Proposed Insured:

Mr. ARNOLD AGAPITO PAMITTAN

Age 38, Male, Non-smoker

Policyowner or Payor:
Mr. ARNOLD AGAPITO PAMITTAN
Age 38, Male

Dear ARNOLD,

Thank you for your interest in AXA products. Axelerator is a regular-pay variable life insurance product that provides greater opportunity
for investment growth to help you meet your financial goals sooner while providing basic life protection for you and your loved ones. But
unlike most investments, it provides multiple benefits as follows:
KEY BENEFITS:
1. Guaranteed Death Benefit equivalent to at least 500% of the annual premium if no withdrawal is made.
2. Potential upsides from portion of the premium placed in bonds, equities and/or money market instruments, depending on your
risk appetite.
3. Guaranteed loyalty bonus as a reward for keeping your investments with AXA.
4. Supplement benefits from riders that provide other forms of protection.
• SECURE gives the Insured additional benefit of PHP 250,000 if death is the result of an accident, or a portion of this amount if the
accident resulted to dismemberment and/or loss of use.
• WAIVER OF PREMIUM waives all future premiums if you become totally and permanently disabled before age 60.
For a premium of PHP 51,910.00 annually, you get to enjoy the following benefits:
BENEFITS
For You For Your Loved Ones
(Living Benefits) (Death Benefits)

When insured reaches age 65 Upon death of the Insured

Based on (PHP) Based on 8.00% annual rate (PHP)
4.00% annual rate of return, Account Value 2,347,607 Age 50 964,751
Or 8.00% annual rate of return, Account Value 4,537,710 Age 60 2,887,947
Age 70 6,961,755
Or 10.00%annual rate of return, Account Value 6,419,056

Notes:
1. The values above are based on the projected performance of your chosen fund/s. Since the fund performance may vary, the values of your
units are not guaranteed and will depend on the actual investment performance at that given period. The illustrated returns on investments
are based on assumed annual rates of 4.00%, 8.00%, and 10.00%. These rates are for illustration purposes only and do not represent
maximum or minimum return on your fund.
2. If after purchasing the variable life insurance contract, you realize that it does not fit your financial needs, you may return the
contract to AXA Philippines within 15 days from the time you receive it. AXA Philippines will return to you the account value, the
bid-offer spread, and all initial charges.
3. Any withdrawal from the Living Benefit will correspondingly reduce the Death Benefit payable.

This is not a deposit product. Earnings are not assured and principal amount invested is exposed to
risk of loss. This product cannot be sold to you unless its benefits and risks have been thoroughly
explained. If you do not fully understand this product, do not purchase or invest in it.

Page 1 of 12 of Proposal No. 23960-201909140451-4-02

Printed on: 9/14/2019 7:27:00 PM Created on: 09/14/2019 Expiry Date: 11/13/2019
Version Number: 4.5.1 Date for Next Insurance Age: 05/02/2020
Plan Code: AXE/ Rider Code: WP, AP0555
 Philippine Peso
for: Mr. ARNOLD AGAPITO PAMITTAN, 38

SPECIAL FEATURES

Top-ups Subject to the rules set by AXA Philippines from time to time, you have the option to increase the
benefits of your Policy by paying additional premiums on top of your regular premium which will
be used to buy more units on your chosen investment fund(s).
Premium Holiday Premiums are paid throughout the life of your Policy, but you have the option to suspend
payment anytime as long as the Account Value is sufficient to cover these.
Loyalty Bonus As long as your Policy remains in force, a 5% Loyalty Bonus will be paid on the 10th and 20th
year to increase your Account Value. The Bonus will be equal to 5% of the average of the
month-end Account Values for the last 120 months.

The succeeding pages of this proposal provide more details on the benefits and features of Axelerator.

Again, thank you for your interest in AXA products. If you have questions, please call me at the number specified below, or call the AXA
Philippines Customer Care Hotline at Tel Nos: (02)5815-292 or (02)3231-292.

FLAMENO, BLENDA ICO

71647
23960
639325441440

Page 2 of 12 of Proposal No. 23960-201909140451-4-02

Printed on: 9/14/2019 at 07:27 PM Created on: 09/14/2019 Expiry Date: 11/13/2019
Version Number: 4.5.1 Date for Next Insurance Age: 05/02/2020
Plan Code: AXE/ Rider Code: WP, AP0555
 Philippine Peso
for: Mr. ARNOLD AGAPITO PAMITTAN, 38

Axelerator is a regular-pay variable life insurance product where a portion of the premiums, net of the company’s charges, is invested into your choice of
funds. Subject to the rules set by AXA Philippines from time to time, you can increase your investment anytime by paying top-up premiums, but the value
of the funds (and your policy benefits) may go up or down depending on market conditions. The minimum Death Benefit in this proposal is PHP
250,000 1 .
Below are important details of the proposal along with how your investment will be allocated between the available funds. You may change this allocation
anytime depending on your investment goals and/or risk appetite.
Basic Plan and Supplements Cover up to Age Sum Insured (PHP) Annual Premium (PHP)

Basic
Axelerator 100 250,000 50,000.00
Supplements
WAIVER OF PREMIUM 60 250,000 1,055.00
SECURE 5 PAY (UP TO AGE 55) 56 250,000 855.00
Total² 51,910.00

You may also pay your premium in the following modes:

Modes of Payment Modal Premium Fund Name ³ Fund Allocation
(PHP)
Semi-Annual 25,955.00 Chinese Tycoon Fund 30%
Quarterly 12,977.50 Philippine Wealth Equity Fund 40%
Monthly 4,325.87 Opportunity Fund 30%

Notes:
1. This is the minimum Death Benefit at policy inception. The minimum Death Benefit for any policy year is equal to 500% of the annual regular Axelerator premium, plus
125% of each paid top-up premium, if any, less 125% of each partial withdrawal, if any.
2 Premiums for all products are payable up to termination age. For the premium term of the supplement/s, if any, please refer to the supplement definition indicated in
the "Summary of the Riders Attached to this Proposal".
3. See Product Notes for description of the funds.

Page 3 of 12 of Proposal No. 23960-201909140451-4-02

Printed on: 9/14/2019 at 07:27 PM Created on: 09/14/2019 Expiry Date: 11/13/2019
Version Number: 4.5.1 Date for Next Insurance Age: 05/02/2020
Plan Code: AXE/ Rider Code: WP, AP0555
 Philippine Peso
for: Mr. ARNOLD AGAPITO PAMITTAN, 38

ILLUSTRATION OF BENEFITS

The illustrated benefits of your policy (subject to actual market performance) are shown below.

Total Cumulative ILLUSTRATION OF BENEFITS

End of Regular Basic 4.00 % Rate of Return 8.00 % Rate of Return 10.00 % Rate of Return
Policy Premium, Rider
Year Premiums and Top Living Benefit Death Benefit Living Benefit Death Benefit Living Benefit Death Benefit
-up, if any, Paid
1 50,000 30,447 250,000 31,650 250,000 32,252 250,000
2 100,000 62,149 250,000 65,875 250,000 67,774 250,000
3 150,000 95,169 250,000 102,898 250,000 106,915 250,000
4 200,000 146,958 250,000 161,017 250,000 168,447 250,000
5 250,000 200,963 250,000 223,961 250,000 236,325 250,000
10 500,000 517,505 517,505 636,539 636,539 706,732 706,732
15 750,000 891,221 891,221 1,229,655 1,229,655 1,450,273 1,450,273
20 1,000,000 1,390,196 1,390,196 2,163,234 2,163,234 2,721,832 2,721,832
25 1,250,000 1,952,983 1,952,983 3,472,869 3,472,869 4,695,611 4,695,611
30 1,500,000 2,637,700 2,637,700 5,397,154 5,397,154 7,874,403 7,874,403
35 1,750,000 3,470,762 3,470,762 8,224,559 8,224,559 12,993,878 12,993,878
40 2,000,000 4,484,310 4,484,310 12,378,945 12,378,945 21,238,844 21,238,844
45 2,250,000 5,717,447 5,717,447 18,483,102 18,483,102 34,517,445 34,517,445
50 2,500,000 7,217,745 7,217,745 27,452,110 27,452,110 55,902,764 55,902,764
55 2,750,000 9,043,088 9,043,088 40,630,525 40,630,525 90,344,035 90,344,035
60 3,000,000 11,263,897 11,263,897 59,993,940 59,993,940 145,812,046 145,812,046

Age60 1,100,000 1,602,163 1,602,163 2,627,564 2,627,564 3,400,762 3,400,762

Age65 1,350,000 2,210,874 2,210,874 4,155,123 4,155,123 5,789,035 5,789,035
Age70 1,600,000 2,951,464 2,951,464 6,399,609 6,399,609 9,635,373 9,635,373
The rates of return shown above are for illustration purposes and are not based on past performance nor guarantee future performance. The actual return may differ.
The illustrated values are net of premium charges of 35%/35%/35% of the basic premium for the 1st to 3rd policy years; all top-ups shall be subject to a premium charge of 2%;
Cost of Insurance has been deducted monthly from the illustrated values as well as Administration Charge amounting to PHP1,200 p.a. The Annual Premiums for any attached
Supplement shall be deducted monthly from the illustrated values if the Policy is under Premium Holiday. An Asset Management Charge of 2% p.a. for Philippine Wealth Bond,
Philippine Wealth Balanced and Philippine Wealth Equity Funds and 2.5% p.a. for Opportunity , Chinese Tycoon and Spanish American Legacy Funds have already been
deducted from the illustrated values. The illustrated values are still subject to a surrender charge for withdrawals (partial or full) transacted up to the 5th policy year. The
surrender charge is equal to the amount withdrawn multiplied by a surrender factor of 100%/100%/25%/10%/5% for the 1st to 5th years respectively.

This illustration shall form part of the insurance contract once the Policy is issued.

Page 4 of 12 of Proposal No. 23960-201909140451-4-02

Printed on: 9/14/2019 at 07:27 PM Created on: 09/14/2019 Expiry Date: 11/13/2019
Version Number: 4.5.1 Date for Next Insurance Age: 05/02/2020
Plan Code: AXE/ Rider Code: WP, AP0555
 Philippine Peso
for: Mr. ARNOLD AGAPITO PAMITTAN, 38

ILLUSTRATION OF BENEFITS (with Premium Holiday on Year 5)

You can choose to suspend payment for regular premium and top-ups as long as the Account Value of your Policy is sufficient to cover
the charges and pay for the premium of any supplement. This feature is called a Premium Holiday which you can apply for. Note that
under this feature, there is a possibility that your Account Value may be depleted and may result to your policy being terminated.

The following table is an example of the impact of a premium holiday at year 5 and/or withdrawals from the fund assuming different
rates of return. However, note that the rates of return are for illustration purposes only. They are not based on past performance nor
guarantee future returns.

The illustrated benefits of your policy (subject to actual market performance) are shown below.

Total Cumulative ILLUSTRATION OF BENEFITS (with Premium Holiday on Year 5)

End of Regular Basic
4.00 % Rate of Return 8.00 % Rate of Return 10.00 % Rate of Return
Policy Premium, Rider
Year Premiums and Top-
up, if any, Paid Living Benefit Death Benefit Living Benefit Death Benefit Living Benefit Death Benefit
1 50,000 30,447 250,000 31,650 250,000 32,252 250,000
2 100,000 62,149 250,000 65,875 250,000 67,774 250,000
3 150,000 95,169 250,000 102,898 250,000 106,915 250,000
4 200,000 146,958 250,000 161,017 250,000 168,447 250,000
5 250,000 200,963 250,000 223,961 250,000 236,325 250,000
10 250,000 238,918 250,000 324,237 324,237 375,955 375,955
15 250,000 278,149 278,149 462,615 462,615 590,978 590,978
20 250,000 339,264 339,264 688,549 688,549 966,562 966,562
25 250,000 404,866 404,866 1,002,866 1,002,866 1,547,313 1,547,313
30 250,000 485,942 485,942 1,466,197 1,466,197 2,484,246 2,484,246
35 250,000 584,583 584,583 2,146,983 2,146,983 3,993,185 3,993,185
40 250,000 704,595 704,595 3,147,282 3,147,282 6,423,348 6,423,348
45 250,000 850,608 850,608 4,617,048 4,617,048 10,337,148 10,337,148
50 250,000 1,028,255 1,028,255 6,776,617 6,776,617 16,640,364 16,640,364
55 250,000 1,244,390 1,244,390 9,949,732 9,949,732 26,791,755 26,791,755
60 250,000 1,507,352 1,507,352 14,612,079 14,612,079 43,140,672 43,140,672

Age60 250,000 363,326 363,326 799,332 799,332 1,165,663 1,165,663

Age65 250,000 435,402 435,402 1,167,140 1,167,140 1,869,594 1,869,594
Age70 250,000 523,094 523,094 1,707,570 1,707,570 3,003,283 3,003,283
The rates of return shown above are for illustration purposes and are not based on past performance nor guarantee future performance. The actual return may differ.
The illustrated values are net of premium charges of 35%/35%/35% of the basic premium for the 1st to 3rd policy years; all top-ups shall be subject to a premium charge of 2%;
Cost of Insurance has been deducted monthly from the illustrated values as well as Administration Charge amounting to Php1,200 p.a. The Annual Premiums for any attached
Supplement shall be deducted monthly from the illustrated values if the Policy is under Premium Holiday. An Asset Management Charge of 2% p.a. for Philippine Wealth Bond,
Philippine Wealth Balanced and Philippine Wealth Equity Funds and 2.5% p.a. for Opportunity , Chinese Tycoon and Spanish American Legacy Funds have already been
deducted from the illustrated values. The illustrated values are still subject to a surrender charge for withdrawals (partial or full) transacted up to the 5th policy year. The
surrender charge is equal to the amount withdrawn multiplied by a surrender factor of 100%/100%/25%/10%/5% for the 1st to 5th years respectively.

The contract term is specified in the illustration of benefits in this proposal. Please refer to the assumptions below used in the above
example.
Other Assumptions:
1. This example assumes that all premiums shown in the above table are paid in full when due and as planned with no premium holiday in the first
5 policy years. It assumes the current scale of charges remains unchanged.
2. A loyalty bonus estimated to be 5% of the average Account Value from 1st to 10th policy years on the 10th year, and 5% of the average Account
Value from the 11th to 20th policy years on the 20th year is included in the Illustration. The Bonus will be equal to 5% of the average of the
month-end Account Values over the last 120 months.
3. The proposed policy charges used in this illustration summary are based on the standard risk class without taking into account your own
circumstances (e.g. occupation and health condition, etc). Risk class will be determined according to our underwriting guidelines. The
investment gains/risks associated with this plan are solely to your account.

Page 5 of 12 of Proposal No. 23960-201909140451-4-02

Printed on: 9/14/2019 at 07:27 PM Created on: 09/14/2019 Expiry Date: 11/13/2019
Version Number: 4.5.1 Date for Next Insurance Age: 05/02/2020
Plan Code: AXE/ Rider Code: WP, AP0555
 Philippine Peso
for: Mr. ARNOLD AGAPITO PAMITTAN, 38

Notes on the illustration of Benefits

1. All payments and benefits shown are in Philippine pesos. Payments are acceptable in policy currency only.
2. AXA Philippines reserves the right to adjust the Basic and Supplement premiums, and any charges in this plan.
3. The quoted values are illustrations only of the key features, benefits and assumptions of the chosen insurance plans. If your application is
accepted, you will receive a policy contract, which will include detailed terms, conditions, and exclusions. A new Illustration of Benefits will be
provided in the contract, which may differ from this proposed illustration.
4. The benefits are based on the projected performance of your chosen fund/s. Since fund performance may vary, the values of your units are not
guaranteed and will depend on the actual investment performance at that given period. The illustrated returns on investments are based on
assumed annual rates of 4.00.00%, 8.00.00%, and 10.00.00%. These rates are for illustration purposes only and do not represent maximum
or minimum return on your fund value.
5. A bid-offer spread, which is the difference between the bid price and the offer price of units, may be determined by AXA Philippines from time to
time. The above illustration is based on a bid-offer spread of 5%.
6. This illustration summary relates to your Axelerator only, and excludes any Supplements in this proposal. It assumes that all premiums are paid
in full when due and as planned with no premium holiday and the current scale of charges remains unchanged. Any deviation from this will
change the illustrated values accordingly.
7. A loyalty bonus, credited on the 10th and 20th policy years, is included in the illustration. The bonus is estimated to be 5% of the average of
the month-end Account Values over the last 120 months.
8. The proposed policy charges used in this illustration summary are based on the standard risk class without taking into account your own
circumstances (e.g. occupation and health condition, etc). Risk class will be determined according to our underwriting guidelines. The
investment gains/risks associated with this plan are solely to your account.

Product Notes

1. Axelerator is a regular-pay variable life insurance plan. Only the minimum Death Benefit is guaranteed while the Policy is in-force. The rest of
the benefits, namely the partial and full withdrawal values and the actual Death Benefit at time of death, all depend on the investment
experience of separate account(s) linked to the Policy.
The death benefit will be the higher of the Sum Insured less the partial withdrawals made for the past twelve (12) months, and the Account
Value.
2. The living benefits shown in the illustration summary are equal to the Account Value of the Policy.
3. The client may choose from the following funds. If client chooses to invest in more than one fund, a minimum allocation of 10% on one fund is
required. The total allocation should always be 100%.
a. Philippine Wealth Bond Fund - This Bond Fund is an actively managed fixed income fund that seeks to capitalize on capital and
income growth through investments in interest-bearing securities issued by the Philippine Government and money market
instruments issued by banks.
b. Philippine Wealth Balanced Fund - This Balanced Fund is designed to achieve long-term growth through both interest income and
capital gains with an emphasis on providing a modest level of risk. It seeks to manage risk by diversifying asset classes and industry
groups through investment in bonds issued by the Philippine government and equities issued by Philippine corporations comprising
the Philippine Stock Exchange Index.
c. Philippine Wealth Equity Fund - This Equity Fund seeks to achieve long-term growth of capital by investing mainly in equities of
Philippine corporations comprising the Philippine Stock Exchange Index. The fund aims to provide access to a diversified portfolio of
equities from different industries.
d. Opportunity Fund - This equity fund aims to achieve long term growth through capital gains and dividends by investing in equities of
Philippine corporations that will provide access to a diversified portfolio of equities from different industries.
e. Chinese Tycoon Fund - This equity fund aims to achieve medium to long term growth through capital gains and dividends by
investing in equities that will provide access to a management themed-portfolio reflective of the Chinese-Filipino entrepreneurial
spirit through strategic investments in Philippine companies from different industries.
f. Spanish American Legacy Fund - This equity fund aims to achieve medium to long term growth through capital gains and dividends
by investing in equities that will provide access to a management themed-portfolio through strategic investments in Philippine
companies from different industries with Spanish/American heritage.
4. The Bid Price of an Investment Fund is the price for canceling a Unit of the Investment Fund as determined in accordance with the Valuation
provision.
5. The Offer Price of an Investment Fund is the price for creating a Unit of the Investment Fund as determined in accordance with the Valuation
provision.

Page 6 of 12 of Proposal No. 23960-201909140451-4-02

Printed on: 9/14/2019 at 07:27 PM Created on: 09/14/2019 Expiry Date: 11/13/2019
Version Number: 4.5.1 Date for Next Insurance Age: 05/02/2020
Plan Code: AXE/ Rider Code: WP, AP0555
 Philippine Peso
for: Mr. ARNOLD AGAPITO PAMITTAN, 38

Attached Supplements
Summary of the Riders Attached to this Proposal
1. SECURE is an additional coverage for Accidents on top of the life insurance benefit. If the insured, because of an accident, dies
or sustains bodily injury in ways describing below, a percentage of the amount insured by SECURE will be given based on the
following:

TYPE OF INJURY % of SECURE

Sum Insured

· Permanent loss of:

- Life 100%
- Two or more limbs 100%
- Sight of both eyes 100%
- Sight of one eye and one limb 100%
- Hearing of both ears 75%
- Hearing of one ear 15%
- Speech 50%
- Sight of one eye 50%
- One limb 50%
- All joints of four fingers and thumb of right hand 40%
- All joints of four fingers and thumb of left hand 35%
- All joints of four fingers of right hand 35%
- All joints of four fingers of left hand 30%
- Two joints of right thumb 25%
- One joint of right thumb 15%
- Two joints of left thumb 20%
- One joint of left thumb 10%
- Three joints of one finger of right hand 10%
- Two joints of one finger of right hand 7.5%
- One joint of one finger of right hand 5%
- Three joints of one finger of left hand 7.5%
- Two joints of one finger of left hand 5%
- One joint of one finger of left hand 2%
- All joints of all toes of one foot 15%
- All joints of big toe 5%
- One joint of big toe 3%

· Fractured leg or patella 10%

· Shortening of leg by at least 5 cms. 7.5%
· Major burns as percent of total body surface
- Head
- 2% but less than 4% 25%
- 4% but less than 6% 50%
- 6% but less than 8% 75%
- 8% or more 100%
-Body
- 10% but less than 12.5% 25%
- 12.5% but less than 15% 50%
- 15% but less than 20% 75%
- 20% or more 100%

SECURE Premiums are payable up to age 43.

Page 7 of 12 of Proposal No. 23960-201909140451-4-02

Printed on: 9/14/2019 at 07:27 PM Created on: 09/14/2019 Expiry Date: 11/13/2019
Version Number: 4.5.1 Date for Next Insurance Age: 05/02/2020
Plan Code: AXE/ Rider Code: WP, AP0555
 Philippine Peso
for: Mr. ARNOLD AGAPITO PAMITTAN, 38

We will not pay You any benefit under this Supplement if Your Death, Dismemberment or Loss of Use shall result, directly or indirectly,
wholly or partly, from any of the following causes:

(1) self-inflicted injury, suicide or any attempt thereat; or

(2) disease or infection (except infection which occurs through an accidental cut or wound), including infection with any Human
Immunodeficiency Virus (HIV) and/or any HIV-related illness including Acquired Immune Deficiency Syndrome (AIDS) and/or any mutations,
derivations or variations thereof; or
(3) strike, riot, civil commotion, Acts of Terrorism, revolution, insurrection, declared or undeclared war, or any warlike operation; or
(4) murder, provoked assault or participation in any brawl; or
(5) any violation or attempted violation of the law or resistance to arrest; or
(6) while the Insured is affected by alcohol or unprescribed drug; or
(7) bodily or mental infirmity, hernia, ptomaines or infection other than infection occurring at the same time with or because of an
accidental cut or wound, disease or sickness of any kind; or
(8) poison, gas or fumes voluntarily or involuntarily taken, atomic explosion, nuclear fission, or radioactive gas; or
(9) while entering, operating, servicing, or ascending from or with any aerial or marine device or conveyance except while traveling as a
passenger in an aircraft or marine transportation operated by a commercial passenger airline or shipping line on a scheduled air or sea
service over an established passenger route; or
(10) service in the military, naval or air force in time of declared or undeclared war or while under the orders for warlike operations or
restoration of public order; or
(11) while undergoing medical or surgical treatment except as a result of accidental injury; or
(12) when occasioned by or happening through pregnancy or childbirth; or
(13) while engaged in hunting, racing of any kind, martial arts, scuba diving, hang-gliding, yachting beyond five (5) kilometer of coast-line,
bungee-jumping, parachuting, sky-diving, mountaineering, and other forms of extreme sports; or
(14) nuclear, biological or chemical (NBC) contamination; or
(15) Pre-Existing Conditions as defined in this Supplement.

“Pre-existing condition” means a condition (1) for which the Insured received medical advice, consultation or treatment, or (2) whose signs
or symptoms are evident, or should have been evident to the Insured, even if the Insured did not seek medical advice, consultation or
treatment for it, prior to the Effective date of this Supplement or date of effectivity of its last reinstatement, if any. “Condition” means any
type of Bodily Injury as defined in this Supplement.

Page 8 of 12 of Proposal No. 23960-201909140451-4-02

Printed on: 9/14/2019 at 07:27 PM Created on: 09/14/2019 Expiry Date: 11/13/2019
Version Number: 4.5.1 Date for Next Insurance Age: 05/02/2020
Plan Code: AXE/ Rider Code: WP, AP0555
 Philippine Peso
for: Mr. ARNOLD AGAPITO PAMITTAN, 38

Attached Supplements
(Continued)
2. WAIVER OF PREMIUM waives premium payments in the event you are suddenly unable to work and pay for the premiums
because of a disability. In effect, with a Waiver of Premium supplement, your policy will be allowed to continue as if premiums
are regularly and continuously paid.

The premium term of the supplement for waiver of premium is the same as the premium term of the plan to which the
supplement for waiver of premium is attached.

NOTES:
1. The rates shown, if any, are those currently in effect. The rates may change subject to the approval of the Insurance Commission.
2. For a detailed description of the Supplements, including exclusions and other provisions, please refer to the policy contract.

Page 9 of 12 of Proposal No. 23960-201909140451-4-02

Printed on: 9/14/2019 at 07:27 PM Created on: 09/14/2019 Expiry Date: 11/13/2019
Version Number: 4.5.1 Date for Next Insurance Age: 05/02/2020
Plan Code: AXE/ Rider Code: WP, AP0555
 Philippine Peso
for: Mr. ARNOLD AGAPITO PAMITTAN, 38

DECLARATIONS AND ACKNOWLEDGMENTS

DECLARATIONS

1. It is my understanding that the total premium I am going to pay when I purchase this plan shall consist of the Axelerator premium, regular
top-up premium, and Supplement premiums shown above, if any. I was also made aware that only the Axelerator premium and top-up
premiums will be allocated to purchase units of the investment fund/s I will choose.
2. I confirm having read and understood the information in this proposal. My Financial Advisor/Financial Executive fully explained to me the
features and charges that will be made on my plan, and that the actual variable plan benefits will reflect the actual investment experience of
the separate account into which my fund is invested. I also confirm that I will fully assume all investment gains / risks associated with the
purchase of this plan.

Acknowledgment of Variability
Variable Life Insurance Plan
I acknowledge that:

I have applied with AXA Philippines for a Variable Life Policy, and have reviewed the illustration(s) that shows how a variable life insurance
policy performs using AXA Philippines’ assumptions and based on Insurance Commission’s guidelines on interest rates.

I understand that since fund performance may vary, the values of my units are not guaranteed and will depend on the actual performance at
that given period and that the value of my Policy could be less than the capital invested. The unit values of my Variable Life Insurance are
periodically published.

I understand that the investment risks under the Policy are to be borne solely by me, as the policyholder.

Product Transparency Declaration

By signing off on the items listed below, I acknowledge that the same have been discussed with and thoroughly explained to me.
· I understand that I am buying an investment-linked insurance product.
· I understand that the principal and earnings are not guaranteed and that the value of my unit investment (NAVPU) may go up or down depending on
the performance of the separate funds.
· I understand that the funds will be invested in Equities and/or Bonds or a combination thereof, and will be subject to changes in market conditions.
· The available funds and the risks that they bear have been thoroughly discussed with me, and I have made my Fund Allocation decision based on my
own judgment of and tolerance for these risks.
· I understand that this product is appropriate for a long-term investment horizon.
· I understand that I will have zero (0) withdrawal value during the first two (2) years of the policy because the amount withdrawn will be subject to
100% surrender charge on the first two (2) years.

CONFORME: These declarations and acknowledgments are made with the knowledge of
the AXA representative whose signature appears below:

_____________________________ ____________________ _____________________________________ ________________________

Applicant/Policy Owner Date Financial Advisor/Financial Executive Date
Signature over Printed Name Signature over Printed Name

TO BE FILLED UP BY AXA PHILIPPINES

_________________________ _________________________
These declarations and acknowledgments are valid for _________________________ _________________________
the following policy/ies with policy number/s: _________________________ _________________________
Disclosure of Conflict of Interest

The Company adopts a Conflict of Interest Policy and undertakes to disclose any material information which gives rise to actual or potential conflict of interest to
our customers. Company likewise takes all reasonable steps to ensure fair dealings with our customers.

General Disclaimer

All information and opinions provided are of a general nature and for information purposes only. The information and any opinions herein are based upon
sources believed to be reliable. AXA Philippines, its officers and directors make no representations or warranty, expressed or implied, with respect to the
correctness, completeness of the information and opinions in this document. Investment or participation in the Fund(s) is subject to risk and possible loss of
principal. Please carefully read the policy and endorsements and consider the investment objectives, risks, charges and expenses before investing. You should
seek professional advice from your financial, tax, accounting or legal consultant before making an investment. Past performance is not indicative of future
performance.

THIS FINANCIAL PRODUCT OF AXA PHILIPPINES IS NOT INSURED BY THE PHILIPPINE DEPOSIT
INSURANCE CORPORATION (PDIC) AND IS NOT GUARANTEED BY METROBANK OR PS BANK.

Page 10 of 12 of Proposal No. 23960-201909140451-4-02

Printed on: 9/14/2019 at 07:27 PM Created on: 09/14/2019 Expiry Date: 11/13/2019
Version Number: 4.5.1 Date for Next Insurance Age: 05/02/2020
Plan Code: AXE/ Rider Code: WP, AP0555
 Reference no.: 23960-201909140451-4-
02
INVESTMENT PORTFOLIO RISK ASSESSMENT
You prefer a balanced investment portfolio
Balanced Investment Portfolio : A balanced investment portfolio typically invest in bonds for income generation and
stocks for investment growth. This combination is to help mitigate financial loss should the stock market experience a
downturn.

· You understand that investing allows for higher returns than savings, but there is a risk that your investments
might yield negative returns and the value of your investments can even be lower than the amount you
invested.
· You understand that diversifying your investments in different asset classes and over different equity funds
reduce the volatility of the average annual returns on your investments.
· You understand that a longer holding period reduces the volatility of the average annual return during the
holding period on your investments.
· You prefer a balance between a probable negative annual return and the possibility of higher average annual
returns over a longer period of time.

INVESTMENT PORTFOLIO RISK ACKNOWLEDGMENT

I acknowledge that the descriptions above match the risk profile of my intended investment portfolio. I also
acknowledge that the recommended fund allocation ranges resulting from my investment portfolio risk profile is only
intended as reference to help me assess my investment portfolio’s risk appetite and investment objectives.

WAIVER FOR RISK PORTFOLIO RE-CLASSIFICATION (For Clients Investing in Products with Different Risks)

I waive the results of my investment portfolio risk profile assessment and have decided to invest instead in another
investment fund or a combination investment funds which falls outside of the recommended fund allocation ranges
indicated by my investment portfolio risk profile.

INVESTMENT POLICY STATEMENT

I acknowledge that my fund allocation represents the Investment Policy of my portfolio. I have carefully read and
understood the investment objective(s) of my selected fund(s) as well as the risk(s) that it(they) bear(s).

Conforme:

Applicant/Policy Owner Date

Signature over Printed Name
 Reference Number: 23960-201909140451-4-02

FINANCIAL UNDERSTANDING SUMMARY

Dear ARNOLD

Thank you for providing us with relevant information with regards to your financial needs.

Based on your current financial situation, which includes, among others, your personal
monthly gross income of 50,000.00, and after taking into consideration your objectives, risk
profile and priorities, you have selected Axelerator for your Wealth Management need.

The details of your insurance coverage and your insurance premium are summarized in your
Axelerator sales illustration.

FLAMENO, BLENDA ICO

71647
23960
639325441440

This document is not intended to be a part of your sales illustration of your application form. This is a
summary of the financial needs that you have provided during assessment by your distributor.