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LIFE INSURANCE TRUST AGREEMENT
 
           THIS AGREEMENT, made on this ______th day of _______________, 19 ___ between __________________________ of ________________________ hereinafter called the INSURED, and ____________________________ hereinafter called the TRUSTEE.
 
WITNESSETH
 
That the INSURED has designated the TRUSTEE as such under the terms of this Agreement for the beneficiaries in the following Life Insurance Policy.
 
The Insular Life Assurance Company, Ltd, Policy No. __________, P _______________(Face Value) ______________ (Plan) issued as of ___________________ in favor of __________ ________________________________________________ ____________________ (Beneficiaries).
 
       The duty and responsibility concerning the payment of premiums and other charges of the said policy shall rest solely upon the Insured.
 
       This Agreement shall be operative only with respect to the net proceeds of such policy as may be due and payable upon the death of the INSURED during the minority of the beneficiaries, and during his lifetime, all rights of every nature accruing solely to the Insured are hereby reserved by him and may be exercised by him without the knowledge or consent of the TRUSTEE or the beneficiaries under this Agreement.
 
       The INSURED also reserved the right to modify, amend, add to, or revoke this Agreement.
 
       As soon as practicable after the death of the INSURED, the TRUSTEE shall make proper proof of death and shall collect all money due under the said policy and give the insurer receipt and acquittances thereof.
 
       The TRUSTEE shall immediately notify the beneficiaries of the death of the INSURED and the amount the TRUSTEE has received as proceeds of the said policy.
 
       The TRUSTEE shall receive, hold, manage, invest, reinvest and otherwise deal with the moneys realized from such policy as he shall deem to be for the best interest of the beneficiaries during their minority to the same extent that the INSURED, if living, might do. the TRUSTEE shall deliver the trust estate, together with any and all earnings to the beneficiaries, upon reaching the age of majority or upon demand of a duly appointed Judicial Guardian of the Property of said beneficiaries.
 
       The TRUSTEE reserved the right to resign this trusteeship during the INSURED'S lifetime by giving him thirty days notice in writing; but after the death of the INSURED only for the cause satisfactory to the heirs of the INSURED, especially the INSURED'S beneficiaries.
 
       The TRUSTEE has received from the INSURED the sum of One Peso (P1.00) and other valuable considerations as compensation for the services he might be called upon to discharge in connection with this charge.
 
       IN WITNESS WHEREOF, the INSURED and the TRUSTEE have signed this Agreement in the City of __________________, on the date first hereinabove mentioned.
 
 
___________________
INSURED
 
CONFORME:
 
___________________
TRUSTEE
 
SIGNED IN THE PRESENCE OF:
 
__________________________
__________________________
 
 
ACKNOWLEDGEMENT
 
 
REPUBLIC OF THE PHILIPPINES)
__________________________) : S.S
 
 
          On this _____ day of ________________________ 19 _____ before me, the undersigned notary public personally came ____________________________ with Residence Certificate No. _____________ issued on _________________________ at ______________________, to me personally know and known by me to be the same person/s described in and who executed the foregoing instrument, and who made oath and acknowledge to me that he/she/they executed the same voluntarily and for the purpose set forth.
 
WITNESS my hand and official seal this ______ day of ___________ 19 ______.
 
 
Doc. No _________
Book No. _________
Page No. _________
Series of _________.
NOTARY PUBLIC

(Print Form)

After printing this form, please affix your signature and include all the necessary requirements
(see Policy Servicing Requirements)
then mail or submit to :

Insular Life Corporate Centre
Insular Life Drive
Filinvest Corporate City
Alabang, Muntinlupa City

ATTN: Mr. Jose A. Padilla

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