Policy of Insurance Against Accident

mortgagee, society, mortgagor, time, day, sum, provided, assured, thereon and pay

Page: 1 2 3 4 5

Form qf a Polity (If Life ilssurance.

Whereas John Bull of Surrey House, Sutton Valence, in the county of Kent, Solicitor (who, with his Executors, Adininistrators, or AsNigns, is hereinafter called " the Assured "), has paid to the ECONONIIC LIFE ASSURANCE. SOCIETY (hereinafter called " the Society ") the Sum of Two Hundred Pounds as a first Premium for this Poliey of Assurance : Now these Presents witness, That in case there shall be paid to the Society, by way of further Premium, the Sum of Two Hundred Pounds on or before each thIrty-first day of December in each year during the continuance of this Policy, the Society shall be liable to pay to the Assured, at the Registered Office of the Society, the Sum of Ten Thousand Pounds, together with such further Sums (if any) as shall have been declared by way of Bonus or Addition to the said Sum here by assured, upon acceptance at the said Registered Office of proof satisfactory to the Directors of the Society of the Death, at any time after the date of this Policy, of the said John Bull : Provided, That this Policy shall lapse and become void if any Premium be not paid before the expiration of thirty days from the date hereinbefore appointed for payment ; but that the Assured shall be entitled to revive the Policy on pay ment of a Fine not exceeding Five per cent. of one year's Premium hereon, and of all Premiums in arrear, with compound Interest on such Premiums at the rate of Five per cent. per annum, at any time, so long as the Surrender Value of this Policy, at the date of its so lapsing, shall exceed the total amount of the Fine and the Premiums so in arrear, with such interest thereon : Provided also, That the Society shall be liable, at any time after three years' Premiums have been paid hereon, and so long as all Premiums shall have been paid as hereinbefore provided, to pay at the said Registered Office for the Surrender of this Policy a Value calculated according to the Society's Scale of Surrender Values in force at the time of such Surrender : Provided also, That the person whose Life is Assured under this Policy may, without notice to the Society and without payment of any extra Premium, proceed to and reside in any part of the World, or engage in any Trade, Occu pation, or Profession : Provided also, That no payment shall be made by the Society until evidence of the title of the person or persons claiming hereunder shall have been left at the said Registered Office and approved by the said Directors : Provided always, That the Society shall only be liable under this Policy to the extent of its Assets and Property from time to time existing after payment of all prior charges thereon, and that no Member of the Society or other person interested in any Policy shall be liable to any call or contribution in Liquidation, or otherwise, for satisfying the demands of the Assured, and that no Director or Officer of the Society shall in anywise be individually liable to any Claim or Demand under or in respect of this Policy on any ground or pretence whatsoever.

In Witness whereof, the Common Seal of the Society is hermit° affixed, this thirty-first day of December, Nineteen Hundred and Ten.

This Indenture, made between the within named A. B. of, &c. (hereinafter called "the Mortgagor "), of the one part, and C. 1). of, &c. (hereinafter called "the Mortgagee "), of the other part : Witnesseth that in consideration of the sum of to the Mortgagor paid by the Mortgagee on or before the execution of these presents (the receipt whereof the Mortgagor loth hereby acknowledge), the Mortgagor as beneficial owner hereby assigns unto the Mort gagee All that the within written Policy of Assurance on the life of the Mortgagor and all bonuses and other monies assured by or to become payable under the said Policy and the full benefit and advantage thereof To hold the same unto the Mortgagee. Provided always that if the Mortgagor shall pay to the Mortgagee

the said sum of with interest thereon in the meantime at the rate of pounds per cent. per annum on the day of next, then the Mortgagee will at any time thereafter upon the request and at the cost of the Mortgagor reassign the said Policy unto the Mortgagor or otherwise as he shall direct. And the Mortgagor hereby covenants with the Mortgagee that he the Mortgagor will pay to the Mortgagee the said sum of on the day of next together with interest thereon at the rate aforesaid computed from the day of the date hereof; and will also if and so long as the said principal money or any part thereof shall remain unpaid after the day herein before appointed for payment thereof pay to the Mortgagee interest thereon at the rate aforesaid by equal half-yearly payments on the day of and the day of in every year. And further, that he the Mort gagor will not do any act or suffer anything whereby the said Policy or any new Policy to be effected in lieu thereof as hereinafter provided may become void or voidable or the Mortgagee be prevented front receiving all or any of the monies assured or to become payable under the same, and that if the said Policy or any Policy in lieu thereof shall by any means become void the Mortgagor will forthwith at his own cost effect a new Policy on his life in the name of the Mortgagee in some office to be approved by him in the sum of at the least, and that every such new Policy and the monies to become payable thereunder shall be subject to the proviso for redemption hereinbefore contained and to the trusts applicable by virtue of these presents to the existing Polley of Assurance and to the monies to become payable thereunder, and shall be subject to the statutory power of sale in like manner in all respects as if originally comprised in these presents. And that he the Mortgagor will from time to time punctually pay the premiums and other sums of money (if any) which shall become payable for keeping the said Policy or any new Policy as aforesaid in force, and will deliver to the Mortgagee the receipt for every such premium within seven days after the same shall have become due and payable. And also that forthwith on demand the Mortgagor will repay to the Mortgagee all monies which the Mortgagee may have reasonably expended in keeping the said Policy or any new Policy in force, together with interest thereon at the rate aforesaid from the time or respective times of expenditure, and that until such monies and interest thereon shall have been repaid the said Policy and any new Policy and the monies to become payable thereunder respectively shall be charged with the payment thereof. And it is hereby declared that the statutory power of sale may at the option of the Mortgagee be exercised by way of surrender. In witness whereof the said parties to these presents have hereunto set_their hands and seals the day and year first above written. .

Page: 1 2 3 4 5