Revised Premium Deposit Account Agreement Form – Effective Monday, 12/11/2023

Effective Monday, December 11, 2023, the Preliminary Details section of the Premium Deposit Account Agreement form (ORD 115811-0923 and ORD 115811-0923 KS) is being updated. The instructions will be updated to refer the applicant to the About the Policy or Your Life Insurance Information pages in the illustration for specific sums and amounts.

The revised form is required with a Part 1 date of 12/11/2023 and later. Older versions of the form will not be accepted with a Part 1 date of 12/11/2023 and later. The updated form will be available on PruXpress on Monday, December 11, 2023.