Exhibit 99. A(5)

LIVES INSURED JOHN M. DOE
MARY C. DOE

POLICY NUMBER 12 345 678

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FLEXIBLE PREMIUM SURVIVORSHIP VARIABLE LIFE INSURANCE POLICY.
PAYABLE ON DEATH OF THE LAST-TO-DIE OF THE LIVES INSURED.
ADJUSTABLE DEATH BENEFIT.
FLEXIBLE PREMIUMS PAYABLE TO THE MATURITY DATE OR UNTIL LAST DEATH, IF EARLIER.

CASH SURRENDER VALUES AND BENEFITS FOR A PORTION OF THE POLICY VALUES ALLOCATED
TO AN INVESTMENT ACCOUNT REFLECT THE INVESTMENT EXPERIENCE OF THE UNDERLYING
SUB-ACCOUNTS. INVESTMENT OPTIONS ARE DESCRIBED IN THE "POLICY VALUE COMPOSITION"
AND THE "INVESTMENT OPTIONS" PROVISIONS. NON-PARTICIPATING (NOT ELIGIBLE FOR
DIVIDENDS).
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In this policy "you" and "your" refer to the owner(s) of the policy. "We", "us"
and "our" refer to The Manufacturers Life Insurance Company of New York.

If at least one of the Lives Insured is living on the Maturity Date, we will pay
you the Net Cash Surrender Value of the policy.

If all of the Lives Insured die while the policy is in force, on the last death
we will pay the Insurance Benefit to the beneficiary, subject to the provisions
of the policy. The Lives Insured and the beneficiary are named in the Policy
Information section of this policy and in the application for this policy, a
copy of which is attached to this policy. The death benefit is described in the
"Insurance Benefit" provision.

The Insurance Benefit is payable following the death of the last-to-die of the
Lives Insured. However, you must give us proof of each death as soon as it
occurs. Proof of death for all the Lives Insured is important for us to
accurately determine benefits under the policy.

YOUR NET PREMIUMS ARE ADDED TO YOUR POLICY VALUE. YOU MAY ALLOCATE THEM TO ONE
OR MORE OF THE INVESTMENT ACCOUNTS AND TO THE FIXED ACCOUNT.

THE PORTION OF YOUR POLICY VALUE THAT IS IN AN INVESTMENT ACCOUNT WILL VARY FROM
DAY TO DAY. THE AMOUNT IS NOT GUARANTEED; IT MAY INCREASE OR DECREASE, DEPENDING
ON THE INVESTMENT EXPERIENCE OF THE UNDERLYING SUB-ACCOUNTS FOR THE INVESTMENT
ACCOUNTS THAT YOU HAVE CHOSEN.

THE PORTION OF YOUR POLICY VALUE THAT IS IN THE FIXED ACCOUNT WILL ACCUMULATE,
AFTER DEDUCTIONS, AT RATES OF INTEREST WE DETERMINE. SUCH RATES WILL NOT BE LESS
THAN AN EFFECTIVE ANNUAL RATE OF 4%.

THE AMOUNT OF THE INSURANCE BENEFIT, OR THE DURATION OF THE INSURANCE COVERAGE,
OR BOTH, MAY BE VARIABLE OR FIXED UNDER SPECIFIED CONDITIONS AND MAY INCREASE OR
DECREASE AS DESCRIBED IN THE "INSURANCE BENEFIT" PROVISION.

READ YOUR POLICY CAREFULLY. IT IS A CONTRACT BETWEEN YOU AND US.

RIGHT TO RETURN POLICY. WITHIN EITHER (1) TEN DAYS AFTER RECEIVING YOUR POLICY
IF IT DOES NOT REPLACE ANOTHER POLICY; OR (2) SIXTY DAYS IF IT REPLACES AN
EXISTING POLICY, YOU CAN RETURN IT FOR CANCELLATION BY DELIVERING OR MAILING IT
TO US OR THE AGENT WHO SOLD IT. IMMEDIATELY UPON DELIVERY OR MAILING, THE POLICY
WILL BE VOID FROM THE BEGINNING. WE WILL REFUND IN FULL THE PREMIUM PAID.

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THE MANUFACTURERS LIFE INSURANCE COMPANY OF NEW YORK
Home Office: 100 Summit Lake Drive, 2nd Floor, Valhalla, NY 10595

/s/ James W. Gallagher /s/ Tracy A. Kane [MANULIFE NEW YORK LOGO]
President Secretary

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TABLE OF CONTENTS

PAGE

Policy Information.......................................................3
Table Of Guaranteed Maximum Cost Of Insurance Rates......................4
Definitions..............................................................5
Payment Of Premiums......................................................6
No-Lapse Guarantee.......................................................7
Policy Termination.......................................................7
Reinstatement............................................................8
Maturity Benefit.........................................................8
Insurance Benefit........................................................9
Policy Value............................................................10
Policy Value Composition................................................11
Separate Account And Sub-Accounts.......................................12
Investment Options......................................................13
Policy Loan Conditions..................................................14
Changing The Death Benefit Option Or The Face Amount....................16
Surrender And Withdrawals...............................................17
Conversion Privilege....................................................19
Right To Postpone Payment Of Benefits...................................19
Right To Cancel Increases...............................................19
Suicide.................................................................20
Beneficiary.............................................................20
Ownership And Assignment................................................20
Protection Against Creditors............................................21
Currency And Place Of Payment...........................................21
Contract................................................................21
Validity................................................................21
Non-Participating.......................................................21
Age And Sex.............................................................22
Flexible Factors........................................................22
How Values Are Computed.................................................22
Annual Statement........................................................22
Tax Considerations......................................................22

Any endorsements, any supplementary benefits, and a copy of the application,
follow page 22.

Page 2

POLICY INFORMATION

LIVES INSURED NO. 1 - JOHN M. DOE AGE AT POLICY DATE: 35
NO. 2 - MARY C. DOE AGE AT POLICY DATE: 35

POLICY NUMBER 12 345 678 POLICY DATE: JAN 1, 1999
ISSUE DATE: FEB 1, 1999
MATURITY DATE: JAN 1, 2064

OWNER JOHN M. DOE AND MARY C. DOE, JOINTLY IF LIVING,
OTHERWISE THE SURVIVOR

BENEFICIARY AS DESIGNATED IN THE APPLICATION OR SUBSEQUENTLY CHANGED

PREMIUM MODE ANNUALLY

BEGINNING ON
MON DAY YEAR PLANNED PREMIUM
JAN 01 1999 $800.00

LIFE INSURANCE COVERAGE MAY EXPIRE PRIOR TO THE MATURITY DATE IF PREMIUMS PAID
ARE INSUFFICIENT TO CONTINUE COVERAGE TO SUCH DATE.

KEEPING THE POLICY AND COVERAGE IN FORCE WILL BE AFFECTED BY FACTORS SUCH AS:
CHANGES IN THE CURRENT COST OF INSURANCE RATES; THE AMOUNT, TIMING AND FREQUENCY
OF PREMIUM PAYMENTS; THE INTEREST RATE BEING CREDITED TO THE FIXED ACCOUNT; THE
INVESTMENT EXPERIENCE OF THE SUB-ACCOUNTS; CHANGES TO THE DEATH BENEFIT OPTION;
CHANGES IN THE FACE AMOUNT; LOAN ACTIVITY; PARTIAL WITHDRAWALS; AND DEDUCTIONS
FOR ANY ATTACHED RIDERS. ALSO REFER TO THE POLICY TERMINATION PROVISION OF YOUR
POLICY.

SUBJECT TO THE GUARANTEES OF THIS POLICY, WE RESERVE THE RIGHT TO CHANGE THE
CURRENT COST OF INSURANCE RATE DEDUCTIONS AND THE CURRENT INTEREST RATE BEING
CREDITED TO THE FIXED ACCOUNT. THESE CHANGES MAY REQUIRE MORE PREMIUM TO BE PAID
THAN THE PLANNED PREMIUM SHOWN, OR CAUSE THE CASH VALUE TO BE LESS THAN WAS
ILLUSTRATED.

PLAN DETAILS, RISK CLASSIFICATION AND ADDITIONAL RATING ARE SHOWN ON THE NEXT
PAGE.

PAGE 3.0A

POLICY INFORMATION (CONTINUED) - POLICY 12 345 678

LIVES INSURED NO. 1 - JOHN M. DOE
NO. 2 - MARY C. DOE

POLICY NUMBER 12 345 678

PLAN FLEXIBLE PREMIUM SURVIVORSHIP VARIABLE LIFE INSURANCE
PAYABLE ON DEATH OF THE LAST-TO-DIE OF THE LIVES INSURED
NON-PARTICIPATING

FACE AMOUNT $250,000.00

DEATH BENEFIT OPTION 1

SEX NO. 1 - MALE
NO. 2 - FEMALE

RISK
CLASSIFICATION NO. 1 - NON-SMOKER,STANDARD CLASS
NO. 2 - NON-SMOKER,STANDARD CLASS

ADDITIONAL
RATING NO. 1 - NOT APPLICABLE
NO. 2 - NOT APPLICABLE

PAGE 3.0B

POLICY INFORMATION (CONTINUED) - POLICY 12 345 678

TABLE OF CHARGES

PREMIUM LOAD:

A CHARGE NOT TO EXCEED 15.0% OF EACH PREMIUM PAID IN THE FIRST TEN POLICY
YEARS.

MONTHLY ADMINISTRATION CHARGE:

A CHARGE NOT TO EXCEED $0.175 FOR EACH $1,000 OF FACE AMOUNT IN THE FIRST
POLICY YEAR.

MORTALITY AND EXPENSE RISKS CHARGE:

A CHARGE NOT TO EXCEED 0.100% IS DEDUCTED MONTHLY FROM EACH INVESTMENT
ACCOUNT VALUE FOR 15 POLICY YEARS AND THEN REDUCES TO 0.025% THEREAFTER.
THIS REDUCTION IN THE CHARGE IS GUARANTEED.

MONTHLY COST OF INSURANCE CHARGE:

SEE THE MONTHLY DEDUCTIONS SECTION OF THE POLICY VALUE PROVISION FOR
DETAILS. THE COST OF ANY SUPPLEMENTARY BENEFIT IS DESCRIBED IN THE
SUPPLEMENTARY BENEFIT PAGE ATTACHED TO THIS POLICY.

PAGE 3.1A

POLICY INFORMATION (CONTINUED) - POLICY 12 345 678

TABLE OF CHARGES (CONTINUED)

SURRENDER CHARGE:

A SURRENDER CHARGE WILL BE DEDUCTED FROM YOUR POLICY VALUE UNDER CERTAIN
CONDITIONS AND WILL REDUCE OVER TIME ACCORDING TO THE GRADING PERCENTAGES SHOWN
IN THE TABLE BELOW. A PRO-RATA SURRENDER CHARGE WILL BE DEDUCTED FOR PARTIAL NET
CASH SURRENDER VALUE WITHDRAWALS IN EXCESS OF THE WITHDRAWAL TIER AMOUNT. SEE
THE POLICY VALUE, CHANGING THE DEATH BENEFIT OPTION OR FACE AMOUNT, SURRENDER
AND WITHDRAWALS PROVISIONS FOR DETAILS.

THE SURRENDER CHARGE IS DETERMINED AS FOLLOWS:

FOR THE INITIAL FACE AMOUNT:

(I) $8.50 MULTIPLIED BY EACH $1,000 OF FACE AMOUNT; PLUS

(II) 82.5% OF THE SURRENDER CHARGE PREMIUM LIMIT SHOWN ON PAGE 3.2.

FOR AN INCREASE IN FACE AMOUNT:

(I) $8.50 MULTIPLIED BY EACH $1,000 OF FACE AMOUNT INCREASE; PLUS

(II) 82.5% OF THE SURRENDER CHARGE PREMIUM LIMIT FOR THE INCREASE.

TABLE OF GRADING PERCENTAGES DURING THE SURRENDER CHARGE PERIOD (APPLIES
TO THE INITIAL FACE AMOUNT AND SEPARATELY TO EACH SUBSEQUENT FACE AMOUNT
INCREASE)

*SURRENDER CHARGE ** AGE AND GRADING PERCENTAGE
PERIOD 0-75 76 77 78 79 80+
- ----------------- ---- ---- ---- ---- ---- ----

1 93% 92% 92% 91% 90% 90%
2 86% 85% 84% 83% 81% 80%
3 80% 78% 76% 75% 72% 70%
4 73% 71% 69% 66% 63% 60%
5 66% 64% 61% 58% 54% 50%
6 60% 57% 53% 50% 45% 40%
7 53% 50% 46% 41% 36% 30%
8 46% 42% 38% 33% 27% 20%
9 40% 35% 30% 25% 18% 10%
10 33% 28% 23% 16% 9% 0%
11 26% 21% 15% 8% 0%
12 20% 14% 7% 0%
13 13% 7% 0%
14 6% 0%
15 0%

* PERIODS SHOWN ARE AFTER END OF POLICY YEAR.

** AGE FOR THE INITIAL FACE AMOUNT REFERS TO THE ISSUE AGE OF THE
YOUNGEST OF THE LIVES INSURED UNDER THIS POLICY AT ISSUE; OR
FOR A SUBSEQUENT FACE AMOUNT INCREASE, AGE REFERS TO THE
ATTAINED AGE OF THE YOUNGEST OF THE LIVES INSURED AT THE TIME
OF THE INCREASE.

PAGE 3.1B

POLICY INFORMATION (CONTINUED) - POLICY 12 345 678

TABLE OF VALUES

REFER TO YOUR POLICY PROVISIONS FOR DETAILS ON THE TERMS AND VALUES SHOWN IN
THIS TABLE.

SURRENDER CHARGE PREMIUM LIMIT $750.00

ANNUAL NO-LAPSE GUARANTEE PREMIUM $750.00

NO-LAPSE GUARANTEE PERIOD FIRST 20 POLICY
YEARS

GUIDELINE SINGLE PREMIUM $21,979.00

GUIDELINE LEVEL PREMIUM $2,145.25

MINIMUM FACE AMOUNT $250,000.00

MINIMUM FACE AMOUNT INCREASE OR DECREASE $50,000.00

TRANSFER FEE $25.00
(FOR TRANSFERS IN EXCESS OF 12 IN A POLICY YEAR)

MAXIMUM ASSET ALLOCATION BALANCER CHARGE $15.00

MAXIMUM DOLLAR COST AVERAGING CHARGE $5.00

FIXED ACCOUNT MAXIMUM TRANSFER PERCENTAGE 15%

FIXED ACCOUNT MAXIMUM TRANSFER AMOUNT $500.00

MINIMUM GUARANTEED ANNUAL FIXED ACCOUNT RATE 3%

WITHDRAWAL TIER AMOUNT PERCENTAGE 10%

FIXED ANNUAL LOAN INTEREST CHARGED RATE 5.25%

MAXIMUM LOAN INTEREST CREDITED DIFFERENTIAL 1.25%

DEATH BENEFIT DISCOUNT FACTOR 1.0032737

FIRST YEAR GUARANTEED MONTHLY COST OF INSURANCE
RATE PER THOUSAND 0.000207

PAGE 3.2

TABLE OF GUARANTEED MAXIMUM COST OF INSURANCE RATES

GUARANTEED MAXIMUM MONTHLY RATES PER $1,000
OF NET AMOUNT AT RISK

FOR THE LIVES INSURED UNDER THIS POLICY

DURATION MONTHLY DURATION MONTHLY DURATION MONTHLY
(POLICY RATE (POLICY RATE (POLICY RATE
YEARS) YEARS) YEARS)

1 0.000207 23 0.103964 45 3.953521
2 0.000665 24 0.122184 46 4.558705
3 0.001212 25 0.143495 47 5.253161
4 0.001864 26 0.168742 48 6.055917
5 0.002654 27 0.198793 49 6.980966
6 0.003598 28 0.235576 50 8.015102
7 0.004763 29 0.281020 51 9.149825
8 0.006128 30 0.336457 52 10.364422
9 0.007748 31 0.401980 53 11.654835
10 0.009612 32 0.478377 54 13.000300
11 0.011830 33 0.565716 55 14.412617
12 0.014426 34 0.664435 56 15.891977
13 0.017472 35 0.777709 57 17.459834
14 0.021034 36 0.911511 58 19.156860
15 0.025213 37 1.080715 59 21.054761
16 0.030130 38 1.268137 60 23.368153
17 0.036011 39 1.507613 61 26.517002
18 0.043094 40 1.795237 62 31.354662
19 0.051658 41 2.130491 63 39.595173
20 0.061825 42 2.513928 64 54.652603
21 0.073840 43 2.944356 65 83.333333
22 0.087887 44 3.421111

THE ABOVE RATES HAVE BEEN INCREASED FOR ANY ADDITIONAL RATING SHOWN IN THE
POLICY INFORMATION SECTION.

Page 4

DEFINITIONS

THE FOLLOWING TERMS HAVE SPECIFIC MEANINGS IN YOUR POLICY. PLEASE REFER TO THESE
DEFINITIONS AS YOU READ YOUR POLICY.

ADDITIONAL RATING is an adjustment to the Cost of Insurance Rate for any of the
Lives Insured who do not meet, at a minimum, our underwriting requirements for
the standard Risk Classification.

AGE means each of the Lives Insured's age on their birthday closer to the Policy
Date.

ATTAINED AGE on any date means the Age plus the number of whole years that have
elapsed since the Policy Date.

BUSINESS DAY is any day that the New York Stock Exchange is open for trading,
and trading is not restricted. The net asset value of the underlying shares of a
Sub-Account will be determined as of the end of each Business Day. We will deem
each Business Day to end at the close of regularly scheduled trading of the New
York Stock Exchange (currently 4:00 p.m. Eastern Time) on that day.

CASH SURRENDER VALUE equals the Policy Value less the Surrender Charge and any
outstanding Monthly Deductions due.

FIXED ACCOUNT is that part of the Policy Value which reflects the value you have
in our general account.

GROSS WITHDRAWAL is the amount of partial Net Cash Surrender Value you request
plus any Surrender Charge applicable to the withdrawal.

INVESTMENT ACCOUNT is that part of the Policy Value that reflects the value you
have in one of the Sub-Accounts.

ISSUE DATE is the date shown in the Policy Information section from which the
Suicide and Validity provisions are applied.

LIFE INSURED is the last-to-die of the Lives Insured.

LIVES INSURED are the persons whose lives are insured under this policy as set
out in the Policy Information section. References to the youngest of the Lives
Insured means the youngest person insured under this policy when it is first
issued.

LOAN ACCOUNT is that part of the Policy Value which reflects the value
transferred from the Fixed Account or the Investment Accounts as collateral for
a policy loan.

MATURITY DATE is the date shown in the Policy Information section. It is the
Policy Anniversary nearest the date on which the youngest of the Lives Insured
reaches Attained Age 100, or the date such person would have reached Attained
Age 100 if living.

NET CASH SURRENDER VALUE is the Cash Surrender Value less the Policy Debt.

NET POLICY VALUE is the Policy Value less the value in the Loan Account.

NET PREMIUM is the gross premium paid less the Premium Load. It is the amount of
premium allocated to the Fixed Account and/or Investment Accounts.

PLANNED PREMIUM is the amount you wish to pay as indicated in the application.
We will send notices setting forth the Planned Premium at the payment intervals
you have selected. You may change the Planned Premium at any time by Written
Request.

POLICY DATE is the date shown in the Policy Information section from which
charges for the first Monthly Deduction are calculated. The Policy Date is used
to determine POLICY YEARS, POLICY MONTHS AND POLICY ANNIVERSARIES.

(continued)

Page 5

DEFINITIONS (continued)

POLICY DEBT as of any date equals (a) plus (b) plus (c) minus (d), where:

(a) is the total amount of loans borrowed as of such date;

(b) is the total amount of any unpaid loan interest charges which have been
borrowed against the policy on a Policy Anniversary;

(d) is the total amount of loan repayments as of such date.

POLICY VALUE is the sum of the values in the Loan Account, the Fixed Account and
the Investment Accounts.

SEPARATE ACCOUNT refers to Separate Account B of The Manufacturers Life
Insurance Company of New York.

SERVICE OFFICE is the office that we designate to service this policy. The
Service Office Mailing Address is The Manufacturers Life Insurance Company of
New York, P.O. Box 633, Niagara Square Station, Buffalo, NY 14201-0633. The Home
Office Address is 100 Summit Lake Drive, 2nd Floor, Valhalla, NY 10595.

SUB-ACCOUNT refers to one of the sub-accounts of the Separate Account.

SURRENDER CHARGE compensates us for some of the expenses of selling and
distributing the policies, such as agent's commissions, advertising, agent
training and the printing of prospectuses and sales material. It also covers
expenses associated with underwriting and issuance of policies, such as
processing applications, conducting medical examinations, determining the risk
classification for the Lives Insured and establishing policy records.

SURRENDER CHARGE PERIOD is the period following the Issue Date of the policy or
following any increase in Face Amount during which we will assess surrender
charges. Surrender charges will apply during this period if you surrender the
policy, make a partial withdrawal, or if it terminates due to default.

SURRENDER CHARGE PREMIUM LIMIT is used to determine the Surrender Charge. The
Surrender Charge Premium Limit for the initial Face Amount is shown in the Table
of Values in the Policy Information section. You will be advised of the
Surrender Charge Premium Limit for any increase in Face Amount.

WITHDRAWAL TIER AMOUNT as of any date is the Net Cash Surrender Value at the
previous Policy Anniversary, multiplied by the Withdrawal Tier Amount Percentage
shown in the Table of Values in the Policy Information Section.

WRITTEN REQUEST is your request to us which must be in a form satisfactory to
us, signed and dated by you, and received at our Service Office.

PAYMENT OF PREMIUMS

No insurance will take effect under this policy before we approve the
application and receive the initial premium. The initial premium is due as of
the Policy Date. The minimum initial premium is one-twelfth of the Annual
No-Lapse Guarantee Premium shown in the Table of Values in the Policy
Information section.

Subsequent premiums can be paid at any time at our Service Office, and in any
amount subject to the limits described below. On request, we will give you a
receipt signed by one of our officers. The Planned Premium you requested in the
application is shown in the Policy Information section.

You may pay premiums until the Maturity Date.

LIMITS. Each premium payment after the first is subject to the following
limitations under Section 7702 of the Internal Revenue Code of 1986, or any
other equivalent section of the Code:

(a) we have the right to refuse or refund any premium payments that would
cause this policy to fail to qualify as life insurance under the Internal
Revenue Code;

(continued)

Page 6

PAYMENT OF PREMIUMS (continued)

(b) we reserve the right to request that you provide us with satisfactory
evidence of insurability if a premium payment would result in an increase
in the Death Benefit that is greater than the increase in Policy Value;
and

(c) the sum of the premiums paid into this policy at any time may not exceed
the guideline premium limitation as of such time. The guideline premium
limitation is, as of any date, the greater of:

(1) the Guideline Single Premium, or

(2) the sum of the Guideline Level Premiums to such date.

The Guideline Single Premium and the Guideline Level Premium are shown in
the Policy Information section.

NO-LAPSE GUARANTEE

Your policy includes a No-Lapse Guarantee. The guarantee period applicable to
this policy is shown in the Table of Values in the Policy Information section.

During your No-Lapse Guarantee Period, if the Net Cash Surrender Value falls to
zero or below, your policy will not go into default provided it satisfies the
cumulative premium test.

CUMULATIVE PREMIUM TEST. The test will be performed at the beginning of any
Policy Month that your policy would otherwise be in default in the absence of
the No-Lapse Guarantee. Your policy will satisfy the test if the sum of the
premiums paid, less any Policy Debt, and less any Gross Withdrawals taken on or
before the date of the test, is equal to or greater than the sum of the monthly
No-Lapse Guarantee Premiums due from the Policy Date to the date of the test.

NO-LAPSE GUARANTEE PREMIUM. The No-Lapse Guarantee Premium is the minimum amount
due at the beginning of each month to satisfy the cumulative premium test.

The No-Lapse Guarantee Premium is shown as an annualized amount in the Table of
Values in the Policy Information section. This amount will change if any of the
following changes occur under your policy:

(a) you add, terminate or change a Supplementary Benefit;

(b) you change the Death Benefit Option under your policy;

(d) you change the Face Amount of insurance; or

(e) there is a change in the Risk Classification of any of the Lives Insured
because of a change from Smoker to Non-Smoker status or a temporary extra
rating terminates.

We will inform you of any change to the No-Lapse Guarantee Premium resulting
from any such change. The revised premium will be effective from the date of the
change. For the purpose of performing the cumulative premium test, we will use
the No-Lapse Guarantee Premium in effect as of the Policy Date up to the date of
the change, including any revised premium in effect as of the date of a prior
change.

POLICY TERMINATION

DEFAULT. Unless the policy has met the No-Lapse Guarantee requirements, it will
go into default if, at the beginning of any Policy Month, the Net Cash Surrender
Value would go to zero or below after we take the Monthly Deduction that is due
for that month.

GRACE PERIOD. We will allow 61 days from the date that the policy goes into
default, for you to pay the amount that is required to bring the policy out of
default. We will send a notice to you and to the Lives Insured at least 15 days,
but not more than 45 days prior to the termination of coverage. This notice will
be sent to the last known address and will specify the amount you must pay to
bring the policy out of default. If we have notice of a policy assignment on
file at our Service Office, we will also mail a copy of the notice of the amount
due to the assignee on record.

(continued)

Page 7

POLICY TERMINATION (continued)

The amount required to bring the policy out of default is equal to (a) plus (b)
plus (c) where:

(a) is the amount necessary to bring the Net Cash Surrender Value to zero, if
it is less than zero, at the date of default; and

(b) is the Monthly Deduction due on the date of default, plus the next two
Monthly Deductions; and

If the policy is in the No-Lapse Guarantee Period, then the following amount, if
less than the amount stated above, will bring the policy out of default. This
amount is equal to (a) plus (b), where:

(a) is the amount, if any, necessary to satisfy the No-Lapse Guarantee
cumulative premium test at the date of default; and

(b) is the No-Lapse Guarantee Premium for the next two Policy Months.

If the amount necessary to bring the policy out of default has not been paid by
the end of the grace period, the policy will terminate.

TERMINATION DATE. This policy terminates on the earliest of the following
events:

(a) the end of the grace period for which you have not paid the amount
necessary to bring the policy out of default;

(b) surrender of the policy for its Net Cash Surrender Value;

(d) the Maturity Date.

REINSTATEMENT

You can ask us to reinstate your policy only if it terminates at the end of a
grace period in which you did not make a required payment. The policy cannot be
reinstated if any of the Lives Insured die after the policy has terminated. You
can reinstate the policy if you:

(a) make a Written Request for reinstatement within 5 years after the date
your policy terminates;

(b) provide us with evidence of insurability satisfactory to us on the Lives
Insured or on the survivor(s) who were insured at the end of the Grace
Period; and

(c) pay a premium equal to the amount that was required during the 61-day
grace period following default plus the next two Monthly Deductions.

If we approve your request,

(a) the reinstatement date will be the later of the date we approve your
request or the date we receive the required payment at our Service Office;
and

(b) any Surrender Charges will be reinstated to the amount they were at the
date of default.

The Policy Value on the date of reinstatement, prior to the crediting of any Net
Premium paid on the reinstatement, will be equal to the Policy Value on the date
the policy terminated. If the policy is in a Surrender Charge Period when it
terminates, upon reinstatement the period will be the same as at the date of
default. The Surrender Charge in effect on the date of reinstatement will be the
same as the Surrender Charge in effect on the date of default.

MATURITY BENEFIT

We will pay you the Net Cash Surrender Value as of the Maturity Date provided
the policy is in force and at least one of the Lives Insured is alive.

Page 8

INSURANCE BENEFIT

The Insurance Benefit is payable when the Life Insured dies, but you must
provide us with proof when any of the Lives Insured die.

If the Life Insured dies while the policy is in force, we will pay the Insurance
Benefit to the beneficiary on receiving due proof of death of the last-to-die of
the Lives Insured, subject to the Age and Sex, Suicide and Validity provisions.

If the Life Insured dies after we receive a request from you to surrender the
policy, there will be no Insurance Benefit. We will pay the amount payable under
the Surrender And Withdrawals provision instead.

INSURANCE BENEFIT. The Insurance Benefit payable is:

(a) the Death Benefit as described below; plus

(b) any amounts payable under any Supplementary Benefits that form part of the
policy; less

If the Life Insured dies during a grace period, the Insurance Benefit described
above will be modified as follows:

(a) the Insurance Benefit will be reduced by any outstanding Monthly
Deductions due; and

(b) the Policy Value used in the calculation of the Death Benefit will be the
Policy Value as of the default date.

DEATH BENEFIT. The Death Benefit will depend on whether Death Benefit Option 1
or 2 is in effect on the date of death.

Under Option 1, the Death Benefit is the Face Amount of the policy at the date
of the Life Insured's death.

Under Option 2, the Death Benefit is the Face Amount of the policy, plus the
Policy Value at the date of the Life Insured's death.

MINIMUM DEATH BENEFIT. To ensure that the policy continues to qualify as life
insurance under the Internal Revenue Code, the Death Benefit will never be less
than the Minimum Death Benefit. The Minimum Death Benefit is equal to the Policy
Value, multiplied by the Minimum Death Benefit Percentage for the Attained Age
of the youngest of the Lives Insured, or the Attained Age such person would have
reached if living. The Minimum Death Benefit Percentages are shown in the Table
of Minimum Death Benefit Percentages shown below.

TABLE OF MINIMUM DEATH BENEFIT PERCENTAGES
ATTAINED AGE APPLICABLE PERCENTAGE

40 and under 250%
45 215%
50 185%
55 150%
60 130%
65 120%
70 115%
75 105%
90 105%
95 and above 100%

To determine the Applicable Percentage, we will use the Attained Age of the
youngest of the Lives Insured, or the Attained Age such person would have
reached if living.

For ages not shown, the Applicable Percentage can be found by reducing the above
Applicable Percentages proportionately.

SIMULTANEOUS DEATH. If the Lives Insured die simultaneously or in circumstances
rendering it uncertain who is the Life Insured, the oldest of the Lives Insured
will be deemed to have been the Life Insured. No payment will be made on the
death of the other Lives Insured.

(continued)

Page 9

INSURANCE BENEFIT (continued)

PAYMENT OF INSURANCE BENEFIT. We will pay the Insurance Benefit in one lump sum
with interest calculated from the date of the Life Insured's death to the date
of payment. The rate of interest we pay will be the same as the rate of interest
we then currently pay on policy proceeds left on deposit with us. Such interest
rate is set by us and is reviewed by us each calendar quarter, at which time we
may change the interest rate.

POLICY VALUE

INITIAL NET PREMIUMS. We will allocate your initial Net Premium plus any earned
interest on the later of the date our underwriters approve issuance of the
policy or the date we receive the initial premium at our Service Office.
Interest will be credited as of the date we received the initial premium payment
at the rate of return then being earned on allocations to the Money Market
Trust. This initial allocation will become your Policy Value to which subsequent
Net Premiums will be allocated.

SUBSEQUENT NET PREMIUMS. As of the Business Day we receive your subsequent
premium payments at our Service Office, we will add your Net Premium to your
Policy Value. We will do this before we take any deductions due as of that
Business Day.

MONTHLY DEDUCTIONS. At the beginning of each Policy Month, a deduction is taken
from your policy to cover Monthly Administration Charges and the cost to provide
the insurance coverage.

The first Monthly Deduction is taken on the later of the date our underwriters
approve issuance of the policy or the date we receive at least the initial
premium at our Service Office.

Monthly Deductions are due until the Maturity Date.

The Monthly Deduction for any Policy Month is the sum of the following amounts
determined as of the beginning of that month:

(a) the Monthly Administration Charge shown in the Table Of Expense Charges in
the Policy Information section;

Page 10

(b) the Mortality and Expense Risks Charge shown in the Table Of Expense
Charges in the Policy Information section;

(d) the monthly Cost of Insurance for the Lives Insured.

Unless you have requested otherwise, we will take Monthly Deductions from the
Fixed Account and the Investment Accounts in the same proportion that the Policy
Value in each of these accounts bears to the Net Policy Value immediately prior
to the deduction. The Cost of Insurance for a specific Policy Month is
determined as the rate for the Cost of Insurance for that month, as described
below, multiplied by the net amount at risk.

For Death Benefit Option 1, the net amount at risk is equal to (a) minus (b),
where:

(a) is the Death Benefit as of the first day of the Policy Month, divided by
the Death Benefit Discount Factor shown in the Table of Values in the
Policy Information section; and

(b) is the Policy Value as of the first day of the Policy Month after the
deduction of the monthly Cost of Insurance for the Lives Insured.

For Death Benefit Option 2, the net amount at risk is equal to the Face Amount
of insurance.

The rates for the Cost of Insurance, on the Policy Date and subsequently for
each Face Amount increase, are blended and based on the Lives Insured's Age,
Sex, Risk Classification and duration that the coverage has been in force. We
will re-determine Cost of Insurance rates from time to time. Any adjustments
will be by class and based on changes in expected mortality and persistency
experience, general account investment earnings and operating expenses.

The rates for the Cost of Insurance are intended to cover future mortality costs
under the policy. These rates may be higher in early Policy Years due to
recovery of initial acquisition costs.

(continued)

Page 11

POLICY VALUE (continued)

The Cost of Insurance Rate shown in the Table of Values in the Policy
Information section is payable for the first Policy Year. After the first Policy
Year, the Cost of Insurance will generally increase on each Policy Anniversary.
The Cost of Insurance calculation will reflect any Additional Rating shown in
the Policy Information section. The Cost of Insurance rates will never exceed
those shown in the Table of Guaranteed Maximum Cost of Insurance Rates on Page
4.

OTHER DEDUCTIONS. We will deduct a Surrender Charge if during the Surrender
Charge Period shown in the Policy Information section:

(a) you surrender the policy for its Net Cash Surrender Value;

(b) you make one or more partial withdrawals in a Policy Year totaling more
than the Withdrawal Tier Amount; or

See the Surrender And Withdrawals provision for details.

POLICY VALUE COMPOSITION

Your Policy Value at any time is equal to the sum of the values you have in the
Loan Account, the Fixed Account and the Investment Accounts.

LOAN ACCOUNT VALUE. The amount you have in the Loan Account at any time equals:

(a) amounts transferred to it for loans or borrowed loan interest; plus

(b) interest credited to it; less

For the details of the Loan Account see the Policy Loan Conditions provision.

FIXED ACCOUNT VALUE. The amount you have in the Fixed Account at any time
equals:

(a) Net Premiums allocated to it; plus

(b) amounts transferred to it; plus

(d) amounts deducted from it; less

(e) amounts transferred from it; less

(f) amounts withdrawn from it.

Interest will be credited to amounts in the Fixed Account at an effective annual
rate of no less than the Minimum Guaranteed Annual Fixed Account Rate shown in
the Table of Values in the Policy Information Section. The actual interest rate
used will be set by us from time to time. For all transactions, interest is
calculated from the date of the transaction. Such interest, once credited is
non-forfeitable.

INVESTMENT ACCOUNT VALUE. The amount you have in an Investment Account at any
time equals the number of units in that Investment Account, multiplied by the
unit value of the corresponding Sub-Account at that time.

The number of units in an Investment Account at any time equals (a) minus (b),
where:

(a) is the number of units credited to the Investment Account because of:

(1) Net Premiums allocated to it; and

(2) amounts transferred to it; and

(b) is the number of units canceled from the Investment Account because of:

(1) amounts deducted from it;

(2) amounts transferred from it; and

(3) amounts withdrawn from it.

Page 12

(continued)

Page 13

POLICY VALUE COMPOSITION (continued)

The number of units credited or canceled for a given transaction is equal to the
dollar amount of the transaction, divided by the unit value as of the Business
Day of the transaction. See the Unit Value Calculation section of the Separate
Account And Sub-Accounts provision for details on how unit values are
determined.

SEPARATE ACCOUNT AND SUB-ACCOUNTS

The Separate Account is authorized to invest in the shares of Manufacturers
Investment Trust, or another management investment company. Each Sub-Account of
the Separate Account purchases shares of a corresponding Fund of Manufacturers
Investment Trust or another management investment company. The Funds are listed
in the Policy Information section.

FUND SUBSTITUTION. A Fund might, in our judgment, become unsuitable for
investment by a Sub-Account. This might happen because of a change of investment
policy; or a change in the applicable laws or regulations; or because the shares
are no longer available for investment; or for some other reason.

If a Fund becomes unsuitable for investment, we have the right to substitute
another Fund or another management investment company. Before doing this, we
would first seek, where required, approval from the Securities and Exchange
Commission and the Superintendent of Insurance of the state of New York.

To the extent permitted by applicable federal and state law, we also have the
right, without your approval, to:

(a) create new separate accounts;

(b) combine any two or more separate accounts including the Separate Account;

(c) make available additional Sub-Accounts investing in additional Funds of
Manufacturers Investment Trust, or another investment company;

(d) eliminate existing Sub-Accounts and stop accepting new allocations and
transfers into the corresponding Fund;

(e) operate the Separate Account as a management investment company under the
Investment Company Act of 1940 or in any other form permitted by law;

(f) de-register the Separate Account under the Investment Company Act of 1940;

(g) transfer assets between the Separate Account and other separate accounts;
and

(h) combine Sub-Accounts or to transfer assets in one Sub-Account to another
Sub-Account.

The investment objectives of a Sub-Account within the Separate Account will not
be changed materially without first filing the change with the Superintendent of
Insurance of the state of New York. We will inform you of any changes deemed to
be material.

UNIT VALUE CALCULATION. We will determine the unit values for each Sub-Account
as of the end of each Business Day. When we need to determine a Policy Value or
an amount after the end of a Business Day, or on a day that is not a Business
Day, we will do so as of the next Business Day.

The value of a unit of each Sub-Account was initially fixed at $10 for the first
Business Day that an amount was allocated, or transferred to the particular
Sub-Account. For any subsequent Business Day, the unit value for that
Sub-Account is obtained by multiplying the unit value for the immediately
preceding Business Day by the net investment factor for the particular
Sub-Account on such subsequent Business Day.

(continued)

Page 14

SEPARATE ACCOUNT AND SUB-ACCOUNTS (continued)

NET INVESTMENT FACTOR. The net investment factor for a Sub-Account on any
Business Day is equal to (a) divided by (b), where:

(a) is the net asset value of the underlying Fund shares held by that
Sub-Account as of the end of such Business Day before any policy
transactions are made on that day; and

(b) is the net asset value of the underlying Fund shares held by that
Sub-Account as of the end of the immediately preceding Business Day after
all policy transactions were made for that day.

We reserve the right to adjust the above formula for any taxes determined by us
to be attributable to the operations of the Sub-Account. Before making any such
changes, we will first seek the approval of the Superintendent of Insurance of
the state of New York.

SEPARATE ACCOUNT ASSETS. The assets held in each Sub-Account are used to support
the Policy Values of Single Premium and Flexible Premium Variable Life Insurance
policies. The Separate Account will be used to fund only variable life insurance
benefits.

Income, gains and losses of the Separate Account are credited to, or charged
against, the applicable Sub-Accounts without regard to our other income, gains
and losses.

The assets of the Separate Account are our property. The part of the assets that
is equal to the Investment Account values in respect of all Single Premium and
Flexible Premium Variable Life Insurance policies will not be charged with
liabilities from any other business we conduct. We can transfer to our general
account, Separate Account assets in excess of the liabilities of the Separate
Account arising under the Single Premium and Flexible Premium Variable Life
Insurance policies supported by the Separate Account.

INVESTMENT OPTIONS

ALLOCATIONS. You may allocate Net Premiums to the Fixed Account or any of the
Investment Accounts. Unless you change the initial premium allocation specified
in your application for this policy, it will continue to apply to subsequent
premium payments.

Allocation percentages must be zero or a whole number not greater than 100. The
sum of the allocation percentages must equal 100. You may change the allocation
percentages by Written Request to our Service Office. The change will take
effect as of the date we receive your request at our Service Office.

TRANSFERS. By Written Request you may transfer portions of your Policy Value
among the Investment Accounts and the Fixed Account.

Transfers are subject to the following restrictions:

(a) you can make as many transfers in a Policy Year as you want. There is no
charge for the first twelve transfers in any Policy Year. If you make more
than twelve transfers in any Policy Year, the Transfer Fee shown in the
Table of Values in the Policy Information section will apply to each
subsequent transfer in that Policy Year. We will consider all transfer
requests received on the same Business Day as one transfer;

(b) you may transfer the Policy Value from any of the Investment Accounts to
the Fixed Account without incurring the Transfer Fee shown in the Table of
Values in the Policy Information section, provided such transfers occur
within:

(1) eighteen months after the Issue Date, as shown in the Policy
Information section of this policy; or

(2) the later of (i) or (ii) below:

(i) 60 days from the effective date of a material change in the
investment objectives of any of the Sub-Accounts; or

(ii) 60 days from the notification date of any such change.

(continued)

Page 15

INVESTMENT OPTIONS (continued)

(c) the maximum amount that you can transfer out of the Fixed Account in any
one Policy Year is limited to the greater of:

(1) the Fixed Account Maximum Transfer Percentage shown in the Table of
Values in the Policy Information section, multiplied by the value in
the Fixed Account at the previous Policy Anniversary; or

(2) the Fixed Account Maximum Transfer Amount shown in the Table of
Values in the Policy Information section.

(d) any transfer out of the Fixed Account may not involve a transfer to the
Investment Account for the Money Market Trust; and

(e) transfer privileges are subject to any restrictions that may be imposed by
the Manufacturers Investment Trust.

ASSET ALLOCATION BALANCER TRANSFERS. If you elect this option, we will
automatically transfer amounts among your specified Investment Accounts in order
to maintain your designated percentage in each account. We will effect the
transfers six months after the Policy Date and each six month interval
thereafter.

The Maximum Asset Allocation Balancer Charge for transfers under this option is
shown in the Table of Values in the Policy Information section of this policy.

When you change your premium allocation instructions, your Asset Allocation
Balancer will change so the two are identical. This change will automatically
occur unless you instruct us otherwise, or a Dollar Cost Averaging request is in
effect.

We reserve the right to cease to offer this option as of 90 days after we send
you written notice.

DOLLAR COST AVERAGING. If you elect this option, we will automatically transfer
amounts each month from one Investment Account to one or more of the other
Investment Accounts or the Fixed Account. You must select the amount to be
transferred and the accounts.

If the value in the Investment Account from which the transfer is being made is
insufficient to cover the transfer amount, we will not effect the transfer and
we will notify you.

The Maximum Dollar Cost Averaging Charge for transfers under this option is
shown in the Table of Values in the Policy Information section of this policy.

We reserve the right to cease to offer this option as of 90 days after we send
you written notice.

POLICY LOAN CONDITIONS

At any time while this policy is in force and has an available loan value, you
can get a loan by Written Request. We may require a loan agreement from you as
the policy is the only security for the loan.

You should consult your tax advisor before making a decision to take out a new
loan.

AVAILABLE LOAN VALUE. The available loan value on any date is 90% of the Net
Cash Surrender Value.

LOAN ACCOUNT. When you take out a loan, or when loan interest charges are
borrowed, we will do a transfer from the Fixed Account and/or one or more of the
Investment Accounts into the Loan Account. Amounts we transfer into the Loan
Account cover the loan principal plus loan interest due to the next Policy
Anniversary.

(continued)

Page 16

POLICY LOAN CONDITIONS (continued)

You may tell us how much of the amount to be transferred to the Loan Account you
wish to allocate to your value in the Fixed Account and each of the Investment
Accounts. If you do not tell us, we will allocate the amounts to be transferred
in the same proportion that your value in the Fixed Account and the Investment
Accounts bears to the Net Policy Value.

When an amount to be transferred is allocated to an Investment Account, we will
redeem units of that Investment Account sufficient in value to cover the
allocated amount. These transfers do not count as a transfer for the purposes of
the Transfers section of the Investment Options provision.

Interest is credited to the Loan Account and interest is also charged on the
Policy Debt, as described under the Loan Interest Charged and the Loan Interest
Credited sections of this provision.

LOAN INTEREST CHARGED. Interest will accrue daily on loans. In the event that
you do not pay the Loan Interest Charged in any Policy Year, it will be borrowed
against the policy and added to the Policy Debt in arrears at the Policy
Anniversary. We will allocate the amount borrowed for interest payment in the
same proportion that your value in the Fixed Account and the Investment Accounts
bears to the Net Policy Value as of the Policy Anniversary.

The policy will go into default at any time the Policy Debt exceeds the Policy
Value. At least 61 days prior to termination, we will send a notice to your last
known address. If you had filed a notice of assignment with us, we will also
send a copy of the notice to the last known address of the assignee on record.
Payment of the loan interest during the 61-day grace period will bring the
policy out of default.

The rate of interest charged is fixed at the effective Annual Loan Interest
Charged Rate shown in the Table of Values in the Policy Information section.

LOAN INTEREST CREDITED. Interest will accrue daily to amounts in the Loan
Account. The effective annual Loan Interest Credited Rate is the difference
between the Loan Interest Charged Rate and the Loan Interest Credited
Differential.

The Maximum Loan Interest Credited Differential is shown in the Table of Values
in the Policy Information section. We may change the differential as of 90 days
after we send you written notice of such change. At least 60 days prior to
changing the differential, we will file the change with the Superintendent of
Insurance of the State of New York.

In no event will the Loan Interest Credited rate be less than the Minimum
Guaranteed Annual Fixed Account Rate shown in the Table of Values in the Policy
Information section.

LOAN REPAYMENT. You may repay the Policy Debt in whole or in part at any time
prior to the death of the Life Insured, and while the policy is in force.

When you repay a loan, we credit the amount to the Loan Account, and make a
transfer to the Fixed Account and/or the Investment Accounts.

We will allocate loan repayments as follows:

(a) first to the Fixed Account, until the value that was transferred from it
is fully restored;

(b) then to each Investment Account in the same proportion that the value that
was transferred from it bears to the value of the Loan Account.

While a loan exists, we will treat the amounts you pay as premiums, unless you
request in writing that they be treated as loan repayments. However, when a
portion of the Loan Account amount is allocated to the Fixed Account, we reserve
the right to require that amounts you pay be treated as loan repayments.

Page 17

CHANGING THE DEATH BENEFIT OPTION OR THE FACE AMOUNT

You may change your Death Benefit Option or your Face Amount of insurance by
Written Request. Such changes are subject to the general conditions of this
provision and the conditions described in the section for each type of change.

The following general conditions apply to changes in Death Benefit Option or
Face Amount of insurance:

(a) changes may be made once in each Policy Year after the first Policy
Anniversary;

(b) no evidence of insurability is required for a Death Benefit Option change;

(d) we reserve the right to limit any changes that would cause this policy to
fail to qualify as life insurance according to Section 7702 of the
Internal Revenue Code of 1986, or any other equivalent of the Code.

A Death Benefit Option Change or a Face Amount Change, will cause a change in
the Guideline Single Premium, Guideline Level Premium, and the No-Lapse
Guarantee Premium. For increases in Face Amount the Surrender Charge Premium
Limit will also change. An additional Surrender Charge Premium Limit will be
associated only with the new Face Amount if it has been added after restoring
prior decreases.

We will inform you of the new premium amounts at the time of the change.

CHANGE FROM DEATH BENEFIT OPTION 1 TO DEATH BENEFIT OPTION 2.

The Face Amount of insurance after the change from Option 1 to Option 2 will be
(a) minus (b), where:

(a) is the Face Amount of insurance immediately before the change; and

(b) is the Policy Value as of the effective date of the change.

We will not allow the change in Death Benefit Option if it would cause the Face
Amount to decrease below the Minimum Face Amount shown in the Table of Values in
the Policy Information section.

CHANGE FROM DEATH BENEFIT OPTION 2 TO DEATH BENEFIT OPTION 1.

The Face Amount of insurance after the change from Option 2 to Option 1 will be
(a) plus (b), where:

(a) is the Face Amount of insurance immediately before the change; and

(b) is the Policy Value as of the effective date of the change.

We will not increase the Surrender Charge because of the increase in the Face
Amount of insurance resulting from this change.

DECREASE IN FACE AMOUNT. The Minimum Face Amount Decrease is shown in the Table
of Values in the Policy Information section. We may decrease this amount as of
90 days after we send you written notice of the change. We will not allow a
decrease if it would cause the Face Amount to go below the Minimum Face Amount
shown in the Table Of Values in the Policy Information section.

When you request a decrease in the Face Amount of insurance, we will reduce the
Face Amount in the following order:

(a) the amounts of insurance provided by any increases you may have requested
to the policy Face Amount, starting with the most recent increase until
all such increases are reduced; then

(b) the initial Face Amount of the policy.

(continued)

Page 18

CHANGING THE DEATH BENEFIT OPTION OR THE FACE AMOUNT (continued)

INCREASE IN FACE AMOUNT. The Lives Insured shown in the Policy Information
Section must all be alive when you request an increase in the Face Amount of
insurance. You must provide us with evidence of insurability on the Lives
Insured that is satisfactory to us. The Minimum Face Amount Increase is shown in
the Policy Information section. We may decrease this amount as of 90 days after
we send you written notice of the change.

We reserve the right to refuse a Face Amount increase if the Attained Age of any
of the Lives Insured at the date the increase would be effective is greater than
90.

The Face Amount of insurance will increase in the following order:

(a) we will restore the Face Amount reduced by the most recent decrease first;
followed by

(b) the next most recent decrease until all decreases are restored; then

There will be no new Surrender Charge associated with the restoration of prior
decreases under (a) or (b) above. However, there will be a new Surrender Charge
associated with the new Face Amount under (c). We will inform you of any new
Surrender Charges at the time of the increase.

You will not necessarily have to pay additional premium with an increase in Face
Amount, but the new Surrender Charge may require an additional premium payment
to prevent the policy from going into default.

For Surrender Charge purposes, the premiums attributable to the new Face Amount
will not exceed the Surrender Charge Premium Limit associated with that
increase.

SURRENDER AND WITHDRAWALS

SURRENDER OF THE POLICY. You may surrender this policy for its Net Cash
Surrender Value at any time prior to the death of the Life Insured. We will
determine the Net Cash Surrender Value as of the end of the Business Day on
which we receive the policy and your Written Request for surrender at our
Service Office. After we receive your surrender request, no insurance will be in
force.

If you surrender your policy during the Surrender Charge Period, we will deduct
a Surrender Charge from your Policy Value in calculating the Net Cash Surrender
Value. If you have increased the Face Amount of insurance, the Surrender Charge
will be the sum of the Surrender Charge for the initial Face Amount plus the
Surrender Charge for each increase as shown in the Policy Update page amending
the policy. No additional Surrender Charge will be imposed on any portion of an
increase in Face Amount that restores a prior decrease.

PARTIAL NET CASH SURRENDER VALUE WITHDRAWAL. You may request a partial Net Cash
Surrender Value withdrawal once each Policy Month after the first Policy
Anniversary. You may make this request provided there is a Net Cash Surrender
Value for the policy. The partial Net Cash Surrender Value withdrawal will be
done as of the end of the Business Day on which we receive your Written Request.

(continued)

Page 19

SURRENDER AND WITHDRAWALS (continued)

You may specify the accounts from which we should make the partial Net Cash
Surrender Value withdrawal. If we do not receive such instructions, we will make
the withdrawal in the same proportion that the value in the Fixed Account and
the Investment Accounts bears to the Net Policy Value.

If the sum of partial Net Cash Surrender Value withdrawals in any Policy Year
during the Surrender Charge Period is greater than the Withdrawal Tier Amount
for that year, we will deduct a pro-rata Surrender Charge from the Policy Value.

The portion of a partial Net Cash Surrender Value withdrawal that is considered
above the Withdrawal Tier Amount includes all previous partial Net Cash
Surrender Value withdrawals that have occurred in the current Policy Year.

The pro-rata charge deducted will equal the sum of the pro-rata Surrender Charge
for the initial Face Amount and any subsequent increase in Face Amount. This
amount is (a) divided by (b), multiplied by (c), where:

(a) is the amount of the partial Net Cash Surrender Value withdrawal in excess
of the Withdrawal Tier Amount;

(b) is the Net Cash Surrender Value prior to the withdrawal, in excess of the
Withdrawal Tier Amount; and

We will allocate the deduction of the pro-rata charges for the withdrawal to the
Fixed Account and the Investment Accounts in the same proportion that the
withdrawal from each account bears to the total withdrawal.

If the withdrawal plus the pro-rata Surrender Charge allocated to a particular
account are greater than the value of that account, we will reduce the portion
of the withdrawal allocated to that account. We will reduce the allocated
portion so that the withdrawal plus the pro-rata charge allocated to the account
equal the value of the account.

If Death Benefit Option 1 is in effect at the time of the withdrawal, the Face
Amount will be reduced by:

(a) the amount of the withdrawal plus the pro-rata Surrender Charge, if at the
time of the withdrawal the Death Benefit equals the Face Amount; otherwise

(b) the amount, if any, by which the withdrawal plus the pro-rata Surrender
Charge exceeds the difference between the Death Benefit and the Face
Amount.

If there has been a prior increase in Face Amount, then the Face Amount will be
decreased in the same order as if you had requested the decrease. See the
Decrease in Face Amount section of the Changing The Death Benefit Option Or The
Face Amount provision. Withdrawals will be limited if they would otherwise cause
the Face Amount to fall below the Minimum Face Amount shown in the Table of
Values in the Policy Information section.

(continued)

Page 20

SURRENDER AND WITHDRAWALS (continued)

Each time we deduct the pro-rata Surrender Charge for a partial withdrawal, we
will reduce the remaining Surrender Charge in the same proportion that the
Surrender Charge deducted bears to the total Surrender Charge immediately before
the partial withdrawal.

Partial Net Cash Surrender Value withdrawals do not affect the Face Amount of
your policy if Death Benefit Option 2 is in effect.

CONVERSION PRIVILEGE

You may convert your policy to a fixed paid-up benefit at any Policy
Anniversary, without evidence of insurability.

The conversion is subject to the following conditions:

(a) no further Monthly Deductions will be taken from the Policy Value after
the date of conversion;

(b) the Death Benefit, the Policy Value, other values based on the Policy
Value, and the Investment Account values will be determined as of the
Business Day on which we receive your Written Request for conversion;

(c) the basis for determining the Policy Value will be the Commissioners 1980
Standard Ordinary Smoker/Non-Smoker Mortality Table and an interest rate
of 4% per year; and

(d) this Flexible Premium Survivorship Variable Life coverage cannot be
reinstated after the date of the conversion.

RIGHT TO POSTPONE PAYMENT OF BENEFITS

We reserve the right to postpone the payment of Net Cash Surrender Values,
partial Net Cash Surrender Value withdrawals, policy loans, except when used to
make a premium payment, and the portion of the Insurance Benefit that depends on
Investment Account values, for any period during which:

(a) the New York Stock Exchange (Exchange) is closed for trading (other than
customary week-end and holiday closings), or trading on the Exchange is
otherwise restricted; or

(b) an emergency exists as defined by the Securities and Exchange Commission
(SEC), or the SEC requires that trading be restricted.

Except when used to make a premium payment, we also reserve the right to
postpone payments for up to six months if such payments are based on values that
do not depend on the investment performance of the Sub-Accounts.

If we do not mail or deliver a requested payment within 10 working days of the
date we receive the documentation necessary to complete the transaction, we will
pay interest from such date, provided that the interest is at least $25.00. The
rate of interest we pay will be the same as the rate of interest we then
currently pay on policy proceeds left on deposit with us. Such interest rate is
set by us and is reviewed by us each calendar quarter, at which time we may
change the interest rate. At our option, the interest will either be added to
and become part of the total payment or we will pay it separately.

In addition, we may defer transfers under the circumstances stated in (a) and
(b) above, and in the Transfers section of the Investment Options provision.

RIGHT TO CANCEL INCREASES

If you request an increase in Face Amount which results in a new Surrender
Charge, you have the same rights to cancel the increase as described on the
front cover of this policy, under the Right to Return Policy. If canceled, the
Policy Value and the Surrender Charge will be recalculated to the amounts they
would have been, had the increase not taken place. You may request a refund for
all or a portion of premiums paid during this period. Upon payment of the
refund, we will recalculate the Policy Value and the Surrender Charge to the
amounts they would have been, had the premiums not been paid.

Page 21

SUICIDE

Except for the last-to-die, if death is by suicide within two years after the
Issue Date, we will terminate this policy and issue a new policy on the life of
the survivor. The new single life policy on the survivor will be substantially
the same as the coverage provided under this policy. It will be effective on the
same date as this policy. We will not require evidence of insurability for the
issue of the new policy. The Suicide and Validity provisions for the new policy
will be effective from the Issue Date of this policy.

Except for the last-to-die, if death is by suicide within two years after an
applied for increase in Face Amount is effective, we will reissue the amount(s)
as a new policy. The new policy will be subject to the conditions outlined in
the above paragraph, except that the Suicide and Validity provisions for any
increase(s) will be measured from the effective date of such applied to
increase(s).

If the last-to-die of the Lives Insured dies by suicide, within two years after
the Issue Date, for this policy, or any applied for Face Amount increase which
was in effect, we will pay only the premiums paid, less any partial Net Cash
Surrender Value withdrawals, less the Policy Debt.

If the last-to-die of the Lives Insured's death occurs within two years after an
applied for increase in the Face Amount is effective, but after the second
Policy Year, the Death Benefit for that applied for increase will be limited to
the Monthly Deductions for the increase.

We reserve the right under this provision to obtain evidence of the manner and
cause of death of the Lives Insured.

BENEFICIARY

The following four sections will apply unless there is a beneficiary appointment
in force that provides otherwise.

BENEFICIARY CLASSIFICATION. You can appoint beneficiaries for the Insurance
Benefit in three classes: primary, secondary and final. Beneficiaries in the
same class will share equally in the Insurance Benefit payable to them.

PAYMENT TO BENEFICIARIES. We will pay the Insurance Benefit:

(a) to any primary beneficiaries who are alive when the Life Insured dies; or

(b) if no primary beneficiary is then alive, to any secondary beneficiaries
who are then alive; or

CHANGE OF BENEFICIARY. Until the Life Insured's death you can change the
beneficiary by Written Request unless you make an irrevocable designation. We
are not responsible if the change does not achieve your purpose. The change will
take effect as of the date you signed such request. It will not apply to any
payments we made or any action we may have taken before we received your Written
Request.

DEATH OF BENEFICIARY. If no beneficiary is alive when the Life Insured dies, the
Insurance Benefit will be payable to you; or to your estate if you are the Life
Insured. Unless otherwise provided, if a beneficiary dies before the seventh day
after the death of the Life Insured, we will pay the Insurance Benefit as if the
beneficiary had died before the Life Insured.

OWNERSHIP AND ASSIGNMENT

Until the Life Insured's death, without the consent of any beneficiary, except
an irrevocable beneficiary, you as owner can:

(a) receive any amount payable under your policy;

(b) exercise all rights and privileges granted by the policy; and

An assignment does not bind us until we receive it in writing at our Service
Office. We are not responsible for its validity or its effects. It should be
filed with us in duplicate. We will return a copy.

(continued)

Page 22

OWNERSHIP AND ASSIGNMENT (continued)

CHANGE OF OWNER. Until the Life Insured's death, the owner can change the
ownership of the policy by Written Request. The change will take effect as of
the date you signed the Written Request. It will not apply to any payments we
made or any action we may have taken before we received your Written Request.

TRUSTEE OWNER. Should the owner be a trustee, payment to the trustee(s) of any
amount to which the trustee(s) is (are) entitled under the policy, either by
death or otherwise, will fully discharge us from all liability under the policy
to the extent of the amount so paid.

JOINT OWNERSHIP. Two or more owners will own the policy as joint tenants with
right of survivorship, unless otherwise requested on the application or in any
subsequent assignment of the policy. On death of any of the owners, the deceased
owner's interest in the policy passes to the surviving owner(s).

Any rights and privileges that may be exercised by the owner, may be exercised
only with the consent of all joint owners.

SUCCESSOR OWNER. Upon the owner's death during the lifetime of the Lives
Insured, a named successor owner will, if then living, have all the owner's
rights and interest in the policy. Until the Life Insured's death, the owner,
without the consent of any revocable beneficiary or any successor owner, can
cancel or change the designation of successor owner. This may be done from time
to time by agreement in writing with us.

PROTECTION AGAINST CREDITORS

If permitted by state law, all payments shall be exempt from the debts and
contracts of the owners and beneficiaries, and from seizure by court order.

CURRENCY AND PLACE OF PAYMENT

All payments to or by us will be in U.S. currency. We will make payments from
our Service Office. We may require proof that the person claiming any payment is
entitled to it.

CONTRACT

The policy, application, supplementary benefits, and any endorsements form your
whole contract. A copy of the application is attached to the policy and deemed a
part of it. We will not be bound by any statement that is not in the application
or the policy.

Only our President or one of our Vice-Presidents can agree to amend or modify
the policy or waive any of its provisions. Any change must be in writing.

Statements made by any of the Lives Insured are representations, not warranties.
We will not use any statement by you or any of the Lives Insured to deny a
claim, unless it is written in the application or any supplement to the
application.

VALIDITY

We have the right to contest the validity of this policy based on material
misstatements made in the initial application or an application for policy
change that requires evidence of insurability. However, we cannot contest the
validity of your policy after it has been in force during the lifetime of the
Lives Insured for two years from the Issue Date, or the effective date of a
policy change as stated above.

We cannot contest the validity of an applied for increase in Face Amount or the
addition of a Supplementary Benefit after such increase or addition, which
requires evidence of insurability, has been in force during the lifetime of the
Lives Insured for two years from the date of such increase or addition.

We can contest after two years if the policy has been reinstated and has been in
force during the lifetime of the Lives Insured for less than two years from the
reinstatement date. If this is the case, we can only contest the validity in
respect of any fact material to the reinstatement that was misrepresented.

NON-PARTICIPATING

Your policy is non-participating. It does not earn dividends.

Page 23

AGE AND SEX

If the Age or Sex of any of the Lives Insured was misstated in the application,
we will change the Face Amount of insurance. The new Face Amount will be
determined so that the Death Benefit will be that which the most recent Cost of
Insurance deduction would have purchased for the correct Age and Sex.

FLEXIBLE FACTORS

When determining the rate of interest to be used in crediting interest to the
portion of the Policy Value in the Fixed Account, and any changes in that rate,
we will consider the following factors: expected mortality and persistency
experience; expected general account investment earnings; and expected operating
expenses. We will consider the same factors when we determine the actual cost of
insurance; the deductions from premiums for premium load; administrative
charges; and whenever changes are made to any of these charges. We will not try
to recover any losses in earlier years by increasing your charges in later
years.

Adjustments to flexible factors will be by class and be determined by us
from time to time based on future expectations for such factors. Any change will
be determined in accordance with procedures and standards on file with the
Superintendent of Insurance of the state of New York.

HOW VALUES ARE COMPUTED

We provide Cash Surrender Values that are at least equal to those required by
law. A detailed statement of the method of computing the values of this policy
has been filed with the insurance department of the state in which this policy
is delivered.

We use the Commissioners 1980 Standard Ordinary Smoker/Non-Smoker
Mortality Table in computing reserves, and in determining Maximum Cost of
Insurance Rates. Values relating to amounts in the Fixed Account are computed at
the Minimum Guaranteed Annual Fixed Account Rate shown in the Table of Values in
the Policy Information section. Current cost of insurance rates and the current
interest rate being credited to the Fixed Account will be reviewed at least once
every five Policy Years, but we will not make a change more than once each
Policy Year.

ANNUAL STATEMENT

Within 30 days after each Policy Anniversary, we will send you a report showing:

(a) the Death Benefit;

(b) the Policy Value;

(d) the value of the units in each chosen Investment Account;

(e) any Loan Account balance and loan interest charged since the last report;

(f) the premiums paid and policy transactions for the year; and

(g) any further information required by law.

TAX CONSIDERATIONS

It is the intent that this policy be considered as life insurance for tax
purposes, to comply with Section 7702 of the Internal Revenue Code of 1986, or
any other equivalent section of the code. We reserve the right to limit the
amount of premiums paid for this policy, or to make any other reasonable
adjustments to the terms or conditions of this policy if it becomes necessary to
allow it to qualify as life insurance.

This provision should not be construed to guarantee that the policy will be
treated as life insurance or that the tax treatment of life insurance will never
be changed by the future actions of any tax authority.

Page 24

SUPPLEMENTARY BENEFIT

RETURN OF PREMIUM DEATH BENEFIT

This benefit is part of the policy to which it is attached. Should any
provisions in the policy conflict with this benefit, the provisions of this
benefit will prevail.

The life insured for this benefit is the same person who is the life insured
under your policy, as shown in the Policy Information page for this benefit.

EFFECTIVE DATE. This benefit is effective on the Effective Date shown in the
Policy Information page for this benefit provided that Death Benefit Option 1 is
in effect under the policy on that date.

BENEFIT. This benefit provides an additional insurance amount, payable on the
death of the life insured. On receiving due proof that the life insured died
while the benefit is in force, we will pay the Benefit Amount to the same
beneficiary and in the same manner as the proceeds payable under the policy. The
Benefit Amount will not be payable if death occurs after the first two Policy
Years while the policy is being kept in force under the No-Lapse Guarantee
provision.

BENEFIT AMOUNT. The benefit is equal to the amount of the Return of Premium
Death Benefit coverage as described below. The Maximum Benefit Amount is shown
in the Policy Information page for this benefit.

RETURN OF PREMIUM DEATH BENEFIT COVERAGE. The amount of the Return of Premium
Death Benefit coverage is determined as follows:

(a) it has an initial value equal to the initial premium paid;

(b) each subsequent premium will increase the coverage at the time of premium
payment by an amount equal to the premium paid;

(c) each partial Net Cash Surrender Value Withdrawal taken under the policy
will reduce the coverage at the time of withdrawal by an amount equal to
the withdrawal plus any applicable Surrender Charge, except that the
coverage will not reduce to less than zero; and

(d) each request for a decrease in the Benefit Amount will reduce the coverage
on the effective date of the decrease by the amount of the decrease
requested.

CESSATION OF INCREASES. Increases in the Return of Premium Death Benefit
coverage will cease at the earlier of:

(a) the beginning of the Policy Month coincident with or next following the
date we approve your Written Request for a change to policy Death Benefit
Option 2; or

(b) the date as of which Monthly Deductions cease and no further premium can
be paid under the policy.

After increases cease, we will not take into account any more premiums paid in
determining the amount of the Return of Premium Death Benefit coverage.

DECREASE IN BENEFIT AMOUNT. You may make a Written Request to decrease the
Benefit Amount. The decrease will take effect at the beginning of the Policy
Month coincident with or next following the date we approve the request. The
Return of Premium Death Benefit coverage will be reduced by the amount of the
requested decrease. Decreases in the Benefit Amount are not subject to pro-rata
Surrender Charges.

PARTIAL NET CASH SURRENDER VALUE WITHDRAWALS. If you make a Written Request for
a partial Net Cash Surrender Value withdrawal under the policy while this
benefit is in force, we will process the withdrawal so that it first reduces the
amount of the Return of Premium Death Benefit coverage. Any withdrawals will be
subject to a pro-rata Surrender Charge in accordance with the Surrender and
Withdrawals provision of the policy. Also, the Face Amount of insurance under
the policy will be reduced by the amount by which the withdrawal plus the
Surrender Charge exceeds the amount of the Return of Premium Death Benefit
coverage.

COST OF INSURANCE. The rates for the Cost of Insurance are based on the life
insured's Age, Sex, Risk Classification, and the duration that the Return of
Premium Death Benefit coverage has been in force. The rates for the Cost of
Insurance under this benefit will always be less than or equal to the rates for
the cost of insurance under the policy. We will re-determine Cost of Insurance
rates from time to time on a basis that does not discriminate unfairly within
any class of life insured. The Cost of Insurance rate per dollar is the rate per
$1000 divided by 1000.

(continued)

Page 1

SUPPLEMENTARY BENEFIT
RETURN OF PREMIUM DEATH BENEFIT

The Cost of Insurance is charged monthly as part of the Monthly Deductions for
the policy and ceases when Monthly Deductions cease under the policy. The
monthly cost is equal to (a) multiplied by (b), where:

(a) is the rate per dollar for the Cost of Insurance for that month divided by
the result of subtracting the per dollar Cost of Insurance rate for that
month from 1.

(b) is the Return of Premium Face Amount at the beginning of the Policy Month
divided by the Death Benefit Discount Factor shown in the Policy
Information section.

Solely for purposes of determining the monthly cost for this benefit, at the
beginning of any Policy Month in which the Policy Value exceeds the total of the
Face Amount of your policy and the Benefit Amount payable under any applicable
Supplementary Benefit on the life insured, we will consider the Return of
Premium Death Benefit coverage amount to be reduced by such excess.

The Cost of Insurance calculation will reflect any Additional Rating Shown in
the Policy Information section. The monthly Cost of Insurance rates per $1000
will never exceed those shown in the Table of Guaranteed Maximum Cost of
Insurance Rates on Page 4 plus any Additional Rating.

NO-LAPSE GUARANTEE. The No-Lapse Guarantee in your policy applies to this
benefit during the first two Policy Years only. Following this period, at any
time the policy is being kept in force under the No-Lapse Guarantee provision
the following conditions will apply to this benefit:

(a) cost of Insurance deductions will be suspended until the Net Cash
Surrender Value of the policy is greater than zero;

(b) the Benefit Amount will be excluded from the policy Death Benefit. The
Death Benefit will be based on the Face Amount of the policy only; and

(c) satisfactory evidence of insurability will be required to reactivate the
Return of Premium Benefit Amount after it has been excluded from the
policy Death Benefit.

VALIDITY. We cannot contest the validity of this benefit after it has been in
force during the life insured's lifetime for two years from the Effective Date
of this benefit.

We can contest after two years if evidence of insurability is provided to
reactivate the Benefit Amount. In this case we can contest within 2 years from
the reactivation date in respect of any material evidence that was
misrepresented.

SUICIDE. If the life insured dies by suicide, while sane or insane, within two
years after the Effective Date of this benefit, this benefit will terminate and
we will pay only the amount of Monthly Deductions charged for the benefit.

TERMINATION. This benefit terminates at the same time as the policy. It cannot
be terminated prior to the policy.

This benefit may be reinstated with the policy, subject to the same conditions
that apply for reinstating the policy. Upon reinstatement, the amount of the
Return of Premium Death Benefit coverage will be equal to the amount at
termination, plus the amount of the premium paid for reinstatement.

THE MANUFACTURERS LIFE INSURANCE COMPANY OF NEW YORK

/s/ James W. Gallagher
President

Page 2

POLICY INFORMATION (CONTINUED)

SUPPLEMENTARY BENEFITS

BENEFIT RETURN OF PREMIUM DEATH BENEFIT

LIFE INSURED NO. 1 - JOHN J. DOE
NO. 2 - MARY C. DOE

AGE AT
EFFECTIVE DATE NO. 1 - 35
NO. 2 - 35

SEX NO. 1 - MALE
NO. 2 - FEMALE

RISK CLASSIFICATION NO. 1 - NON-SMOKER, STANDARD CLASS
NO. 2 - NON-SMOKER, STANDARD CLASS

EFFECTIVE DATE MAY 1, 2002

BENEFICIARY AS DESIGNATED IN THE APPLICATION OR
SUBSEQUENTLY CHANGED

BENEFIT AMOUNT AS DETERMINED BY THE RETURN OF PREMIUM DEATH BENEFIT COVERAGE
PROVISION

MAXIMUM BENEFIT $100,000.00
AMOUNT

ADDITIONAL RATING NOT APPLICABLE

REFERENCE TO THE LIFE INSURED IN THE RETURN OF PREMIUM DEATH BENEFIT
RIDER REFERS TO THE PERSONS WHOSE LIFE IS COVERED BY THE POLICY AS
REFERENCED ABOVE. ALL PROVISIONS IN THE RIDER WHICH ARE BASED ON THE
DEATH OF THE LIFE INSURED WILL BE BASED ON THE DEATH OF THE LAST SURVIVOR
OF THE PERSONS SO NAMED.

Page 3.3

THE MANUFACTURERS LIFE INSURANCE COMPANY OF NEW YORK
HOME OFFICE: 100 SUMMIT LAKE DRIVE, 2ND FLOOR, VALHALLA, NY 10595

SUPPLEMENTARY BENEFIT

POLICY SPLIT OPTION

This benefit is part of your policy. Should any provisions in your policy
conflict with this benefit, the provisions of the benefit will prevail.

EFFECTIVE DATE. This benefit takes effect on the Policy Date.

LIVES INSURED. These are the persons whose lives are insured under your policy,
as shown in the Policy Information section of your policy.

BENEFIT. This benefit provides you with the option to evenly split your policy
if one of the Contingent Events listed below occurs. The Face Amount and the
Policy Value of your policy will be split into two separate policies, one on
each of the Lives Insured. The Face Amount to be split will not include any Four
Year Term Insurance amount in force under the policy.

No evidence of insurability will be required on either of the Lives Insured to
exercise this option.

CONTINGENT EVENTS. You may exercise the option to split your policy if either of
the following events occur:

(a) a final divorce decree which ends the marriage of the Lives Insured.

(b) a change in Federal estate tax law which results in either:

(1) removal of the unlimited marital deduction provision; or

(2) reduction of at least 50% in the level of estate taxes payable on
death.

EXERCISING THE OPTION. You are eligible to exercise the option on the date of
the final divorce decree, or on the effective date of the change in tax law.
Both Lives Insured must be alive on the date you exercise the option. We must
receive your Written Request within 90 days after the date you become eligible.

You should consult with your personal tax adviser before you exercise this
option.

IMPACT ON YOUR ORIGINAL POLICY. To effect the split of your original policy, the
following amounts will be divided and transferred equally to each new policy:

(a) the value of your original policy's Investment Accounts, Fixed Account
and Loan Account; and

(b) any existing Policy Debt under your original policy.

If only one new policy becomes effective, the other half of the Policy Value as
described in (a) above, minus one-half of any existing Policy Debt will be
payable. We will deduct one-half of any surrender charge applicable under the
original policy from the amount payable.

Your original policy will terminate on the date we transfer and/or pay the
amounts as described above. Any assignment of your original policy will apply to
each new policy.

NEW POLICY. Any new policy resulting from the split of your original policy will
be subject to the following conditions:

(a) it can be any variable life non-participating policy covering one
insured, that is offered by us at the time you exercise the option;

Page 1

POLICY SPLIT OPTION

(b) it can include any of the Supplementary Benefits on your original policy,
provided they are available on the new policy;

(c) the face amount of each new policy will be for one-half of the Face
Amount of your original policy and any supplementary benefit amounts in
force when you exercise the option. The new policy must conform to our
rules for minimum face amount;

(d) the new policy will take effect on the date the original policy
terminates, and will not provide any insurance until such time;

(e) the new policy will have a current Policy Date;

(f) we will base the premiums for each new policy on the attained age and
risk class of each of the Lives Insured at the time of the policy split;

(g) the new policy will be subject to any applicable surrender charges under
the new policy.

SUICIDE AND VALIDITY. The Suicide and Validity provisions will start anew as
described in the new policy.

BENEFIT COST. The cost of the benefit is one of the Monthly Deductions under
your policy. The annual cost is $0.75 per $1000 of the total current Face Amount
of insurance, excluding any Four Year Term Insurance amount.

TERMINATION. This benefit terminates on the earliest of:

(a) the death of one of the Lives Insured under your policy;

(b) the date we receive your Written Request to split your policy;

(d) the date we receive your Written Request for cancellation of this
benefit.

THE MANUFACTURERS LIFE INSURANCE COMPANY OF NEW YORK

/s/ James W. Gallagher
----------------------------------------------------
President

Page 2

SUPPLEMENTARY BENEFIT

FOUR YEAR RENEWABLE AND NON-CONVERTIBLE TERM

This benefit is part of your policy. Should any provisions in your policy
conflict with this benefit, the provisions of this benefit will prevail.

EFFECTIVE DATE. This benefit takes effect on the Policy Date set out in the
Policy Information section of your policy.

LIVES INSURED are the persons whose lives are insured under your policy, as set
out in the Policy Information section of your policy.

BENEFIT. This benefit provides an additional insurance amount, payable on the
death of the last-to-die of the Lives Insured. The amount is set out in the
Policy Information section of your policy.

On receiving due proof of the death of the last-to-die of the Lives Insured
while the benefit was in force, we will pay the death benefit amount to the same
beneficiary and in the same manner as the proceeds payable under your policy.

EXPIRY DATE. This benefit will terminate four years from the Policy Date. It
cannot be renewed after the Expiry Date set out in the Policy Information
section of your policy.

BENEFIT COST. The cost of the benefit is one of the Monthly Deductions under
your policy. The annual cost is set out in the Policy Information section of
your policy.

SUICIDE. If the first death is by suicide within two years after the Issue Date,
you may include this rider for one-half the benefit amount with the re-issued
single-life policy.

If the last death is by suicide within two years after the Issue Date, the
amount of any insurance under this benefit will not be paid.

VALIDITY. With respect to each of the Lives Insured, we cannot contest the
validity of this benefit after it has been in force during each person's
lifetime for two years from the Issue Date.

BENEFIT REDUCTION. The amount of insurance under this benefit will reduce
proportionally upon the occurrence of any of the following:

(a) any reduction in the Face Amount of your basic policy; or

(b) a partial Net Cash Surrender Value withdrawal made under your policy.

TERMINATION. This benefit terminates on the earliest of:

(a) the benefit Expiry Date set out in the Policy Information section of your
policy;

(b) the termination date of your policy; or

THE MANUFACTURERS LIFE INSURANCE COMPANY OF NEW YORK

/s/ James W. Gallagher
----------------------------------------------------
President

SUPPLEMENTARY BENEFIT

EXTENSION OF MATURITY DATE PAST ATTAINED AGE 100

This benefit is part of the policy to which it is attached. Should any
provisions in the policy conflict with this benefit, the provisions of this
benefit will prevail.

Effective Date. This benefit takes effect on the Policy Date shown in the Policy
Information section of your policy.

LIFE INSURED. The life insured is the person or persons whose life is covered by
the policy as specified in the Policy Information section of the policy. If more
than one person is so named, then references in this benefit to the life insured
refers to the youngest of such persons and references to reaching Attained Age
100 refers to the date that person reaches such age or would have reached it if
living. Any reference to the death of the life insured refers to the death of
the last survivor.

BENEFIT. This benefit provides for extension of the policy's Maturity Date,
whereby we will continue the policy after the life insured reaches Attained Age
100. If for any reason you choose not to continue the policy, you may surrender
the policy for its Net Cash Surrender Value.

The following applies when the policy is continued in force after the life
insured reaches Attained Age 100:

(a) the policy will be continued until the earlier of the death of the life
insured or the date you surrender the policy;

(b) we will not accept any further premium payments, only loan payments;

(c) we will discontinue making Monthly Deductions for cost of insurance
charges and for expense charges listed in the Policy Information section
of the policy;

(d) we will continue to credit interest monthly to your Policy Value;

(e) you can continue to take Partial Net Cash Surrender Value Withdrawals and
policy loans;

(f) you can continue to transfer portions of your Policy Value among the
Investment Accounts and the Fixed Account; and

(g) interest on any Policy Debt will continue to accrue.

DEFAULT AFTER THE MATURITY DATE. The policy will go into default if the Policy
Debt equals or exceeds the Policy Value.

We will allow 61 days from the date that the policy goes into default, for you
to pay the loan interest to bring the policy out of default. We will send a
notice to you and to the life insured at least 15 days, but not more than 45
days prior to the termination of coverage. This notice will be sent to the last
known address and will specify the required amount you must pay to bring the
policy out of default. If we have notice of a policy assignment on file at our
Service Office, we will also mail a copy of the notice of the amount due to the
assignee on record.

BENEFIT COST. There are no Monthly Deductions for this benefit.

TAXATION. THE POLICY MAY NOT QUALIFY AS LIFE INSURANCE AFTER ATTAINED AGE 100
AND MAY BE SUBJECT TO ADVERSE TAX CONSEQUENCES. YOU SHOULD CONSULT A TAX ADVISOR
BEFORE CHOOSING TO CONTINUE THE POLICY AFTER ATTAINED AGE 100.

THE MANUFACTURERS LIFE INSURANCE COMPANY OF NEW YORK

/s/ James W. Gallagher
----------------------------------------------------
President

ENDORSEMENT

PRO-RATA SURRENDER CHARGES ON FACE AMOUNT DECREASES

This endorsement has been added to and made part of the policy to which it is
attached. Should any provisions in your policy conflict with this endorsement,
the provisions of this endorsement will prevail.

This endorsement takes effect on the Policy Date shown in the Policy Information
section of your policy.

It amends your policy when you decrease the Face Amount of Insurance, to allow
for the deduction of a pro-rata Surrender Charge during the Surrender Charge
Period. The Surrender Charge Period is shown in the Policy Information section
of your policy.

PRO-RATA SURRENDER CHARGE. If you decrease the Face Amount of insurance during
the Surrender Charge Period, we will deduct a pro-rata Surrender Charge from the
Policy Value. The pro-rata Surrender Charge deducted for the initial Face Amount
or for any previous increase in Face Amount will equal (a) divided by (b),
multiplied by (c), where:

(a) is the amount of the decrease in Face Amount or previous increase in Face
Amount;

(b) is the amount of the corresponding Face Amount or previous increase in a
Face Amount, prior to the decrease; and

(c) is the current total Surrender Charge for the corresponding Face Amount
or previous increase in Face Amount, immediately prior to the decrease.

We will allocate the deduction of the pro-rata charges for the decrease to the
Fixed Account and the Investment Accounts in the same proportion that the value
in each account bears to the Net Policy Value.

A decrease in Face Amount caused by a change from Death Benefit Option 1 to 2
will not incur the pro-rata Surrender Charge described above.

Each time we deduct the pro-rata Surrender Charge for a Face Amount decrease, we
will reduce the remaining Surrender Charge in the same proportion that the
Surrender Charge deducted bears to the total Surrender Charge immediately before
the Face Amount decrease.

THE MANUFACTURERS LIFE INSURANCE COMPANY OF NEW YORK

/s/ James W. Gallagher
----------------------------------------------------
President

THE MANUFACTURERS LIFE INSURANCE COMPANY OF NEW YORK
Home Office: 100 Summit Lake Drive, 2nd Floor, Valhalla, NY 10595

FLEXIBLE PREMIUM SURVIVORSHIP VARIABLE LIFE INSURANCE POLICY.

PAYABLE ON DEATH OF THE LAST-TO-DIE OF THE LIVES INSURED.

ADJUSTABLE DEATH BENEFIT.

FLEXIBLE PREMIUMS PAYABLE TO THE MATURITY DATE OR UNTIL LAST DEATH, IF EARLIER.

IMPORTANT NOTICE

To claim a benefit or request a change in your policy, contact our
nearest representative or write to our Service Office at the
address below.

Please tell us promptly of any change in your address.

WE STRONGLY URGE THAT, BEFORE YOU TAKE ANY ACTION TO REPLACE THIS
OR ANY OTHER POLICY, YOU ASK THE ADVICE OF THE COMPANY THAT ISSUED
THE POLICY.

[MANUALIFE NEW YORK LOGO]

Service Office Mailing Address:
The Manufacturers Life Insurance Company of New York
P.O. Box 633
Niagara Square Station
Buffalo, NY 14202-0633

Toll Free Number: 1-888-267-7784

Manulife Financial and the block design are registered service
marks of The Manufacturers Life Insurance Company and are used
by it and its subsidiaries.