IMAGE EVALUATION TEST TARGET (MT-3) 1.0 I.I IIM 112.5 m ,; ' 2.2 2.0 1.8 1.25 1.4 1.6 M 6" - ► V] (^ Tl 'el <^; ^2 ^el c'^^ ^ Photographic Sciences Corporation 23 WEST MAIN STREET WEBSTER, NY MS80 (716) 872-4503 CIHM/ICMH Microfiche Series. CIHM/ICMH Collection de microfiches. Canadian Institute for Historical Microreproductions / Institut canadien de microreproductions historiques Technical and Biblicgraphic Notes/Notes techniques et bibliographiques The institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibliographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. L'Institut a microfilm^ le meillebr exemplaire qu'il lui a 6td possible de se procurer. 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Entered according to tlie Act of tlie Parliament of Canada, in the 3'ear 1895. by JoiiN* Francis Mathihson, at the Department of Agriculture. PRINTED BY W. H. EATON & SON, 1^^02SrTK;EIA.Ij. F The includes 1 or Reserv< Age. 20 21 22 23 24 FIFTEEN YEARS' PAYMENT. The ollowmg Table of Rates pt-r Ji.ooo includes the Expense Fund and the Emergency or Reserve Fund : Ak*. Quarterly, Aemi-Annitally. AnniiRllv 20 $6.50 j; 12.85 ♦25.20 21 (>.2 44.15 45 11.70 23.15 45.40 46 12.07 23.00 46. .S5 47 12.44 24.64 4s.:io tH 12.80 25.34 40.70 4i> 13.18 26.10 51.2" 50 13.60 26.05 52. hO 61 13.05 27.70 54.30 52 14.10 28.45 55. SO 5;{ 14.70 20.20 57.35 #4 15.20 30.10 59.00 §5 16.70 31.00 60.70 3 3. B 9 3 O 3 :S I t. I t) a. S if-:? S 3 •< » £; 8 o •' 5 g =• 3 5^ S. ^■p i w 2 - ^ - ? »■ •■ 1/1 Sc s = 3 lit M — f» =: r. a. - ^ c 5 S 3 _ 9 li. .- > H § - o ;? ii >• r3 3' 9 c •3 9 •< i> 3 i <» 9 . 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REGULATIONS AND C( lit.— Each applicant to become a benefit member of said Association must sign the Association's Form of Application therefor, tilled out by the applicant or some one on his or her behalf, and fpass a satisfactory examination by a duly licensed physician, who shall be deemed the a^ent of applicant. A Policy if issued shall not be in force until the first payment thereon, as per table of graduated payments printed hereon, shall have been paid to the Association duiing the good health of the member, and this Policy delivered during such member's life time. No agent of the Association is authorized to make or alter any such Application, and in doing any such act he is to \ie considered the agent of the applicant. sad.— The statements and declarations made by or on tiehnlf of said member, in order to become a benefit member of said Association, are the basis of said contract, and form n part hereof, on the faith of which chis Policy is issued, and every renewal hereof is made ; they are warranted true, and that no fact in regard to the health, habits or conditions of such member has been omitted relating to the warrantees : provided that the Policy shall not be void by reason of any statement in the Application thereof not being true, unless such statement is material in the contract, and that any warrantees made hereon by the member thall be subject to the qualification implied in this provision. 3rd.^f within two years from the date of this Policy the said member shall die by any act of self-destruction whatever, whether such member be sane or insane, or engage as an occupation in blasting, mining, submarine labour, the pro- duction of any highly explosive material, or in naval or military service (except in the militia or volunteer corps of Canada), or engage in serial or arctic voyages, this Policy shall be void, and all payments made .lereon shall be forfeited to the Association. 4th. — After two years from the date of this Policy, if three full years' payments have been made upon it, the msured may, by giving the Association thirty days' notice, while this Policy is in force, of a desire to do so, apply any dividends which shall have been declared by the Association in favour of the Policy towards making future payments. 5th.— The insured may, at any time after this Policy shall have been three years in force, provided the insured shall have given thirty days' notice to the Association while this Policy is in full force, surrender the same, and receive therefor in cash, in full settlement of all liability of the Association under the same, his or her equitable share of the emergency or reserve fiind. 6th — The death cl.<«im shall be payable in sixty days after there shall have lieen fur- ..» .„ ..J)iJyitelL.JMi>6uUQiy„pr^ uid Association of a valid claim under thit. contract. Such proof shall comprise a sworn statement of the physician who attended the insured in h'. or her las* illness, claimant, clergyman and under- taker, on the blanks furnished by the Association, and any such information as the said Association may require. No suit shall be valid under this contract unless commenced within one year from the date of the death of the insured. 7th. — This contract is a quarterly term insurance, renewable at the option of the insured Ijefore expiration, upon payment of the premiums and dues, at the time, and in the ,. manner lierein provided. The insured shall pay under this contract, in advance, at the head office of the Association, quarterly, reckoned from the date liereof during eacli and every year, respectively, the sum sjiecified in the Table of Kates printed on the back hereof for his age at entry, unless the Directors shall by special notice require a different amount, and in such case the call may be based on the curr with to tl durii emei Poll with the I rece and and eme in t valu to b sect of e tivel Ass call< ciati beet ciati alte proi any rate obli sam - Notice add tioii the and evei ing 9th. — Pro V id oft the one ann proi clai sha loth. — No a and the It is I whi deti ami this 8th. nth. IONS AND CONDITIONS. inust sign the >licant or some a duly licenced if issued shall lated payments good health of i(e time. No h Application, pplicnnt. mhrr, in order said contract, led, anil every (act in regard nitted relating I by reason of such statement by the member :r shall die by «ne or insane, Ixinr, the pro- service (except erial or arctic ;reon shall be payments have jn thirty days' r any dividends _ , of the Policy ' years in force, the Association !ive therefor in r the same, his 9th. lave been fur- im under thii physician who lan and iinder- ich information ced within one of the insured time, and in the let, in advance, the (late iiereof Table of Kates shall by special le baseil on the loth nth current age of the member. Payment may be made in advance in accordance with the annual, semi-annual or quarterly table, and when so made shall be applied to the renewal of this contract. The payments which shall be made hereunder, during the first year of the currency of this Policy, may (after providing fok the emergency fund required by the Act of Incorporation, and after providing for this Policy's pro rata share ot death claims occurring upon Policies becaming claims within a year of the date of issue) be used as a part of the expense fund, and after the said first year, four dollars per one thousand dollars insured of the monies so received shall be appropriated and used as a further part of the expense fund, and not exceeding one-tenth of one per cent, quarterly on the amount insured, and the balance afler the first year shall be earned to an emergency fund. The emergency fund may be used for any or all of the following purposes,— namely, in the payment of death claims, or afterwards in the payment of surrender values for Policies, or to meet any liability to guarantors, or to make any deposit to be made with any Government. Sixty per cent, of all sums paid under this section may be carried to the emergency or reserve fund. If within thirty days of each of the above named dates, on which the insured shall elect to pay, respec- tively, the payments herein provided for are not received at the head office of the Association, such non-payment shall be taken as conclusive proof that the party called the insured has decided to terminate his or her connection with this Asso- ciation, which connection shall thereu|x>n terminate, and this contract shall become null and void, and all rights thereunder shall lie forfeited to the .Asso- ciation. Should the mortality rxprrienced by the AsstKiation require any alteration of said rates in any call, due notice shall lie civen, according to the provisions contained herein, provided, however, that notice shall lie given when any portion of an assessment is for expenses. Any variation in excess of said rate may be taken from the emergency or reserve fund. If a note, draft or other obligation be given in payment of a premium or assessment hereunder, and the same be not fully paid when due, this Policy shall become and be null and void. - Notice of any mortuary payment, call, or other notice mailed to the post office address of the insured, as such address may appear on the Uooks of the Associa- tion, shall betaken to be a sufficient notice under this contract, and the affidavit of the officer whose duty it may he to give such notice, that a notice was so addressed and mailed, shall be taken as conclusive proof that such notice has been sent, and every one acquiring or claiming any interest hereunder is hereby estopped from deny- ing the sufficiency of said o flidavit to establish in any court the facts herein contained. —Provided that in the event of a claim arising under this contract owing to the death of the said party hereby insured, from any cause whatever, within one year from the date hereof, the amount of this Policy shall not become due or payable in one payment, but in lieu thereof the amount hereof shall be payable in live equal annual instalments, the first of such instalments to become due thirty days after proof satisfactory to the Hoard of Directors shall have lieen furnished by the claimant of a valid claim hereunder, and yearly thereafter until the whole sum shall have been paid. — No agent of the Association is authori/.ed to make, alter, or discharge contracts ; and any such act, in order to tie binding upon the Association, shall lie signed by the President and General Manager of the Association. It is hereby agreed that in any distribution of surplus the principles and methods which may be adopted by the Hoard of Directors for such distribution, and its determination of the amount equitably belonging to this Policy are hereby ratified and accepted by and for every person who shall have or claim any interest under this contract. * Iln COnSibCVntiOn »l' Htv ajiplimfinn for //ns /Win/, ami of tnirrrinnil lui the pari of l/ir insiind la acrcpt t/if rciitilations mid niiKlitinii.s a coitnidfrntion nf the paiiincnt of jnrmiiini ns per tnhic of r//frs npplinihlv /imio, /icrchii ''oiisritiitcn of 1 1 he II cf it sniisfnctorii proof Itos lur/i funiislml ill its lifinl ojjice of tlw ilciith of the i/isi di'iitli fund of tlir Sssorii/tio//, and out of mill monies realized for that purpose, t( Piiiinients shall he made upon this l*oliri/, anordinu to the said renrili tahle of rates on the havic hereof, da rind the jieriod of Jiftcen ijears from the date said peril d, the then oa-iier, or oirners, shall he entitled to a hond of the. .'issoriati irhich >%';all inrlade the e(jniralent of anil pro/itK then due on this Policy. On the sarrender of this I'olirn aiiile in force, on or after its third mm or ijire its hond for an ei/niralent aiiioant, paipihle apon the death of the insnret pa II meats heremider, after this Policu has heen tiro fall years in force. ."4 iiracc of thirtu days irill he a Hoard, fapsed policies may he reinst health from an accredited medical e.xaminer of the .Association, sahject to its api The Association Jvrthir ayrees forthuitli from time to time to male funds, to pay all ohlmatioiis created under this Policy, without deduction or alh In witness WbCVCOf the said :issociatinnhts hen and (ieneral Manager signed and dclirered this i day of '^ 'iir ////.v Pf the insured,— on this Policu. I or after its third anniversaru, the Association will pan its et/uitat/le cash ralur, fhe death of the insured. Diridends declared nunj l)e used toirards makiiHi future '/ears in force. policies maij he reinstated a-ithin six months bij furnishimi a certificate of ipiod uition, suljject to its approral and panini.i all arrears, irith six per cent interest. tivic to time to male assey^fncnts to an amount ade Hi z > d z d z 05 Age. 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 Sfi 36 37 38 39 40 41 43 43 44 45 46 47 48 49 50 51 52 5a 54 55 c r > z > z d z FIFTEEN YEARS' PAYMENT. The following Table of Rates pui $i,ooo includes the Expense Fund and the Emergency or Reserve Fund : Age. Quarterly. SemUAiinually. Aiiiiualty. 20 $6.50 $12.85 $25.2(» 21 (i.))5 J 3. 15 25.76 22 «.77 13.42 26.30 23 H.'.H 13.71i 26.90 24 7.10 14.01 27.50 25 7.23 14.30 28.05 26 7.35 14.58 28.57 27 7.50 14.87 29.15 28 7.65 15. IC 29.75 29 7.83 15.50 30.40 30 7.98 15.85 31.05 31 8.17 16.20 31.75 32 8.37 16.56 32.46 33 8.55 16.95 33.22 34 8.76 17.34 34.00 SS 8.96 17.75 34.80 36 9.20 lH.2!t 35.65 37 9.43 18.67 36.60 38 9.66 19.13 37.50 39 9.91 19.64 38.50 40 10.17 20.15 39.50 41 10.4r) 20.70 40.60 42 10.80 21.30 41.75 43 11.07 21.9-' 43.00 44 11.37 22.52 44.15 46 11.70 23.15 45.40 46 12.07 23.90 46.85 47 12.44 24.64 48.30 48 12.80 25.34 49.70 49 13.18 26.10 51.20 50 13.60 26.95 52.80 51 13.95 27.70 54.30 62 14.19 28.46 55.80 53 14.70 29.20 57.35 54 15.20 30.10 59.00 65 15.70 31.00 60.70 rD ~-i » ^ 5 = c « o n g^ 2 o^ Q, 2. 3 B 3 P 3 ^ =• s- < -1 "^ r^ (/> 3 r. S. ui a- r =. ^ o p o n r» ft 3 •% n - 3" 3 *V p •y. o IT 3 3 cr p p ^ .. .. ?. ^ p • "^ 3 ST " u" ~ " n "< ° ., " B _ n. '^ 9 S'.o '♦. n ^ ■^ P t n 1 3 a' 2 S '- 3 ^ ; ^ J3 3- >< a. S £. K a' 7' P 2 2. = 5- i? a- = or B. e. " =-5 = 2 " 3 o G. q S. s P !» 5' "23 5" O -■ !r p 3 o 3* ft "n " 5 O N 3 r o p °s. — 3' 2 o « £" E §■ S-'n p p 5!' .5' C n 3. re -. 3- g- " S 5 S § S .? 3 =■ -^ "1 u 3 ^ Z 3 !< 3- P D. re J- p re a. > - m o IS p « 3 = B 2, a < o 3 " 3- w i s. re ^ -■^ o re t/) P _— !£. •/. P O 3 3 3 « i^ 5' 3 3 S 3" =^ re re 2. 3 w -> B .-. 3- re S' a c/i 3 =^ S^ f* re >~ 3* v> P re c e 3 s a _. Q, 3- o- ? -. o re 2 S d. •^ O. e« en r. o o -> = a. s-l — -^ _ TO ■§ I re 3 a- o re p P < -. re re z z s re 3 3 3 S^ 3" o » o S re fT Q. 13 B P re '< p 5- S 5 s- ?■ " re re p REGULATIONS AND C lit. — Each applicant to become a benefit memlier of said Association must sign the Association's Form of Application therefor, filled out by the applicant or some one on his or her behalf, and Fpass a satisfactory examination by a duly licensed physician, who shall lie deemed the a| fact in regard imitted relatir^ id by reason of i^uch statement by the member XT shall die by sane or insane, ibour, the pro- f service (except serial or arctic lereon shall be payments have on thirty days' y any dividends r of the I'oiicy : years in force, the Association eive therefor in r the same, his have been fur- lim under this physician who nan and under- ich information iced within one of the insured time, and in the ict, in advance, the dale hereof Table of Kates i shall by special lie based on the current age of the member. Payment may lie made in advance in accordance with the annual, semi-annual or quarterly table, and when so made shall be applied to the renewal of this contract. The payments which shall be made hereunder, during the first year of the currency of this Policy, may (after providing for the emergency fund required by the Act of Incorporation, and after providing for this Policy's pro rata share of death claims occurring upon Policies becoming claims within a year of the date of issue) be used as a part of the expense fund, and after the said first year, four dollars per one thousand dollars insured of the monies so received shall be appropriated and used as a further part of the expense fund, and not exceeding one-tenth of one per cent, quarterly on the amount insured, and the balance after the first year shall be carried to an emergency fund. The emergency fund may be used for any or all of the following purposes,— namely, in the payment of death claims, or afterwards in the payment of surrender values for Policies, or to meet any liability to guarantors, or to make any deposit to be nade with any Government. Sixty per cent, of all sums paid under this section may be carried to the emergency or reserve fund. If within thirty days of each of the above named dates, on which the insured shall elect to pay, respec- tively, the payments herein provided for are not received at the head office of the- Association, such non-payment shall be taken as conclusive proof that the party called the injured has decided to terminate his or her connection with this Asso' ciation, which connection shall thereupon terminate, and this contract shall become null and void, and all rights thereunder shall lie forfeited to the Asso- ciation. Should the mortality experienced by the .\ssociation require any alteration of said rates in any call, due notice shall Ite i^iven, according to the provisions contained herein, provided, however, that notice shall lie given when any portion of an assessment is for expenses. Any variation in excess of said rate may l>e taken from the emergency or reserve fund. If a note, draft or other obligation be given in payment of a premium or assessment hereunder, anil the same 1>e not fully paid when due, this Policy shall become and be null and void. 8th.— Notice of any mortuary payment, call, or other notice mailed to the post office address of the insured, as such address may appear on the Hooks of the Associa- tion, shall be taken to be a sufficient notice under this contract, and the affidavit of the officer whose duty it may be to give such notice, that a notice was so addressed and mailed, shall be taken as conclusive proof that such notice has been sent, and every one acquiring or claiming any interest hereunder is hereby estopped from deny- ing the sufficiency of said affidavit to establish in any court the facts herein contained. 9th. — Provided »V.at in the event of a claim arisinp under this contract owing to the death of the said party hereby insured, from any cause whatever, within one year from the date hereof, the amount of this Policy shall not become due or payable in one payment, but in lieu thereof the amount hereof shall be payable in five equal annual instalments, the first of such instalments to become due thirty days after proof satisfactory to the Hoard of Directors shall have been furnished by the claimant of a valid claim hereunder, and yearly thereafter until the whole sum shall have been paid. loth.— No agent of the Association is authorized to make, alter, or discharge contracts ; and any such act, in order to be binding upon the Association, shall In; signed by the President and General Manager of the Association. nth. It is hereby agreed that in any distribution of surplus the principles and methods which maybe adopted by the Hoard of Directors for such distribution, and its determination of the amount equitably belonging to this I'oiicy are hereby ratified and accepted by and for every person who shall have or claim any interest under this contract. Ull COnSibCtcltiOn (,f the (ii>plinith„i f„r Uns Polifii, oin} of iii.inciiH'/il 0/1 the part of the. i/isiircd to aircpt the rajulatioiis and conditions o consideration of the pai/inenf of premium as per tal>le of rates aj)j>lica/)le hereto, herel>ti constitutes of a henejit satisfactorii proof has been furnished at its head ofjice of the death of the ins/ death fund //• 1/iis Policii, M z > z d z ? H z Hfe FIFTEEN YEAR SAVINGS BANK POLICY. Table of Rates per $1,000 from which payments shall be made: Age. Quarterly. Semi. Annually. Annuallv. 2:{ $11.16 $22.70 $44.50 24 11.48 22.75 44.60 25 11.51 22.80 44.70 26 11.55 22.85 44.80 27 11.58 22.90 44.90 28 11.62 22.95 45.00 29 11.65 23.03 45.15 30 11.67 23.10 45.34 31 11.70 23.18 45.45 32 11.74 23.25 45.60 33 11.80 23.35 45.80 M 11.86 23.45 46.00 35 11.92 23.r)li 46.20 36 12.00 23.67 46.40 3-7 12.08 23.80 46.60 38 12.15 23.95 46.85 39 12.22 24.10 47.15 40 12.29 24.23 47.45 41 12.32 24.3J 47.70 42 12.3(i 24 47 48.00 43 12.40 24.53 48.30 44 12.46 24.72 48.65 45 12.53 24.05 49.00 46 12.67 25.20 49.40 47 12.83 26.43 49.85 48 12.95 25.65 50.30 49 13.08 25.90 50.80 60 13.20 26.15 51.30 51 13.35 26.43 51.85 52 13.50 26.75 52.45 53 13.67 27.10 53.10 54 13.84 27.40 53.75 55 14.02 27.78 54.45 s ^ B S H — n o tz o _ s a e F* n S31 2.1 3 n ir n s =- f* (a sr g- r*_ P f —^ (J 6 |g 3 S 3 >:: 3 b: » 3 3> a 2 S « S 12 3- 3> B S =r 3 3 — s » — sr 3 3 < o- 2 B ■ 3 ■ sr 2 <» 3 o, ««! P S n " f 3 =• ■^^ 2. s 31 3* n u O. § =• O. § 3 a. en a p -> 3 *^ Q. o 3 p a. I, o n B o ,. £, P 3" n a. ><: -^ 2. W E. = ? S 2, rt r 75 -C n a ? ft " o s 3 ,♦ u:' O- 3- O n » O n 3 S a" n n O J* c- S § >?' 3 a- p i' ^ S. n ^ (/I S S- 3- i ^3 3 3 •S' g. S ^ g. « g 2 <» 3" » = o a. rt n> s- 2, =■ 3 5- a- ^ o ^ o --< 5- c fV X 3 O Q. § ^ f 3- 3 P ^ n. TO „ n *B p 3 2 3'* o a. = B 3- g p p 3 rii?: 15 s- ^ op)'— _. a o " B 3 S f? ^ 5. a- g ft 3* >< 3 s 3 § = 3 fif § s. :. I =-' " 5- >»■ J! " (X E. ts £■ p 2 3. c S g- o o -> 3 §■-=-. 2. nna -i ■!! l-i O "> B ft S> " 7 B _ =: 3" 3. o 3 ^ S: 9. p g" "5 rt 3. § 3 s s- " o p* 3 3 p 3 a. n ^ ■ Sr " {/I r» E' o 3 O. (C 3 3 =r a- o ^ (/I P 3> REGULATIONS AND C< Itt. — Each applicant to )>ecoine a benefit member of said Association must sign the Association's Form of Applicatmn therefor, filled out by the applicant or some one on his or her behalf, and pass a satisfactory examination by a duly licenced physician, who shall 1>e deemed the agent of applicant. A I'olicy if issued shall not lie in force until the first payment thereon, as per table of graduated payments printed hereon, shall have lieen paid tu the Association duiing the good health of the memljer, and this Policy delivered during such memlifr's life time No agent of the Association is authorized to make or alter any such Appiicniion, and in doing any such act he is to lie considered the agent of the applicant. a«d.— The statements and declarations made by or on behalf of said memlxr, in order to liecome a tenefit member of said Association, are ihe basis of said contract, and form .i part hereof, on the faith of which this I'olicy is issued, and every renewal hereof is made ; they are warranted true, and that no (act in regard to the health, habits or conditions of such memlier has been omitted relating to the warrantees : provided that the Policy shall not be void by reason of any statement in the Application thereof not being true, unless such statement is material in the contra-t, and that any warrantees made hereon by the member shall lie subject to the qualification implied in this provision. 3rd.— If within t'.vo years from the date of this Policy the said memlier shall die by any act of self-destruction whatever, \ hether such member be sane or insane, or engage as an occupation in blast' .g, mining, submarine labour, the pro- duction of any highly explosive material, or in naval or military service (except in the militia or volunteer coi'ps of Canada), or engage in serial or arctic voyages, this Policy shall be void, and all payments made hereon shall be forfeited to the Association. 4th. — The insured may, at any time after this Policy shall have been five years in force, provided the insured shall have given thirty days' notice to the .\ssociation while this Policy is in full force, surrender the same, and receive therefor in cash, in full settlement of all liability of the Association under the same, his or her equitable share of the emergency or reserve fund. 5th — TTie death claim shall be payable in sixty days after there shall have been fur- nished satisfactory proof to said Association of a valid claim under this contract. Such proof shall comprise a sworn statement of the physician who attended the insured in his or her last illness, claimant, clergyman and under- taker, on the blanks furnished by the Association, and any such information as the said Association may require. «iir i.ijiicfc No suit shall be valid under this contract unless commenced within one, year from the date of the death of the insured. 6th.^This contract is a quarterly term insurance, renewable at the option of the insureecial e based on the in accordance hall he applied ule heieunder, during the first year of the currency of this Policy, may (after providing for the emergency fund required by the Act of Incorporation, and after providing for this Policy's pro rata share of reniiuin or as>essnient hereunder, and the same !« not fully paid when due, this I'olicy shall b.eome anil lie null and void. yth.-- Notice ol any mortuary payment, call, or other notice mailed to the post office address of the insuied, as Mich address may appear on the liooks of the Associa- tion, shall be taken to be a sufficient notice under this contract, and the affidavit of the officer whose duty it may lie to give such notice, that a notice was so addressed .ind mailed, shall l>e taken as conclusive proof that such notice has lx:tn sent, and everyone acquiring or claiming any iiiteiest hereunder is hereby estopped from deny- ing the sufficiency of said affidavit to establish in any court the facts herein cont.iined. 8th. — Provided that in the event of a claim arising under this contract owing to the ileath of the said party hereby insuied, from any cause whatever, within one year from the date hereof, the amount of this Policy shall not become due or payable in one payment, but in lieu thereof the amount hereof shall be payable in five equal annual instalments, the first of such instalments to liecome due thirty days after _.^ proof satisfactory to the Hoard of Directors shall have l,een furnished by the claimant of a valid claim liereunder, and yearly thereafter until the whole sum shall have been paid. gth. — No agent of the Association is authorized to make, alter, or discharge contracts; and any such act, in order to be binding upon the .Association, shall be signed by the President and (u-neral Manager of the Association. loth. It is hereby agreed that in any distribution of surplus the principles and methods which may lie .idopted by the Hoard of Directors for sucli distribution, and its determination of the amount eijuitably belonging to this I'olicy are hereby ratified and accepted by and for every jierson who shall have or claim any interest under this contract, and that the profits or surplus shall be distributed hereunder, only to those who survive the term for which this I'olicy is issued, and then only if this I'olicy be then in force. * Iln COnSibCt^tiOll of thv appUnitioi, for ///is Polini, and of 1 ii{/reement on the part of the in.surcd to acrrjtl the miulationa and conditions uh consideration of the. pai/ment of preminm as per taljle of rates apj)lica/Ue hereto, hereby constitutes of a benefit i satisfactory proof lias Ijccn furnished at its head of]ice of the death of the insu death fund of the .Association, and out of ami monies realized for that purpose, to I* AAA* A**AAA««******«***< ♦»▼*»»¥▼»¥¥•••▼•••»*»▼»▼••»▼*•"•*••*■ "a^^ ■■•TWW*****' 7'his Po/icy s?iaU be renetralAe duriuu the period of fifteen years from < table of rates printed hereon in conformity irith said rei/ulations and conditions. .V/ the end of fifteen years from the date hereof, if this Policy be then i/. amount standinij to the credit of this Policy, estimated to be its full face ralue. In case the fund to the credit of this Policy slum Id amount to its full fay to the addition of profits, the same shall thereupon become payable upon request < .'4 i/race of thirty days /rill be allowed, fapsed policies may be reinstii health from an accredited medical examiner of the .dissociation, subject to its app The Association further agrees fcrthuHh from time to time to make < funds, to pay all obligations created under this Policy, uithout deduction or abi 111! witness VVbCVCOf the said.-issodation has here and General Afanai/er signed and delirered this d day of ^ //• i/iis Pdliru, and of Ihr ^statntiaits and afimiaciits /lerriit co/ilaincd, and of t/te f/on.s and rondition.s un tltr hack- hereof as a pari of litis contract, and the farther Dollars, that ainoant beinu the vonstitutes a benefit member of said Association, and agrees, in sixtu dans after f the death of the insured durinu the continuance of this l^oUcjj, to pan oat of the zed for that purpose, to Executors, ."idministrators or ."^ssiz/ns, the sum of ^. ^**A«*«**A*A**«A««*AA««A*««A**A*«< »»▼»•*»•»•••■ "Cl^ of fifteen //ears from the date hereof, upon pui/ment of the premiums as per the 'ations and conditions. f this Polic// be then in force, the insured shall be entitled to withdraw the whole be its full face ralue. d amount to its full face ralue before the end of said period of p'fteen ip-ars, owim.i paijable upon re(juest of the partu entitled thereto. fiolicies man be reinstated within six months bn furnishinn a certificate of (piod 'It ion, subject to its approral and paninu all arrears, with six per cent interest. time to time to male assessments to an amount adequate with its other available 'ithout deduction or abatement. id. 'Association has hereunto ajjixed its Corporate Seal, and bn its led and delivered this contract, at the dtp of.Uontreaf this .i.D. 189 President * -■•3 u O ^-i 3 a .0 C c o ^ ^ Cfq ri :i."B 1 p - =. 5' 3 2 rt C- r* £.r 3- '< C ft = 3) rt .< =• = 5 n rr S; f ' -r f^ c - S » r ^ £i- =r '^ 3 s O 175 fT a n. * (/> rr =r p if s- a. - p £ §■ I S * rt - ST t/i S- e 2 i* 5- 3 « f» = r s 5 awe 3 C » y : n " "3 :i, — >r S' 3) 3 a. =• _. p 3 « r;:s ft cr; ?| " .^ -3 3 P - E - ^ 2. 5" 2. 2 ?§ 3 3 3 n " |.P 3 2, '^' a. a. P !-► 3 5 3 3 3 « < p (^ .5 p p ^ 3 a. o < = O 3 p o 3 3 •to ff. O sr ■£ 2. « 5. 2 -^^ » a- 2 ■• " 5. 5' r. ^ 3^ -^ ST « 1 S- n O 3 P T3 -. !/> ^3 •n ff 3 r» o 3 a. 3- = 3 3 S, - p =r 2 s s P o (O 3 5 I 2. 3 3 2 o -c 3 ~ B. -^ o 5 S B 3 a- n p •: 3 a. " o ^ c f^ r; c '/) ;j Z- ^ ^ p ■s. -^ — - < t? 2. •-< a. a 2 a Sop 3" a. '■" =- c c p, 3 5 < •? n =• ;. ? a 2 " S — « =. X a. s o ^ s. i- -5 o5 oS 5 < « 2. 3 If. g ^ ^ ?* C rt rt f^ 3 -r £, o rr. IT, sr ^ o — n (T o ■< a- r> n 2 Zi. c " •" t; 17 n 3* n S — =r p o =• M 3 B 5 " O ^ "" ft 3 C 2. i? 5 i n -t 5' p 3- ;; a. t g 3 r n 3 S £. - p 3 ^ -1 • 3 IS C rt "^ "^ 3-7 6 s- E P r a. Q. C p o r» » "T p ^ >< r " i s a, »• S. _ P 3 5 2, |:a.r>2-S S"? .5 3" ■^ w 61 o S !5 P — _ 3" — — (t ■•^ •< 3 » a. o ^ , — ^ ft r £.-s * ^ J? B , 3* « P ; ft "1 . — 3 ^ ^ a- 3- s 2 §! t o ft p r^ 5 = P n ? ^ 2 6 1 P '-^ r» — 2 ft a ? a. ft S C5 * -> = 2 *.. » •^ rt ■- < (I 3 =^ '- i 3 =^ 3 * O P -^ 3 < p S P =^ =. u ft O 5- 3 11? o tf 2 o s 5 E. a. 3 ft c-- P « -n 3 p n a. ft p 3 fi a. a. l^ ft ^ 2 S p Q. 3 < — O „ a; =• «- . ft ^ 3 = 3- r, < 5 S c 5 — [/. s p. ^ ft r* « - ?L " =; p t'^ s. - I- ?. 3- Q -• I/l ft " -, o t > -; -» « « p « T! 3 a. ft - ~ g 3- C 3 S a. ;i, ^ 2 rt ft a ■? I' "< — 3 e - 2 5- B "■• S « -1 ft 3" a '£. " 2 rt » "* '^ ? a- c 3 3- ^ I " i s !, ? a. H ora » S 2. ^ a 5- ^ ST 2.1 I g ^ i 3 ^ E. " tf •* -.. -* " " 3 « ^ ft a. i^ S o ft ^ T3 ^ P (I •n ft p < % y S'ST? 2 = a. 5- o 5 X ft "5 Q- 2 5 rr ft a- 5^ s o B "1 S "" ft s ? '^ - — p p ft ^ m^ 3 o s- 2. a. g g: 5- S M z > z z z 5B 57 58 59 60 ■ ALL LIFE PLAN, WITH PROFITS. Table of Rates per $i ooo upon which payment shall be nnade. Af. Qutirtarly. Hi'iiii-.Kiiiiuin.v, AniiUHUy. 20 1 3.53 $ 7.ni 113.75 -M 3.55 7.04 13.8(1 22 3.57 7.09 13.90 23 3.60 7.14 14.00 24 3.65 7.21 14.15 2S 3.68 7.29 14.30 26 3.73 7.40 14.50 27 3.78 7.51) 14.70 28 3.85 7.61 14.95 29 3.91 7.75 15.20 30 3.99 7.91 15.50 31 4.07 8.06 15.80 32 4.15 8.23 16.15 33 4.26 8.44 16.55 34 4.37 8.64 16.95 35 4.49 8.89 17.45 3H 4.64 9.18 . 18.00 37 4.79 9.49 18.60 38 4.96 9.84 19.30 3 g s I rt -1 - i. 3 r- o' " a Xi a = s n •< It 3 3 C 3 31_ 1 O 3 a. " 3 I5 B B 2. 3 5 - 3" D. — n ir. O. g E. 2 "O = 3 3 1 3 « IT */. " - :? X "t i = s - S. c. 3- - n •> " - I _ o 3' - <" s " 9 3 H s. 3 S 3 ? S " a- ^ " rt 15, -J » =: 21 So-"' c •-« o o ^ "^ O 3 5" '^ 5- =■ - i -n 3 ™ o O t e t- y n re a 3' £, a. 5- o n 3 2 ■-I ^ S r o* t> a n Z. h' 3- -* cu i s. 2 o* 1? tft o 3 :s 3- C V) 3- P x> p o- o 3 "2. . 5' TO p ^ 3 3- X n » O !? ■0 o' p ■1 n a* -" 3- Wl " ll. _ B 3. (T cr '^ a » " B ^ ^ = ^ 5 S. Ob 3 rti o C s 8 r I. a 2.? §■ ^ B a- g =• ^H 3 3:g- I' 8 g. S« r» '^ p t> » tf) ''■ s * ■/) '^ o jS 9 2. - 3 p li. o a t "^ "^ 55 '3- I 3 " i B § =•1* •* r* 1-1 m. ■ g ? = ° " a. p ? p «S 3 3- g. p H " D- - > ■» *. ft S 2_ P 3 So- IT ^ B ST p p e -■ °S 2: 5. c o i^ 2- 3 &•: S. FA £A ^ 3 S S- i 2. n r s. > * o » P 3 S '^ W) TI p 1 3 3 p_ b' 8 S n ■7* p p P 3 E 3' t/} w n ? P ? p_ 3 3 3 < O* TI P J B EI P- 3 P 31 n B 3- 3* iiS 1 s ■*» 3 a. B n s- ta- rt p 2 5' 3 B rt n •< p 3 E g 3" r* -** p C O o -" => a. Eg- 2. o TO 3 3 *♦ rt 3 fi. o a- w 3- n p p < 3* rt " fT 3 B B" 3. rt (/I 3- a. s-i- 5 2. •-« s o. a> p < -! rt ? e rt p REGULATIONS AND CO) lit.— Each applicant to liccome a benefit member of taid Auocialion mutt sign the Axcociatiun't Form of Application therefor, filled out by the applicont or tome one on hi* or her behalf, and 'pas* a satisfactory examination by a duly lirenred physician, who shall lie deemed the agent of applicant. A I'olicy if issued shall not he in force until the first pnyment thereon, as |)er table of graduated payments printed hereon, shall have been paid to the Association duiing the good health of the member, and this Policy delivered during such memlier's life time. No agent of the Association is authorized to make or alter any such Application, and in doini; any such act he is to !« considered the ngent of the applicant. sad. — The statements and declarations made by or on behnlf of said memWr, in order to become a benefit member of said Association, are the basis of said contiact, and form a jiart hereof, on the faith of which this Policy is issued, niul every renewal hereof is made ; they are warranted true, and that no (act in regard to the health, habits or conditions of such member has been omitted relating to the warrantees : provided that the Policy shall not be void by reason of any statement in the Application thereof not being true, unless such statement is material in the contract, and that any warrantees made hereon by the member shall \x subject to the qualification implied in this provision. 3nL— If within two years from the date of this Policy the said member shall die by any act of self-destruction whatever, whether such meml)er be sane or insane, or engage as an occupation in blasting, mining, submarine labour, the pro- duction of any highly explosive material, or in naval or military service (except in the militia or volunteer corps of Can. da), or engage in aerial or arctic voyages, this Policy shall be void, nnd all payments made hereon shall be forfeited to the Association. 4th. — After two years from the date of this Policy, if three full years' payments have been made upon it, the insured may, by giving the Association thirty days' notice, while this Policy is in force, of a desire to do so, apply any dividends which shall have been declared by the Association in favour of the Policy towards making future payments. 5th. — llie insured may, at any time after this Policy shall have been three years in force, provided the insured shall have given thirty days' notice to th.> Association while this Policy is in full force, surrender the same, and receive therefor in cash, in full settlement of all liability of the Association under the same, his or her equitable share of the emergency or reserve fund. 6th — The death claim shall be payable in sixty days after there shall have been fur- nished satisfactory proof to said As.sociation of a valid claim under this contract. Such proof shall comprise a sworn statement of the physician who attended the insured in his or her last illness, claimant, clergyman and under- taker, on the blanks furnished by the Association, and any such information as the said Association may require. No suit shall be valid under this contract unless commenced within one year from the date of the death of the insured. 7th. — This contract is a quarterly term insurance, renewable at the option of the insured before e.\piration, upon payment of the premiums and dues, at the time, and in the manner herein provided. The insured shall pay under this contract, in advance, at the head office of the Association, quarterly, reckoned from the date hereof during each and every year, respectively, the sum sjiecified in the Table of Rates printed on the back hereof for his age at entry, unless the Directors shall by special notice require a different amount, and in such case tlie call may be based on the curreni with th to the during emerge Policy' within the sail receive and ito and th( emergi in the values to be I sectior r f eac: lively, Assoc! called ciation liecoro ciation alterat provisi any p. rate m obliga same I -Notice o addres tion, ! the of and IT every ing th 9th.— Providet of th( the di one p annu: proof claim shall loth. — No agf and a the P It is he wlilcl deter and ; this - 8th. nth. >NS AND CONDITIONS. It lign the nt or kome ily licenred Mued thai I [I paytnenU )(l health of time. No ipplication, icnin. r, in order id contiact, niul every in regard ted relating reason of h statement the member shall die by t or insane, X, the pro- vice (except >l or arctic on shall be j^ments have thirty days' ny dividends if the Policy ears in force, Association i therefor in he same, his re been fur- I under this lysician who 1 and iinder- information i within one r the insured oe, and in the , in advance, ; date hereof ible of Rates all by special baser l/ils PoUvn, iiml i,f miri'vinviit on the }>iirt of the. iii.si/red to accept the refiulatioiis a ml voiiilltioiis i consideratio/i of the paijme/it of piriniiim as per table of rates applicaltle hereto, herelni co/istittites of a benefit sat is/actor II proof has been famished at its head office of the death of the ins death fund of the dissociation, and out of ani/ monies realized for that purpose, t * ft *«A A A AAA ******* AAA AAA**** A. ...™._i#2_.. •••i »»»*••»»' On the surrender of this Polici/ while in force, on or after its third anni Diridends declared man ^^f- used towards niakini) future patjments hereunder, aft When the insured shall reach his or her life-expectancn, if this Policu sh notice to the J^ssociation, while this Folic// is in force, of his or her intention to the full amount of the cvitrnencn or reserve standing to the credit of this Poll thereto, as determined bii the :>lssociation. ' ' ?l {/race of thirtjj days will he allowed. Lapsed policies man be reinsti health from an accredited medical examiner of the :issociation, subject to its app The Association further agrees forthwith frcmi time to time to male < funds, to pay all obligations created under this Policy, uithout deduction or ah lln \VitllC68 WbCtCOf the said ^ssodationhm here and General Afanayer signed and delivered t?iis a day of ,i.. ''w 1/iis Polivii, and of llic statc7iievts and atjirfincnts herein contained, and of the at ions and ro/iditions on the liaek hereof as a jtart of this enntrart, and the further Dollars, that amount beinij the constitutes a benefit iiieniher of said Association, and ai/rees, in sixtj/ dai/s after of the deatn of the insured during the continuance of this Put icy, to /mil out of the ized for that purpose, to Executors, ."id uiinist rotors or .'■Issif/zis, the sum of _5#l... '»••▼»»»*' r-^ ' or after its third annirersarij, t/ie .'dissociation will pan its equitable cash ralue. Hjuients hereunder, after this Policy has been two full years in force. tancy, if this Policy shall then be in force, the insured may, by (jiring thirty days' his or her intention to do so, surrender this Policy, and receire therefor, in cash, the credit of this Policy, toijether with the equitable proportion of all accretions i/olicies may he reinstated within six months by furnishiny a certificate of (ioomciits to an amount adequate with its other availoble ithout deduction or abatement. d Association has hereunto aj)i.xed its Corporate Seal, and by its frf and delivered this contract, at the i^ity of .\fontreal, this A.D. /.S'.9 President 3- ft ■J " T.r: .t ? •f f .^ re S » E. ? 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