L-01 / D-01

SA-9286(Rev.5/02)

Policy Forms 01-1123L-01 / 01-1123D-01 and state variations Issued by National Western Life Insurance Company

Consumer Information

Issued by National Western Life Insurance Company

Consumer Information

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R

O

P

B

R

*

This optional benefit provides a refund of all premiums(initial pre- mium as stated in the policy) paid plus an additional 5% bonus pay- ment at the end of the policy term. Even if you should cancel your policy before the end of the policy term, you may receive a partial refund of your premium payments as long as you have had continuous coverage for at least 6 years.

G

P

P

O

Your premium payment can be guaranteed for the selected term or shorter period.

D

I

B

R

*

(F^ORM01-3108-01)

This optional benefit provides a monthly income that will allow you to make mortgage payments in the event you become disabled.

C

I

R

*

(F^ORM01-3105-01)

If you are diagnosed with a cov- ered critical illness, this optional benefit will allow a portion of your death benefit to be paid prior to your death. Following verifi- cation of your covered illness, you may choose to receive a lump sum benefit up to 25% or 50%

of the face amount depending on which death benefit you elect. These dollars paid while you are living could make an

important difference in the quality of your life.

NWL ProviderSelect is term life insurance ideal for protecting mortgages. A variety of optional benefit riders provides added value and protection for your family.

L

O

D

D

B

You have the option of two types of death benefits, level or decreas- ing term periods of 15, 20, 25 and 30 years.

You choose the term of years that most closely match your mortgage term. The decreasing benefit decreases annually but never to less than half the initial death benefit selected. The level death benefit option gives you the flexibility of having a higher level death benefit in the event you purchase a more expensive home or refinance your current home. The level death benefit will never be less than the face amount at the time your policy is issued. With either policy the proceeds in the event of death will be paid directly to your

beneficiary.

S a f e g u a r ding your family’s most important asset

Your home is one

of the largest

investments you

will ever make.

NWL ProviderSelect

gives you flexible

protection against

premature death

and disability.

Protection if you

need it and 105%

of your money back

if you don’t.

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W

O

P

D

B

R

*

(F^ORM 01-3103-01)

This optional benefit rider will waive all of your monthly pre- miums if you become disabled including optional benefit rid- ers.

W

O

P

F

D

U

B

R

*

Involuntary unemployment can mean loss of income necessary to pay the premiums

for your NWL ProviderSelect term plan. In addition to the benefits paid by the Waiver of Premium Disability Benefit, this optional benefit rider provides for all premiums to be waived for up to 6 months of qualifying unemployment, after a 120 days waiting period.

A

D

B

R

*

(F^ORM 01-3102-01)

This optional benefit rider pro- vides for an additional death benefit in the event of your accidental death.

O

I

T

R

*

For many Americans, two family incomes make it possible to purchase their home. The loss of one of those incomes due to death may affect your ability to pay your mortgage payment. If your loan has mortgage co-holders, you will want to take advantage of this rider. This benefit provides term life insurance (same base plan as primary insured with no optional benefits) on the other person and is designed for the protection of both mortgage holders.

C

’

T

B

R

*

This optional benefit provides

$1,000 for each unit (minimum of 5 units) of level term life insurance for each child. Each child, born or legally adopted, between the age 15 days through 17 years at the time of application is eligible for cov- erage. Coverage is provided to age 25 and may be converted into a new individual policy.

*Product and benefit riders may not be available in all states. Certain limitations, restrictions and exclusions apply.

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NWL ProviderSelect

Client Profile Worksheet

OPTION #1

______________________

Monthly Premium

OPTION #2

______________________

Monthly Premium

OPTION #3

______________________

Monthly Premium

SA-9288

Level ❑ Decreasing ❑ Term Period/Premium Guarantee Circle one of the following:

30/30 25/25 20/20 15/15 30/15 25/5 20/5 15/5 NWL ProviderSelect is a Level or Decreasing Term Life Insurance Policy(01-1123L-01/01-1123D-01) issued by National Western Life Insurance Company, Austin, TX. Death Benefit is guaranteed for the term period chosen. Premium can be guaranteed for the selected term period or shorter, if desired.

Client Personal Information

Name: _______________________________________ Sex: ❑ M ❑ F Tobacco Use: ❑ Y ❑ N

Date of Birth:__________________________________ Mortgage Balance:_______________________________ Monthly Mortgage Payment: ______________________

NWL ProviderSelect Basic Benefits

• Income Tax-Free Death Benefit $_______________

• ___________________________$_______________

(Additional Optional Benefit Rider)

• ___________________________$_______________

(Additional Optional Benefit Rider)

NWL ProviderSelect with Return of Premium Benefits

• Income Tax-Free Death Benefit $_______________

• Return of Premium

• ___________________________ $_______________

(Additional Optional Benefit Rider)

• ___________________________ $_______________

(Additional Optional Benefit Rider)

NWL ProviderSelect with Return of Premium & Disability Protection Benefits

• Income Tax-Free Death Benefit $_______________

• Return of Premium

• Disability Protection $_______________ per month

• ___________________________ $_______________

(Additional Optional Benefit Rider)

• ___________________________ $_______________

(Additional Optional Benefit Rider)

Other NWL ProviderSelect Optional Benefits

• Waiver of Premium Rider (After initial waiting period, waives policy premiums during disability).

• Waiver of Premium for Disability or Unemployment Rider (After initial waiting period, waives policy premiums during disability or unemployment).

• Accidental Death Rider (Pays an additional benefit at accidental death).

• Critical Illness Rider (Pays up to 50% of the face amount for level term and 25% of face amount for decreasing term [maximum $250,000] for a covered critical illness).

• Other Insured Term Rider (Provides protection for spouse or other co-mortgage holder).

• Children’s Rider (Provides basic insurance for your children).

Product and benefit riders may not be available in all states. Certain limitations, restrictions and exclusions apply.

®

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About NWL ProviderSelect

Q. What is NWL ProviderSelect?

A. NWL ProviderSelect is term life insurance that offers you both protection and flexibility to protect your home and your family’s future from the four financial fears.

• Death • Critical Illness

• Disability • Unemployment

Q. What kind of protection does NWL ProviderSelect provide for my family?

A. NWL ProviderSelect will provide cash to pay your mortgage if you die, provide income if you are disabled, diagnosed with a covered critical illness or become unemployed; or will refund all of your premiums plus an additional 5% if you live.

Q. How much does NWL ProviderSelect cost?

A. NWL ProviderSelect is very affordable given the protection benefits it provides for you and your loved ones.

Q. How can I apply?

A. Contact your local agent for more information. Applying for NWL ProviderSelect is simple and convenient. The application is easy to understand, with just a few basic health questions. Your NWL representative can help you learn more about NWL ProviderSelect.

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A

C

National Western Life Insurance Company is a Colorado corpora- tion with executive offices in Austin, Texas. The Company offers a full line of life insurance and annuity products (both on an individual and group basis), through general agency offices in 46 states, the District of Columbia, and several foreign countries. As of December 31, 2001, the

Company had $10 billion of insur- ance in force, $3.43 billion in assets, $3.00 billion in liabilities, and $431 million in capital and surplus. National Western has consistently ranked in the top 10% of companies in the industry by total admitted assets.

Since its start in 1956, National Western has emphasized financial strength for the protection of its policyholders. As a legal reserve insurance company, National Western must set aside a portion of its assets equal to reserves required by law. Annually, a financial statement is filed with each state’s insurance department. Through reviews and in-depth audits, these departments verify that the appropriate reserves are maintained.

E

R

Rating agencies continue to

recognize the strengths of National Western and the positive steps we are taking to make this a company that is responsive to both our policyholders and stockholders. Standard and Poor’s^®has rated National Western “A+ (Strong),” while A.M. Best Company’s rating is “A- (Excellent).” A.M. Best’s ratings evaluates company factors in order to provide an opinion of the company’s financial strength, operating performance and ability to meet its obligations to policy- holders. Ratings range from A++ (superior) to F (in liquidation). A Standard & Poor’s^® rating is an opinion of a company’s financial security with respect to its ability to pay on its insurance policies and contracts in accordance with their terms. Ratings range from AAA (extremely strong) to CC (extremely weak) and R (regulatory supervision).

www.nationalwesternlife.com

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