UNDERWRITING INFORMATION ON RATINGS

Agent Name/s Branch Date

CASTRO, RAZCHELLE CASTILLO EASTERN SUMMIT LIFE March 5, 2020

Life Assured Payor

MACION, MICHAEL ENGOC

Policy Number Currency Face Amount

12096393

Dear Valued Customer,

Allow us to thank you for entrusting your financial planning to Pru Life UK.

We would like to inform you that your application has been reviewed and that we are earnest to be of further service to you. A
revised offer has been prepared and we hope that the attached proposal/s will merit your consideration.

LIFE ASSURED is rated due to OCCUPATION

CORE BENEFITS

Basic Life Standard Total and Permanent Disability Standard

RIDERS

Accidental Death and Disablement Class 3

Life Care Benefit Standard

Waiver of Premium on TPD Standard

Personal Accident Class 3

PAYOR is rated due to NOT APPLICABLE

CONFORME ON RATINGS

I agree and accept the revised terms and conditions as outlined above.

I further undertake to inform Pru Life UK if there is any change in the state of health, occupation or activity of the undersigned
between the date of this consent and acceptance of risk.

MACION, MICHAEL ENGOC 0

Signature Signature
LIFE ASSURED POLICY OWNER

For any clarification or assistance, you may get in touch with Jannelle Erika Alimurung, Underwriting Executive, NBU