POLICY INFORMATION REPORT

POLICY NUMBER: 01876601

GENERAL INFORMATION

POLICY OWNER : DE LA CRUZ, JOSE BANDIOLA CONTRACT STATUS : IN FORCE

INSURED NAME : DE LA CRUZ, JOSE BANDIOLA PLAN DESCRIPTION : PRULINK ASSURANCE ACCOUNT

AGENT NAME : GARIN, KRISEL ANNE MEDINA BRANCH NAME : JASPER BRANCH

POLICY EFFECTIVE DATE : 03/15/2007 PLAN CURRENCY : PHP

FIRST ISSUE DATE : 03/15/2007 PREMIUM STATUS : PREMIUM PAYING

NON-FORFEITURE STATUS : N/A SUM ASSURED : 2,000,000.00

DIVIDEND OPTION : N/A

MAILING ADDRESS : B18 L23 SAVANNAH TRAILS B OTON, ILOILO PHILIPPINES

RESIDENCE ADDRESS : B18 L23 SAVANNAH TRAILS B OTON, ILOILO PHILIPPINES

PAYMENT INFORMATION

PAYMENT METHOD : CREDIT CARD BILLING FREQUENCY : MONTHLY

PAID TO DATE : 12/15/2019 MODAL PREMIUM : 5,000.00

SINGLE PREMIUM : 0.00

PLAN DETAILS

PLAN / RIDER DESCRIPTION SUM ASSURED CONTRACT STATUS PREMIUM STATUS

RUAC Crisis Cover Benefit 1,900,000.00 IN FORCE PREMIUM PAYING
RUAD Total & Permanent Disability 1,500,000.00 IN FORCE PREMIUM PAYING
PLAA PRULINK ASSURANCE ACCOUNT 2,000,000.00 IN FORCE PREMIUM PAYING
RADD Accidental Death & Disablement 2,000,000.00 IN FORCE PREMIUM PAYING

FUND DETAILS

FUND TYPE UNIT BALANCE UNIT PRICE PRICE DATE FUND VALUE
PRUlink Growth Fund 8,852.49 4.00 12/03/2019 35,450.93
PRUlink Managed Fund 10,112.78 3.29 12/03/2019 33,269.54

BENEFICIARY DETAILS

NAME RELATIONSHIP BIRTHDATE PERCENTAGE DESIGNATION

DE LA CRUZ, JEFFREY BANDIOLA BROTHER 15-OCT-1973 25.00% P-RE
MANDERICO, VERONICA DE LA CRUZ SISTER 30-APR-1963 25.00% P-RE
DE LA CRUZ, VICTOR BANDIOLA BROTHER 12-MAY-1978 25.00% P-RE
DE LA CRUZ, MARY CHRIST B. SISTER 25-DEC-1981 25.00% P-RE

BENEFICIARY DESIGNATION LEGEND: P-Primary S-Secondary RE-Revocable IR-Irrevocable

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Displayed data are as of December 3, 2019

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