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FINANCIAL SERVICES FOR THE GREATER GOOD* December 21, 2017 Gerard Arthus 3208 Rexford Dr South Bend, IN 46615-3842 Dear Gerard Arthus: We are pleased to advise you that the conversion of your term insurance policy to Intelligent Life® UL a TIAA Lite Universal Life Insurance Policy, has been approved and is described as follows: INSURED: Gerard Arthus PLAN: Intelligent Life UL FACE AMOUNT: $100,000.00 RIDERS/ENDORSEMENTS: Level Cost of Insurance Endorsement RATE BASIS: Preferred Plus The cash value in your contract will fluctuate based u premiums paid, policy charges, and on the declared interest rate, which will never go below 3%. People who want the benefit of permanent life insurance with built-in flexibility often find a Universal Life policy to be an ideal solution. Intelligent Life UL is designed to provide financial protection to your survivors in the event of your death and potential financial benefits to you during your lifetime. In order for us to send you your policy and to put your coverage into effect, the initial premium payment mnet h(» Kir r r J An Initial Premium Notice for the Total Amount Due and a postage-paid return envelope are enclosed for your convenience. Your future planned premium payments will be paid through the Electronic Funds Transfer Option as elected. However, initial planned premiums cannot be processed through this payment option. Therefore, please submit your check for your first payment now and all future payments will be deducted from your account. Once your payment is received, the policy will be promptly mailed to you. If you have any questions, please call the TIAA Insurance Service Center at out toll free number 1-877-694-0305. Sincerely, LisaJL. Wright Mancini Lisa A. Wright Mancini, FALU, ACS, AIAA Vice President TIAA-CREF Life Insurance Company TIAA-CREF Life Insurance Company Insurance Service Center P.O. Box 724508 Atlanta, GA 31139 G6800346 LTIAA TIAA-CREF Life Insurance Company 730 Third Avenue New York, NY 10017-3206 212 490-9000 1 800223-1200 Endorsement to your TIAA-CREF Life Insurance Policy This endorsement is part of your TIAA-CREF Life Insurance Company policy. Please read this endorsement and attach it to your policy. The Loan, withdrawals and surrenders provision of your policy has been changed to read: Lo^ns' Any time after the right to cancel period ends you can take out a loan from us usinq withdrawals and your policy as collateral. surrenders The loan interest rate is fixed at an effective annual rate of 5% per year. The loan account guaranteed effective annual interest rate is 4.35% for policy years 1 through 10 and 4.80% for policy years 11 and later. The interest rate credited on the loan account may be less than the interest rate credited on the fixed-rate account. You can take out all or part of your cash surrender value by making partial withdrawals or surrendering your policy. Secretary TCL-UL 2008-NY LOAN-END 0TIAA TIAA-CREF Life Insurance Company 730 Third Avenue New York, NY 10017-3206 212490-9000 1 800 223-1200 Endorsement to your TIAA-CREF Life Insurance Company Policy This endorsement is attached to and made a part of your TIAA-CREF Life Insurance Company policy. If you believe your underwriting class has improved, you may request that it be changed to a more favorable underwriting class. Changes to your underwriting class may include a change in tobacco or smoking status. To request a change, please contact us at our administrative office. We will underwrite your request based upon our underwriting standards at the time of your request. If we approve your request, we will inform you of the new underwriting class. If we do not approve your request, your underwriting class will not change. Any change in the underwriting class will impact those charges which your policy indicates are based on your underwriting class. The reclassification will be incontestable after it has been in force during the insured’s lifetime for two years from the issue date of the approval. All other terms and conditions of your policy remain unchanged. IMPORTANT: Any change in the underwriting classification may result in possible tax consequences. Please consult your personal tax advisor before requesting a change in your underwriting classification. ( Secretary TCL-NYULR113-END G6800346 Gerard Arthus 3208 Rexford Dr South Bend, IN 46615-3842 APPLICATION FOR CERTIFICATE OF TITLE FOR A VEHICLE State Form 205 (R9/7-16) Approved by State Board of Accounts, 2016 INDIANA BUREAU OF MOTOR VEHICLES *This agency is requesting disclosure of your Social Security Number/ Federal Identification Number in accordance with 1C 4-1 -8-1; disclosure is mandatory, and this record cannot be processed without it I swear and affirm that I am authorized to perform this transaction, and To be completed by a police officer, BMV official, or BMV certified I agree to indemnify and hold harmless the Indiana BMV from any and dealer signee for out-of-state titles. I hereby certify that I personally all liability arising from this transaction. examined the following vehicle and find the identification number to be as follows. I swear and affirm that the information that I have entered on this form is correct. I understand that making a false statement on this form may Vehicle Identification Number constitute the crime of perjury. Applicant Signature: Year Make Model Type Date (mm/dd/yyyy) Printed Name: Inspector’s Printed Name and Title City Applicant Signature:. Printed Name:_ Inspector’s Signature Badge, Branch, or Dealer Plate Number Date (mm/dd/yyyy):. Transaction Number Branch Number Invoice Number BMV Use Only 01031839200087 392 TRANSFER-MV-NON DEALER-PREVIOUS TITLE Social Security Number / Federal Identification Number * Name of Applicant BMV Use Only GERARD ANTHONY ARTHUS Residence Address (number and street) City State ZIP Code 409 E LOWELL AVE MISHAWAKA IN 46545-6331 Vehicle Identification Number Vehicle Year Vehicle Make Vehicle Model Vehicle Type Odometer EXCEEDS MECH 2FMZA51413BA43795 2003 FOR WIN VA 159,370 M LIMIT Former Title Number Purchase Date (mm/dd/yyyy) Lien (Y/N) Speed (Y/N) Dealer Number BMV Use Only 15735173000074 12/23/2017 5 No Holder of First Lien, Mortgage, or Other Encumbrance / Special Mailing Address GERARD ANTHONY ARTHUS 409 E LOWELL AVE City State ZIP Code BMV Use Only MISHAWAKA IN 46545-6331 Holder of Second Lien, Mortgage, or Other Encumbrance Mailing Address (number and street) City State ZIP Code License Number License Year Forms Use BMV Use Only JR Gross Retail and Use Tax Affidavit- I/We hereby certify that sales or use tax on this vehicle was paid as indicated below. Selling Price Less Trade-In / Discount Amount Subject to Tax Amount of Tax Dealer Branch Exempt Exemption Code $ 250.00 $ 0.00 0.00 $ 250.00 $ 17.50 X N CUSTOMER COPY