surplus paid .

Exclusions - Items or conditions that are not covered by the general insurance contract.

Future Purchase Option (Guaranteed Insurability Option) - Life insurance provision that guarantees the insured the right to buy additional coverage without proving insurability. Also known as “insurability protection rider.”

General Account - All premiums are paid into an insurer’s general account. Thus, buyers are subject to credit-risk exposure to the insurance company, which is low but not zero.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

Grace Period - The length of time (usually 31 days) after a premium is due and unpaid during which the certificate, including all riders, remains in force. If a premium is paid during the grace period, the premium is considered to have been paid on time.

Guaranty Association - An organization of life insurance companies within a state responsible for covering the financial obligations of a member company that becomes insolvent.

Hazardous Activity - Bungee jumping, scuba diving, horse riding and other activities not generally covered by standard insurance certificates.

Indemnity - Restoration to the victim of a loss by payment, repair or replacement.

Insurable Interest - Interest in property such that loss or destruction of the property could cause a financial loss.

Investment Income - The return received by insurers from their investment portfolios including interest, dividends and realized capital gains on stocks. It doesn’t include the value of any stocks or bonds that the company currently owns.

National Association of Insurance Commissioners (NAIC) - Association of state insurance commissioners whose purpose is to promote uniformity of insurance regulation, monitor insurance solvency and develop model laws for passage by state legislatures.

Paid-Up Additional Insurance - An option that allows the certificate holder to use certificate dividends and/or additional premiums to buy additional insurance on the same plan as the basic certificate and at a face amount determined by the insured’s attained age.

Policy - The written contract effecting insurance or the certificate thereof, by whatever name called, and including all clauses, riders, endorsements, and papers attached thereto and made a part thereof.

Policy or Sales Illustration - Material used by an agent and insurer to show how a certificate may perform under a variety of conditions and over a number of years.

Premium - The price of insurance protection for a specified risk for a specified period of time.

Qualified Versus Non-Qualified Policies - Qualified plans are those employee benefit plans that meet Internal Revenue Service requirements as stated in IRS Code Section 401a. When a plan is approved, contributions made by the employer are tax deductible expenses.

Rebating - The practice of returning the agent’s commission, or a portion of it, to the insured with the desire of assuring an insurance sale for the insurer.

Reinsurance - Insurance that an insurance company buys for its own protection. The risk of loss is spread so a disproportionately large loss under a single certificate doesn’t fall on one company. Reinsurance enables an insurance company to expand its capacity; stabilize its underwriting results; finance its expanding volume; secure catastrophe protection against shock losses; withdraw from a line of business or a geographical area within a specified time period.

Renewal - The automatic re-establishment of in-force status affected by the payment of anBack to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

other premium.

Reserve - An amount representing actual or potential liabilities kept by an insurer to cover debts to certificate holders. A reserve is usually treated as a liability.

Section 1035 Exchange - This refers to a part of the Internal Revenue Code that allows owners to replace a life insurance or annuity certificate without creating a taxable event.

Section 7702 - Part of the Internal Revenue Code that defines the conditions a life certificate must satisfy to qualify as a life insurance contract, which has tax advantages.

Solvency - Having sufficient assets – capital, surplus, and reserves – and being able to satisfy financial requirements – investments, annual reports, examinations – to be eligible to transact insurance business and meet liabilities.

State of Domicile - The state in which a company is incorporated or chartered. The company also is licensed under the state’s insurance statutes for those lines of business for which it qualifies.

Surrender Charge - Fee charged to a certificate holder when a life insurance certificate or annuity is surrendered for its cash value. This fee reflects expenses the insurance company incurs by placing the certificate on its books, and subsequent administrative expenses.

Surrender Period - A set amount of time during which you have to keep the majority of your money in an annuity contract. Most surrender periods last from 5 to 10 years. Most contracts will allow you to take out at least 10% a year of the accumulated value of the account, even during the surrender period. If you take out more than that 10%, you will have to pay a surrender charge on the amount that you have withdrawn above that 10%.

Term Life Insurance - Life insurance that provides protection for a specified period of time.

Common certificate periods are one year, five years, 10 years or until the insured reaches age 65 or 70. The certificate doesn’t build up any of the non-forfeiture values associated with Whole Life certificates.

Tobacco Use - Is defined as any use of cigarettes, cigars, pipes, chewing tobacco or snuff, ecigarettes, vaping, nicotine gum or patches, water pipes and dissolvable tobacco.

Total Admitted Assets - This item is the sum of all admitted assets, and are valued in accordance with state laws and regulations, as reported by the company in its financial statements filed with state insurance regulatory authorities. This item is reported net as to encumbrances on real estate (the amount of any encumbrances on real estate is deducted from the value of the real estate) and net as to amounts recoverable from reinsurers (which are deducted from the corresponding liabilities for unpaid losses and unearned premiums).

Twisting - The act of inducing or attempting to induce a certificate owner to drop an existing life insurance certificate and to take another certificate that is substantially the same kind by using misrepresentations or incomplete comparisons of the advantages and disadvantages of the two certificate.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

Underwriter - The individual trained in evaluating risks and determining rates and coverage for them.

Underwriting - The process of selecting risks for insurance and classifying them according to their degrees of insurability so that the appropriate rates may be assigned. The process also includes rejection of those risks that do not qualify.

Universal Life Insurance - A combination flexible premium, adjustable life insurance certificate.

Valuation - A calculation of the certificate reserve in life insurance.

Variable Annuitization - The act of converting a variable annuity from the accumulation phase to the payout phase.

Variable Life Insurance - A form of life insurance whose face value fluctuates depending upon the value of the dollar, securities or other equity products supporting the certificate at the time payment is due.

Variable Universal Life Insurance - A combination of the features of Variable Life insurance and Universal Life insurance under the same contract. Benefits are variable based on the value of underlying equity investments, and premiums and benefits are adjustable at the option of the certificate holder.

Viatical Settlement Provider - Someone who serves as a sales agent, but does not actually sell certificates.

Waiver of Premium - A provision in some insurance contracts which enables an insurance company to waive the collection of premiums while keeping the certificate in force if the certificate holder becomes unable to work because of an accident or injury. The Waiver of Premium for disability remains in effect as long as the insured is disabled.

Whole Life Insurance - Life insurance which might be kept in force for a person’s whole life and which pays a benefit upon the person’s death, whenever that might be.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

HERMANN SONS LIFE FORMS & BROCHURES

FORM FORM # LIFE INSURANCE APPLICATION Application for Life Insurance & Membership APP Certificate Illustraction Routing Cover Needs Analysis Bank Draft Authorization Request Form Health Insurance Portability and Accountability Act Form Insurance and Annuity Replacement Form Life Insurance Buyer’s Guide Underwriting Brochure AGENT LIFE INSURANCE FORMS 100% Family Family Builder Bonus Alcohol Usage Questionnaire Application for Accidental Death Rider Application for Reinstatement Attention Deficit/Hyperactivity Questionnaire Aviation Questionnaire Crop Dusting Questionnaire Diabetes Questionnaire Drug Usage Questionnaire Life Insurance 1035 Exchange Request Multi Product Bonus Newborn Bonus Request Newborn Bonus Request-Permanent Coverage Newborn Term Life Insurance Application Notice & Consent Form for AIDS Virus (HIV) Testing Respiratory Questionnaire Sport, Amusement, Avocation Questionnaire Term Conversion Application Tobacco Usage Questionnaire Waiver of Premium Rider Payor Information

Back to Table of Contents

NB

TRM CONV

AGENT RESOURCE SECTION

REVISION DATE

Copies Available (P) Public Website (A) Agent Website (O) Office Mailing

June-17 Nov-16 Nov-16 Nov-16 Aug-20 Nov-16 Mar-20 Jul-29

A,O A,O A,O P,A,O A,O A,O A,O A,O

Nov-16 Nov-16 Nov-16 Nov-16 Nov-16 Oct-15 Nov-16 Nov-16 Nov-16 Nov. 16 Nov-16 Aug-20 Nov-16 Nov-16 June-17 Nov-16 Nov-16 Nov-16 June-17 Aug-17 Aug-18

A,O A,O A,O A,O A,O A,O A,O A,O A,O A,O A,O A,O A,O A,O A,O A,O A,O A,O A,O A,O A,O

Revised 09/01/2020

AGENT ANNUITY FORMS Annuity Application Needs and Financial Objectives for Annuity Annuity Buyer’s Guide Annuity Contribution and Withdrawal Form Traditional IRA Transfer Request ROTH IRA Transfer Request Annuity Full 1035 Exchange Form Annuity Partial 1035 Exchange Form Traditional IRA Contribution Eligibility ROTH IRA Contribution Eligibility Direct Conversion Request - Traditional to ROTH Direct Rollover Request Form Matured Annuity Application

ANNAPP GR1.5

302/2325 6302/2425

109 6109 6305 487

MEMBER SERVICES FORMS Address Change Request Form Agent Replacement Compliance Letter Application for Decrease Certificate Bank Draft Authorization Request Form Beneficiary Change Request Form Change of Agent Notification Death Notice Lodge Transfer Request Form Lost Certificate Request Form Name Change Request Form Ownership Change Request Form BROCHURES General Information Outline of produtcs offered Annuity brochure SAFE brochure Hermann Sons Life Camp flyer Hermann Sons Life Dance flyer Hermann Sons Life Retirement Home flyer Agent to Client postcard Perk Spot flyer

Back to Table of Contents

AGENT RESOURCE SECTION

June-17 Nov-16 Jan-20 Nov-16 Jan-20 Oct-17 Nov-16 Nov-16 Jan-20 Oct-19

A,O P,A,O A,O P,A,O A,O A,O A,O A,O A,O A,O

Oct-15 Oct-15 Jun-17

A,O A,O O

Nov-16 Nov-16 Nov-16 Nov-16 Nov-16 Nov-16 Nov-16 Nov-16 Nov-16 Nov. 16 Nov-16

P,A,O A,O A,O P,A,O P,A,O A,O A,O P,A,O P,A,O P,A,O P,A,O

April-20 March-20 June-19 March-20 March-20 March-20 July-20 Dec-19 Sept-19

O O O O O O O O O

Revised 09/01/2020

Application for Life Insurance & Membership PROPOSED INSURED INFORMATION

PLEASE PRINT IN BLUE OR BLACK INK ONLY

DATE OF BIRTH

FULL NAME (Last, First, Middle) MAILING ADDRESS AGE

SEX

STATE

CITY

ZIP CODE

MARITAL STATUS £ Married £ Single £ Widowed £ Divorced

BIRTHPLACE (City and State)

Is proposed insured a citizen of the United States?

Yes No If no, does proposed insured plan to become a citizen?

Yes No OCCUPATION/JOB DESCRIPTION

SOCIAL SECURITY NO. HOME PHONE NO. CELL PHONE NO. WORK PHONE NO.

FIRM NAME

E L P

BENEFICIARY DESIGNATION NAME

DATE OF BIRTH

RELATIONSHIP

SOCIAL SECURITY NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

M A S NAME

DATE OF BIRTH

RELATIONSHIP

SOCIAL SECURITY NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

NAME

DATE OF BIRTH

RELATIONSHIP

BILLING INFORMATION

FULL NAME (Last, First, Middle)

RELATIONSHIP TO PROPOSED INSURED

DATE OF BIRTH PHONE

OCCUPATION

MAILING ADDRESS

CITY

PICTURE ID REQUIRED #

OWNERSHIP INFORMATION

SOCIAL SECURITY NO.

STATE

ZIP CODE

TYPE

Check if same as Proposed Insured.

OWNER’S FULL NAME (Last, First, Middle)

DATE OF BIRTH

SOCIAL SECURITY NO. OR EMP. ID. NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

SOCIAL SECURITY NO. OR EMP. ID. NO. OWNER’S FULL NAME (Last, First, Middle) DATE OF BIRTH

CONTACT E-MAIL ADDRESS FORM # APP (REV 6/17)

PART A - PAGE 1

Page 1 of 5 Pages including Conditional Receipt

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Certificate Illustration Routing Cover TO BE RETURNED WITH APPLICATION/ILLUSTRATION Applicant________________________________________________________________________________________

THE ILLUSTRATION Please check one only ❏ Is correct as printed. ❏ Has been corrected.

NOTE: All corrections must be initialed by the Owner and the Agent.

E L P

❏ No illustration was provided due to application being written on emergency basis. ❏ Is revised due to a substandard rating by the Underwriter.

NOTE: Agent must have Owner sign two copies of the revised illustration.

M A S

One copy is returned to the Home Office and one copy is given to the Owner/Applicant.

THE OWNER/APPLICANT

Please check one only ❏ Was given a copy of the illustration.

❏ Was NOT given a copy of the illustration.

❏ Requires a revised copy of the illustration.

Applicant/Owner Signature

Agent Signature

An illustration conforming to the application will be provided to the Owner/Applicant no later than the time of the certificate delivery.

ROUTING COVER (Rev. 11/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Needs Analysis Applicant: ________________________________________ SSN: _________________________ CASH NEEDS Funeral, medical, legal, etc.

Pay debt, credit cards, auto loans, etc.

Emergency fund (1/2 annual income) Mortgage, incl. tax, etc. - 120 months Child care to age 18 Children’s education Special needs (incl. living expenses for survivor)

E L P

TOTAL CASH NEEDS

M A S

FUNDS AVAILABLE AT DEATH Hermann Sons Life insurance and annuities Employer group insurance Other insurance or investments Other insurance or investments Cash on hand Other income

FUNDS AVAILABLE AT DEATH

LIFE INSURANCE OR ANNUITY NEEDS

(Cash needs minus funds available at death)

LIFE INSURANCE OR ANNUITY APPLIED FOR

(

) I HAVE READ AND UNDERSTAND THE RECOMMENDED MINIMUM LIFE INSURANCE OR ANNUITY NEEDS (AMOUNT) PROPOSED.

(

) I REJECT THE MINIMUM LIFE INSURANCE OR ANNUITY NEEDS (AMOUNT) PROPOSED.

APPLICANT/ANNUITANT/PROPOSER

DATE

AGENT/WITNESS

DATE

Needs Analysis (Rev. 11/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Bank Draft Authorization Request Form Date ___________________________________________________________ Certificate No. __________________ Name ___________________________________________________________________________________________ Address _________________________________________________________________________________________ City _______________________________________________ State ____________________ Zip ________________ Email ___________________________________________________________________________________________ Phone No. ________________________________________ Social Security No.___________________________ Please list all certificates you are requesting bank draft for: Certificate No.

Issued To

1. _______________

Certificate No. 4. _______________

_______________________

Certificate No.

Issued To

2. _______________ Certificate No.

5. _______________

Issued To

3. _______________

Certificate No.

6. _______________

M A S _______________________

______________________

E L P

Certificate No.

_______________________

Issued To Issued To

______________________

Issued To

______________________

Name of bank or credit union to be drafted ________________________________________________________ Name(s) of authorized users on bank account _____________________________________________________ _________________________________________________________________________________________________

Type of account:

Checking - attach voided check

Savings - attached voided deposit slip

Draft frequency:

Monthly

Routing No.: __________________________ Account No.: __________________________

Draft Date:

Quarterly

1st of month drafting

15th of month drafting

Semi-annually Annually

Amount Per Draft: $ _________ (Annuities Only)

I hereby give the above mentioned bank or credit union authorization to honor electronic drafts drawn from my account by Hermann Sons Life for insurance or annuity payments on the above listed accounts. I understand that if my bank rejects a draft request for any reason, it is still my responsibility to pay the defaulted amount immediately and I will contact Hermann Sons Life for payment options. I further understand that Hermann Sons Life is not responsible for bank overdraft charges or other related draft fees. ______________________________________

Signature of Account Holder Mail completed form to: Hermann Sons Life, P.O. Box 1941, San Antonio, TX 78297-1941.

Home Office Phone: 800-234-4124 or 210-226-9261 • Website: hermannsonslife.org Bank Draft Authorization Request Form - Rev. 11-1-16

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Health Insurance Portability and Accountability Act

Name of proposed insured/patient (please print)

Date of Birth

I authorize any physician, health care professional, hospital, clinic, laboratory, pharmacy, medical facility, pharmacy benefit manager or other health care provider that has provided services to me or on my behalf within the past 10 years (“My Providers”) to disclose my entire medical record and any other protected health information concerning me with Hermann Sons Life, a life insurance company. This includes information on the diagnosis or treatment of Human Immunodeficiency Virus (HIV) infection and sexually transmitted diseases. This also includes information on the diagnosis and treatment of mental illness and the use of alcohol, drugs and tobacco.

By my signature below, I acknowledge that any agreements I have made to restrict my protected health information do not apply to this authorization and I instruct any physician, health care professional, hospital, clinic, medical facility or other health care provider to release and disclose my entire medical record without restriction.

E L P

This protected health information is to be disclosed under this Authorization so that Hermann Sons Life may: 1) underwrite my application for coverage, make eligibility, risk rating and policy issuance determinations; 2) obtain reinsurance; 3) administer claims and determine or fulfill responsibility for coverage and provisions of benefits; 4) administer coverage; and 5) conduct other legally permissible activities that relate to any coverage I have or have applied for with Hermann Sons Life.

M A S

A copy of this authorization is as valid as the original. I understand that I have the right to revoke this authorization in writing, at any time, by sending a written request for revocation to Hermann Sons Life at 515 South St. Mary’s Street, San Antonio, TX 78205-3430. I understand that my information that is disclosed pursuant to this authorization may be re-disclosed and is no longer covered by federal rules governing privacy and confidentiality of health information.

This authorization, and all authority to disclose information pertaining to me, shall expire 90 days from the date of the signature below, unless earlier revoked by me in writing.

I understand that if I refuse to sign this authorization to release my complete medical record Hermann Sons Life may not be able to process my application. I acknowledge that I have received a copy of this authorization.

I understand and agree that Hermann Sons Life may disclose all or some of the information that it collects about me to MIB, company reinsurers, and contractors and others who may perform business services for Hermann Sons Life relating to my application or insurance coverage (generally known as “service providers” or “business associates”).

Signature of Proposed Insured/Patient or Personal Representative

Date

Description of Personal Representative’s Authority or Relationship to Proposed Insured/Patient

Witness/Agent

Date

HSL 11.01.16 (Rev. 08.20) Health Insurance Portability and Accountability Act

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 09/01/2020

Replacement of Life Insurance or Annuities This document must be signed by the applicant and the producer, if there is one, and a copy left with the applicant.

You are contemplating the purchase of a life insurance certificate or annuity contract. In some cases this purchase may involve discontinuing or changing an existing policy or contract. If so, a replacement is occurring. Financed purchases are also considered replacements.

A replacement occurs when a new certificate or contract is purchased and, in connection with the sale, you discontinue making premium payments on the existing policy or contract, or an existing policy or contract is surrendered, forfeited, assigned to the replacing insurer, or otherwise terminated or used in a financed purchase.

A financed purchase occurs when the purchase of a new life insurance certificate involves the use of funds obtained by the withdrawal or surrender of or by borrowing some or all of the policy values, including accumulated dividends, of an existing policy to pay all or part of any premium or payment due on the new certificate. A financed purchase is a replacement.

You should carefully consider whether a replacement is in your best interest. You will pay acquisition costs and there may be surrender costs deducted from your policy or contract. You may be able to make changes to your existing policy or contract to meet your insurance needs at less cost. A financed purchase will reduce the value of your existing policy and may reduce the amount paid upon the death of the insured.

E L P

We want you to understand the effects of replacements before you make your purchase decision and ask that you answer the following questions and consider the questions on the back of this form.

1. Are you considering discontinuing making premium payments, surrendering, forfeiting, assigning to the insurer, or otherwise terminating your existing policy or contract? __________ YES __________ NO

M A S

2. Are you considering using funds from your existing policies or contracts to pay premiums due on the new certificate or contract? __________ YES __________ NO If you answered “yes” to either of the above questions, list each existing policy or contract you are contemplating replacing (include the name of the insurer, the insured or annuitant, and the policy or contract number if available) and whether each policy or contract will be replaced or used as a source of financing: INSURER CONTRACT OR INSURED OR REPLACED (R) OR NAME POLICY# ANNUITANT FINANCING (F) 1.

2.

Make sure you know the facts. Contact your existing company or its agent for information about the old policy or contract.

If you request one, an in-force illustration, policy summary or available disclosure documents must be sent to you by the existing insurer. Ask for and retain all sales material used by the agent in the sales presentation. Be sure that you are making an informed decision.

The existing policy or contract is being replaced because: ______________________________________________________________ I certify that the responses herein are, to the best of my knowledge, accurate: ______________________________ Applicant’s Signature and Printed Name

_________________________ Date

______________________________ Producer’s Signature and Printed Name

_________________________ Date

I do not want this notice read aloud to me. __________ (Applicants must initial only if they do not want the notice read aloud.)

OFFICE COPY Page 1 of 2 HSL 11.01.16 Replacement of Life Insurance or Annuities This document is not considered complete without both pages.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Life Insurance Buyer’s Guide This Buyer’s Guide is intended to help guide you when shopping for life insurance. It explains the importance of the following: ● ● ● ●

Examining your needs (Why are you purchasing life insurance?)

Making sure you understand life insurance and the different plans available Determining which plan(s) meet your needs Other important information

EXAMINE YOUR NEEDS When you buy life insurance, you want coverage that fits your needs. Review your own insurance needs and circumstances. Choose the kind of policy(s) and benefits that most closely fit your needs. A comprehensive Needs Analysis is a dependable way to calculate the financial needs of surviving family members. Individuals and families using this form privately, or with the aid of a Hermann Sons Life agent, can closely determine current needs and anticipated future needs. Examining needs will help ascertain the amount of death benefit and the type(s) of life insurance plans to purchase.

UNDERSTANDING LIFE INSURANCE

E L P

M A S

All life insurance plans are not the same. Certain plans give coverage for your lifetime and others cover you for a specific number of years. Some build cash value and others do not. Various plans may offer other benefits while you are still living. Your choice should be based on your needs and what you can afford.

There are two basic types of life insurance: term life and whole life. Term insurance usually has lower premiums in the early years, but does not build up cash value like whole life insurance.

Term Life plans provide coverage for a stated period of time. At the end of that term the contract ends or, depending on the certificate, may be renewed with premium rates based on the attained age. In a level term plan the coverage ends at a stated time and is not renewable. Generally in a level term plan, the premium payment and death benefit also are level. A renewable term plan may be renewed, without proof of medical insurability, at designated times until a specific age. Premiums at renewal will be based on attained age and therefore will be higher. Premium costs, after age 45, rise rapidly and may become unaffordable in senior years. Term Life does not have cash value or provisions for automatic premium loans. Premiums unpaid 30 days after the payment due date will lapse the contract.

Many term plans have the option to convert to a Whole Life plan without evidence of medical insurability but with certain face value limits. In some Term Life plans a conversion credit is available to offset the initial premiums on the Whole Life plan.

Whole Life plans are designed to provide coverage for the lifetime of the insured. Whole Life payments are typically level, but are initially more expensive than a Term Life plan for the younger and middleaged insured. A limited pay Whole Life plan may provide for payments to end after a specific number of years and the plan is then paid in full. Hermann Sons Life also offers an Annual Premium Flex Life plan which is a Whole Life certificate with an interest sensitive accumulation account. It has a level guaranteed death benefit with adjustable cash values.

This is Page 1 of the Online Version.

Also available in booklet form.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Now that the agent has collected your personal and medical information, here is what happens next: 1. The agent will review all medical and personal information collected on the application to verify accuracy and completeness. If all information is complete, the agent will deliver the application to the Underwriting Department for processing. If the agent discovers any information missing or incomplete, the agent may contact you to clarify.

2. Once your application is delivered to the Underwriting Department, it is input into our computer system to begin the formal review by the Underwriter. Based on your medical history, your personal avocations and the amount of insurance you are requesting, the Underwriter will decide whether or not a paramedical exam is required, if medical records will be requested or if a follow-up interview* is necessary.

E L P

M A S

If a paramedical exam is not necessary, the Underwriter will determine whether or not your application for insurance can be approved at this time. Once you are approved, the Underwriter will issue your insurance contract and it is delivered to your local agent. Your local agent will then contact you to set an appointment to deliver your contract to you.

If a paramedical exam is necessary, the Underwriter will order the exam from a third party at no cost to you!

Paramedical exams are performed by licensed paramedical examiners in your area. The exams typically include questions about your medical history, your height and weight, blood pressure is taken and a urine specimen and blood sample may be collected. The paramedical exam typically takes at most 30 minutes to complete.

3. Once the Underwriter receives the results of the paramedical exam, the Underwriter will determine if further records or information are necessary and whether or not your application for insurance can be approved.

If you are rated or declined, you are encouraged to contact the Underwriter to discuss the reasons for this decision. * Typically necessary when higher amounts of coverage are applied for.

This is the second page of the four-page pamphlet

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

100% Hermann Sons Life Family PLEASE LIST ALL DEPENDENTS. PLEASE RETURN FORM WITH APPLICATION.

MEMBER

CHECK IF NEW MEMBER

FATHER/HUSBAND

LODGE NAME

MOTHER/WIFE CHILDREN

E L P

M A S

OTHER FAMILY MEMBERS

HOUSEHOLD ADDRESS Street

City

Zip

SUBMITTED WITH APPLICATION BY AGENT

AGENT NO.

100% (Revised 11/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Family Buiilder Bonus Form Adult Member Name _____________________________________________________________________________ Adult Certificate No. _____________________________________________________________________________ Junior Member Name ____________________________________________________________________________ Associated Junior Certificate No. _________________________________________________________________ Junior Member Issue Date _______________________________________________________________________

E L P

Agent's Name ___________________________________________ Agent's No. ___________________ AGENT: Please return this form to the Marketing Department.

M A S

NOTE:

Application must be approved and issued to receive bonus.

For Home Office Use Only: Application Approval Date: _______________________________________________________________________ FAMILY BUILDER BONUS FORM (Revised 11/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Alcohol Usage Questionnaire TO BE COMPLETED BY APPLICANT PLEASE PRINT IN BLUE OR BLACK INK ONLY

Name __________________________________________________________ Date of Birth ____________________ 1. Do you presently use alcoholic beverages?

Yes No If "yes," please record quantity in each category below (glasses, ounces or bottles on a daily, weekly or monthly basis).

Amount Daily Weekly Monthly

Wine

Beer

Liquor

E L P

2. Did you ever drink substantially more than as outlined above?

If "yes," please complete:

Amount Daily Weekly Monthly

Wine

Beer

Date of last drink

Liquor

Yes

No

Date started

M A S

No. of years

3. Have you ever consulted a doctor or received treatment because of your alcohol use?

Yes If "yes," indicate dates, names and addresses of any doctors, hospitals or treatment centers:

No

_____________________________________________________________________________________ _____________________________________________________________________________________ 4. Have you ever been charged with impaired driving, lost your job or been arrested due to the influence of alcohol?

Yes No If "yes," give details: ____________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 5. Has any member of your immediate family been treated for or died due to excessive alcohol?

Yes

No

If "yes," give details: ____________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ I declare that the above information is true and complete and shall form part of the application on my life.

Signature of the Proposed Insured

Date

Witness ALCOHOL USAGE (Rev. 11/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Application for Accidental Death Benefit Rider PLEASE PRINT IN BLUE OR BLACK INK ONLY

Application for a $ ___________________________________ Accidental Death Benefit Hermann Sons Life Accidental Death Benefits are limited to 100% of the certificate face value(s) to a cumulative maximum of $250,000 on any individual life.

In connection with Certificate Number ______________ issued to ___________________________________ in the amount of $ ____________________ as a basis for such application, I make the following representations and I further agree that this request shall not be binding until accepted and approved by the Home Office. I represent that my present occupation is and has been since ______ day of ___________________ 20___, that of ________________________________________________________________ and that my duties are ______________________________________________________________________, and it is not my intention to change my occupation to one more hazardous.

E L P

I have not engaged in the following during the past three years: skin diving or scuba diving; parachuting; sky diving; hang gliding or ballooning; underground exploration; horse, auto (stock, drag, etc.) or motorcycle racing; mountain climbing or rodeo performing; or any other hazardous sports.

M A S

If you have engaged in any hazardous sports, give details: ________________________________________ _________________________________________________________________________________________________

I further represent that I am now in good health and free from any abnormalities or medical disorders.

(If there are any exceptions to this, give details.)

Abnormality/Disorder

Date

Physician Consulted

Result

I also agree that upon approval of this application, the Accidental Death Benefit Rider shall become effective upon payment of the required premium as of the ________ day of __________________ 20 ____. in accordance with the laws of Hermann Sons Life.

Dated at ____________________, this ______ day of ____________________, 20 ___.

Applicant Name Agent Name

Agent No.

Home Office approval

Date

APP ADB (Rev. 11/1/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Application for Reinstatement PLEASE PRINT IN BLUE OR BLACK INK ONLY

This Application for Reinstatement is for Certificate No. ____________________________________ in the name of ____________________________________________________________________ To the best of your knowledge and belief: 1. Within the past three years (or the period since the date of the policy, whichever is shorter) have you: A. Been declined, postponed, rated or charged an extra premium or offered a policy different from that applied for, or have been refused reinstatement or renewal of life insurance?

B. Been in a hospital, clinic or institution for examination, observation, diagnosis, operation or treatment?

C. In addition to any doctors or hospitals listed for Question 1B have you: (1) consulted or been treated or examined by any other doctors or other practitioners?

(2) been treated for any other cause(s) not named under Question 1B? 2. Do you now have or are you receiving treatment for any abnormality, deformity, disease or disorder?

3. Have you applied for or are you now receiving disability benefits from any source?

4. Within the past 10 years have you: A. had or been told you had Acquired Immune Deficiency Syndrome (AIDS), AIDS Related Complex (ARC) or AIDS related conditions?

B. received advice or treatment in connection with any of the categories mentioned in Question 4A? C. tested positive for antibodies to the AIDS (Human T-cell Lymphotropic, Type III) virus?

QUESTION NO.

DISEASE OR INJURY

DATES

NO

E L P

M A S

GIVE DETAILS OF ALL "YES" ANSWERS ABOVE

YES

5. Do you currently or have you ever used tobacco in any form? YES

RESULTS

NAMES & ADDRESSES OF DOCTORS

NO

If "Yes," give type, amount and date last used: ____________________________________________________________ _________________________________________________________________________________________________ If a former user, when did you quit? ______________________ 6. Current height _________________

7. Current weight _________________

Please note: "You" and "Your" refer to the applicant. "We," "Us" and "Our" refer to Hermann Sons Life (The Grand Lodge of the Order of the Sons of Hermann in the State of Texas).

PLEASE COMPLETE REVERSE SIDE APP REINSTATE (Rev. 11/1/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Attention Deficit/Hyperactivity Disorder Questionnaire CIRCLE ANSWER AND PROVIDE DETAILS FOR ANY POSITIVE RESPONSES PLEASE PRINT IN BLUE OR BLACK INK ONLY

Name _________________________________________________________________________ Date of Birth _____________________________ 1. Do you have or have you ever been diagnosed with Attention Deficit/Hyperactivity Disorder (ADD/ADHD)?

Yes

No

2. When was this diagnosed? ____________________________________________________________________________________________ 3. List all physicians who have treated you for this condition (Provide name, type of doctor and address) __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ 4. Date you last consulted above physician? ______________________________ How often do you see? __________________ ______ _______

E L P

5. Have you ever been hospitalized or seen in the emergency room due to your condition? Yes No If yes, provide dates, names and addresses for all treatment locations. __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________

M A S

6. Have you received any treatment or medications for the condition? Yes No

If yes, provide details, including medications being taken and when last used. __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ 7. Is medication taken all year long or on a modified schedule? _________________________________________________________________ 8. Are symptoms: Improved

Same

More Severe

9. Are you receiving psychotherapy, counseling or behavior modification? Yes (provide details) No __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ 10. Do you have any depression or other mood disorder problems associated with ADD/ADHD? Yes (provide details) No __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ 11. Please provide any additional information you feel is important concerning your ADD/ADHD: __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________ I understand that this declaration will be relied upon by Hermann Sons Life in determining my insurability. I understand that any material misstatement in this declaration, or elsewhere, could render the certificate, if issued, voidable. I declare that the above answers are true and complete to the best of my knowledge.

Signature of the Proposed Insured or Guardian

Date

Attention Deficit/HyperactivityDisorderQuestionnaire (10/15)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 09/01/2020

Aviation Questionnaire TO BE COMPLETED BY APPLICANT PLEASE PRINT IN BLUE OR BLACK INK ONLY

Name __________________________________________________________ Date of Birth ____________________ 1. Type of license or certificate? ____________________________________________________________________ 2. Date certificate issued? _________________________________________________________________________ 3. Date certificate last renewed? ___________________________________________________________________ 4. Date of last flight as pilot or as crewmember? ______________________________________________________ 5. Total hours flown as pilot or as crewmember? ______________________________________________________ 6. Has your license or certificate been revoked or suspended?

Yes

No

7. Do you intend to apply for a higher grade of certificate?

Yes

No

E L P

8. Are you a member of the Air Force, Army, Navy or Coast Guard or in any other branch of the armed services (including Reserve or National Guard)?

9. Give details of flying experience by hours

Type of Flying

M A S

a. Regularly scheduled airlines

Pilot Crew

b. Non-scheduled commerical,

including charter or taxi flights

Pilot Crew

c. Flights in company-owned planes

for transportation of employees

Pilot Crew

d. Flight instruction

Student Instructor

e. Private or pleasure flying

Pilot Crew

f. Military

(except see "h" for proficiency, etc.)

(Complete No. 11)

Pilot Crew Paratrooper

g. Sightseeing, photography, surveying,

crop dusting, test or experimential

(Describe in No. 13)

Pilot Crew

h. All other flying including military

proficiency and qualification for

flight pay (Describe in No. 13)

Pilot Crew Passenger

Yes No

Last 12 1 to 2 Years 2 to 3 Years Next 12 Months Ago Ago Months

AVIATION (Rev. 11/1/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Crop Dusting Questionnaire TO BE COMPLETED BY APPLICANT PLEASE PRINT IN BLUE OR BLACK INK ONLY

Name __________________________________________________________ Date of Birth ____________________ 1. Type of pilot certificate (please specify exact type)?_________________________________________________

a. Date of issue? ______________________________________________________________________

b. Date of last renewal? _________________________________________________________________

2. Total hours flown as a pilot? ______________________________________________________________ 3. Total agricultural hours (crop dusting)? ______________________________________________________ 4. Type of plane flown (please check below and specify type)

a. Specially designed crop dusting plane (Piper Pawnee, Thrush, A.G. Wagon, Continental Helicopter, etc.)

Yes No

b. Converted plane (bi-wing and upper wing, etc.)

Yes

c. Other (please specify type)? ___________________________________________________________

E L P

5 Do you operate from more than one base during the year?

M A S

6. Location of base of operation:

Yes

No No

a. Address ___________________________________________________________________________

b. City/State/Zip _______________________________________________________________________

c. How long have you been operating from this location? _______________________________________

7. Location of previous base of operation?

a. Address ___________________________________________________________________________

b. City/State/Zip _______________________________________________________________________

c. How long were you there? _____________________________________________________________

8. Have you ever had an aircraft accident or been grounded, fined or reprimanded for violations of air regulations?

Yes

No

9. Additional details to any "yes" answers above:

_____________________________________________________________________________________ _____________________________________________________________________________________ I hereby agree that these changes shall be an amendment to and form a part of the original application and of any policy issued thereunder, and that such changes shall be binding on any person who shall have or claim any interest in such policy.

Signature of the Proposed Insured

Date

Witness CROP DUSTING (Rev. 11/1/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Diabetes Questionnaire TO BE COMPLETED BY APPLICANT PLEASE PRINT IN BLUE OR BLACK INK ONLY

Name __________________________________________________________ Date of Birth ____________________ Source ________________________________________________________ Date ___________________________ 1. Name and address of physician(s) consulted for diabetes? (If Kaiser, obtain patient number) Name ________________________________________________________________________________________ Address ______________________________________________________________________________________ Date last consulted? ___________________________________________________________________________ Details _______________________________________________________________________________________ How often do you consult your physician? _________________________________________________________

E L P

2. Date of diagnosis? _____________________________________________________________________________ What were your symptoms? _____________________________________________________________________ _____________________________________________________________________________________________

M A S

3. Do any of your parents, brothers or sisters have diabetes?

Yes

No

Details _______________________________________________________________________________________ 4. How is your diabtes controlled? (Check all that apply)

Diet

Oral Medication(s)

Insulin

List medications _______________________________________________________________________________ _____________________________________________________________________________________________

5. Do you test your own blood sugar?

Yes

No

How often?_____________________________________

Readings: Fasting ____________________________ Non-fasting ______________________________________ 6. Any loss of work or disability associated with diabetes?

Yes

No

Details _______________________________________________________________________________________ 7. Have you ever had: a. b. c. d.

Diabetic coma Insulin shock Heart trouble High blood pressure

Yes Yes Yes Yes

No No No No

e. Kidney trouble f. Neuropathy or numbness/tingling g. Retinopathy or eye problems

Yes Yes Yes

No No No

Details _______________________________________________________________________________________ 8. Have you ever been hospitalized due to your diabetes?

Yes

No

If yes, when and where? ________________________________________________________________________ _____________________________________________________________________________________________

Signature of the Proposed Insured

Date

DIABETES (Rev. 11/1/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

GRAND LODGE OF THE ORDER OF THE SONS OF HERMANN IN THE STATE OF TEXAS Drug USAGE Usage Questionnaire DRUG QUESTIONNAIRE TO BE COMPLETED BY APPLICANT PLEASE PRINT IN BLUE OR BLACK INK ONLY

Name __________________________________________________________ Date of Birth ____________________ 1. Are you currently using or have you ever used or abused illegal or controlled substances?

If "yes," check the names of all drugs used or write in the name of drugs not listed.

Yes

No

Opium derivatives

Heroine

Morphine

Hydromorphone

Percodan

Dilaudid

Talwan

Demerol

Methadone

Marijuana

Bhang grass

Grass

Charas pot

Ganja tea

Hashish

Cannabis

Cheese

Amphetamines

Benzedrine

Dexedrine

Dolophine

Cocaine

Crack

Crank

Barbituates

Amytal

Phenobarbital

Seconal

Nembutal

Pentobarbital

Hallucinogens

LSD

DMT

Mescaline

Psilocybin

Peyote

Acid

Codeine

Paregoric

Hydrocodone

Oxycodone

Naloxone

Vicodin

Cyclazocine

Mushrooms

STP

Thai sticks

Morning glory seeds

TWA

PCP

Angel dust

Desoxyn

Dextroamphetamines

Bennies

Crystal

Crystal meth

Epinephrine

Dexies

Pep pills

Speed

Methadrine

Methylphenidate

Uppers

Downers

Preludin

Librium

Chloral hydrate

Meprobamate

Equanil

Miltown

Diazepam

Valium

Alcohol

Other

E L P

M A S

How much? _____________________________________ How often? __________________________________ Date of your first use? ____________________________ Date of your last use? _________________________

2. Have you ever consulted a physician, counselor or clergy because of drug or alcohol use?

If "yes," provide dates, names and addresses of all treatment facilities:

Yes

No

_____________________________________________________________________________________________ _____________________________________________________________________________________________

3. Have you ever been charged with a driving violation due to drugs or alcohol or failed or refused to take a breathalyzer test? Yes No If "yes," provide details: _____________________________________________________________________________________________ _____________________________________________________________________________________________

4. a. Have you ever experienced job difficulties, missed work, had family problems or had legal problems due to drug or alcohol use?

Yes

No

b. Have you ever been in an altercation or arrested or charged with an alcohol-related offense?

Yes

No

If "yes," provide details: _____________________________________________________________________________________________

DRUG USAGE (Rev. 11/1/16)

_____________________________________________________________________________________________ DRUG USAGE (Rev. 10/1/14)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Life Insurance 1035 Exchange Request

(Name and address of transferring company) Please consider this letter as an assignment of all my rights, title and interest in life insurance certificate number _________________________ for ___________________________________ to Hermann Sons Life. I understand that I am irrevocably waiving all rights, claims and demands under the certificate.

E L P

The purpose of the assignment is to effect a non-taxable exchange of this contract under Internal Revenue Code Section 1035 for a contract with Hermann Sons Life. I certify that the contract is not subject to any assignment, pledge, collateral assignment or other lien and that no proceedings in bankruptcy or insolvency, voluntary or involuntary, have been instituted by or against me and that I am not subject to any form of guardianship.

M A S

I understand that Hermann Sons Life will surrender the contract and that it is the current insurance company’s responsibility to pay the surrender proceeds in a timely manner for my benefit to: HERMANN SONS LIFE P.O. BOX 1941 SAN ANTONIO, TEXAS 78297

Member's Signature

Social Security Number Date Contract is:

Officer Authorization (Home Office use only) Attached

Lost

Hermann Sons Life Officer Signature Hermann Sons Life Officer Title Date

Life Insurance 1035 Exchange Form (11/2016)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Multi Product Bonus Insured's Name ___________________________________________________________________ Age ____________________________________________________________________________

Certificate No. ______________Product ______________ Amount __________________________ Certificate No. ______________Product ______________ Amount __________________________ Certificate No. ______________Product ______________ Amount __________________________

E L P

Agent Name______________________________________________ Agent No. _______________ Date of Application_________________________________________________________________

M A S

Bonus qualification information is listed in the Agent's Manual and may be subject to change.

Sales Department Approval __________________________________________________________

MULTI PRODUCT BONUS-2020

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 09/01/2020

Newborn Certificate Delivery Receipt & Bonus Request Form Name of Newborn _______________________________________________________________________________ Certificate No. ___________________________________________________________________________________ Issue Date ______________________________________________________________________________________ Termination Date ________________________________________________________________________________ The certificate described above was personally delivered to me by:

Agent's Name ___________________________________________ Agent's No. ___________________

E L P

And the agent has advised me of the benefits and limitations in this certificate.

M A S

Parent/Owner ________________________________________________ Date ___________________

AGENT: Please return this form to the Marketing Department.

NEWBORN CERTIFICATE DELIVERY BONUS FORM (Revised 11/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Permanent Coverage - Newborn Bonus Form Newborn benefit certificate issued to: Newborn Member Name _________________________________________________________________________ Newborn Certificate No. __________________________________________________________________________ Permanent Certificate No. ________________________________________________________________________ Date of Certificate _______________________________________________________________________________

Agent's Name ___________________________________________ Agent's No. ___________________

E L P

AGENT: Please return this form to the Marketing Department.

M A S PERMANENT COVERAGE NEWBORN BONUS FORM (Revised 11/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Application for Newborn Term Life & Membership PLEASE PRINT IN BLUE OR BLACK INK ONLY

PROPOSED INSURED INFORMATION FULL NAME (Last, First, Middle)

DATE OF BIRTH CITY

MAILING ADDRESS AGE (In Months and Days)

SEX

STATE

ZIP CODE

BIRTHPLACE (City and State)

HOME PHONE NO.

IS PARENT A MEMBER?

PARENT NAME

£

YES

£

LODGE NAME and NO.

CERTIFICATE NO.

NO

BENEFICIARY DESIGNATION NAME

SOCIAL SECURITY NO.

E L P DATE OF BIRTH

RELATIONSHIP

1

SOCIAL SECURITY NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

M A S NAME

2

DATE OF BIRTH

RELATIONSHIP

SOCIAL SECURITY NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

NAME

3

BILLING INFORMATION

FULL NAME (Last, First, Middle)

RELATIONSHIP TO PROPOSED INSURED MAILING ADDRESS

DATE OF BIRTH

RELATIONSHIP

SOCIAL SECURITY NO.

DATE OF BIRTH PHONE

OCCUPATION CITY

PICTURE ID REQUIRED #

STATE

ZIP CODE

TYPE

FORM # NB (REV 6/17)

Page 1 of 2

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Notice & Consent Form for AIDS Virus (HIV) Testing TO BE COMPLETED BY APPLICANT PLEASE PRINT IN BLUE OR BLACK INK ONLY

To evaluate your eligibility for insurance or insurance benefits, it is requested that you consent to be tested for the AIDS virus (HIV). By signing and dating this form, you agree that this test may be performed and that underwriting decisions will be based on the test results.

DISCLOSURE OF TEST RESULTS: All test results will be treated confidentially. The results of the test will be reported to the insurer identified on this form. Results of the test will not otherwise be disclosed except as allowed by law or as stated below.

MEANING OF TEST RESULTS: While positive HIV antibody results do not mean that you have AIDS, they do mean that you may be at increased risk of developing AIDS or AIDS-related conditions. The test is a test for antibodies to the HIV virus, the causative agent for AIDS, and shows whether you have been exposed to the virus.

Positive HIV antibody test results could adversely affect your application for insurance. This means that your application may be declined, that an increased premium may be charged, or that other policy changes may be necessary.

E L P

M A S

RELEASE OF RESULTS:

The results of this test may be released to the following: 1. The proposed insured.

2. The person legally authorized to consent to the test.

3. A licensed physician, medical practitioner, or other person designated by the proposed insured.

4. An insurance medical information exchange under procedures that are designed to assure confidentiality, including the use of general codes that also cover results of tests for other diseases or conditions not related to AIDS, or for the preparation of statistical reports that do not disclose the identity of any particular proposed insured.

5. A reinsurer, if the reinsurer is involved in the underwriting process, under procedures that are designed to assure confidentiality.

6. Persons who have the responsibility to make underwriting decisions on behalf of the insurer.

7. Insurer legal counsel who needs such information to effectively represent the insurer in regard to matters concerning the proposed insured.

The Insurer may contact you for the name of a physician or other health care provider to whom you may authorize disclosure and with whom you may want to discuss the results.

CONSENT: I have read and I understand this Notice and Consent Form. I voluntarily consent to testing and disclosure as described above. I understand that I have the right to request and receive a copy of this form. A photocopy of this form shall be as valid as the original. _____________________________________________________ Signature of Proposed Insured or Parent/Legal Guardian _____________________________________________________ Proposed Insured Printed Name

_________________________________ Date

HIV TEST CONSENT (11/1/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

Respiratory Questionnaire TO BE COMPLETED BY APPLICANT PLEASE PRINT IN BLUE OR BLACK INK ONLY

Name __________________________________________________________ Date of Birth ____________________ 1. CHECK ALL THAT APPLY:

Allergy

Asthma

Bronchitis

Other

2. Age at onset? ____________________ 3. Date last noticed? ______________________________________ 4. Have you had any wheezing?

Yes

No

If "yes," explain: _______________________________________________________________________________ _____________________________________________________________________________________________

5. Have you stopped any activity for a short time?

Yes

No

If "yes," explain: _______________________________________________________________________________

E L P

_____________________________________________________________________________________________

6. How often do these episodes occur in a year's time (weekly, monthly, etc.) _____________________________ 7. How long do these episodes last? ________________________________________________________________ 8. Have you ever been treated with:

Antihistamines?

M A S Inhalants?

Yes

No

Oxygen?

Yes

No

Yes

No

Ephedrine?

Yes

No

Other? _______________________________________________________________________________________ 9. Is medication being taken now?

Yes

No

If "yes," what? _____________________________ How often? _________________________________________ 10. Have you required medical attention or hospitalization?

If "yes," give details below:

Name of Doctor or Address/Phone No. Hospital (Specify)

Date

Yes

No

Treatment

Signature of the Proposed Insured or Parent or Legal Guardian

Results

Date

RESPIRATORY (Rev. 11/1/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Sport, Amusement or Avocation Questionnaire DO NOT USE FOR AVIATION

TO BE COMPLETED BY APPLICANT PLEASE PRINT IN BLUE OR BLACK INK ONLY

Name __________________________________________________________ Date of Birth ____________________ Auto racing Boat racing Boxing

Ballooning Hang gliding Motorcycle racing

Parachuting Professional athletics Scuba or skin diving

Snowmobile racing Other

1. What national clubs or associations are you affliated with in connection with this activity? _____________________________________________________________________________________________

E L P

2. List any special licenses, professional or amateur titles you hold in connection with this activity?

_____________________________________________________________________________________________

3. Do you participate for monetary gain or profit? Yes No Earnings in last 12 months?

4. In what geographical locations do you normally participate in this sport or avocation? (i.e. type of track or

M A S

body of water, etc.) _____________________________________________________________________________ 5. Do you or have you ever participated in any experimental forms of this sport or avocation? Yes No If "yes," give details:

_____________________________________________________________________________________________

6. How long have you been participating in this sport or avocation? ________________________________________ 7. Frequency of participation: 1-2 years ago ________ Past 12 months __________ Next 12 months ____________ 8. What is the greatest height-depth-speed you have attained? ___________________________________________ 9. How many times have you attained this height-depth-speed? Total ____________ Last 12 months ____________ 10. What is the average height-depth-speed? ___________________________________________________________ 11. What is the average length of time you spend in each instance of participation in this activity? ________________ 12. The following questions are to be answered by those participating in motor sports:

a. Type of motor sport? ___________________________ e. What HP? _________________________________

b. Make and model of vehicle?_____________________ f. Engine displacement? _______________________

c. Is it modified? ________________________________ g. Type of fuel? _______________________________

d. Class? ______________________________________ h. Estimated top speed? _______________________

13. The following questions are to be answered by those participating in scuba and other diving activities:

a. What equipment do you use? ___________________________________________________________________

b. Do you own this equipment? Yes No

c. Do you dive alone? Yes No

14. Would you prefer this policy to be issued with extra premium (if necessary) or exclusion rider (if possible)?

I agree that all statements and answers to the above questions are complete and true to the best of my knowledge and belief, and I agree that they will be a part of the application for issue, reinstatement or change of a policy of insurance on my life.

Signature of the Proposed Insured

Date

Signature of Witness SPORT-AMUSEMENT-AVOCATION (Rev. 11/1/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Term Conversion Application PROPOSED INSURED INFORMATION

PLEASE PRINT IN BLUE OR BLACK INK ONLY

DATE OF BIRTH

FULL NAME (Last, First, Middle) MAILING ADDRESS AGE

SEX

STATE

CITY

MARITAL STATUS £ Married £ Single £ Widowed £ Divorced

BIRTHPLACE (City and State)

OCCUPATION/JOB DESCRIPTION

SOCIAL SECURITY NO. HOME PHONE NO. CELL PHONE NO.

E L P WORK PHONE NO.

FIRM NAME

BENEFICIARY DESIGNATION

M A S

DATE OF BIRTH

RELATIONSHIP

NAME

1

ZIP CODE

SOCIAL SECURITY NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

NAME

2

DATE OF BIRTH

RELATIONSHIP

SOCIAL SECURITY NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

NAME

3

OWNERSHIP INFORMATION

DATE OF BIRTH

RELATIONSHIP

SOCIAL SECURITY NO.

Check if same as Proposed Insured.

OWNER’S FULL NAME (Last, First, Middle)

DATE OF BIRTH

SOCIAL SECURITY NO. OR EMP. ID. NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

OWNER’S FULL NAME (Last, First, Middle)

DATE OF BIRTH

SOCIAL SECURITY NO. OR EMP. ID. NO.

CONTACT E-MAIL ADDRESS

FORM # TRMCONV (REV 6/17)

Page 1 of 2

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

E L P

M A S Back to Table of Contents

Waiver of Premium Rider Payor Information PAYOR’S NAME

PLEASE PRINT IN BLUE OR BLACK INK ONLY

FULL NAME (Last, First, Middle)

PAYOR’S DATE OF BIRTH

PROPOSED INSURED’S NAME

PAYOR’S SOCIAL SECURITY NO. PAYOR’S PICTURE ID NO.

ID TYPE

PAYOR’S MEDICAL INFORMATION 1. (a) Exact Height (b) Weight

ft.

YES

in.

NO

10.

YES Have you received treatment by a member of the medical profession in connection with any of the categories mentioned in (9)? .................................................................................................

11.

Have you ever tested positive for antibodies to the AIDS (Human T-cell Lymphotropic Type III; HTLV-III) virus? ..........................................

12.

Have you ever had, been told you had or ever been treated for: a) Any disorder of the heart, circulatory, blood or immune system? (Examples include chest pain, heart murmur, heart attack, abnormal heart beat, high blood pressure, varicose veins, shortness of breath, disorder of blood vessels, anemia, etc.) ........................................................................................ b) Cancer, tumor, cyst, growth or enlargement of the lymph gland? ........................................................................................... c) Any disorder in breathing or of the respiratory system? (Examples include allergies, asthma, bronchitis, emphysema, tuberculosis, or other lung disorders.) ................................................ d) Any disorder of the digestive system, such as disease of the stomach, intestines, rectum, liver, gallbladder, esophagus, diarrhea of more than one week’s duration, ulcer, hermorrhoids, polyps or hernia, etc.?............................................................ e) Any disorder of the urinary system? (Examples include references to the urinary organs or functions such as albumin, blood, sugar or pus in the urine; diseases of the kidney, bladder, etc.?) ....................................................................................... £ f) Any disorder of the endocrine/hormone systems? (Examples include diabetes, thyroid, adrenal, pituitary or other glandular disorders.) ..................................................................................... g) Any disorder of the nervous system, such as epilepsy, convulsions, loss of consciousness, dizziness, paralysis, headaches, nervousness, mental disorder, or received psychiatric treatment or attempted suicide, etc.? ..................................... h) Any disorder of the muscles, skin or bone? (Examples include gout, arthritis, collagen disease (connective tissue disease), disorders of the back, joints, extremities, muscles, etc.; or received chiropractic or therapist consultation.) .................................. i) Any disorder or the male or female reproductive organs? (Examples depending on gender include menstrual disorder, complications of pregnancy, Caesarean section, or prostate disorder, etc.) .................................................................................. j) Any disorder of eyes, ears, nose or throat? (Except for cataracts, not necessary to include vision corrected with glasses or contact lenses.) ...........................................................................

lbs.

2. Have you gained or lost weight within the last two years?

Gained Lost (If “YES”, give amount and reason.) .................................. _____________________________________________________ _____________________________________________________ 3. Have you ever had a life insurance application declined, postponed, rated, modified, or withdrawn? (If “YES”, give name of company(ies), date and reason.) ....................................................................................... _____________________________________________________

£

£

_____________________________________________________

NO

E L P

M A S

4. Within the last five years, has the proposed insured been cited for DUI or reckless driving or other moving violations? If “YES”, give driver’s license number and please explain: ............................................................

£

£

_____________________________________________________ _____________________________________________________

_____________________________________________________ 5. Have you ever used or are currently using addictive or self-prescribed drugs? (Examples include cocaine, heroin, morphine, other narcotics, marijuana, barbiturates, amphetamines or hallucinogenic drugs.) (If “YES”, give type and amount of daily usage.) ................................ _____________________________________________________

_____________________________________________________ 6. Have you ever been treated for, received counseling, been advised to seek counseling, or joined a support organization because of ALCOHOL or DRUG usage? (If “YES”, explain and give name and address of doctor.) ..................................................................................... _____________________________________________________

_____________________________________________________ 7. Have your PARENTS, BROTHERS or SISTERS ever had diabetes, cancer, high blood pressure, heart disease or a congenital disorder?

(If “YES”, give relationship, condition, age at diagnosis and current age or age at time of death.)........................................................................ _____________________________________________________ _____________________________________________________ 8. Have you ever been treated or evaluated at a hospital, clinic or other facility, or been advised to have any test or surgery not yet completed? (If “YES”, explain.) ..........................................................................

13.

_____________________________________________________

£

Do you currently or have you ever used tobacco in any form? ...............................................

If “YES,” give type, amount and dates used. __________________________________________________ __________________________________________________

_____________________________________________________ 9. Have you had or been told you had Acquired Immune Deficiency Syndrome (“AIDS”), AIDS Related Complex (“ARC”), or AIDS related conditions? .....................................................................................

__________________________________________________

NAME AND ADDRESS OF ALL PHYSICIANS CONSULTED IN LAST 5 YEARS AND DETAILS OF EACH “YES” ANSWER FROM ABOVE QUES. DISEASE OR DISORDER NO.

NAME OF MEDICATION

DATE BEGAN MO/YR

DATE ENDED MO/YR

RESULTS

PRINT FULL NAME, ADDRESS & PHONE NO. OF PHYSICIANS & HOSPITALS

WPR INFO (8/18)

Page 1 of 2

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

Application for Annuity & Membership PROPOSED ANNUITANT INFORMATION

PLEASE PRINT IN BLUE OR BLACK INK ONLY

FULL NAME (Last, First, Middle)

MAILING ADDRESS

AGE

CITY

SEX

BIRTHPLACE (City and State)

CONTACT EMAIL ADDRESS

BUSINESS PHONE NO.

E L P TYPE

AMOUNT SUBMITTED

5-YEAR FLEXIBLE PREMIUM DEFERRED NON-QUALIFIED

9-YEAR FLEXIBLE PREMIUM DEFERRED NON-QUALIFIED

TRADITIONAL IRA

TRADITIONAL IRA

ROTH IRA

ROTH IRA

SEP IRA

SEP IRA

INHERITED IRA

INHERITED IRA

$

M A S NAME

ZIP CODE

PICTURE ID

PLAN APPLIED FOR

1

STATE

HOME PHONE NO.

#

BENEFICIARY DESIGNATION

SOCIAL SECURITY NO.

DATE OF BIRTH

Total of initial deposit and lodge dues (if applicable).

NO CASH ACCEPTED

BANK DRAFT

YES

If YES, attach Bank Draft Authorization Request Form

APPLICANT’S LODGE NO.

NO

AGENT’S NAME

RELATIONSHIP

DATE OF BIRTH

AGENT NO.

SOCIAL SECURITY NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

2

NAME

RELATIONSHIP

DATE OF BIRTH

SOCIAL SECURITY NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

3

NAME

RELATIONSHIP

DATE OF BIRTH

SOCIAL SECURITY NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

4

NAME

RELATIONSHIP

DATE OF BIRTH

SOCIAL SECURITY NO.

If, at any time, the sole primary beneficiary that is stated is someone other than the spouse, the spouse’s signature is required.

DATE

SIGNATURE OF SPOUSE

ANNAPP GR1.5 (Rev. 6/17)

Page 1 of 2

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Needs and Financial Objectives to Review Before the Purchase of an Annuity To be completed by Hermann Sons Life Agent (Definition of concepts on reverse side) 1. Is the applicant asking for a recommendation from the Hermann Sons Life Agent regarding the investment benefits of a Hermann Sons Life Annuity? ______ Yes - Continue to Questions 2, 3, 4 and 5. ______ No - The applicant has decided on the investment choice independently.

Have member sign below that they do not wish information regarding how this annuity addresses their financial plans, tax status or how this product meets their overall investment objectives.

E L P

2. Does the applicant understand the withdrawal restrictions and penalties during the first five years of the contract?

M A S

3. If the applicant is filing an annual federal income tax return, is he/she aware that the gain is taxable to them or their beneficiaries when withdrawn from the annuity and not as it is earned (tax deferred vs. tax free)?

4. Is the applicant looking for a conservative investment product with safety of capital and a return that approximates a bank certificate of deposit (is the applicant risk adverse)?

5. What is the applicant’s investment objective during the next five years with this annuity? ______ Funds will be needed five or more years away ______ Accumulation of funds to leave to beneficiaries upon applicant’s death (If this is the goal, is a life insurance product better suited to the client’s needs?) ______ Other items or needs

Agent Conclusion: A thorough discussion of the above factors in items 2-5 indicates a Hermann Sons Life Fixed Annuity reasonably meets the applicant’s financial needs.

__________________________________ Applicant & Date

_________________________________ Agent & Date

______ Check here if member does not wish to sign Page 1 of 2 This document is not considered complete without both pages.

HSL 11.01.16 Needs and Financial Objectives to Review Before the Purchase of an Annuity

Back to Table of Contents

AGENT RESOURCE SECTION

CLIENT COPY

Revised 10/1/2017

Buyer’s Guide to Fixed-Rate Deferred Annuities This booklet is intended to help guide you when shopping for annuity products. It explains the importance of the following:

● ● ● ●

What is an annuity?

What are the different types of annuities?

How do I decide what is best for me?

What other important information should I consider?

WHAT IS AN ANNUITY? An annuity is an investment contract sold by a life insurance company. It accumulates value and provides income for contract holders in their later years.

E L P

You fund an annuity (in a single deposit or multiple deposits) and the insurer promises to pay out money from the annuity to you in a series of payments. Only an annuity can pay an income that can be guaranteed to last as long as you live. The annuitant can choose what type of payment schedule works best for them.

M A S

An annuity may be qualified (Traditional IRA, ROTH IRA, etc.) or non-qualified.

An annuity is not a savings account. It is a retirement account. If you buy an annuity, it should be for long-term financial planning.

WHAT ARE THE DIFFERENT TYPES OF ANNUITIES?

It’s important to understand the differences among various annuities so you can choose the kind that best fits your needs. Hermann Sons Life offers only fixed-rate annuities.

Annuities differ in several ways: ● How many premiums you pay ● How the money in the annuity earns interest ● When the company makes income payments to you How many premiums you pay: Single premium or multiple premium annuities You pay the insurance company only one payment for a single premium annuity. You make a series of payments for a multiple premium annuity; for one type of multiple premium annuity, a flexible premium annuity, you pay whenever you want, within set limits.

How the money in an annuity earns interest: Fixed, variable and indexed annuities Fixed During the accumulation phase of a fixed deferred annuity, your money earns interest at rates set by the insurance company or in a way spelled out in the annuity contract. The company guarantees the contract will earn no less than a minimum rate of interest. Once you begin to receive payments in the annuitization phase, the amount of each payment is set and will not change. Hermann Sons Life sells only fixed annuities.

This is Page 1 of the Online Version.

Also available in booklet form.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Annuity Contribution/Withdrawal Request Form Date ___________________________________________________________ Annuity No. _____________________ Name ___________________________________________________________________________________________ Address _________________________________________________________________________________________ City _______________________________________________ State ____________________ Zip ________________ Email ___________________________________________________________________________________________ Phone No. ________________________________________ Social Security No.___________________________ Please check one:

E L P

Contribution (see Section 1)

Withdrawal (see Section 2)

SECTION 1 - CONTRIBUTION REQUEST

Contribution amount: $ _______________________ For prior year?*

M A S

Yes

No

* Prior year contributions only apply to IRA accounts and will only be accepted if received before the year’s tax filing deadline (generally April 15).

Signature of Annuitant ____________________________________________________________ SECTION 2 - WITHDRAWAL REQUEST

As of the current date, I elect not to have Federal income tax withheld. I understand I am still liable for any and all taxes and penalties incurred regarding these withdrawals.

Withhold Federal income tax at a rate of _____% (not less than 10% per IRS). I understand I am liable for any additional tax or penalty if I do not withold enough.

PLEASE NOTE:

If you do not elect to waive withholding or specify a percentage to be withheld, or if your election is not clear, we are required to withhold 10% from your request for Federal income tax.

Net Withdrawal Amount: $ _________________________ I understand any Federal withholding requested above, as well as any applicable surrender charges from Hermann Sons Life as defined in my annuity contract, will be taken out of my account in addition to the requested Net Withdrawal Amount above. I also understand that any Federal withholding election above will be assessed on the total Net Withdrawal Amount requested regardless of how much of said withdrawal is subject to Federal income taxation.

Signature of Annuitant _______________________________________________________________ Mail completed form to: Hermann Sons Life, P.O. Box 1941, San Antonio, TX 78297-1941.

Home Office Phone: 800-234-4124 or 210-226-9261 • Website: hermannsonslife.org Annuity Contribution-Withdrawal Request Form - Rev. 11-1-16

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

E L P

M A S Back to Table of Contents

AGENT RESOURCE SECTION

Revised 09/01/2020

E L P

M A S Back to Table of Contents

AGENT RESOURCE SECTION

Revised 09/01/2020

Full Value 1035 Exchange Request

(Name and address of transferring company) Re: Policy No. ________________________ Name _________________________________________ (At transferring company) (Full name of client)

E L P

Please consider this letter as an assignment of all my rights, title and interest in the policy identified above to Hermann Sons Life.

The purpose of the assignment is to effect a non-taxable exchange of this contract under Internal Revenue Code Section 1035(a) and Revenue Rule 72-358 for a contract with Hermann Sons Life with ______________________________________.

(Name of transferring company)

M A S

Acceptance by Hermann Sons Life of this assignment and of the policy values from other companies should not be construed as a guarantee that the transaction will qualify as a bone fide 1035 exchange.

PLEASE COMPLETE AND RETURN THE ENCLOSED COST BASIS.

Member's Signature

Date

Social Security Number

Spouse's Signature

Date

Social Security Number

Contract is:

Attached

Lost

By signature of an authorized officer below, Hermann Sons Life accepts assignment of the above contract for purpose of complying with client's intention of effecting a non-taxable exchange under Section 1035.

Please issue a check payable to Hermann Sons Life for the FULL VALUE of the contract and forward to: HERMANN SONS LIFE P.O. BOX 1941 SAN ANTONIO, TX 78297 Officer

Title

Date

Full Value 1035 Exchange Form (11/2016)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Partial Value 1035 Exchange Request

(Name and address of transferring company) Re: Policy No. ________________________ Name _________________________________________ (At transferring company) (Full name of client)

E L P

Please consider this letter as a partial assignment of all my rights, title and interest in the policy identified above to Hermann Sons Life in accordance with IRS Notice 2003-51 and Revenue Ruling 2003-76.

The purpose of the partial assignment is to effect a non-taxable exchange of a portion of this contract under Internal Revenue Code Section 1035(a) and Revenue Rule 72-358 for a contract with Hermann Sons Life with ______________________________________.

(Name of transferring company)

M A S

Acceptance by Hermann Sons Life of this assignment and of the policy values from other companies should not be construed as a guarantee that the transaction will qualify as a bone fide 1035 exchange.

PLEASE COMPLETE AND RETURN THE ENCLOSED COST BASIS IN ACCORDANCE WITH REVENUE RULING 2003-76.

Member's Signature

Date

Social Security Number

Spouse's Signature

Date

Social Security Number

Contract is:

Attached

Lost

By signature of an authorized officer below, Hermann Sons Life accepts assignment of the above partial contract for purpose of complying with client's intention of effecting a non-taxable exchange under Section 1035.

Please issue a check payable to Hermann Sons Life in the amount of $ _________________ and forward to: HERMANN SONS LIFE P.O. BOX 1941 SAN ANTONIO, TX 78297 Officer

Title

Date

Partial Value 1035 Exchange Form (11/2016)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

E L P

M A S Back to Table of Contents

AGENT RESOURCE SECTION

Revised 09/01/2020

E L P

M A S Back to Table of Contents

AGENT RESOURCE SECTION

Revised 09/01/2020

E L P

M A S Back to Table of Contents

AGENT RESOURCE SECTION

Revised 09/01/2020

E L P

M A S Back to Table of Contents

Application for Matured Annuity & Membership PROPOSED ANNUITANT INFORMATION

PLEASE PRINT IN BLUE OR BLACK INK ONLY

FULL NAME (Last, First, Middle)

DATE OF BIRTH

ORIGINAL CONTRACT NO. Attached Lost

MAILING ADDRESS

AGE

CITY

SEX

BIRTHPLACE (City and State)

STATE

APPLICANT’S LODGE NO. 1 2

HOME PHONE NO.

BUSINESS PHONE NO.

PLAN APPLIED FOR SINGLE PREMIUM DEFERRED ANNUITY NON-QUALIFIED TRADITIONAL IRA ROTH IRA

SEP IRA INHERITED IRA

NAME

1

SOCIAL SECURITY NO.

3 4

CONTACT EMAIL ADDRESS

E L P

PICTURE ID#

M A S

BENEFICIARY DESIGNATION

ZIP CODE

TYPE

AGENT’S NAME

RELATIONSHIP

DATE OF BIRTH

AGENT NO.

SOCIAL SECURITY NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

NAME

2

RELATIONSHIP

DATE OF BIRTH

SOCIAL SECURITY NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

NAME

3

RELATIONSHIP

DATE OF BIRTH

SOCIAL SECURITY NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

NAME

4

RELATIONSHIP

DATE OF BIRTH

SOCIAL SECURITY NO.

If, at any time, the sole primary beneficiary that is stated is someone other than the spouse, the spouse’s signature is required.

DATE

SIGNATURE OF SPOUSE

SPECIAL REQUESTS

MATANNAPP GR1.5 (Rev. 6/17)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Address Change Request Form Date ___________________________________________________________ Certificate No. __________________ Name ___________________________________________________________________________________________ Address _________________________________________________________________________________________ City _______________________________________________ State ____________________ Zip ________________ Email ___________________________________________________________________________________________ Phone No. ________________________________________ Social Security No.___________________________ I request an address change on the following certificate(s): Certificate No.

Issued To

New Mailing Address

E L P

M A S

______________________________________

Signature of Insured Insured Address Change Request Form - Rev. 11-1-16

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Agent Replacement Compliance Letter TO BE COMPLETED WITH THE SUBMISSION OF AN APPLICATION I, the undersigned Hermann Sons Life agent, represent that: (A) I used only Hermann Sons Life approved sales material on the member's application listed below; and (B) All copies of all sales materials used in this sales presentation were left with the applicant named below in accordance with Section 1114.051(f) of the Texas Insurance Code.

E L P

Agent's Signature Date Signed by Agent

M A S

Applicant's Printed Name

Agent Replacement Compliance Letter (Revised 11/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Application for Decrease of Insurance PLEASE PRINT IN BLUE OR BLACK INK ONLY

I, __________________________________________________________________________________, a member in good standing, born on ____________________, do hereby attach Certificate No. ____________________, issued to me under Plan __________________________ on ____________________ in the face amount of $____________________, and hereby request the above certificate be reissued under the same Plan in the face amount of $___________________________.

I agree to pay the premium rates according to the table of rates at age of entry and that the new certificate shall bear the same effective date as the original effective date.

Name of Certificate Owner (Please type or print)

E L P

M A S

Address

Social Security No.

Telephone No.

Signature of Certificate Owner

Date

NOTICE: Submitting this form may impact certificate beneficiary designations.

Please complete the Application for Change of Beneficiary form if applicable.

Please indicate the status of the original certificate:

Enclosed

Lost

If certificate is lost, please attach the Lost Certificate Affidavit form.

(You may download the Application for Change of Beneficiary and Lost Certificate Affidavit forms from the website at hermannsonslife.org or request the forms by calling the Home Office at 210-226-9261 or 800-234-4124.)

APP DEC INS (Rev. 11/1/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Bank Draft Authorization Request Form Date ___________________________________________________________ Certificate No. __________________ Name ___________________________________________________________________________________________ Address _________________________________________________________________________________________ City _______________________________________________ State ____________________ Zip ________________ Email ___________________________________________________________________________________________ Phone No. ________________________________________ Social Security No.___________________________ Please list all certificates you are requesting bank draft for: Certificate No.

Issued To

1. _______________

Certificate No.

Certificate No.

E L P

4. _______________

_______________________

Issued To

2. _______________

Certificate No.

5. _______________

_______________________

Certificate No.

Issued To

M A S

3. _______________

Certificate No.

6. _______________

_______________________

Issued To ______________________

Issued To

______________________

Issued To

______________________

Name of bank or credit union to be drafted ________________________________________________________ Name(s) of authorized users on bank account _____________________________________________________ _________________________________________________________________________________________________

Type of account:

Checking - attach voided check

Savings - attached voided deposit slip

Draft frequency:

Monthly

Routing No.: __________________________ Account No.: __________________________

Draft Date:

Quarterly

1st of month drafting 15th of month drafting

Semi-annually Annually

Amount Per Draft: $ _________ (Annuities Only)

I hereby give the above mentioned bank or credit union authorization to honor electronic drafts drawn from my account by Hermann Sons Life for insurance or annuity payments on the above listed accounts. I understand that if my bank rejects a draft request for any reason, it is still my responsibility to pay the defaulted amount immediately and I will contact Hermann Sons Life for payment options. I further understand that Hermann Sons Life is not responsible for bank overdraft charges or other related draft fees. ______________________________________ Bank Draft Authorization Request Form - Rev. 11-1-16

Back to Table of Contents

Signature of Account Holder

AGENT RESOURCE SECTION

Revised 10/1/2017

Beneficiary Change Request Form Date ___________________________________________________________ Certificate No. __________________ Name ___________________________________________________________________________________________ Address _________________________________________________________________________________________ City _______________________________________________ State ____________________ Zip ________________ Email ___________________________________________________________________________________________ Phone No. ________________________________________ Social Security No.___________________________ NAME

DATE OF BIRTH

RELATIONSHIP

1

SOCIAL SECURITY NO.

E L P

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

NAME

2

RELATIONSHIP

DATE OF BIRTH

M A S

SOCIAL SECURITY NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

NAME

3

RELATIONSHIP

DATE OF BIRTH

SOCIAL SECURITY NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

NAME

4

RELATIONSHIP

DATE OF BIRTH

SOCIAL SECURITY NO.

Please Choose One Designation: If Living Otherwise * OR * And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

NAME

5

DATE OF BIRTH

RELATIONSHIP

SOCIAL SECURITY NO.

I request the beneficiary on the above mentioned certificate be changed as I have designated on this form. I understand that this request for change of beneficiary shall take effect as of the date I signed this form provided this form has been received and approved by the Vice President-Secretary/Treasurer as being in compliance with the Laws of Hermann Sons Life governing beneficiaries. Any reference to a beneficiary “if living” shall mean if living at the time of my death. The “and” designation implies that the named beneficiaries will share equally unless otherwise stated. If payment to a trust is provided herein, a copy of such trust must be enclosed. Hermann Sons Life will not be responsible for the performance of the trustee’s duties as trustee.

Signature of Insured Insured

Signature of Spouse (Only required if change requested is for an annuity and the annuitant’s spouse is not listed as the sole first beneficiary.)

Beneficiary Change Request Form - Rev. 11-1-16

Back to Table of Contents

Signature of Disinterested Witness

AGENT RESOURCE SECTION

Revised 10/1/2017

Change of Agent Notification PLEASE PRINT IN BLUE OR BLACK INK ONLY

Member's Name _________________________________________________________________________________ Certificate No. __________________Region _____________ Lodge Name _______________________________

This is to inform the Home Office that _____________________________________________________________ will be my new representative.

I ask for this change because ____________________________________________________________________ _________________________________________________________________________________________________

E L P

_________________________________________________________________________________________________ _________________________________________________________________________________________________

M A S

Member signature

Date

Address _______________________________________________________________________________________ City _______________________________________________________ State _________ Zip __________________ Home Phone __________________________________ Cell Phone ______________________________________

Agent's Name ___________________________________________ Agent's No. ___________________

Names of other family members:

___________________________________________________________ Certificate Number ___________________ ___________________________________________________________ Certificate Number ___________________ ___________________________________________________________ Certificate Number ___________________ ___________________________________________________________ Certificate Number ___________________ ___________________________________________________________ Certificate Number ___________________ ___________________________________________________________ Certificate Number ___________________ ___________________________________________________________ Certificate Number ___________________ ___________________________________________________________ Certificate Number ___________________ APP CHANGE OF AGENT (Revised 11/16)

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Death Notice PLEASE PRINT IN BLUE OR BLACK INK ONLY

Lodge _________________________________________________________________________ No. ___________ To the Grand Vice President-Secretary/Treasurer of Hermann Sons Life: We report herewith that _____________________________________________________________________, Certificate No. ____________________, a member of this lodge, died on the _____________ day of ____________________ A.D. ____________________ at the age of ____________________ years. ❏ Married He/She was ❏ Single ❏ Widowed He/She had been a member of Hermann Sons Life since the ____ day of __________, _____.

His/Her death benefit certificate designates as beneficiaries (Please give full name or names of beneficiaries) ______________________________________________________________________

E L P

M A S

_________________________________________________________________________________________________ _________________________________________________________________________________________________

Address, if known: ___________________________________________________________________________ _________________________________________________________________________________________________ _________________________ Texas,

this the _____________ day of ___________________, _____________. _____________________________________________

President

_____________________________________________

Secretary

BURIAL NOTICE We, the undersigned members of _______________________________________ Lodge, Hermann Sons Life, located in __________________, Texas, hereby certify that ______________________________, a member of _______________________________ Lodge, Hermann Sons Life, was buried on the ______ day of _______________, _______, and that we were present at visitation/funeral services of said member. _____________________________________________

_____________________________________________

Witness

Witness

DEATH NOTICE (Revised 11/16)

Back to Table of Contents

Lodge Transfer Request Form Date ___________________________________________________________ Certificate No. __________________ Name ___________________________________________________________________________________________ Address _________________________________________________________________________________________ City _______________________________________________ State ____________________ Zip ________________ Email ___________________________________________________________________________________________ Phone No. ________________________________________ Social Security No.___________________________ I request to transfer lodge membership on the following certificate(s): Certificate No.

Issued to

Lodge I request transfer to

E L P

M A S The reason for my transfer request is:

☐ The lodge I request to transfer to is a more convenient location for me. ☐ The lodge I request to transfer to has members that are friends or relatives. ☐ Other - Please explain: _____________________________________________________

Lodge Transfer Request Form - Rev. 11-1-16

Back to Table of Contents

________________________________ Signature of Insured Insured

AGENT RESOURCE SECTION

Revised 10/1/2017

Lost Certificate Request Form Date ___________________________________________________________ Certificate No. __________________ Name ___________________________________________________________________________________________ Address _________________________________________________________________________________________ City _______________________________________________ State ____________________ Zip ________________ Email ___________________________________________________________________________________________ Phone No. ________________________________________ Social Security No.___________________________ I have made a diligent effort to locate the above mentioned certificate, but have been unsuccessful.

E L P

Should I locate the misplaced certificate once this form has been submitted, I agree to promptly surrender it to the Hermann Sons Life Home Office.

____________________________________________ Signature of Insured Insured

M A S

State of ________________________

County of ______________________

This instrument was acknowledged before me on ________________________________________ by ________________________________________

(Personalized Seal)

Lost Certificate Request Form - Rev. 11-1-16

Back to Table of Contents

____________________________________________ Notary Public’s Signature

Name Change Request Form Date ___________________________________________________________ Certificate No. __________________ Name ___________________________________________________________________________________________ Address _________________________________________________________________________________________ City _______________________________________________ State ____________________ Zip ________________ Email ___________________________________________________________________________________________ Phone No. ________________________________________ Social Security No.___________________________ In regard to the above mentioned certificate, I request the name be changed to:

E L P

________________________________________________________________________________ The reason for this change request is:

M A S

________________________________________________________________________________ If the reason for this request is anything other than marriage, a copy of legal documentation confirming said change must be provided.

____________________________________________ Signature of Insured Insured

State of ________________________

County of ______________________

This instrument was acknowledged before me on ________________________________________ by ________________________________________

(Personalized Seal)

____________________________________________ Notary Public’s Signature

Name Change Request Form - Rev. 11-1-16

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

Ownership Change Request Form Date ___________________________________________________________ Certificate No. __________________ Name ___________________________________________________________________________________________ Address _________________________________________________________________________________________ City _______________________________________________ State ____________________ Zip ________________ Email ___________________________________________________________________________________________ Phone No. ________________________________________ Social Security No.___________________________ I assign and transfer, without any exception, limitation or reservation whatsoever all of the rights, title and interest in and to the above mentioned certificate to: Name 1. ________________________________

☐

E L P

Date of Birth

Social Security No.

__________________

________________________

☐

Please Choose One Designation: If Living Otherwise *OR* And If you fail to choose a designation or if your choice is unclear If Living Otherwise is assumed.

M A S

2. ________________________________

__________________

________________________

Once approved, this document gives the new owner(s) all contractural rights, including but not limited to surrendering, taking a loan against and changing beneficiary of the certificate. Changing ownership may generate a tax consequence. Please speak with your competent tax advisor regarding any tax applicable to this transaction. ____________________________________________ Signature of Current Owner

State of ________________________

County of ______________________

This instrument was acknowledged before me on ________________________________________ by ________________________________________

(Personalized Seal) Ownership Change Request Form - Rev. 11-1-16

Back to Table of Contents

____________________________________________ Notary Public’s Signature

BROCHURES ANNUITIES

00 and $10,000 or make plans for final ly wise toPREMIUM consider DEFERRED ANNUITY LEXIBLE al needs.

A way of 18-89 Issue Ages: S(Local LIFE Senior LodgeAdult Dues Are Payable) The SAFE Plan is a tial Issue Minimum Deposit: $2,500 th issue ages from t Year Maximum Deposit: $100,000 ing death benefit. quent benefit Years Maximum Deposit: $20,000 death keep Rtion EARLY WITHDRAWAL CHARGE PERIOD is required on ANNUAL PENALTY FREE WITHDRAWAL edical examination

We strengthen community.

Protecting every member of the family

r may cause tax consequences and/or an early E-2017 ender charge. Seek competent tax advice before surrendering.

FORM HSL-FPDA-2020-5YR

ucts

s are turning to LEXIBLE PREMIUM DEFERRED ANNUITY t vehicle. Our fixed Issue Ages: 18-89 vestors seeking a tial Issue Minimum Deposit: $2,500 deferred earnings t Yeartolerance Maximumfor Deposit: $250,000 low uent Years Maximum MANN SONS LIFE Deposit: $150,000 ThePERIOD mission of Hermann Sons Life is to strengthen EARLY WITHDRAWAL CHARGE community through financial protection and service.

ANNUAL PENALTY FREE WITHDRAWAL And we do this in several ways. eturn onearly yourwithdrawal for permanent alty for g home admittance and terminal illness As a life insurance company, we strive to offer products may cause tax consequences and/or an early designed nder charge. Seek competent tax advice to protect the financial future of every eturn. before surrendering. member of your family – from newborns to seniors. We FORM HSL-FPDA-2020-9YR want to be your life insurance company “for today, for tomorrow, for life.”

IRA As a non-profit organization, we offer benefits not DUAL RETIREMENT ARRANGEMENT) by commercial life insurance companies. itial Issue Minimum Deposit: provided $500 INDIVIDUAL TRADITIONALOur IRAmembers have access to a youth camp, a dance program and a retirement home. And, they enjoy the HERMANN SONS LIFE *SPOUSAL TRADITIONAL IRA opportunity to work side-by-side on projects that itial Issue Minimum Deposit: $500 HOME OFFICE strengthen the communities in which they live. *INDIVIDUAL ROTH 515 S. St. Mary’s St., San Antonio, TX 78205 *SPOUSAL ROTH When you choose to be a part of the 210-527-9113 or 877-437-6266 Hermann Sons y chartered by the State of itial Issue Minimum Deposit: Life $500family, you aren’t just recognizingwww.hermannsonslife.org the importance Code and regulated by the *Transfers from 401k or of life insurance, you’re choosing to strengthen NOTICE by a local lodge with the Hermann Sons Life is a fraternal benefit life insurance society chartered by the State of Texas, organized community. othercontract. qualified plans accepted. annuity Hermann under 501(c)(8) of the Internal Revenue Code and regulated by the Texas Department of Insurance. able to members thesetransfer conditions eposit limitsbutand Membership is conferred by a local lodge with the approval by the Home Office of a life insurance cerance. Life insurance always tificate or annuity contract. Hermann Sons Life is a nonprofit corporation. Certain benefits are available are defined by federal law. als of the individual buyer. to members but these intended as an inducement to buy life insurance. Life insurance Please an look inside for information on benefits the are lifenot insurance may causeSons taxLife. consequences and/or early xas as Hermann always should be purchased on its own merit for the needs and goals of the individual buyer. Hermann nder charge. Seek competent tax advice and annuity products we Sons offer benefits youis available will to any person who is a citizen of the United Life isand licensedthe in Texas only. Membership Revised 03/20 before surrendering. enjoy as a member/policyholder.

States or has expressed the intent to become a citizen. Life insurance certificates are issued pursuant to

talk t! or 6

org FORM HSL-FPDA-2020-5YR FORM HSL-FPDA-2020-9YR

normal and standard underwriting procedures and to the laws of the State of Texas.

We strengthen community through financial protection and service.

Revised 01/20

General Information Brochure

Product Information Brochure

Size: 8.5” x 11” folded to 3.5” x 8.5”

Size: 8.5” x 11” folded to 3.5” x 8.5”

Offers a condensed look at Hermann Sons Life including our three major benefits - Retirement Home, Camp and Schools of Dance - as well as general information about our products.

Offers a more detailed description of each life insurance and annuity product.

Can be persoanlized with agent’s name and contact information.

Can be persoanlized with agent’s name and contact information.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 10/1/2017

PRODUCT BROCHURES

e Back

Sons Life an an organizag the commu-

ann Sons Life mmunity sersmall. We are when disaster eone needs a ney for many fire departth cancer.

WHY BUY FROM US? Many companies offer pre-need burial plans that are designed to cover final expenses but most of these plans don’t cover all of the costs associated with a funeral. There are no restrictions on how the proceeds from your SAFE Plan can be used. This money can help cover the cost of incidentals such as the fees for the church Non-Qualified and clergy, police escorts, the burial plot Traditional IRA and monument, etc. But the SAFE Plan can also be used to pay off debt, like medical Rothbills, IRAcredit card bills and a mortgage.

Fixed Rate Flexible Premium Deferred Annuities

bers have ace a summer for children for seniors.

Or if you don’t need the money for final expenses, you can leave the proceeds in your SAFE Plan to your children and grandchildren or to a trust or foundation.

erent kind pany erence.

You decide how the money is spent and who gets to spend it!

Senior Adult Final Expense Plan

And remember, life insurance proceeds pass tax-free to your beneficiary or beneficiaries.

LIFE

HERMANN SONS LIFE HOME OFFICE

TX 78205 6266 org

515 S. St. Mary’s St., San Antonio, TX 78205 210-527-9113 or 877-437-6266 www.hermannsonslife.org

ate of Texas, organized under of Insurance. Membership is contract or annuity. Hermann s, but these benefits are not urchased on its own merit for only.

NOTICE Hermann Sons Life is a fraternal benefit life insurance society chartered by the State of Texas, organized under 501(c)(8) of the Internal Revenue Code and regulated by the Texas Department of Insurance. Membership is conferred by a local lodge with the approval by the Home Office of a life insurance contract or annuity. Hermann Sons Life is a non-profit corporation. Certain benefits are available to members, but these benefits are not intended as an inducement to buy life insurance. Life insurance always should be purchased on its own merit for the needs and goals of the individual buyer. Hermann Sons Life is licensed in Texas only.

We strengthenFORMcommunity.

HSL - SAFE 2001 (rev 6/2017)

We strengthen community.

Annuity Brochure

SAFE Plan Brochure

Size: 8.5” x 11” folded to 3.5” x 8.5”

Size: 7” x 3.5” folded to 3.5” x 8.5”

Offers a detailed look at our annuity products and how they work.

Offers an overview of Senior Adult Final Expense Plan.

Can be persoanlized with agent’s name and contact information.

Can be persoanlized with agent’s name and contact information.

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

FLYERS There is a flyer available for each of our three main benefits. On the back of each flyer is information on the benefit including eligibility requirements and other details.

Each one is 8.5” x 11” flat.

Each one can be personalized with the agent’s name and contact information.

S C H O O L S O F DA N C E

CAMP

A Benefit for Members Hermann Sons Life operates tuition-free Schools of Dance throughout South and Central Texas.

The dance school year parallels the school year.

To learn more about the life insurance products we offer for your children and the benefits they may enjoy as a member call the Home Office Sales Department at

To learn more about the life insurance products we offer for your children and the benefits they may enjoy as members contact the Marketing Department at 210-527-9113 or 877-437-6266 or marketing@hermannsonslife.org www.hermannsonslife.org

210-527-9113 or 877-437-6266 sales@hermannsonslife.org • www.hermannsonslife.org

R E T I R E M E N T H O ME

A Benefit for Members Hermann Sons Life operates a Retirement Home for its members located near Comfort in the beautiful Texas Hill Country.

To learn more about the life insurance products offered by Hermann Sons Life and the benefits you may enjoy as a member call the Home Office Marketing Department at

210-527-9113 or 877-437-6266 marketing@hermannsonslife.org • www.hermannsonslife.org

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018

POSTCARD This is a 8.5” x 5.5” postcard that will be personalized with the agent’s photo and contact information.

It can be used by new agents to introduce themselves to potential clients. Other agents can use it to contact existing clients about a possible update on their life insurance needs.

We Strengthen Community Through Financial Protection and Service.

Whether you are single, married, have started a business or just bought a home to accommodate a growing family, our Hermann Sons Life agents can help you cover the financial risks you face. Our agents are life insurance professionals who believe in our products and services and want to help others realize the benefits of Hermann Sons Life membership.

• Permanent Whole Life Plans can be used for estate preservation and final expenses. We offer youth and adult products for lifetime protection with level premiums that do not increase with age.

Protecting Texas Families at Each Stage of Life

Agent Photo Here

Protecting Texas Families at Each Stage of Life

Agent’s Name Agent Address City, TX Phone Number

• Term Life Plans can be used to provide individual, mortgage and business protection and young family protection. Our plans are affordable and convertible to whole life at the appropriate time.

• Annuities and other retirement plans like IRAs also are offered.

Call or contact your area agent today for help analyzing your needs and putting together a plan that protects your family’s financial future.

Agent Name Agent’s Phone Number & Email hermannsonslife.org

Client Mailing Information

PERK SPOT FLYER This is an 8.5” x 11” flyer that promotes the Perk Spot member benefit. It is included in each new certificate or agents can request some to carry with them when calling on clients.

Hermann Sons Life and Perkspot have teamed up to offer our members a discount program that will save you money on a wide range of products and services.

• Travel • Entertainment • Food • Electronics • Fashion • Health & wellness • And much more!

To sign up, visit hermannsonslife.org go to Member Benefits, click Member Discounts

Back to Table of Contents

AGENT RESOURCE SECTION

Revised 08/01/2018