[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Proposed Insured #1: Mr. SEP-NY 6 Simple Avg Death Benefit Option = Level Presented By:
Male, Age 55 Total Initial Face Amount = 1,500,000 PL agent
Select Nonsmoker Premium Payment Interval = Annual 12535 Insurance Dr
Proposed Insured #2: Mrs. Insured
Female, Age 55
Select Nonsmoker
Summary Page
- ------------------------------------------------------------------------------------------------------------------------------------
Current Policy Charges (1) Guaranteed Policy Charges (2)
Assuming Hypothetical Gross Assuming Hypothetical Gross Assuming Hypothetical Gross
Annual Investment Return of Annual Investment Return of Annual Investment Return of
6.00% (5.02% Net) 0.00% (-0.92% Net) 6.00% (5.02% Net)
---------------------------------------------------------------------------------------------
[Net
Loans Net Net Net Net Net Net
Planned Premiums and With- Accum'd Surr'r Death Accum'd Surr'r Death Accum'd Surr'r Death
Annual Plus 5% drawals Value Value Benefit Value Value Benefit Value Value Benefit
Yr Premium Interest (BOY)] (EOY) (EOY) (EOY) (EOY) (EOY) (EOY) (EOY) (EOY) (EOY)
- ----------------------------------------------------------------------------------------------------------------------------------
1 31,711 33,297 0 28,533 5,142 1,500,000 26,835 3,444 1,500,000 28,531 5,140 1,500,000
2 31,711 68,259 0 57,985 37,193 1,500,000 52,944 32,152 1,500,000 57,980 37,188 1,500,000
3 31,711 104,969 0 88,358 70,165 1,500,000 78,301 60,108 1,500,000 88,346 70,153 1,500,000
4 31,711 143,514 0 119,652 104,058 1,500,000 102,883 87,289 1,500,000 119,630 104,036 1,500,000
5 31,711 183,987 0 151,866 138,871 1,500,000 126,659 113,664 1,500,000 151,831 138,836 1,500,000
6 31,711 226,483 0 184,992 174,596 1,500,000 149,592 139,196 1,500,000 184,938 174,542 1,500,000
7 31,711 271,104 0 219,007 211,210 1,500,000 171,626 163,829 1,500,000 218,928 211,131 1,500,000
8 31,711 317,956 0 253,870 248,672 1,500,000 192,685 187,487 1,500,000 253,761 248,563 1,500,000
9 31,711 367,151 0 289,515 286,916 1,500,000 212,665 210,066 1,500,000 289,367 286,768 1,500,000
10 31,711 418,806 0 326,102 326,102 1,500,000 231,447 231,447 1,500,000 325,672 325,672 1,500,000
15 31,711 718,501 0 559,703 559,703 1,500,000 321,265 321,265 1,500,000 541,406 541,406 1,500,000
20 31,711 1,100,996 0 863,169 863,169 1,500,000 355,794 355,794 1,500,000 778,923 778,923 1,500,000
25 31,711 1,589,168 0 1,273,869 1,273,869 1,500,000 269,552 269,552 1,500,000 1,046,052 1,046,052 1,500,000
30 31,711 2,212,212 0 1,809,265 1,809,265 1,899,728 ## ## ## 1,388,135 1,388,135 1,500,000
35 31,711 3,007,393 0 2,491,008 2,491,008 2,615,559 1,873,199 1,873,199 1,966,859
## - Additional premiums are required to maintain the requested benefits.
All values except premiums, loans, loan interest and withdrawals are values at the end of the policy year. The 'Net Surrender Value'
column is equal to the accumulated value, less any policy debt and less any surrender charges. The 'Net Death Benefit' column is the
policy death benefit less any policy debt.
1 - The policy values under the Current Policy Charges heading reflect current policy charges, current cost of insurance rates,
current mortality and expense charges and the hypothetical gross earnings rate assumption described in the section entitled Gross
Hypothetical Returns. Current policy charges and cost of insurance rates are subject to change. Policy values will vary from those
illustrated if actual rates differ from those assumed. Current cost of insurance rates are not dependent upon future improvements in
underlying mortality.
2 - The policy values under the Guaranteed Policy Charges heading assume maximum cost of insurance rates.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 1 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Important Information About Your Illustration
- ------------------------------------------------------------------------------------------------------------------------------------
THIS IS AN This is an illustration and not a contract. Although the information contained in this illustration is based on
ILLUSTRATION, certain tax and legal assumptions, it is not intended to be tax or legal advice. Such advice should be obtained
NOT A CONTRACT from the applicant's own counsel or other advisor.
This illustration is prepared for presentation in the state of NY.
ILLUSTRATED
BENEFITS: Death Benefit Option
Start End Option
1 65 Level
Base Policy Face Amount
Start End Amount
1 65 1,500,000
PREMIUM Illustrated periodic premium payments are assumed to be made one time per year at the beginning of each premium
FREQUENCY: payment interval.
ANNUAL
TIMING OF All values assume premiums and loan interest are paid when due. If a payment is received without being
PAYMENTS designated as a premium payment or loan payment, and there is an outstanding loan, the payment will be applied
as a loan payment.
All values except premiums, loans, loan interest and withdrawals are values at the end of the policy year.
GROSS You have selected to have your accumulated value allocated to the variable investment options.
HYPOTHETICAL
RETURNS
Hypothetical Gross Earnings Rate
Start End Gross Net
1 65 6.00% 5.02%
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 2 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
The hypothetical rates of return and values shown are illustrative only and should not be deemed as a
representation of past or future investment results. The illustrated policy values might not be achieved if
actual rates of return, policy charges, premium amount or frequency differ from those assumed. Actual rates of
return may be more or less than those shown and will depend on a number of factors including the investment
allocations made to the variable investment options by the policyowner and the experience of those investment
options. No representation can be made by Pacific Life & Annuity, the Separate Account, or the underlying Fund
that these hypothetical rates of return can be achieved for any one year or sustained over any period of time.
The gross annual earnings rate assumption is after brokerage expenses and any foreign taxes. A portfolio's
foreign investment may be subject to foreign taxes. Foreign taxes from interest and dividend income are treated
as a deduction from relevant income for accounting purposes rather than an expense.
SUB-ACCOUNT This illustration assumes that all net premiums (after deduction of premium load) have been allocated to the
ALLOCATION variable investment options. The amounts shown for Death Benefits, Accumulated Values and Cash Surrender Values
in this illustration reflect an average daily investment advisory fee equivalent to an annual rate of 0.85% of
the aggregate average daily net assets of the fund. The policy values also reflect net operating expenses
(after any offset for custodian credits and excluding any foreign taxes) at an annual rate of 0.07% of the
aggregate average daily net assets of the portfolios. The total aggregate annualized expenses for the periods
ending December 31, 2000 (including investment advisory fees and excluding any foreign taxes) is 0.92%.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Simple Avg
Pacific Life & Annuity Company, 700 Newporft Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonG I Page: 3 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Portfolio Investment Operating
Advisory Fee Expenses
Aggressive Equity 0.80% 0.04%
Aggressive Growth 1.00% 0.06%
Blue Chip 0.95% 0.06%
Capital Opportunities 0.80% 0.06%
Diversified Research 0.90% 0.08%
Emerging Markets 1.10% 0.20%
Equity 0.65% 0.04%
Equity Income 0.95% 0.10%
Equity Index 0.25% 0.04%
Financial Services 1.10% 0.10%
Focused 30 0.95% 0.10%
Global Growth 1.10% 0.19%
Growth LT 0.75% 0.04%
Health Sciences 1.10% 0.10%
High Yield Bond 0.60% 0.04%
I-Net Tollkeeper 1.40% 0.06%
Inflation Managed 0.60% 0.02%
International Large-Cap 1.05% 0.12%
International Value 0.85% 0.11%
Large-Cap Core 0.65% 0.04%
Large-Cap Value 0.85% 0.05%
Managed Bond 0.60% 0.04%
Mid-Cap Growth 0.90% 0.06%
Mid-Cap Value 0.85% 0.03%
Money Market 0.34% 0.04%
Multi-Strategy 0.65% 0.04%
REIT 1.10% 0.04%
Research 1.00% 0.10%
Small-Cap Equity 0.65% 0.04%
Small-Cap Index 0.50% 0.10%
Strategic Value 0.95% 0.10%
Technology 1.10% 0.08%
Telecommunications 1.10% 0.08%
The investment advisory fees and net operating expenses for the underlying portfolios reflect fees and expenses
incurred by the portfolios for the periods ending December 31, 2000. The operating expenses for Aggressive
Growth, Blue Chip, Capital Opportunities, Equity Income, Financial Services, Global Growth, Health Sciences,
Mid-Cap Growth, Research, Technology, and Telecommunications are estimated. The Inflation Managed portfolio was
formerly called the Government Securities portfolio. The Large-Cap Core portfolio was formerly called the
Equity Income portfolio.
Although some portfolios may have names or investment objectives that resemble retail mutual funds managed by
the portfolio manager, these portfolios will not have the same underlying holdings or performance.
Please note: Net Premiums and Policy Accumulated Value may be invested in up to twenty (20) investment options
at one time.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 4 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver- NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
NET ANNUAL After deduction of the investment advisory fees and other operating expenses, illustrated gross annual
RETURN investment returns of 0% and 6.00% correspond to approximate net annual rates of return of -0.92% and 5.02%
respectively.
The amounts shown for Death Benefits, Accumulated Values and Cash Surrender Values reflect a non-guaranteed
persistency credit of 0.15% beginning in year 16, increasing to 0.25% in year 21. This persistency credit is
applied at the end of each policy year, based on the average annual unloaned policy accumulated value for the
year. The gross and net earnings rates shown on this illustration do not reflect the impact of this credit. For
the effects on the policy without this persistency credit, please refer to the guaranteed policy charge columns
in the illustration.
The amounts shown for Death Benefits, Accumulated Values and Cash Surrender Values also reflect the fact that
the net investment return on the variable investment options is lower than the gross return of the assets as a
result of the charges levied against the account.
FIXED ACCOUNT Net premiums or Accumulated Value may also be allocated to a choice of two fixed options: Fixed Account and
OPTION(S) Fixed LT Account. At the beginning of each year, a current rate will be declared and guaranteed for that year.
The guaranteed minimum annual interest rate on amounts allocated to the Fixed Account and Fixed LT Account is
3.00%. The current rate is set at Pacific Life & Annuity's discretion and is likely to change from year to year
but will never be less than the guaranteed rate. Our ability to pay these guarantees is backed by our financial
strength as a company.
There are limitations on transferring in and out of the Fixed Account and Fixed LT Account:
. You can make transfers from the variable investment options to the fixed options only in the policy month
right before each policy anniversary.
. You can only make one transfer from each Fixed Account option in any 12-month period, except if you have
signed up for the first year transfer program.
. Currently, the company has waived the restrictions for transfers from the Fixed LT Account option during the
first policy year. You will be permitted to transfer any amount out of the Fixed LT Account at any time
during the first twelve policy months. We reserve the right to discontinue this program at any time.
However, if the program is in effect on the date you sign the application for your policy, the waiver on
transfer restrictions will remain in effect for your first policy year. After the first policy year, you can
only transfer up to the greater of $5,000 or 10% of your policy's accumulated value in the Fixed LT Account
in any 12-month period.
. Fixed Account: Transfers into the Fixed Account in any 12-month period are limited to the greater of
$5,000 or 25% of your policy's accumulated value, except for scheduled transfers under the
first year transfer program.
. Fixed LT Account: Transfers into the Fixed LT Account in any 12-month period are limited to the greater of
$5,000 or 10% of your policy's accumulated value.
There is a limitation on amounts allocated to the Fixed LT Account during any 12-month period of $1,000,000
for all policies of the same owner.
For more information on the Fixed Account Option(s), please consult the product prospectus.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 5 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
This illustration does not reflect allocations to either fixed account.
DEDUCTIONS AND A Premium Load is deducted from each premium payment. The Accumulated Value is subject to several monthly
CHARGES charges: cost of insurance charges, administrative charge, mortality and expense risk charge, and deductions
for optional insurance benefits, if present.
The surrender charge is equal to a specified amount that is determined by the insured's age and risk
classification, the death benefit option selected, the policy face amount, and any face increases. Over time,
the surrender charge decreases until it reaches zero at the end of the 120th policy month. For more detailed
information about the surrender charge, please see the current prospectus.
LOANS/PARTIAL [Any loans or withdrawals illustrated are based on Current Policy Charge Assumptions and might not be
WITHDRAWALS available under Guaranteed Policy Charge Assumptions. Policy loans and/or Partial Withdrawals may have an
adverse effect on the policyowner's Benefits.
This illustration shows a policy loan. Interest is charged on policy loans at an effective annual rate of 4.10%
in arrears. The guaranteed interest rate credited to the portion of the Accumulated Value securing the policy
loan is 3.10% in policy years 1-10, 3.70% in policy years 11-20 and 3.85% thereafter. This illustration
reflects interest credited to the portion of the accumulated value securing the policy loan at a current
effective annual rate of 3.10% in policy years 1-10, 3.70% in policy years 11-20 and a current effective annual
rate of 4.10% thereafter. Pacific Life & Annuity reserves the right to decrease the current rate credited. For
example, we may decrease the rate credited if we believe that it is necessary to maintain the policy loan as a
non-taxable distribution. However we will not reduce the effective annual rate credited to less than the
guaranteed rate stated above. All values assume premiums and loan interest are paid when due. If a payment is
received without being designated as a premium payment or loan payment, and there is an outstanding loan, the
payment will be applied as a loan payment.
The loan is automatically repaid from the Gross Death Benefit at the death of the second insured, resulting in
the estimated payment to the beneficiary of the Net Death Benefit illustrated. Upon lapse or surrender, the
loan is automatically repaid, resulting in the estimated payment to the policyowner of the Net Surrender Value.
The automatic repayment of the loan during a lapse or surrender will cause the recognition of taxable income,
to the extent that the Net Surrender Value plus the amount of the repaid loan exceeds the policyowner's basis
in the policy.
The policy will lapse if the Accumulated Value less Policy Debt is insufficient to cover the current monthly
deduction for charges on any monthly payment date, and a grace period expires without the policyowner making a
sufficient payment. If the policy is insufficiently funded in relation to the income stream from the policy,
the policy can lapse prematurely and result in a significant income tax liability to the policyowner in the
year in which the lapse occurs.
A policyowner should be careful to structure a policy so that the policy will not lapse prematurely under
various market conditions or scenarios as a result of withdrawals and/or loans taken from the policy. The
policyowner should also request at least annually a revised illustration that reflects current policy values to
assure the policy is sufficiently funded to support a desired income stream, if any.]
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 6 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
FUTURE ACTION If you want to change the premium amount that you are billed, you must request the change in writing.
REQUIRED BY
POLICYOWNER [Policy loans or withdrawals are illustrated. This illustration assumes that a written request is submitted by
the policyowner at the start of the policy year indicated to receive the partial withdrawal or loan
illustrated, unless the policyowner is eligible for and elects the Automated Income Option (AIO).]
COLUMN Accumulated The total value of the amounts in the Investment Options for the Policy as well as any amounts
DEFINITIONS AND Value set aside in the Loan Account, including any accrued earned interest, as of the end of the
KEY TERMS policy year.
Age (BOY) The insured's age as of his or her nearest birthday as of the policy date, increased by the
number of complete policy years elapsed.
BOY Beginning of year.
Cash The Accumulated Value minus any applicable Surrender Charge as of the end of the policy year.
Surrender
Value (EOY)
Cum. Premium The illustrated premiums paid each year accumulated at a hypothetical rate of return of 5%.
Plus 5%
"Current Reflect current policy charges at the hypothetical gross earnings rate(s).
Policy
Charges"
columns
EOY End of year.
Estimated Estimated dollar amount of any tax that may be due as a result of a policy loan or partial
Tax on withdrawal.
Disbursements
Face Amount The minimum death benefit for so long as the policy remains in force. The face amount may be
increased or decreased under certain circumstances.
Fixed Account An account that is part of Pacific Life & Annuity's general account to which all or a portion
of the net premiums may be allocated for accumulation at a fixed rate of interest (which may
not be less than 3.0%) declared by Pacific Life & Annuity.
Fixed LT An account that is part of Pacific Life & Annuity's general account to which all or a portion
of the net premiums may be allocated for accumulation at a fixed rate of interest (which may
not be less than 3.0%) declared by Pacific Life & Annuity.
"Guaranteed Reflect maximum policy charges at 0% hypothetical gross investment return and at an assumed
Policy Charges" hypothetical gross earnings rate.
Columns
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 7 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Material Change IRC 7702A describes the 7-Pay Test and also provides that a Material Change will cause the
7-Pay Test period to start over. A Material Change may occur when there is an increase in
benefits, depending on the amount of cumulative premiums paid into the policy at that time. In
addition, a Material Change will occur if certain policy guarantees change (e.g. a change in
rating class).
Net Annual Loan The loan amount taken in cash from a policy. This does not include loans taken to pay loan
(BOY) interest.
Net Cash Cash Surrender Value after deducting any outstanding loan amount.
Surrender Value
Net Death The amount payable upon the second insured's death. The death benefit proceeds are always
Benefit (EOY) reduced by any outstanding loan balance and increased by any applicable rider benefits.
Partial A partial withdrawal of a portion of the Net Cash Surrender Value. All illustrated partial
Withdrawal withdrawals are based on current policy charges and hypothetical gross earnings rate
(BOY) assumptions and may not be available if actual experience is different from the assumptions.
Premium Outlay Annualized premiums that are the sum of the periodic payments you plan to make each year.
Variable A separate account of Pacific Life & Annuity or a subaccount of such a separate account, which
Investment is used only to support the variable death benefits and policy values of variable life
Options insurance policies, and the assets of which are segregated from the Pacific Life & Annuity's
general account and our other separate accounts.
TAX INFORMATION Although the information in this illustration is based on our understanding of the Internal Revenue Code (IRC)
and on certain tax and legal assumptions, it is not intended to be tax or legal advice. Such advice should be
obtained from your own counsel or other tax advisor.
The following tax rates have been used to estimate your taxes, if any, due to a policy loan or partial
withdrawal:
Assumed Income Tax Rate
Start End Rate
1 65 31.00%
Death Proceeds: Death benefit proceeds from a life insurance policy are generally excludable from the
beneficiary's gross income for income tax purposes.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 8 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Guideline Premium Test: A life insurance policy will qualify as life insurance under IRC Section 7702 if it
meets one of two alternative tests. This illustration uses the Guideline Premium Test which requires that the
sum of the premiums paid reduced by non-taxable partial withdrawals and non-taxable cash dividends at any time
does not exceed the greater of the guideline single premium or the sum of the guideline level premiums at such
time, and the death benefit payable under the policy at any time is at least equal to an applicable percentage
of the accumulated value (the "cash value corridor test"). For the policy being illustrated here, the Guideline
Single Premium at issue is $327,996.20 and the Guideline Level Premium at issue is $31,711.40 per year. Failure
to qualify as life insurance will have adverse tax consequences.
Withdrawals/Loans: Interest credited to the accumulated value of a life insurance policy is generally tax-
deferred and may be taxable at the time of partial withdrawal, surrender or lapse. Assuming the life insurance
policy is not a MEC (as described below), partial withdrawals are taxed under the "cost recovery rule" and are
generally taxable only to the extent the partial withdrawal exceeds the cost basis of the policy. Basis equals
the gross premiums paid less prior non-taxable partial withdrawals and non-taxable cash dividends. For a life
insurance policy that is not a Modified Endowment Contract as defined in IRC Sec. 7702A: Withdrawals in the
first 15 policy years may be taxable under IRC 7702(f)(7)(B); after 15 years, withdrawals up to policy tax
basis are not taxable; and policy loans are not taxable provided that the policy remains in force until the
insured dies. Withdrawals and policy loans may reduce policy values and death benefits.
If a life insurance policy loan is still outstanding when a policy is surrendered or lapses, the loan is
automatically repaid from policy values. This will result in taxable income to the extent the cash surrender
value plus the amount of the repaid loan exceeds the cost basis of the policy. Any tax estimate(s) included in
this illustration does not include an estimate of this tax.
If a life insurance policy loan is still outstanding at the time of death, the loan is automatically repaid
from the policy's death benefit. This use of the death benefit to repay a policy loan does not cause the
recognition of taxable income.
Modified Endowment Contracts: As defined in IRC Section 7702A, a modified endowment contract (MEC) is a life
insurance policy in which the cumulative premium payments (less non-taxable partial withdrawals and non-taxable
cash dividends) since the policy effective date exceeds, at any time during the first seven policy years, the
cumulative total of the Seven-Pay Premiums (the 7-pay test). The initial annual Seven-Pay Premium limit on the
policy being illustrated here is $79,505.37.
Generally, once a policy is a MEC, it is always a MEC. However, if premiums in excess of the Seven-Pay Premium
limit are paid, the MEC status can be avoided if such premium payments, plus interest (which is taxable), are
returned to the policyowner within 60 days after the end of the 'measuring year' in which the premium payment
was made. For this purpose, the 'measuring year' is the same as a policy year, except that, if the policy has a
Material Change then the 'measuring year' will run between anniversaries of the Material Change date instead.
Note, if a Material Change occurs on a date other than a policy anniversary, the specific timing of the 60-day
window may change.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 9 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Distributions from a MEC, either a partial withdrawal, a cash dividend, or loan, are taxed to the extent there
is a gain in the policy and may be subject to additional penalties. Distributions taken from a policy during
the two years prior to the policy becoming a MEC will be treated as taxable under MEC rules in the year the
policy becomes a MEC. This illustration does not reflect this taxation process.
If there is a "material change" in the terms or benefits of the policy, the 7-pay test will be applied as if
this is a new policy at the date of the material change.
Based on our understanding of the Internal Revenue Code and the assumptions in this illustration, THIS POLICY
WOULD NOT BECOME A MEC.
PREMIUM LIMITS Initial Guideline Single,Premium: $327,996.20
SUMMARY Initial Guideline Level Premium: $ 31,711.40
Initial Seven Pay Premium: $ 79,505.37
When the death benefit is greater than the face amount due to accumulated value growth, payment of additional
premium will be subject to approval.
POLICY FREE LOOK There is a free look right in the policy, which provides that you may return it within 10 days after you
RIGHT receive it. You need only deliver it to Pacific Life & Annuity Company or to the agent who delivered the policy
to you. In such case, the policy will be deemed void from the beginning and Pacific Life & Annuity Company will
refund the premiums paid. If the policy is issued as a replacement of existing coverage, the free look period
is 60 days and Pacific Life & Annuity Company will refund the policy value plus any charges and loads which
were deducted.
END OF SUMMARY PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 10 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Proposed Insured #1: Mr. SEP-NY 12 Simple Avg Death Benefit Option = Level Presented By:
Male, Age 55 Total Initial Face Amount = 1,500,000 PL agent
Select Nonsmoker Premium Payment Interval = Annual 12535 Insurance Dr
Proposed Insured #2: Mrs. Insured
Female, Age 55
Select Nonsmoker
Summary Page
- ------------------------------------------------------------------------------------------------------------------------------------
Current Policy Charges (1) Guaranteed Policy Charges (2)
Assuming Hypothetical Gross Assuming Hypothetical Gross Assuming Hypothetical Gross
Annual Investment Return of Annual Investment Return of Annual Investment Return of
12.00% (10.97% Net) 0.00% (-0.92% Net) 12.00% (10.97% Net)
------------------------------------------------------------------------------------------------
[Net
Loans Net Net Net Net Net Net
Planned Premiums and With- Accum'd Surr'r Death Accum'd Surr'r Death Accum'd Surr'r Death
Annual Plus 5% drawals Value Value Benefit Value Value Benefit Value Value Benefit
Yr Premium Interest (BOY)] (EOY) (EOY) (EOY) (EOY) (EOY) (EOY) (EOY) (EOY) (EOY)
- ------------------------------------------------------------------------------------------------------------------------------------
1 31,711 33,297 0 30,231 6,840 1,500,000 26,835 3,444 1,500,000 30,230 6,839 1,500,000
2 31,711 68,259 0 63,226 42,434 1,500,000 52,944 32,152 1,500,000 63,221 42,429 1,500,000
3 31,711 104,969 0 99,223 81,030 1,500,000 78,301 60,108 1,500,000 99,211 81,018 1,500,000
4 31,711 143,514 0 138,490 122,896 1,500,000 102,883 87,289 1,500,000 138,467 122,873 1,500,000
5 31,711 183,987 0 181,318 168,323 1,500,000 126,659 113,664 1,500,000 181,279 168,284 1,500,000
6 31,711 226,483 0 228,026 217,630 1,500,000 149,592 139,196 1,500,000 227,967 217,571 1,500,000
7 31,711 271,104 0 278,957 271,160 1,500,000 171,626 163,829 1,500,000 278,869 271,072 1,500,000
8 31,711 317,956 0 334,478 329,280 1,500,000 192,685 187,487 1,500,000 334,354 329,156 1,500,000
9 31,711 367,151 0 394,982 392,383 1,500,000 212,665 210,066 1,500,000 394,814 392,215 1,500,000
10 31,711 418,806 0 461,134 461,134 1,500,000 231,447 231,447 1,500,000 460,693 460,693 1,500,000
15 31,711 718,501 0 947,660 947,660 1,500,000 321,265 321,265 1,500,000 932,335 932,335 1,500,000
20 31,711 1,100,996 0 1,778,039 1,778,039 1,902,501 355,794 355,794 1,500,000 1,722,292 1,722,292 1,842,852
25 31,711 1,589,168 0 3,220,828 3,220,828 3,381,869 269,552 269,552 1,500,000 3,067,265 3,067,265 3,220,628
30 31,711 2,212,212 0 5,658,883 5,658,883 5,941,828 ## ## ## 5,254,505 5,254,505 5,517,230
35 31,711 3,007,393 0 9,755,279 9,755,279 10,243,042 8,706,160 8,706,160 9,141,468
## - Additional premiums are required to maintain the requested benefits.
All values except premiums, loans, loan interest and withdrawals are values at the end of the policy year. The 'Net Surrender Value'
column is equal to the accumulated value, less any policy debt and less any surrender charges. The 'Net Death Benefit' column is the
policy death benefit less any policy debt.
1 - The policy values under the Current Policy Charges heading reflect current policy charges, current cost of insurance rates,
current mortality and expense charges and the hypothetical gross earnings rate assumption described in the section entitled Gross
Hypothetical Returns. Current policy charges and cost of insurance rates are subject to change. Policy values will vary from those
illustrated if actual rates differ from those assumed. Current cost of insurance rates are not dependent upon future improvements in
underlying mortality.
2 - The policy values under the Guaranteed Policy Charges heading assume maximum cost of insurance rates.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 1 of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Important Information About Your Illustration
- ------------------------------------------------------------------------------------------------------------------------------------
THIS IS AN This is an illustration and not a contract. Although the information contained in this illustration is based
ILLUSTRATION, on certain tax and legal assumptions, it is not intended to be tax or legal advice. Such advice should be
NOT A CONTRACT obtained from the applicant's own counsel or other advisor.
This illustration is prepared for presentation in the state of NY.
ILLUSTRATED
BENEFITS: Death Benefit Option
Start End Option
1 65 Level
Base Policy Face Amount
Start End Amount
1 65 1,500,000
PREMIUM Illustrated periodic premium payments are assumed to be made one time per year at the beginning of each
FREQUENCY: premium payment interval.
ANNUAL
TIMING OF All values assume premiums and loan interest are paid when due. If a payment is received without being
PAYMENTS designated as a premium payment or loan payment, and there is an outstanding loan, the payment will be applied
as a loan payment.
All values except premiums, loans, loan interest and withdrawals are values at the end of the policy year.
GROSS You have selected to have your accumulated value allocated to the variable investment options.
HYPOTHETICAL
RETURNS
Hypothetical Gross Earnings Rate
Start End Gross Net
1 65 12.00% 10.97%
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 2 of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
The hypothetical rates of return and values shown are illustrative only and should not be deemed as a
representation of past or future investment results. The illustrated policy values might not be achieved if
actual rates of return, policy charges, premium amount or frequency differ from those assumed. Actual rates of
return may be more or less than those shown and will depend on a number of factors including the investment
allocations made to the variable investment options by the policyowner and the experience of those investment
options. No representation can be made by Pacific Life & Annuity, the Separate Account, or the underlying Fund
that these hypothetical rates of return can be achieved for any one year or sustained over any period of time.
The gross annual earnings rate assumption is after brokerage expenses and any foreign taxes. A portfolio's
foreign investment may be subject to foreign taxes. Foreign taxes from interest and dividend income are
treated as a deduction from relevant income for accounting purposes rather than an expense.
SUB-ACCOUNT This illustration assumes that all net premiums (after deduction of premium load) have been allocated to the
ALLOCATION variable investment options. The amounts shown for Death Benefits, Accumulated Values and Cash Surrender Values
in this illustration reflect an average daily investment advisory fee equivalent to an annual rate of 0.85% of
the aggregate average daily net assets of the fund. The policy values also reflect net operating expenses
(after any offset for custodian credits and excluding any foreign taxes) at an annual rate of 0.07% of the
aggregate average daily net assets of the portfolios. The total aggregate annualized expenses for the periods
ending December 31, 2000 (including investment advisory fees and excluding any foreign taxes) is 0.92%.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 3 of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Portfolio Investment Operating
Advisory Fee Expenses
Aggressive Equity 0.80% 0.04%
Aggressive Growth 1.00% 0.06%
Blue Chip 0.95% 0.06%
Capital Opportunities 0.80% 0.06%
Diversified Research 0.90% 0.08%
Emerging Markets 1.10% 0.20%
Equity 0.65% 0.04%
Equity Income 0.95% 0.10%
Equity Index 0.25% 0.04%
Financial Services 1.10% 0.10%
Focused 30 0.95% 0.10%
Global Growth 1.10% 0.19%
Growth LT 0.75% 0.04%
Health Sciences 1.10% 0.10%
High Yield Bond 0.60% 0.04%
I-Net Tollkeeper 1.40% 0.06%
Inflation Managed 0.60% 0.02%
International Large-Cap 1.05% 0.12%
International Value 0.85% 0.11%
Large-Cap Core 0.65% 0.04%
Large-Cap Value 0.85% 0.05%
Managed Bond 0.60% 0.04%
Mid-Cap Growth 0.90% 0.06%
Mid-Cap Value 0.85% 0.03%
Money Market 0.34% 0.04%
Multi-Strategy 0.65% 0.04%
REIT 1.10% 0.04%
Research 1.00% 0.10%
Small-Cap Equity 0.65% 0.04%
Small-Cap Index 0.50% 0.10%
Strategic Value 0.95% 0.10%
Technology 1.10% 0.08%
Telecommunications 1.10% 0.08%
The investment advisory fees and net operating expenses for the underlying portfolios reflect fees and
expenses incurred by the portfolios for the periods ending December 31, 2000. The operating expenses for
Aggressive Growth, Blue Chip, Capital Opportunities, Equity Income, Financial Services, Global Growth, Health
Sciences, Mid-Cap Growth, Research, Technology, and Telecommunications are estimated. The Inflation Managed
portfolio was formerly called the Government Securities portfolio. The Large-Cap Core portfolio was formerly
called the Equity Income portfolio.
Although some portfolios may have names or investment objectives that resemble retail mutual funds managed by
the portfolio manager, these portfolios will not have the same underlying holdings or performance.
Please note: Net Premiums and Policy Accumulated Value may be invested in up to twenty (20) investment options
at one time.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 4 of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
NET ANNUAL After deduction of the investment advisory fees and other operating expenses, illustrated gross annual
RETURN investment returns of 0% and 12.00% correspond to approximate net annual rates of return of -0.92% and 10.97%
respectively.
The amounts shown for Death Benefits, Accumulated Values and Cash Surrender Values reflect a non-guaranteed
persistency credit of 0.15% beginning in year 16, increasing to 0.25% in year 21. This persistency credit is
applied at the end of each policy year, based on the average annual unloaned policy accumulated value for the
year. The gross and net earnings rates shown on this illustration do not reflect the impact of this credit.
For the effects on the policy without this persistency credit, please refer to the guaranteed policy charge
columns in the illustration.
The amounts shown for Death Benefits, Accumulated Values and Cash Surrender Values also reflect the fact that
the net investment return on the variable investment options is lower than the gross return of the assets as a
result of the charges levied against the account.
FIXED ACCOUNT Net premiums or Accumulated Value may also be allocated to a choice of two fixed options: Fixed Account and
OPTION(S) Fixed LT Account. At the beginning of each year, a current rate will be declared and guaranteed for that year.
The guaranteed minimum annual interest rate on amounts allocated to the Fixed Account and Fixed LT Account is
3.00%. The current rate is set at Pacific Life & Annuity's discretion and is likely to change from year to
year but will never be less than the guaranteed rate. Our ability to pay these guarantees is backed by our
financial strength as a company.
There are limitations on transferring in and out of the Fixed Account and Fixed LT Account:
. You can make transfers from the variable investment options to the fixed options only in the policy month
right before each policy anniversary.
. You can only make one transfer from each Fixed Account option in any 12-month period, except if you have
signed up for the first year transfer program.
. Currently, the company has waived the restrictions for transfers from the Fixed LT Account option during
the first policy year. You will be permitted to transfer any amount out of the Fixed LT Account at any time
during the first twelve policy months. We reserve the right to discontinue this program at any time.
However, if the program is in effect on the date you sign the application for your policy, the waiver on
transfer restrictions will remain in effect for your first policy year. After the first policy year, you
can only transfer up to the greater of $5,000 or 10% of your policy's accumulated value in the Fixed LT
Account in any 12-month period.
. Fixed Account: Transfers into the Fixed Account in any 12-month period are limited to the greater of
$5,000 or 25% of your policy's accumulated value, except for scheduled transfers under
the first year transfer program.
. Fixed LT Account: Transfers into the Fixed LT Account in any 12-month period are limited to the greater
of $5,000 or 10% of your policy's accumulated value.
There is a limitation on amounts allocated to the Fixed LT Account during any 12-month period of $1,000,000
for all policies of the same owner.
For more information on the Fixed Account Option(s), please consult the product prospectus.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 5 of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
This illustration does not reflect allocations to either fixed account.
DEDUCTIONS AND A Premium Load is deducted from each premium payment. The Accumulated Value is subject to several monthly
CHARGES charges: cost of insurance charges, administrative charge, mortality and expense risk charge, and deductions
for optional insurance benefits, if present.
The surrender charge is equal to a specified amount that is determined by the insured's age and risk
classification, the death benefit option selected, the policy face amount, and any face increases. Over
time, the surrender charge decreases until it reaches zero at the end of the 120th policy month. For more
detailed information about the surrender charge, please see the current prospectus.
LOANS/PARTIAL [Any loans or withdrawals illustrated are based on Current Policy Charge Assumptions and might not be
WITHDRAWALS available under Guaranteed Policy Charge Assumptions. Policy loans and/or Partial Withdrawals may have an
adverse effect on the policyowner's Benefits.
This illustration shows a policy loan. Interest is charged on policy loans at an effective annual rate of
4.10% in arrears. The guaranteed interest rate credited to the portion of the Accumulated Value securing the
policy loan is 3.10% in policy years 1-10, 3.70% in policy years 11-20 and 3.85% thereafter. This illustration
reflects interest credited to the portion of the accumulated value securing the policy loan at a current
effective annual rate of 3.10% in policy years 1-10, 3.70% in policy years 11-20 and a current effective
annual rate of 4.10% thereafter. Pacific Life & Annuity reserves the right to decrease the current rate
credited. For example, we may decrease the rate credited if we believe that it is necessary to maintain the
policy loan as a non-taxable distribution. However we will not reduce the effective annual rate credited to
less than the guaranteed rate stated above. All values assume premiums and loan interest are paid when due. If
a payment is received without being designated as a premium payment or loan payment, and there is an
outstanding loan, the payment will be applied as a loan payment.
The loan is automatically repaid from the Gross Death Benefit at the death of the second insured, resulting in
the estimated payment to the beneficiary of the Net Death Benefit illustrated. Upon lapse or surrender, the
loan is automatically repaid, resulting in the estimated payment to the policyowner of the Net Surrender
Value. The automatic repayment of the loan during a lapse or surrender will cause the recognition of taxable
income, to the extent that the Net Surrender Value plus the amount of the repaid loan exceeds the
policyowner's basis in the policy.
The policy will lapse if the Accumulated Value less Policy Debt is insufficient to cover the current monthly
deduction for charges on any monthly payment date, and a grace period expires without the policyowner making a
sufficient payment. If the policy is insufficiently funded in relation to the income stream from the policy,
the policy can lapse prematurely and result in a significant income tax liability to the policyowner in the
year in which the lapse occurs.
A policyowner should be careful to structure a policy so that the policy will not lapse prematurely under
various market conditions or scenarios as a result of withdrawals and/or loans taken from the policy. The
policyowner should also request at least annually a revised illustration that reflects current policy values
to assure the policy is sufficiently funded to support a desired income stream, if any.]
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 6 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
FUTURE ACTION If you want to change the premium amount that you are billed, you must request the change in writing.
REQUIRED BY
POLICYOWNER [Policy loans or withdrawals are illustrated. This illustration assumes that a written request is submitted by
the policyowner at the start of the policy year indicated to receive the partial withdrawal or loan
illustrated, unless the policyowner is eligible for and elects the Automated Income Option (AIO).]
COLUMN Accumulated The total value of the amounts in the Investment Options for the Policy as well as any
DEFINITIONS AND Value amounts set aside in the Loan Account, including any accrued earned interest, as of the end
KEY TERMS of the policy year.
Age (BOY) The insured's age as of his or her nearest birthday as of the policy date, increased by the
number of complete policy years elapsed.
BOY Beginning of year.
Cash Surrender The Accumulated Value minus any applicable Surrender Charge as of the end of the policy year.
Value (EOY)
Cum. Premium The illustrated premiums paid each year accumulated at a hypothetical rate of return of 5%.
Plus 5%
"Current Reflect current policy charges at the hypothetical gross earnings rate(s).
Policy
Charges"
columns
EOY End of year.
Estimated Estimated dollar amount of any tax that may be due as a result of a policy loan or partial
Tax on withdrawal.
Disbursements
Face Amount The minimum death benefit for so long as the policy remains in force. The face amount may
be increased or decreased under certain circumstances.
Fixed Account An account that is part of Pacific Life & Annuity's general account to which all or a portion
of the net premiums may be allocated for accumulation at a fixed rate of interest (which
may not be less than 3.0%) declared by Pacific Life & Annuity.
Fixed LT An account that is part of Pacific Life & Annuity's general account to which all or a
Account portion of the net premiums may be allocated for accumulation at a fixed rate of interest
(which may not be less than 3.0%) declared by Pacific Life & Annuity.
"Guaranteed Reflect maximum policy charges at 0% hypothetical gross investment return and at an assumed
Policy Charges" hypothetical gross earnings rate.
columns
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 7 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Material IRC 7702A describes the 7-Pay Test and also provides that a Material Change will cause the
Change 7-Pay Test period to start over. A Material Change may occur when there is an increase in
benefits, depending on the amount of cumulative premiums paid into the policy at that time.
In addition, a Material Change will occur if certain policy guarantees change (e.g. a change
in rating class).
Net Annual The loan amount taken in cash from a policy. This does not include loans taken to pay loan
Loan (BOY) interest.
Net Cash Cash Surrender Value after deducting any outstanding loan amount.
Surrender
Value
Net Death The amount payable upon the second insured's death. The death benefit proceeds are always
Benefit (EOY) reduced by any outstanding loan balance and increased by any applicable rider benefits.
Partial A partial withdrawal of a portion of the Net Cash Surrender Value. All illustrated partial
Withdrawal withdrawals are based on current policy charges and hypothetical gross earnings rate
(BOY) assumptions and may not be available if actual experience is different from the assumptions.
Premium Outlay Annualized premiums that are the sum of the periodic payments you plan to make each year.
Variable A separate account of Pacific Life & Annuity or a subaccount of such a separate account,
Investment which is used only to support the variable death benefits and policy values of variable life
Options insurance policies, and the assets of which are segregated from the Pacific Life & Annuity's
general account and our other separate accounts.
TAX INFORMATION Although the information in this illustration is based on our understanding of the Internal Revenue Code
(IRC) and on certain tax and legal assumptions, it is not intended to be tax or legal advice. Such advice
should be obtained from your own counsel or other tax advisor.
The following tax rates have been used to estimate your taxes, if any, due to a policy loan or partial
withdrawal:
Assumed Income Tax Rate
Start End Rate
1 65 31.00%
Death Proceeds: Death benefit proceeds from a life insurance policy are generally excludable from the
beneficiary's gross income for income tax purposes.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 8 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Guideline Premium Test: A life insurance policy will qualify as life insurance under IRC Section 7702 if it
meets one of two alternative tests. This illustration uses the Guideline Premium Test which requires that the
sum of the premiums paid reduced by non-taxable partial withdrawals and non-taxable cash dividends at any time
does not exceed the greater of the guideline single premium or the sum of the guideline level premiums at such
time, and the death benefit payable under the policy at any time is at least equal to an applicable percentage
of the accumulated value (the "cash value corridor test"). For the policy being illustrated here, the
Guideline Single Premium at issue is $327,996.20 and the Guideline Level Premium at issue is $31,711.40 per
year. Failure to qualify as life insurance will have adverse tax consequences.
Withdrawals/Loans: Interest credited to the accumulated value of a life insurance policy is generally tax-
deferred and may be taxable at the time of partial withdrawal, surrender or lapse. Assuming the life insurance
policy is not a MEC (as described below), partial withdrawals are taxed under the "cost recovery rule" and are
generally taxable only to the extent the partial withdrawal exceeds the cost basis of the policy. Basis equals
the gross premiums paid less prior non-taxable partial withdrawals and non-taxable cash dividends. For a life
insurance policy that is not a Modified Endowment Contract as defined in IRC Sec. 7702A: Withdrawals in the
first 15 policy years may be taxable under IRC 7702(f)(7)(B); after 15 years, withdrawals up to policy tax
basis are not taxable; and policy loans are not taxable provided that the policy remains in force until the
insured dies. Withdrawals and policy loans may reduce policy values and death benefits.
If a life insurance policy loan is still outstanding when a policy is surrendered or lapses, the loan is
automatically repaid from policy values. This will result in taxable income to the extent the cash surrender
value plus the amount of the repaid loan exceeds the cost basis of the policy. Any tax estimate(s) included in
this illustration does not include an estimate of this tax.
If a life insurance policy loan is still outstanding at the time of death, the loan is automatically repaid
from the policy's death benefit. This use of the death benefit to repay a policy loan does not cause the
recognition of taxable income.
Modified Endowment Contracts: As defined in IRC Section 7702A, a modified endowment contract (MEC) is a life
insurance policy in which the cumulative premium payments (less non-taxable partial withdrawals and non-
taxable cash dividends) since the policy effective date exceeds, at any time during the first seven policy
years, the cumulative total of the Seven-Pay Premiums (the 7-pay test). The initial annual Seven-Pay Premium
limit on the policy being illustrated here is $79,505.37.
Generally, once a policy is a MEC, it is always a MEC. However, if premiums in excess of the Seven-Pay
Premium limit are paid, the MEC status can be avoided if such premium payments, plus interest (which is
taxable), are returned to the policyowner within 60 days after the end of the 'measuring year' in which the
premium payment was made. For this purpose, the 'measuring year' is the same as a policy year, except that,
if the policy has a Material Change then the 'measuring year' will run between anniversaries of the Material
Change date instead. Note, if a Material Change occurs on a date other than a policy anniversary, the
specific timing of the 60-day window may change.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 9 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Distributions from a MEC, either a partial withdrawal, a cash dividend, or loan, are taxed to the extent
there is a gain in the policy and may be subject to additional penalties. Distributions taken from a policy
during the two years prior to the policy becoming a MEC will be treated as taxable under MEC rules in the
year the policy becomes a MEC. This illustration does not reflect this taxation process.
If there is a "material change" in the terms or benefits of the policy, the 7-pay test will be applied as if
this is a new policy at the date of the material change.
Based on our understanding of the Internal Revenue Code and the assumptions in this illustration,
THIS POLICY WOULD NOT BECOME A MEC.
PREMIUM LIMITS Initial Guideline Single Premium: $327,996.20
SUMMARY Initial Guideline Level Premium: $31,711.40
Initial Seven Pay Premium: $79,505.37
When the death benefit is greater than the face amount due to accumulated value growth, payment of additional
premium will be subject to approval.
POLICY FREE LOOK There is a free look right in the policy, which provides that you may return it within 10 days after you
RIGHT receive it. You need only deliver it to Pacific Life & Annuity Company or to the agent who delivered the
policy to you. In such case, the policy will be deemed void from the beginning and Pacific Life & Annuity
Company will refund the premiums paid. If the policy is issued as a replacement of existing coverage, the free
look period is 60 days and Pacific Life & Annuity Company will refund the policy value plus any charges and
loads which were deducted.
END OF SUMMARY PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Simple Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 10 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Proposed Insured #1: Mr. SEP-NY 6 Weighted Avg Death Benefit Option = Level Presented By:
Male, Age 55 Total Initial Face Amount = 1,500,000 PL agent
Select Nonsmoker Premium Payment Interval = Annual 12535 Insurance Dr
Proposed Insured #2: Mrs. Insured
Female, Age 55
Select Nonsmoker
Summary Page
- ------------------------------------------------------------------------------------------------------------------------------------
Current Policy Charges (1) Guaranteed Policy Charges (2)
Assuming Hypothetical Gross Assuming Hypothetical Gross Assuming Hypothetical Gross
Annual Investment Return of Annual Investment Return of Annual Investment Return of
6.00% (5.25% Net) 0.00% (-0.71% Net) 6.00% (5.25% Net)
----------------------------------------------------------------------------------------------
[Net
Loans Net Net Net Net Net Net
Planned Premiums and With- Accum'd Surr'r Death Accum'd Surr'r Death Accum'd Surr'r Death
Annual Plus 5% drawals Value Value Benefit Value Value Benefit Value Value Benefit
Yr Premium Interest (BOY)] (EOY) (EOY) (EOY) (EOY) (EOY) (EOY) (EOY) (EOY) (EOY)
- ------------------------------------------------------------------------------------------------------------------------------------
1 31,711 33,297 0 28,596 5,205 1,500,000 26,895 3,504 1,500,000 28,595 5,204 1,500,000
2 31,711 68,259 0 58,178 37,386 1,500,000 53,118 32,326 1,500,000 58,173 37,381 1,500,000
3 31,711 104,969 0 88,749 70,556 1,500,000 78,643 60,450 1,500,000 88,738 70,545 1,500,000
4 31,711 143,514 0 120,318 104,724 1,500,000 103,441 87,847 1,500,000 120,297 104,703 1,500,000
5 31,711 183,987 0 152,888 139,893 1,500,000 127,481 114,486 1,500,000 152,853 139,858 1,500,000
6 31,711 226,483 0 186,456 176,060 1,500,000 150,724 140,328 1,500,000 186,402 176,006 1,500,000
7 31,711 271,104 0 221,006 213,209 1,500,000 173,111 165,314 1,500,000 220,927 213,130 1,500,000
8 31,711 317,956 0 256,504 251,306 1,500,000 194,564 189,366 1,500,000 256,394 251,196 1,500,000
9 31,711 367,151 0 292,891 290,292 1,500,000 214,977 212,378 1,500,000 292,742 290,143 1,500,000
10 31,711 418,806 0 330,333 330,333 1,500,000 234,228 234,228 1,500,000 329,902 329,902 1,500,000
15 31,711 718,501 0 570,589 570,589 1,500,000 327,089 327,089 1,500,000 552,351 552,351 1,500,000
20 31,711 1,100,996 0 886,032 886,032 1,500,000 365,666 365,666 1,500,000 802,371 802,371 1,500,000
25 31,711 1,589,168 0 1,317,535 1,317,535 1,500,000 284,945 284,945 1,500,000 1,094,749 1,094,749 1,500,000
30 31,711 2,212,212 0 1,885,185 1,885,185 1,979,445 ## ## ## 1,495,540 1,495,540 1,570,317
35 31,711 3,007,393 0 2,615,161 2,615,161 2,745,919 2,026,136 2,026,136 2,127,443
## - Additional premiums are required to maintain the requested benefits.
All values except premiums, loans, loan interest and withdrawals are values at the end of the policy year. The 'Net Surrender Value'
column is equal to the accumulated value, less any policy debt and less any surrender charges. The 'Net Death Benefit' column is the
policy death benefit less any policy debt.
1 - The policy values under the Current Policy Charges heading reflect current policy charges, current cost of insurance rates,
current mortality and expense charges and the hypothetical gross earnings rate assumption described in the section entitled Gross
Hypothetical Returns. Current policy charges and cost of insurance rates are subject to change. Policy values will vary from those
illustrated if actual rates differ from those assumed. Current cost of insurance rates are not dependent upon future improvements in
underlying mortality.
2 - The policy values under the Guaranteed Policy Charges heading assume maximum cost of insurance rates.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 1 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Important Information About Your Illustration
- -------------------------------------------------------------------------------------------------------------------------
THIS IS AN This is an illustration and not a contract. Although the information contained in this illustration
ILLUSTRATION, is based on certain tax and legal assumptions, it is not intended to be tax or legal advice. Such
NOT A CONTRACT advice should be obtained from the applicant's own counsel or other advisor.
This illustration is prepared for presentation in the state of NY.
ILLUSTRATED
BENEFITS: Death Benefit Option
Start End Option
1 65 Level
Base Policy Face Amount
Start End Amount
1 65 1,500,000
PREMIUM Illustrated periodic premium payments are assumed to be made one time per year at the beginning of
FREQUENCY: each premium payment interval.
ANNUAL
TIMING OF All values assume premiums and loan interest are paid when due. If a payment is received without
PAYMENTS being designated as a premium payment or loan payment, and there is an outstanding loan, the
payment will be applied as a loan payment.
All values except premiums, loans, loan interest and withdrawals are values at the end of the
policy year.
GROSS You have selected to have your accumulated value allocated to the variable investment options.
HYPOTHETICAL
RETURNS
Hypothetical Gross Earnings Rate
Start End Gross Net
1 65 6.00% 5.25%
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 2 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
The hypothetical rates of return and values shown are illustrative only and should not be deemed as a
representation of past or future investment results. The illustrated policy values might not be achieved if
actual rates of return, policy charges, premium amount or frequency differ from those assumed. Actual rates of
return may be more or less than those shown and will depend on a number of factors including the investment
allocations made to the variable investment options by the policyowner and the experience of those investment
options. No representation can be made by Pacific Life & Annuity, the Separate Account, or the underlying Fund
that these hypothetical rates of return can be achieved for any one year or sustained over any period of time.
The gross annual earnings rate assumption is after brokerage expenses and any foreign taxes. A portfolio's
foreign investment may be subject to foreign taxes. Foreign taxes from interest and dividend income are treated
as a deduction from relevant income for accounting purposes rather than an expense.
SUB-ACCOUNT This illustration assumes that all net premiums (after deduction of premium load) have been allocated
ALLOCATION to the variable investment options. You have requested that this illustration reflect your selection of
investment options. The amounts shown for the Death Benefits, Accumulated Values and Cash Surrender Values in
this illustration reflect your selection of investment options and the underlying portfolios' annualized fund
expenses (excluding any foreign taxes) incurred by the portfolios for the periods ending December 31, 2000
adjusted to reflect a decrease in fees for certain operating expenses.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 3 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Investment
Portfolio Advisory Operating
Fee Expenses
Aggressive Equity 0.80% 0.04%
Aggressive Growth 1.00% 0.06%
Blue Chip 0.95% 0.06%
Capital Opportunities 0.80% 0.06%
Diversified Research 0.90% 0.08%
Emerging Markets 1.10% 0.20%
Equity 0.65% 0.04%
Equity Income 0.95% 0.10%
Equity Index 0.25% 0.04%
Financial Services 1.10% 0.10%
Focused 30 0.95% 0.10%
Global Growth 1.10% 0.19%
Growth LT 0.75% 0.04%
Health Sciences 1.10% 0.10%
High Yield Bond 0.60% 0.04%
I-Net Tollkeeper 1.40% 0.06%
Inflation Managed 0.60% 0.02%
International Large-Cap 1.05% 0.12%
International Value 0.85% 0.11%
Large-Cap Core 0.65% 0.04%
Large-Cap Value 0.85% 0.05%
Managed Bond 0.60% 0.04%
Mid-Cap Growth 0.90% 0.06%
Mid-Cap Value 0.85% 0.03%
Money Market 0.34% 0.04%
Multi-Strategy 0.65% 0.04%
REIT 1.10% 0.04%
Research 1.00% 0.10%
Small-Cap Equity 0.65% 0.04%
Small-Cap Index 0.50% 0.10%
Strategic Value 0.95% 0.10%
Technology 1.10% 0.08%
Telecommunications 1.10% 0.08%
You have selected allocations in the investment options that reflect the weighted annualized expenses of all
the available underlying portfolios as of December 31, 2000. The annualized expenses of the underlying
portfolios weighted according to your selection is equivalent to an annual rate of 0.66% for investment
advisory fees and 0.05% for operating expenses (after any offset for custodian credits and excluding any
foreign taxes) which amounts to a total of 0.71%. The investment advisory fees and net operating expenses for
the underlying portfolios reflect fees and expenses incurred by the portfolios for the periods ending December
31, 2000. The operating expenses for Aggressive Growth, Blue Chip, Capital Opportunities, Equity Income,
Financial Services, Global Growth, Health Sciences, Mid-Cap Growth, Research, Technology, and
Telecommunications are estimated. The Inflation Managed portfolio was formerly called the Government Securities
portfolio. The Large-Cap Core portfolio was formerly called the Equity Income portfolio.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 4 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Although some portfolios may have names or investment objectives that resemble retail mutual funds managed by
the portfolio manager, these portfolios will not have the same underlying holdings or performance.
Please note: Net Premiums and Policy Accumulated Value may be invested in up to twenty (20) investment options
at one time.
The annualized expenses for all available portfolios for the periods ending December 31, 2000 reflect an
average daily investment advisory fee equivalent to an annual rate of 0.85% of the aggregate average daily net
assets of the fund. They also reflect net operating expenses (after any offset for custodian credits and
excluding any foreign taxes) at an annual rate of 0.07% of the aggregate average daily net assets of the
portfolios. The total aggregate annualized expenses for the periods ending December 31, 2000 (including
investment advisory fees and excluding any foreign taxes) is 0.92%.
NET ANNUAL After deduction of the investment advisory fees and other operating expenses, illustrated gross annual
RETURN investment returns of 0% and 6.00% correspond to approximate net annual rates of return of -0.71% and 5.25%
respectively.
The amounts shown for Death Benefits, Accumulated Values and Cash Surrender Values reflect a non-guaranteed
persistency credit of 0.15% beginning in year 16, increasing to 0.25% in year 21. This persistency credit is
applied at the end of each policy year, based on the average annual unloaned policy accumulated value for the
year. The gross and net earnings rates shown on this illustration do not reflect the impact of this credit. For
the effects on the policy without this persistency credit, please refer to the guaranteed policy charge columns
in the illustration.
The amounts shown for Death Benefits, Accumulated Values and Cash Surrender Values also reflect the fact that
the net investment return on the variable investment options is lower than the gross return of the assets as a
result of the charges levied against the account.
FIXED ACCOUNT Net premiums or Accumulated Value may also be allocated to a choice of two fixed options:
OPTION(S) Fixed Account and Fixed LT Account. At the beginning of each year, a current rate will be declared and
guaranteed for that year. The guaranteed minimum annual interest rate on amounts allocated to the Fixed Account
and Fixed LT Account is 3.00%. The current rate is set at Pacific Life & Annuity's discretion and is likely to
change from year to year but will never be less than the guaranteed rate. Our ability to pay these guarantees
is backed by our financial strength as a company.
There are limitations on transferring in and out of the Fixed Account and Fixed LT Account:
. You can make transfers from the variable investment options to the fixed options only in the policy month
right before each policy anniversary.
. You can only make one transfer from each Fixed Account option in any 12-month period, except if you have
signed up for the first year transfer program.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 5 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver- NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
. Currently, the company has waived the restrictions for transfers from the Fixed LT Account option during the
first policy year. You will be permitted to transfer any amount out of the Fixed LT Account at any time
during the first twelve policy months. We reserve the right to discontinue this program at any time. However,
if the program is in effect on the date you sign the application for your policy, the waiver on transfer
restrictions will remain in effect for your first policy year. After the first policy year, you can only
transfer up to the greater of $5,000 or 10% of your policy's accumulated value in the Fixed LT Account in any
12-month period.
. Fixed Account: Transfers into the Fixed Account in any 12-month period are limited to the greater of
$5,000 or 25% of your policy's accumulated value, except for scheduled transfers under
the first year transfer program.
. Fixed LT Account: Transfers into the Fixed LT Account in any 12-month period are limited to the greater
of $5,000 or 10% of your policy's accumulated value.
There is a limitation on amounts allocated to the Fixed LT Account during any 12-month period of $1,000,000
for all policies of the same owner.
For more information on the Fixed Account Option(s), please consult the product prospectus.
This illustration does not reflect allocations to either fixed account.
DEDUCTIONS AND A Premium Load is deducted from each premium payment. The Accumulated Value is subject to several monthly
CHARGES charges: cost of insurance charges, administrative charge, mortality and expense risk charge, and deductions
for optional insurance benefits, if present.
The surrender charge is equal to a specified amount that is determined by the insured's age and risk
classification, the death benefit option selected, the policy face amount, and any face increases. Over time,
the surrender charge decreases until it reaches zero at the end of the 120th policy month. For more detailed
information about the surrender charge, please see the current prospectus.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 6 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver- NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
LOANS/PARTIAL [Any loans or withdrawals illustrated are based on Current Policy Charge Assumptions and might not be
WITHDRAWALS available under Guaranteed Policy Charge Assumptions. Policy loans and/or Partial Withdrawals may have an
adverse effect on the policyowner's Benefits.
This illustration shows a policy loan. Interest is charged on policy loans at an effective annual rate of
4.10% in arrears. The guaranteed interest rate credited to the portion of the Accumulated Value securing the
policy loan is 3.10% in policy years 1-10, 3.70% in policy years 11-20 and 3.85% thereafter. This
illustration reflects interest credited to the portion of the accumulated value securing the policy loan at a
current effective annual rate of 3.10% in policy years 1-10, 3.70% in policy years 11-20 and a current
effective annual rate of 4.10% thereafter. Pacific Life & Annuity reserves the right to decrease the current
rate credited. For example, we may decrease the rate credited if we believe that it is necessary to maintain
the policy loan as a non-taxable distribution. However we will not reduce the effective annual rate credited
to less than the guaranteed rate stated above. All values assume premiums and loan interest are paid when
due. If a payment is received without being designated as a premium payment or loan payment, and there is an
outstanding loan, the payment will be applied as a loan payment.
The loan is automatically repaid from the Gross Death Benefit at the death of the second insured, resulting
in the estimated payment to the beneficiary of the Net Death Benefit illustrated. Upon lapse or surrender,
the loan is automatically repaid, resulting in the estimated payment to the policyowner of the Net Surrender
Value. The automatic repayment of the loan during a lapse or surrender will cause the recognition of taxable
income, to the extent that the Net Surrender Value plus the amount of the repaid loan exceeds the
policyowner's basis in the policy.
The policy will lapse if the Accumulated Value less Policy Debt is insufficient to cover the current monthly
deduction for charges on any monthly payment date, and a grace period expires without the policyowner making
a sufficient payment. If the policy is insufficiently funded in relation to the income stream from the
policy, the policy can lapse prematurely and result in a significant income tax liability to the policyowner
in the year in which the lapse occurs.
A policyowner should be careful to structure a policy so that the policy will not lapse prematurely under
various market conditions or scenarios as a result of withdrawals and/or loans taken from the policy. The
policyowner should also request at least annually a revised illustration that reflects current policy values
to assure the policy is sufficiently funded to support a desired income stream, if any.]
FUTURE ACTION If you want to change the premium amount that you are billed, you must request the change in writing.
REQUIRED BY
POLICYOWNER Policy loans or withdrawals are illustrated. This illustration assumes that a written request is submitted by
the policyowner at the start of the policy year indicated to receive the partial withdrawal or loan
illustrated, unless the policyowner is eligible for and elects the Automated Income Option (AIO).
COLUMN Accumulated The total value of the amounts in the Investment Options for the Policy as well as any amount
DEFINITIONS AND Value set aside in the Loan Account, including any accrued earned interest, as of the end of the
KEY TERMS policy year.
Age (BOY) The insured's age as of his or her nearest birthday as of the policy date, increased by the
number of complete policy years elapsed.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 7 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
BOY Beginning of year.
Cash Surrender The Accumulated Value minus any applicable Surrender Charge as of the end of the
Value (EOY) policy year.
Cum. Premium The illustrated premiums paid each year accumulated at a hypothetical rate of return
Plus 5% of 5%.
"Current Policy Reflect current policy charges at the hypothetical gross earnings rate(s).
Charges"
columns
EOY End of year.
Estimated Tax on Estimated dollar amount of any tax that may be due as a result of a policy loan or
Disbursements partial withdrawal.
Face Amount The minimum death benefit for so long as the policy remains in force. The face amount
may be increased or decreased under certain circumstances.
Fixed Account An account that is part of Pacific Life & Annuity's general account to which all or a
portion of the net premiums may be allocated for accumulation at a fixed rate of
interest (which may not be less than 3.0%) declared by Pacific Life & Annuity.
Fixed LT An account that is part of Pacific Life & Annuity's general account to which all or
Account a portion of the net premiums may be allocated for accumulation at a fixed rate of
interest (which may not be less than 3.0%) declared by Pacific Life & Annuity.
"Guaranteed Reflect maximum policy charges at 0% hypothetical gross investment return and at an
Policy Charges" assumed hypothetical gross earnings rate.
columns
Material Change IRC 7702A describes the 7-Pay Test and also provides that a Material Change will cause
the 7-Pay Test period to start over. A Material Change may occur when there is an
increase in benefits, depending on the amount of cumulative premiums paid into the
policy at that time. In addition, a Material Change will occur if certain policy
guarantees change (e.g. a change in rating class).
Net Annual Loan The loan amount taken in cash from a policy. This does not include loans taken to
(BOY) pay loan interest.
Net Cash Cash Surrender Value after deducting any outstanding loan amount.
Surrender Value
Net Death The amount payable upon the second insured's death. The death benefit proceeds
Benefit (EOY) are always reduced by any outstanding loan balance and increased by any applicable
rider benefits.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 8 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver- NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Partial A partial withdrawal of a portion of the Net Cash Surrender Value. All illustrated
Withdrawal partial withdrawals are based on current policy charges and hypothetical gross
(BOY) earnings rate assumptions and may not be available if actual experience is different
from the assumptions.
Premium Outlay Annualized premiums that are the sum of the periodic payments you plan to make each
year.
Variable A separate account of Pacific Life & Annuity or a subaccount of such a separate
Investment account, which is used only to support the variable death benefits and policy values
Options of variable life insurance policies, and the assets of which are segregated from the
Pacific Life & Annuity's general account and our other separate accounts.
TAX INFORMATION Although the information in this illustration is based on our understanding of the Internal Revenue Code
(IRC) and on certain tax and legal assumptions, it is not intended to be tax or legal advice. Such advice
should be obtained from your own counsel or other tax advisor.
The following tax rates have been used to estimate your taxes, if any, due to a policy loan or partial
withdrawal:
Assumed Income Tax Rate
Start End Rate
1 65 31.00%
Death Proceeds: Death benefit proceeds from a life insurance policy are generally excludable from the
beneficiary's gross income for income tax purposes.
Guideline Premium Test: A life insurance policy will qualify as life insurance under IRC Section 7702 if it
meets one of two alternative tests. This illustration uses the Guideline Premium Test which requires that the
sum of the premiums paid reduced by non-taxable partial withdrawals and non-taxable cash dividends at any
time does not exceed the greater of the guideline single premium or the sum of the guideline level premiums
at such time, and the death benefit payable under the policy at any time is at least equal to an applicable
percentage of the accumulated value (the "cash value corridor test"). For the policy being illustrated here,
the Guideline Single Premium at issue is $327,996.20 and the Guideline Level Premium at issue is $31,711.40
per year. Failure to qualify as life insurance will have adverse tax consequences.
Withdrawals/Loans: Interest credited to the accumulated value of a life insurance policy is generally tax-
deferred and may be taxable at the time of partial withdrawal, surrender or lapse. Assuming the life
insurance policy is not a MEC (as described below), partial withdrawals are taxed under the "cost recovery
rule" and are generally taxable only to the extent the partial withdrawal exceeds the cost basis of the
policy. Basis equals the gross premiums paid less prior non-taxable partial withdrawals and non-taxable cash
dividends. For a life insurance policy that is not a Modified Endowment Contract as defined in IRC Sec.
7702A: Withdrawals in the first 15 policy years may be taxable under IRC 7702(f)(7)(B); after 15 years,
withdrawals up to policy tax basis are not taxable; and policy loans are not taxable provided that the policy
remains in force until the insured dies. Withdrawals and policy loans may reduce policy values and death
benefits.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 9 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY- GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
If a life insurance policy loan is still outstanding when a policy is surrendered or lapses, the loan is
automatically repaid from policy values. This will result in taxable income to the extent the cash surrender
value plus the amount of the repaid loan exceeds the cost basis of the policy. Any tax estimate(s) included
in this illustration does not include an estimate of this tax.
If a life insurance policy loan is still outstanding at the time of death, the loan is automatically repaid
from the policy's death benefit. This use of the death benefit to repay a policy loan does not cause the
recognition of taxable income.
Modified Endowment Contracts: As defined in IRC Section 7702A, a modified endowment contract (MEC) is a life
insurance policy in which the cumulative premium payments (less non-taxable partial withdrawals and non-
taxable cash dividends) since the policy effective date exceeds, at any time during the first seven policy
years, the cumulative total of the Seven-Pay Premiums (the 7-pay test). The initial annual Seven-Pay Premium
limit on the policy being illustrated here is $79,505.37.
Generally, once a policy is a MEC, it is always a MEC. However, if premiums in excess of the Seven-Pay
Premium limit are paid, the MEC status can be avoided if such premium payments, plus interest (which is
taxable), are returned to the policyowner within 60 days after the end of the 'measuring year' in which the
premium payment was made. For this purpose, the 'measuring year' is the same as a policy year, except that,
if the policy has a Material Change then the 'measuring year' will run between anniversaries of the Material
Change date instead. Note, if a Material Change occurs on a date other than a policy anniversary, the
specific timing of the 60-day window may change.
Distributions from a MEC, either a partial withdrawal, a cash dividend, or loan, are taxed to the extent
there is a gain in the policy and may be subject to additional penalties. Distributions taken from a policy
during the two years prior to the policy becoming a MEC will be treated as taxable under MEC rules in the
year the policy becomes a MEC. This illustration does not reflect this taxation process.
If there is a "material change" in the terms or benefits of the policy, the 7-pay test will be applied as if
this is a new policy at the date of the material change.
Based on our understanding of the Internal Revenue Code and the assumptions in this illustration, THIS POLICY
WOULD NOT BECOME A MEC.
PREMIUM LIMITS Initial Guideline Single Premium: $327,996.20
SUMMARY Initial Guideline Level Premium: $ 31,711.40
Initial Seven Pay Premium: $ 79,505.37
When the death benefit is greater than the face amount due to accumulated value growth, payment of additional
premium will be subject to approval.
POLICY FREE LOOK There is a free look right in the policy, which provides that you may return it within 10 days after you
RIGHT receive it. You need only deliver it to Pacific Life & Annuity Company or to the agent who delivered the
policy to you. In such case, the policy will be deemed void from the beginning and Pacific Life & Annuity
Company will refund the premiums paid. If the policy is issued as a replacement of existing coverage, the
free look period is 60 days and Pacific Life & Annuity Company will refund the policy value plus any charges
and loads which were deducted.
END OF SUMMARY PAGE
Presented by: PL agent For: Mr. SEP-NY 6 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 10 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Proposed Insured #1: Mr. SEP-NY 12 Weighted Avg Death Benefit Option = Level Presented By:
Male, Age 55 Total Initial Face Amount = 1,500,000 PL agent
Select Nonsmoker Premium Payment Interval = Annual 12535 Insurance Dr
Proposed Insured #2: Mrs. Insured
Female, Age 55
Select Nonsmoker
Summary Page
- ------------------------------------------------------------------------------------------------------------------------------------
Current Policy Charges (1) Guaranteed Policy Charges (2)
Assuming Hypothetical Gross Assuming Hypothetical Gross Assuming Hypothetical Gross
Annual Investment Return of Annual Investment Return of Annual Investment Return of
12.00% (11.21% Net) 0.00% (-0.71% Net) 12.00% (11.21% Net)
-------------------------------------------------------------------------------------------------
[Net
Loans Net Net Net Net Net Net
Planned Premiums and With- Accum'd Surr'r Death Accum'd Surr'r Death Accum'd Surr'r Death
Annual Plus 5% drawals Value Value Benefit Value Value Benefit Value Value Benefit
Yr Premium Interest (BOY)] (EOY) (EOY) (EOY) (EOY) (EOY) (EOY) (EOY) (EOY) (EOY)
- ------------------------------------------------------------------------------------------------------------------------------------
1 31,711 33,297 0 30,298 6,907 1,500,000 26,895 3,504 1,500,000 30,297 6,906 1,500,000
2 31,711 68,259 0 63,437 42,645 1,500,000 53,118 32,326 1,500,000 63,432 42,640 1,500,000
3 31,711 104,969 0 99,670 81,477 1,500,000 78,643 60,450 1,500,000 99,658 81,465 1,500,000
4 31,711 143,514 0 139,280 123,686 1,500,000 103,441 87,847 1,500,000 139,257 123,663 1,500,000
5 31,711 183,987 0 182,579 169,584 1,500,000 127,481 114,486 1,500,000 182,540 169,545 1,500,000
6 31,711 226,483 0 229,906 219,510 1,500,000 150,724 140,328 1,500,000 229,846 219,450 1,500,000
7 31,711 271,104 0 281,628 273,831 1,500,000 173,111 165,314 1,500,000 281,540 273,743 1,500,000
8 31,711 317,956 0 338,143 332,945 1,500,000 194,564 189,366 1,500,000 338,019 332,821 1,500,000
9 31,711 367,151 0 399,877 397,278 1,500,000 214,977 212,378 1,500,000 399,708 397,109 1,500,000
10 31,711 418,806 0 467,530 467,530 1,500,000 234,228 234,228 1,500,000 467,089 467,089 1,500,000
15 31,711 718,501 0 968,031 968,031 1,500,000 327,089 327,089 1,500,000 952,897 952,897 1,500,000
20 31,711 1,100,996 0 1,830,903 1,830,903 1,959,066 365,666 365,666 1,500,000 1,775,731 1,775,731 1,900,032
25 31,711 1,589,168 0 3,344,908 3,344,908 3,512,153 284,945 284,945 1,500,000 3,188,979 3,188,979 3,348,428
30 31,711 2,212,212 0 5,930,604 5,930,604 6,227,134 ## ## ## 5,512,324 5,512,324 5,787,941
35 31,711 3,007,393 0 10,321,664 10,321,664 10,837,748 9,219,922 9,219,922 9,680,918
## - Additional premiums are required to maintain the requested benefits.
All values except premiums, loans, loan interest and withdrawals are values at the end of the policy year. The 'Net Surrender Value'
column is equal to the accumulated value, less any policy debt and less any surrender charges. The 'Net Death Benefit' column is the
policy death benefit less any policy debt.
1 - The policy values under the Current Policy Charges heading reflect current policy charges, current cost of insurance rates,
current mortality and expense charges and the hypothetical gross earnings rate assumption described in the section entitled Gross
Hypothetical Returns. Current policy charges and cost of insurance rates are subject to change. Policy values will vary from those
illustrated if actual rates differ from those assumed. Current cost of insurance rates are not dependent upon future improvements in
underlying mortality.
2 - The policy values under the Guaranteed Policy Charges heading assume maximum cost of insurance rates.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 1 of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Important Information About Your Illustration
- ---------------------------------------------------------------------------------------------------------------------------
THIS IS AN This is an illustration and not a contract. Although the information contained in this illustration
ILLUSTRATION, is based on certain tax and legal assumptions, it is not intended to be tax or legal advice. Such
NOT A CONTRACT advice should be obtained from the applicant's own counsel or other advisor.
This illustration is prepared for presentation in the state of NY.
Death Benefit Option
ILLUSTRATED
BENEFITS: Start End Option
1 65 Level
Base Policy Face Amount
Start End Amount
1 65 1,500,000
PREMIUM Illustrated periodic premium payments are assumed to be made one time per year at the beginning of each
FREQUENCY: premium payment interval.
ANNUAL
TIMING OF All values assume premiums and loan payment interest are paid when due. If a payment is received without
PAYMENTS being designated as a premium payment or loan payment, and there is an outstanding loan, the payment will be
applied as a loan payment.
All values except premiums, loans, loan interest and withdrawals are values at the end of the policy year.
GROSS You have selected to have your accumulated value allocated to the variable investment options.
HYPOTHETICAL
RETURNS
Hypothetical Gross Earnings Rate
Start End Gross Net
1 65 12.00% 11.21%
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 2 of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
The hypothetical rates of return and values shown are illustrative only and should not be deemed as
a representation of past or future investment results. The illustrated policy values might not be
achieved if actual rates of return, policy charges, premium amount or frequency differ from those
assumed. Actual rates of return may be more or less than those shown and will depend on a number of
factors including the investment allocations made to the variable investment options by the
policyowner and the experience of those investment options. No representation can be made by Pacific
Life & Annuity, the Separate Account, or the underlying Fund that these hypothetical rates of return
can be achieved for any one year or sustained over any period of time.
The gross annual earnings rate assumption is after brokerage expenses and any foreign taxes. A
portfolio's foreign investment may be subject to foreign taxes. Foreign taxes from interest and
dividend income are treated as a deduction from relevant income for accounting purposes rather than
an expense.
SUB-ACCOUNT This illustration assumes that all net premiums (after deduction of premium load) have been
ALLOCATION allocated to the variable investment options. You have requested that this illustration reflect your
selection of investment options. The amounts shown for the Death Benefits, Accumulated Values and
Cash Surrender Values in this illustration reflect your selection of investment options and the
underlying portfolios' annualized fund expenses (excluding any foreign taxes) incurred by the
portfolios for the periods ending December 31, 2000 adjusted to reflect a decrease in fees for
certain operating expenses.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 3 of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Portfolio Investment Operating
Advisory Fee Expenses
Aggressive Equity 0.80% 0.04%
Aggressive Growth 1.00% 0.06%
Blue Chip 0.95% 0.06%
Capital Opportunities 0.80% 0.06%
Diversified Research 0.90% 0.08%
Emerging Markets 1.10% 0.20%
Equity 0.65% 0.04%
Equity Income 0.95% 0.10%
Equity Index 0.25% 0.04%
Financial Services 1.10% 0.10%
Focused 30 0.95% 0.10%
Global Growth 1.10% 0.19%
Growth LT 0.75% 0.04%
Health Sciences 1.10% 0.10%
High Yield Bond 0.60% 0.04%
I-Net Tollkeeper 1.40% 0.06%
Inflation Managed 0.60% 0.02%
International Large-Cap 1.05% 0.12%
International Value 0.85% 0.11%
Large-Cap Core 0.65% 0.04%
Large-Cap Value 0.85% 0.05%
Managed Bond 0.60% 0.04%
Mid-Cap Growth 0.90% 0.06%
Mid-Cap Value 0.85% 0.03%
Money Market 0.34% 0.04%
Multi-Strategy 0.65% 0.04%
REIT 1.10% 0.04%
Research 1.00% 0.10%
Small-Cap Equity 0.65% 0.04%
Small-Cap Index 0.50% 0.10%
Strategic Value 0.95% 0.10%
Technology 1.10% 0.08%
Telecommunications 1.10% 0.08%
You have selected allocations in the investment options that reflect the weighted annualized expenses of all
the available underlying portfolios as of December 31, 2000. The annualized expenses of the underlying
portfolios weighted according to your selection is equivalent to an annual rate of 0.66% for investment
advisory fees and 0.05% for operating expenses (after any offset for custodian credits and excluding any
foreign taxes) which amounts to a total of 0.71%. The investment advisory fees and net operating expenses for
the underlying portfolios reflect fees and expenses incurred by the portfolios for the periods ending December
31, 2000. The operating expenses for Aggressive Growth, Blue Chip, Capital Opportunities, Equity Income,
Financial Services, Global Growth, Health Sciences, Mid-Cap Growth, Research, Technology, and
Telecommunications are estimated. The Inflation Managed portfolio was formerly called the Government
Securities portfolio. The Large-Cap Core portfolio was formerly called the Equity Income portfolio.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 4 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Although some portfolios may have names or investment objectives that resemble retail mutual funds
managed by the portfolio manager, these portfolios will not have the same underlying holdings or
performance.
Please note: Net Premiums and Policy Accumulated Value may be invested in up to twenty (20)
investment options at one time.
The annualized expenses for all available portfolios for the periods ending December 31, 2000
reflect an average daily investment advisory fee equivalent to an annual rate of 0.85% of the
aggregate average daily net assets of the fund. They also reflect net operating expenses (after any
offset for custodian credits and excluding any foreign taxes) at an annual rate of 0.07% of the
aggregate average daily net assets of the portfolios. The total aggregate annualized expenses for
the periods ending December 31, 2000 (including investment advisory fees and excluding any foreign
taxes) is 0.92%.
NET ANNUAL After deduction of the investment advisory fees and other operating expenses, illustrated gross
RETURN annual investment returns of 0% and 12.00% correspond to approximate net annual rates of return of
-0.71% and 11.21% respectively.
The amounts shown for Death Benefits, Accumulated Values and Cash Surrender Values reflect a
non-guaranteed persistency credit of 0.15% beginning in year 16, increasing to 0.25% in year 21.
This persistency credit is applied at the end of each policy year, based on the average annual
unloaned policy accumulated value for the year. The gross and net earnings rates shown on this
illustration do not reflect the impact of this credit. For the effects on the policy without this
persistency credit, please refer to the guaranteed policy charge columns in the illustration.
The amounts shown for Death Benefits, Accumulated Values and Cash Surrender Values also reflect the
fact that the net investment return on the variable investment options is lower than the gross
return of the assets as a result of the charges levied against the account.
FIXED ACCOUNT Net premiums or Accumulated Value may also be allocated to a choice of two fixed options: Fixed
OPTION(S) Account and Fixed LT Account. At the beginning of each year, a current rate will be declared and
guaranteed for that year. The guaranteed minimum annual interest rate on amounts allocated to the
Fixed Account and Fixed LT Account is 3.00%. The current rate is set at Pacific Life & Annuity's
discretion and is likely to change from year to year but will never be less than the guaranteed
rate. Our ability to pay these guarantees is backed by our financial strength as a company.
There are limitations on transferring in and out of the Fixed Account and Fixed LT Account:
. You can make transfers from the variable investment options to the fixed options only in the policy
month right before each policy anniversary.
. You can only make one transfer from each Fixed Account option in any 12-month period, except if you
have signed up for the first year transfer program.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 5 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
. Currently, the company has waived the restrictions for transfers from the Fixed LT Account option during
the first policy year. You will be permitted to transfer any amount out of the Fixed LT Account at any time
during the first twelve policy months. We reserve the right to discontinue this program at any time.
However, if the program is in effect on the date you sign the application for your policy, the waiver on
transfer restrictions will remain in effect for your first policy year. After the first policy year, you can
only transfer up to the greater of $5,000 or 10% of your policy's accumulated value in the Fixed LT Account
in any 12-month period.
. Fixed Account: Transfers into the Fixed Account in any 12-month period are limited to the greater of
$5,000 or 25% of your policy's accumulated value, except for scheduled transfers under
the first year transfer program.
. Fixed LT Account: Transfers into the Fixed LT Account in any 12-month period are limited to the greater of
$5,000 or 10% of your policy's accumulated value.
There is a limitation on amounts allocated to the Fixed LT Account during any 12-month period of
$1,000,000 for all policies of the same owner.
For more information on the Fixed Account Option(s), please consult the product prospectus.
This illustration does not reflect allocations to either fixed account.
DEDUCTIONS AND A Premium Load is deducted from each premium payment. The Accumulated Value is subject to several
CHARGES monthly charges: cost of insurance charges, administrative charge, mortality and expense risk
charge, and deductions for optional insurance benefits, if present.
The surrender charge is equal to a specified amount that is determined by the insured's age and risk
classification, the death benefit option selected, the policy face amount, and any face increases.
Over time, the surrender charge decreases until it reaches zero at the end of the 120th policy
month. For more detailed information about the surrender charge, please see the current prospectus.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 6 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
LOANS/PARTIAL [Any loans or withdrawals illustrated are based on Current Policy Charge Assumptions and might not be
WITHDRAWALS available under Guaranteed Policy Charge Assumptions. Policy loans and/or Partial Withdrawals may have an
adverse effect on the policyowner's Benefits.
This illustration shows a policy loan. Interest is charged on policy loans at an effective annual rate of
4.10% in arrears. The guaranteed interest rate credited to the portion of the Accumulated Value securing the
policy loan is 3.10% in policy years 1-10, 3.70% in policy years 11-20 and 3.85% thereafter. This illustration
reflects interest credited to the portion of the accumulated value securing the policy loan at a current
effective annual rate of 3.10% in policy years 1-10, 3.70% in policy years 11-20 and a current effective
annual rate of 4.10% thereafter. Pacific Life & Annuity reserves the right to decrease the current rate
credited. For example, we may decrease the rate credited if we believe that it is necessary to maintain the
policy loan as a non-taxable distribution. However we will not reduce the effective annual rate credited to
less than the guaranteed rate stated above. All values assume premiums and loan interest are paid when due. If
a payment is received without being designated as a premium payment or loan payment, and there is an
outstanding loan, the payment will be applied as a loan payment.
The loan is automatically repaid from the Gross Death Benefit at the death of the second insured, resulting in
the estimated payment to the beneficiary of the Net Death Benefit illustrated. Upon lapse or surrender, the
loan is automatically repaid, resulting in the estimated payment to the policyowner of the Net Surrender
Value. The automatic repayment of the loan during a lapse or surrender will cause the recognition of taxable
income, to the extent that the Net Surrender Value plus the amount of the repaid loan exceeds the
policyowner's basis in the policy.
The policy will lapse if the Accumulated Value less Policy Debt is insufficient to cover the current monthly
deduction for charges on any monthly payment date, and a grace period expires without the policyowner making a
sufficient payment. If the policy is insufficiently funded in relation to the income stream from the policy,
the policy can lapse prematurely and result in a significant income tax liability to the policyowner in the
year in which the lapse occurs.
A policyowner should be careful to structure a policy so that the policy will not lapse prematurely under
various market conditions or scenarios as a result of withdrawals and/or loans taken from the policy. The
policyowner should also request at least annually a revised illustration that reflects current policy values
to assure the policy is sufficiently funded to support a desired income stream, if any.
FUTURE ACTION If you want to change the premium amount that you are billed, you must request the change in
REQUIRED BY writing.
POLICYOWNER
Policy loans or withdrawals are illustrated. This illustration assumes that a written request is submitted by
the policyowner at the start of the policy year indicated to receive the partial withdrawal or loan
illustrated, unless the policyowner is eligible for and elects the Automated Income Option (AIO).
COLUMN DEFINITIONS Accumulated The total value of the amounts in the Investment Options for the Policy as well
AND KEY TERMS Value as any amounts set aside in the Loan Account, including any accrued earned
interest, as of the end of the policy year.
Age (BOY) The insured's age as of his or her nearest birthday as of the policy date,
increased by the number of complete policy years elapsed.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 7 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
BOY Beginning of year.
Cash Surrender The Accumulated Value minus any applicable Surrender Charge as of the end of the
Value (EOY) policy year.
Cum. Premium The illustrated premiums paid each year accumulated at a hypothetical rate of
Plus 5% return of 5%.
"Current Policy Reflect current policy charges at the hypothetical gross earnings rate(s).
Charges"
columns
EOY End of year.
Estimated Tax on Estimated dollar amount of any tax that may be due as a result of a policy loan
Disbursements or partial withdrawal.
Face Amount The minimum death benefit for so long as the policy remains in force. The face
amount may be increased or decreased under certain circumstances.
Fixed Account An account that is part of Pacific Life & Annuity's general account to which all
or a portion of the net premiums may be allocated for accumulation at a fixed
rate of interest (which may not be less than 3.0%) declared by Pacific Life &
Annuity.
Fixed LT An account that is part of Pacific Life & Annuity's general account to which all
Account or a portion of the net premiums may be allocated for accumulation at a fixed
rate of interest (which may not be less than 3.0%) declared by Pacific Life &
Annuity.
"Guaranteed Reflect maximum policy charges at 0% hypothetical gross investment return and at
Policy Charges" an assumed hypothetical gross earnings rate.
columns
Material Change IRC 7702A describes the 7-Pay Test and also provides that a Material Change will
cause the 7-Pay Test period to start over. A Material Change may occur when
there is an increase in benefits, depending on the amount of cumulative premiums
paid into the policy at that time. In addition, a Material Change will occur if
certain policy guarantees change (e.g. a change in rating class).
Net Annual Loan The loan amount taken in cash from a policy. This does not include loans taken
(BOY) to pay loan interest.
Net Cash Cash Surrender Value after deducting any outstanding loan amount.
Surrender Value
Net Death The amount payable upon the second insured's death. The death benefit proceeds
Benefit (EOY) are always reduced by any outstanding loan balance and increased by any
applicable rider benefits.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 8 of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
Partial A partial withdrawal of a portion of the Net Cash Surrender Value. All
Withdrawal illustrated partial withdrawals are based on current policy charges and
BOY) hypothetical gross earnings rate assumptions and may not be available if actual
experience is different from the assumptions.
Premium Outlay Annualized premiums that are the sum of the periodic payments you plan to make
each year.
Variable A separate account of Pacific Life & Annuity or a subaccount of such a separate
Investment account, which is used only to support the variable death benefits and policy
Options values of variable life insurance policies, and the assets of which are
segregated from the Pacific Life & Annuity's general account and our other
separate accounts.
TAX INFORMATION Although the information in this illustration is based on our understanding of the Internal Revenue
Code (IRC) and on certain tax and legal assumptions, it is not intended to be tax or legal advice.
Such advice should be obtained from your own counsel or other tax advisor.
The following tax rates have been used to estimate your taxes, if any, due to a policy loan or
partial withdrawal:
Assumed Income Tax Rate
Start End Rate
1 65 31.00%
Death Proceeds: Death benefit proceeds from a life insurance policy are generally excludable from
the beneficiary's gross income for income tax purposes.
Guideline Premium Test: A life insurance policy will qualify as life insurance under IRC Section
7702 if it meets one of two alternative tests. This illustration uses the Guideline Premium Test
which requires that the sum of the premiums paid reduced by non-taxable partial withdrawals and
non-taxable cash dividends at any time does not exceed the greater of the guideline single premium
or the sum of the guideline level premiums at such time, and the death benefit payable under the
policy at any time is at least equal to an applicable percentage of the accumulated value (the "cash
value corridor test"). For the policy being illustrated here, the Guideline Single Premium at issue
is $327,996.20 and the Guideline Level Premium at issue is $31,711.40 per year. Failure to qualify
as life insurance will have adverse tax consequences.
Withdrawals/Loans: Interest credited to the accumulated value of a life insurance policy is
generally tax-deferred and may be taxable at the time of partial withdrawal, surrender or lapse.
Assuming the life insurance policy is not a MEC (as described below), partial withdrawals are taxed
under the "cost recovery rule" and are generally taxable only to the extent the partial withdrawal
exceeds the cost basis of the policy. Basis equals the gross premiums paid less prior non-taxable
partial withdrawals and non-taxable cash dividends. For a life insurance policy that is not a
Modified Endowment Contract as defined in IRC Sec. 7702A: Withdrawals in the first 15 policy years
may be taxable under IRC 7702(f)(7)(B); after 15 years, withdrawals up to policy tax basis are not
taxable; and policy loans are not taxable provided that the policy remains in force until the
insured dies. Withdrawals and policy loans may reduce policy values and death benefits.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 9 Of 10
[LOGO OF PACIFIC LIFE Pacific Select Estate Preserver - NY - GPT - Life Insurance Illustration
& ANNUITY COMPANY] Last Survivor Flexible Premium Variable Universal Life Insurance Policy
Form #P0156NY - For Presentation in NY
If a life insurance policy loan is still outstanding when a policy is surrendered or lapses, the
loan is automatically repaid from policy values. This will result in taxable income to the extent
the cash surrender value plus the amount of the repaid loan exceeds the cost basis of the policy.
Any tax estimate(s) included in this illustration does not include an estimate of this tax.
If a life insurance policy loan is still outstanding at the time of death, the loan is automatically
repaid from the policy's death benefit. This use of the death benefit to repay a policy loan does
not cause the recognition of taxable income.
Modified Endowment Contracts: As defined in IRC Section 7702A, a modified endowment contract (MEC)
is a life insurance policy in which the cumulative premium payments (less non-taxable partial
withdrawals and non-taxable cash dividends) since the policy effective date exceeds, at any time
during the first seven policy years, the cumulative total of the Seven-Pay Premiums (the 7-pay
test). The initial annual Seven-Pay Premium limit on the policy being illustrated here is
$79,505.37.
Generally, once a policy is a MEC, it is always a MEC. However, if premiums in excess of the
Seven-Pay Premium limit are paid, the MEC status can be avoided if such premium payments, plus
interest (which is taxable), are returned to the policyowner within 60 days after the end of the
'measuring year' in which the premium payment was made. For this purpose, the 'measuring year' is
the same as a policy year, except that, if the policy has a Material Change then the 'measuring
year' will run between anniversaries of the Material Change date instead. Note, if a Material Change
occurs on a date other than a policy anniversary, the specific timing of the 60-day window may
change.
Distributions from a MEC, either a partial withdrawal, a cash dividend, or loan, are taxed to the
extent there is a gain in the policy and may be subject to additional penalties. Distributions taken
from a policy during the two years prior to the policy becoming a MEC will be treated as taxable
under MEC rules in the year the policy becomes a MEC. This illustration does not reflect this
taxation process.
If there is a "material change" in the terms or benefits of the policy, the 7-pay test will be
applied as if this is a new policy at the date of the material change.
Based on our understanding of the Internal Revenue Code and the assumptions in this illustration,
THIS POLICY WOULD NOT BECOME A MEC.
PREMIUM LIMITS Initial Guideline Single Premium: $327,996.20
SUMMARY Initial Guideline Level Premium: $31,711.40
Initial Seven Pay Premium: $79,505.37
When the death benefit is greater than the face amount due to accumulated value growth, payment of
additional premium will be subject to approval.
POLICY FREE LOOK There is a free look right in the policy, which provides that you may return it within 10 days after
RIGHT you receive it. You need only deliver it to Pacific Life & Annuity Company or to the agent who
delivered the policy to you. In such case, the policy will be deemed void from the beginning and
Pacific Life & Annuity Company will refund the premiums paid. If the policy is issued as a
replacement of existing coverage, the free look period is 60 days and Pacific Life & Annuity Company
will refund the policy value plus any charges and loads which were deducted.
SUMMARY PAGE CONTINUED ON NEXT PAGE
Presented by: PL agent For: Mr. SEP-NY 12 Weighted Avg
Pacific Life & Annuity Company, 700 Newport Center Drive,
Newport Beach, CA 92660
SEPNY - GPT - NonGI Page: 10 Of 10