(Deed of Assignment of Insurance)

DEED OF ASSIGNMENT

KNOW ALL MEN BY THESE PRESENTS:

For valuable consideration I, _____________, Filipino, of legal age, (single / married /

widow), and a resident of _____________, Philippines, and the Owner of Policy No.
_____________ ("Policy"), issued by _____________ LIFE INSURANCE CO., INC., upon
my life, do hereby ASSIGN, TRANSFER and CONVEY unto __ASSIGNEE__, its successors
and assigns, all my rights, titles, interests, participation, claims, and demands of whatsoever
nature on the said Policy to the extent of the outstanding balance of my loan with the said
__ASSIGNEE__, with the excess, if any, to be paid upon my beneficiaries named in the Policy.
However, this assignment shall exclude premium deposits, policy funds and dividend
withdrawals arising out of, or in connection with, the Policy.

IN WITNESS WHEREOF, I have hereunto set my hand this _____________, at

_____________, Philippines.

ASSIGNOR

CONFORME:

IRREVOCABLE BENEFICIARY

SIGNED IN THE PRESENCE OF:

__________________ __________________

(ACKNOWLEDGMENT)