Exhibit A(5)(b) The Northwestern Mutual Life Insurance Company agrees to pay the benefits provided in this policy,subject to its terms and conditions. Signed at Milwaukee, Wisconsin on the Date of Issue. FLEXIBLE PREMIUM VARIABLE JOINT LIFE INSURANCE POLICY INSURANCE PAYABLE ON SECOND DEATH Eligible for Annual Dividends Flexible premiums. Benefits reflect investment results. Variable benefits described in Sections 1, 3, 6, 7 and 8. THE DEATH BENEFIT AND CASH VALUE UNDER THIS POLICY ARE VARIABLE. THEY MAY INCREASE OR DECREASE DAILY DEPENDING ON THE INVESTMENT RESULTS OF THE SEPARATE ACCOUNT. THE AMOUNT OF THE DEATH BENEFIT AND THE AMOUNT OF THE CASH VALUE ARE NOT GUARANTEED. RIGHT TO RETURN POLICY. Please read this policy carefully. The policy may be returned by the Owner for any reason within ten days after it was received. The policy may be returned to your agent or to the Home Office of the Company at 720 East Wisconsin Avenue, Milwaukee, WI 53202. If returned, the policy will be considered void from the beginning. The Company will refund the sum of (a) the difference between any premium paid and the amount allocated to the Separate Account plus (b) the value of the policy in the Separate Account on the date the returned policy is received. INSURED John J. Doe AGE AND SEX 35 Male Jane J. Doe 35 Female POLICY DATE December 31, 1998 POLICY NUMBER 10 000 000 PLAN Flexible Premium Variable SPECIFIED AMOUNT $1,000,000.00 Joint Life Insurance RR.VJL.(1298) THIS POLICY IS A LEGAL CONTRACT BETWEEN THE OWNER AND THE NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY. READ YOUR POLICY CAREFULLY. GUIDE TO POLICY PROVISIONS BENEFITS AND PREMIUMS SECTION 1. THE CONTRACT Life Insurance Benefit payable on second death. Incontestability. Suicide. Definition of dates. Reports to Owner. SECTION 2. OWNERSHIP Rights of the Owner. Assignment as collateral. SECTION 3. DEATH BENEFIT Description of death benefit options. Changes to death benefits. SECTION 4. PREMIUMS, TRANSFERS AND REINSTATEMENT Payment of premiums. Calculation and allocation of net premiums. Transfer of assets. Premium limitations. Grace period of 61 days to pay premium. How to reinstate the policy. SECTION 5. DIVIDENDS Annual dividends. Use of dividends. Dividend at death. SECTION 6. THE SEPARATE ACCOUNT The Separate Account and the Divisions. Valuation of assets. SECTION 7. DETERMINATION OF VALUES Policy Value. Monthly Policy Charge. SECTION 8. CASH VALUE AND SURRENDER Cash value. Surrender. Deferral of payments. SECTION 9. LOANS AND WITHDRAWALS Policy loans. Interest on loans. Withdrawals. SECTION 10. BENEFICIARIES Naming and change of beneficiaries. Succession in interest of beneficiaries. ADDITIONAL BENEFITS (if any) APPLICATION RR.VJL.(1298) BENEFITS AND PREMIUMS DATE OF ISSUE - DECEMBER 31, 1998 Plan: Flexible Premium Variable Joint Life Insurance Specified Amount: $1,000,000.00 Death Benefit Option: Specified Amount (Option A) Definition of Life Insurance Test: Guideline Premium/Cash Value Corridor Test The Age 100 Date (Section 3) is December 31, 2063. The Final Premium Date (Section 4) is December 30, 2058. The minimum premium (Section 4.4) is $25.00. The maximum premium under the Guideline Premium/Cash Value Corridor Test: Guideline Single Premium = $ 87,370.00 Guideline Annual Level Premium = $ 8,960.00 The minimum withdrawal amount (Section 9.5) is $250.00. This policy is issued in a select (nonsmoker) rate class on John J. Doe and in a select (nonsmoker) rate class on Jane J. Doe. DIRECT BENEFICIARY JANE M. DOE, DAUGHTER OF THE INSURED OWNER JOHN J. DOE, THE INSURED INSURED John J. Doe AGE AND SEX 35 Male Jane J. Doe 35 Female POLICY DATE December 31, 1998 POLICY NUMBER 10 000 000 PLAN Flexible Premium Variable SPECIFIED AMOUNT $1,000,000.00 Joint Life Insurance RR.VJL.(1298) Page 3 POLICY NUMBER 10 000 000 SCHEDULE OF CHARGES The Premium Expense Charge (Section 4.2) is the sum of the following: 1. Sales Load: Policy Years 1 Policy Years Premium Paid - 10 after 10 ------------ --------------------------------- Up to $ $7,120.00 6.4% 2.4% In Excess of $ 7,120.00 2.4% 2.4% 2. Federal Deferred Acquisition Cost Charge l.25% of premium 3. Premium Tax Charge 2.35% of premium The Premium Expense Charge for Federal Deferred Acquisition Cost and Premium Tax may change to reflect changes in tax law. Monthly Policy Charge (Section 7.2): The maximum monthly Administrative Charge is $7.50. The maximum monthly Underwriting and Issue Charge is $15.00. There is no charge after the tenth policy year. The maximum monthly Mortality and Expense Risk Charge during the first ten policy years is the sum of .075% of Policy Value less policy debt, plus $11.67. The maximum monthly Mortality and Expense Risk Charge after the first ten policy years is .075% of Policy Value less policy debt. The maximum monthly Deferred Sales Charge is $44.50. There is no charge after the tenth policy year. RR.VJL.(1298) Page 4 POLICY NUMBER 10 000 000 SCHEDULE OF CHARGES (continued) Maximum Transaction Charges: The maximum charge for death benefit option changes (Section 3.2) is $250.00 per change. The maximum charge for Specified Amount changes (Section 3.3) is $25.00 per change for more than one change during any policy year. The maximum transfer fee (Section 4.3) is $25.00 per transfer for more than 12 transfers during any policy year. The maximum withdrawal charge (Section 9.5) is $25.00 per withdrawal. Surrender Charge (Section 8.3): The surrender charge percentage is 50% during the first policy year; this percentage is decreased by 0.462963% on each monthly processing date during the second through tenth policy years. The maximum surrender charge is $3,560.00 during the first policy year; this charge is decreased by $32.96 on each monthly processing date during the second through tenth policy years. There is no surrender charge after the tenth policy year. RR.VJL.(1298) Page 5 POLICY NUMBER 10 000 000 TABLE OF GUARANTEED MAXIMUM COST OF INSURANCE RATES MONTHLY RATES PER $1,000.00 (Section 7.3) Policy Monthly Rate Policy Monthly Rate Policy Monthly Rate Year Year Year 1 .00021 26 .16877 51 9.14987 2 .00067 27 .19882 52 10.36448 3 .00121 28 .23560 53 11.65487 4 .00186 29 .28104 54 13.00037 5 .00266 30 .33649 55 14.41268 6 .00360 31 .40202 56 15.89204 7 .00476 32 .47841 57 17.45991 8 .00613 33 .56575 58 19.15688 9 .00775 34 .66447 59 21.05478 10 .00962 35 .77774 60 23.36818 11 .01184 36 .91157 61 26.51705 12 .01443 37 1.08075 62 31.35472 13 .01748 38 1.26820 63 39.59522 14 .02104 39 1.50766 64 54.65267 15 .02522 40 1.79530 65 83.33333 16 .03014 41 2.13054 After 65 .00000 17 .03602 42 2.51400 18 .04311 43 2.94442 19 .05167 44 3.42118 20 .06184 45 3.95359 21 .07386 46 4.55879 22 .08791 47 5.25323 23 .10398 48 6.05601 24 .12221 49 6.98106 25 .14352 50 8.01516 The monthly rates shown above are based on the appropriate Commissioners 1980 Standard Ordinary Smoker and/or Nonsmoker Mortality Table for the sex and class of the Insureds. RR.VJL.(1298) Page 6 POLICY NUMBER 10 000 000 GUIDELINE PREMIUM/CASH VALUE CORRIDOR PERCENTAGES The Corridor Percentages are used to determine the Minimum Death Benefit under the Guideline Premium/Cash Value Corridor Test (Section 3.1). Policy Policy Policy Year Corridor % Year Corridor % Year Corridor % 1 250 26 130 51 105 2 250 27 128 52 105 3 250 28 126 53 105 4 250 29 124 54 105 5 250 30 122 55 105 6 250 31 120 56 105 7 243 32 119 57 104 8 236 33 118 58 103 9 229 34 117 59 102 10 222 35 116 60 101 11 215 36 115 After 60 100 12 209 37 113 13 203 38 111 14 197 39 109 15 191 40 107 16 185 41 105 17 178 42 105 18 171 43 105 19 164 44 105 20 157 45 105 21 150 46 105 22 146 47 105 23 142 48 105 24 138 49 105 25 134 50 105 RR.VJL.(1298) Page 7 POLICY NUMBER 10 000 000 SEPARATE ACCOUNT DIVISIONS (Section 6) Money Market Division Select Bond Division High Yield Bond Division Balanced Division Index 500 Stock Division Growth & Income Stock Division Growth Stock Division International Equity Division Aggressive Growth Stock Division The Initial Allocation Date is January 15, 1999. RR.VJL.(1298) Page 8 SECTION 1. THE CONTRACT 1.1 LIFE INSURANCE BENEFIT The Northwestern Mutual Life Insurance Company will pay a benefit on the death of the second of the Insureds to die (the "second death") while this policy is in force. No benefit is payable on the death of the first of the Insureds to die. Subject to the terms and conditions of the policy: - payment of the death proceeds will be made after proof of the deaths of both Insureds is received at the Home Office; and - payment will be made to the beneficiary or other payee under Section 10. The amount of the death proceeds will be: - the death benefit (Section 3.1); less - the amount of any policy debt (Section 9.3); less - any Monthly Policy Charges due and unpaid if the second death occurs during the grace period (Section 4.5). These amounts will be determined as of the date of the second death. The Company will pay interest on the death proceeds from the date of the second death until the proceeds are paid. Interest will be at an annual effective rate of not less than 2%, or at any higher rate required by state law. 1.2 NOTICE AND PROOF OF DEATH Written notice and proof of the death of each Insured must be given to the Company as soon as reasonably possible after each death. RR.VJL.(1298) 9 1.3 ENTIRE CONTRACT; CHANGES This policy, including the attached application and any amendments, endorsements or riders, is the entire contract. Statements in the application are representations and not warranties. A change in the policy is valid only if it is approved in writing by an officer of the Company. The Company may require that the policy be sent to it for endorsement to show a change. No agent has the authority to change the policy or to waive any of its terms. 1.4 INCONTESTABILITY In issuing the insurance, the Company has relied on the application. While the insurance is contestable, the Company, on the basis of a material misstatement in the application, may rescind the insurance or deny a claim. The Company will not contest insurance under this policy after that insurance has been in force, during the lifetime of at least one Insured, for two years from the Date of Issue or for two years from the effective date of a reinstatement (Section 4.6). An increase in the amount of insurance after the Date of Issue, which occurred upon the request of the Owner and was subject to the Company's insurability requirements, will be incontestable after the increase has been in force, during the lifetime of at least one Insured, for two years from the effective date of the increase. 1.5 SUICIDE If either Insured dies by suicide within one year from the Date of Issue, the policy will terminate. The amount payable by the Company will be limited to the premiums paid, less the amount of any policy debt and withdrawals. If either Insured dies by suicide within one year from the effective date of an increase in the amount of insurance which occurred upon the request of the Owner and was subject to the Company's insurability requirements, the amount payable with respect to such increase will be limited to the Monthly Policy Charges plus any transaction charges attributable to the increase. 1.6 POLICY DATE AND DATE OF ISSUE Monthly processing dates and policy months, years and anniversaries are computed from the Policy Date. The contestable and suicide periods begin with the Date of Issue. These dates are shown on page 3. The Date of Issue for any insurance issued under Specified Amount Changes (Section 3.3) will be shown on an amendment to the Schedule of Benefits and Premiums. 1.7 MISSTATEMENT OF AGE OR SEX If the age or sex of either insured has been misstated, the death benefit and Policy Value will be modified by recalculating all Monthly Policy Charges based on the correct age and sex of the Insureds. 1.8 PAYMENTS BY THE COMPANY All payments by the Company under this policy are payable at its Home Office. 1.9 REPORTS TO OWNER At least once each policy year, the Company will send to the Owner: - a statement of the death benefit, the Policy Value, and any policy debt, including loan interest. - a report of the Separate Account, including financial statements. - any other information required by law. SECTION 2. OWNERSHIP 2.1 THE OWNER The Owner is named on page 3. The Owner, the Owner's successor or the Owner's transferee may exercise policy rights without the consent of any beneficiary, except to the extent the Owner's rights are restricted by a designation of an irrevocable beneficiary. After the second death, policy rights may be exercised only as provided in Section 10. 2.2 TRANSFER OF OWNERSHIP The Owner may transfer the ownership of this policy. Written proof of transfer satisfactory to the Company must be received at its Home Office. The transfer will then take effect as of the date that it was signed. The Company may require that the policy be sent to it for endorsement to show the transfer. 2.3 COLLATERAL ASSIGNMENT The Owner may assign this policy as collateral security. The Company is not responsible for the validity or effect of the collateral assignment. The Company will not be responsible to an assignee for any payment or other action taken by the Company before receipt of the assignment in writing at its Home Office. The interest of any beneficiary will be subject to any collateral assignment made either before or after the beneficiary is named, unless the beneficiary was designated an irrevocable beneficiary before the assignment. The collateral assignee is not an Owner. The collateral assignment is not a transfer of ownership. Ownership can be transferred only by complying with Section 2.2. RR.VJL.(1298) 10 SECTION 3. DEATH BENEFIT 3.1 DEATH BENEFIT OPTIONS This policy provides for three death benefit options prior to the Age 100 Date. The option in effect and the Age 100 Date are shown on page 3. SPECIFIED AMOUNT (OPTION A) - The death benefit before the Age 100 Date is the greater of: - the Specified Amount; or - the Minimum Death Benefit. SPECIFIED AMOUNT PLUS POLICY VALUE (OPTION B) - The death benefit before the Age 100 Date is the greater of: - the Specified Amount plus the Policy Value; or - the Minimum Death Benefit. SPECIFIED AMOUNT PLUS PREMIUMS PAID (OPTION C) - The death benefit before the Age 100 Date is the greater of: - the Specified Amount plus the sum of the premiums paid; or - the Minimum Death Benefit. MINIMUM DEATH BENEFIT. The Minimum Death Benefit is the amount required to maintain this policy as a life insurance contract for federal tax purposes. The test used for determining compliance with the federal tax definition of a life insurance contract is shown on page 3 and will be either: (1) the Guideline Premium/Cash Value Corridor Test: in that case, the Minimum Death Benefit equals the greater of the Policy Value multiplied by the corridor percentage shown on page 7 for the current policy year or the minimum amount required to maintain this policy as a life insurance contract for federal tax purposes; or (2) the Cash Value Accumulation Test: in that case, the Minimum Death Benefit equals the greater of the Policy Value divided by the Net Single Premium shown on page 7 for the current policy year or the minimum amount required to maintain this policy as a life insurance contract for federal tax purposes. AGE 100 DATE AND LATER. The death benefit on and after the Age 100 Date will be the greater of the Policy Value or the minimum amount required to maintain this policy as a life insurance contract for federal tax purposes. 3.2 DEATH BENEFIT OPTION CHANGES Subject to approval by the Company, the Owner may change the death benefit option upon written request. This change will be effective on the first monthly processing date following receipt of the request at the Home Office. The Company reserves the right to charge for a death benefit option change. This charge will be deducted from the Policy Value and will not exceed the amount shown on page 5. A change will not be allowed if the Specified Amount following a change would be less than the minimum amount the Company would issue at the time of change. CHANGES TO OPTION A. The death benefit option may be changed to Option A at any time before the Age 100 Date. On the effective date of change, the Specified Amount will be changed as follows: (1) If the change is from Option B to Option A, the Specified Amount after the change will be equal to the Specified Amount before the change plus the Policy Value on the effective date of the change. (2) If the change is from Option C to Option A, the Specified Amount after the change will be equal to the Specified Amount before the change plus the sum of the premiums paid as of the effective date of the change. CHANGES TO OPTION B OR OPTION C. The death benefit option may be changed to Option B or Option C at any time before the policy anniversary nearest the older Insured's 85th birthday provided the following requirements are met: - both Insureds are alive; - evidence of insurability is given that is satisfactory to the Company; and - under the Company's underwriting standards, both Insureds are in the same underwriting classification as, or in a better underwriting classification than, they were in on the Date of Issue. On the effective date of change, the Specified Amount will be changed as follows: (1) If the change is from Option A to Option B, the Specified Amount after the change will be equal to the Specified Amount before the change minus the Policy Value on the effective date of the change. (2) If the change is from Option A to Option C, the Specified Amount after the change will be equal to the Specified Amount before the change minus the sum of the premiums paid as of the effective date of the change. (3) If the change is from Option B to Option C, the Specified Amount after the change will be equal to the Specified Amount before the change plus (a) the Policy Value on the effective date of the change, minus (b) the sum of the premiums paid as of the effective date of the change. (4) If the change is from Option C to Option B, the Specified Amount after the change will be equal to the Specified Amount before the change plus (a) the sum of the premiums paid as of the effective date of the change, minus (b) the Policy Value on the effective date of the change. RR.VJL.(1298) 11 3.3 SPECIFIED AMOUNT CHANGES The Owner may change the Specified Amount upon written request subject to approval by the Company. This change will be effective on the first monthly processing date following receipt of the request at the Home Office. The Company reserves the right to charge for more than one Specified Amount change in a policy year. This charge will be deducted from the Policy Value and will not exceed the amount shown on page 5. INCREASES. An increase will be made only if, at the time applied for, the following requirements are met: - both Insureds are alive; - the insurance in force, as increased, will be within the Company's issue limits; - the increase request is received prior to the policy anniversary nearest the older Insured's 85th birthday; - evidence of insurability is given that is satisfactory to the Company; and - under the Company's underwriting standards, both Insureds are in the same underwriting classification as, or in a better underwriting classification than, they were in on the Date of Issue. DECREASES. A decrease will not be allowed if the Specified Amount following the decrease would be less than the minimum amount the Company would issue at the time of change. For the purposes of incontestability and suicide provisions (Section 1.4 and Section 1.5), a decrease in Specified Amount will first reduce any past increases in the reverse order in which they occurred and then reduce the Specified Amount originally issued. SECTION 4. PREMIUMS, TRANSFERS AND REINSTATEMENT 4.1 PREMIUM PAYMENT Premiums may be paid to the Company at any time on or before the Final Premium Date shown on page 3. All premiums after the first are payable at the Home Office or to an authorized agent. A receipt signed by an officer of the Company will be furnished on request. The minimum premium the Company will accept is shown on page 3. Other premium limitations are described in Section 4.4. 4.2 NET PREMIUM The net premium is the amount of each premium paid that is available for allocation to the Divisions of the Separate Account. The amount of the net premium will be: - the premium paid; less - the Premium Expense Charge. The Premium Expense Charge will consist of the amounts shown on page 4. 4.3 ALLOCATION OF NET PREMIUMS AND SUBSEQUENT TRANSFERS For premiums paid to the Company prior to the Initial Allocation Date, the net premiums will be allocated to the Money Market Division on the date the premiums are received in the Home Office. The Initial Allocation Date is shown on page 8. On the Initial Allocation Date, amounts in the Money Market Division will be allocated in accordance with the application. This allocation will remain in effect for subsequent net premiums, loan repayments, and dividends credited unless changed by the Owner by written request. Any change in allocation will be in effect for net premiums, loan repayments, and dividends credited to the policy following the receipt of the written request at the Home Office. Allocations must be in whole percentages. On or after the Initial Allocation Date, the Owner may transfer the amounts invested in any of the Divisions. The transfer will take effect on the date a written request is received in the Home Office. The Company reserves the right to charge for more than twelve transfers in a policy year. This charge will be deducted from the Policy Value and will not exceed the amount shown on page 5. RR.VJL.(1298) 12 4.4 PREMIUM LIMITATIONS A premium payment that would increase the policy's death benefit more than it increases the Policy Value will be accepted only if: - both Insureds are alive; - the insurance in force, as increased, will be within the Company's issue limits; - the premium payment is received prior to the policy anniversary nearest the older Insured's 85th birthday; - evidence of insurability is given that is satisfactory to the Company; and - under the Company's underwriting standards, both Insureds are in the same underwriting classification as, or in a better underwriting classification than, they were in on the Date of Issue. If the Definition of Life Insurance Test shown on page 3 is the Guideline Premium/Cash Value Corridor Test, then the Company will not accept any premium that disqualifies this policy as a life insurance contract for federal tax purposes. Further, the Company reserves the right to make distributions or refunds of excess premium (with interest as required by the federal tax law) from this policy as necessary to continue to qualify the policy as a life insurance contract for federal tax purposes. 4.5 GRACE PERIOD A grace period of 61 days will be allowed for the payment of sufficient premium to keep the policy in force if the cash value on a monthly processing date is less than the current Monthly Policy Charge; however, no premium will be accepted after the Final Premium Date shown on page 3. The minimum premium that must be paid is three times the Monthly Policy Charge due when the insufficiency occurred. The grace period will begin on the date the Company sends written notice of the insufficiency. The grace period will end 61 days after the notice is sent. The notice will be sent to the Owner and will state the date the grace period ends and the amount of premium required to keep the policy in force. Upon receipt of payment, the Company will allocate the net premium, less any Monthly Policy Charges due and unpaid, to the Divisions of the Separate Account according to the allocation of net premiums then in effect. The policy will remain in force during the grace period. If sufficient premium is not paid by the end of the grace period, the policy will terminate with no value. If the second death occurs during the grace period, any Monthly Policy Charges due and unpaid will be deducted from the death proceeds of the policy. 4.6 REINSTATEMENT CONDITIONS. If this policy has terminated under Section 4.5, it may be reinstated upon receipt at the Home Office of: - an application for reinstatement within three years after the end of the grace period; and - a reinstatement premium equal to or greater than the minimum reinstatement premium. In addition, the Company's insurability requirements must be met. This policy may not be reinstated: - if the policy was surrendered for its cash value; or - if either of the Insureds died after the end of the grace period. MINIMUM REINSTATEMENT PREMIUM. The minimum premium needed to reinstate the policy is: - the sum of all Monthly Policy Charges (Section 7.2) that were due and unpaid before the end of the grace period; plus - three times the Monthly Policy Charge due on the effective date of reinstatement. INSURABILITY REQUIREMENTS. These requirements are: - evidence of insurability is given that is satisfactory to the Company; and - under the Company's underwriting standards, both Insureds are in the same underwriting classification as, or in a better underwriting classification than, they were in on the Date of Issue, or if only one Insured was alive at the end of the grace period, that Insured is in the same underwriting classification as, or in a better underwriting classification than, that Insured was in on the Date of Issue. EFFECTIVE DATE OF REINSTATEMENT. If the Company approves the application for reinstatement, the effective date of reinstatement will be the first monthly processing date following receipt at the Home Office of the reinstatement application. On the effective date of reinstatement, the Policy Value will be equal to: - the reinstatement premium paid, less the Premium Expense Charge; plus - any policy debt as of the end of the grace period; less - the sum of all Monthly Policy Charges that were due and unpaid before the end of the grace period; less - the Monthly Policy Charge due on the effective date of reinstatement. On the effective date of reinstatement, the Policy Value, less any policy debt that is not repaid, will be allocated to the Divisions of the Separate Account according to the allocation in effect at the end of the grace period. RR.VJL.(1298) 13 SECTION 5. DIVIDENDS 5.1 ANNUAL DIVIDENDS This policy will share in the divisible surplus of the Company to the extent it contributes to this surplus. This surplus is determined each year. This policy's share will be credited as a dividend on the policy anniversary. Since this policy is not expected to contribute to divisible surplus, it is not expected that any dividends will be paid. 5.2 USE OF DIVIDENDS Annual dividends may be paid in cash or used to increase the Policy Value. Dividends used to increase the Policy Value will be allocated to the Divisions of the Separate Account according to the allocation of net premiums then in effect. If no direction is given for the use of dividends, they will be used to increase the Policy Value. 5.3 DIVIDEND AT DEATH If a dividend is payable for the period from the beginning of the policy year to the date of the second death, the dividend is payable as part of the policy proceeds. SECTION 6. THE SEPARATE ACCOUNT 6.1 DESCRIPTION Northwestern Mutual Variable Life Account (the Separate Account) is registered as a unit investment trust under the Investment Company Act of 1940. The Separate Account has several Divisions, as shown on page 8. Assets of the Separate Account are invested in shares of Northwestern Mutual Series Fund, Inc. (the Fund). The Fund is registered under the Investment Company Act of 1940 as an open-end, diversified investment company. The Fund has one Portfolio for each Division. Assets of each Division of the Separate Account are invested in shares of the corresponding Portfolio of the Fund. Shares of the Fund are purchased for the Separate Account at their net asset value. The Company may make available additional Divisions and Portfolios. Assets will be allocated to the Separate Account to support the operation of this and other variable life insurance policies. Assets may also be allocated for other purposes, but not to support the operation of any contracts or policies other than variable life insurance. Income and realized and unrealized gains and losses from assets in the Separate Account are credited to or charged against it without regard to other income, gains or losses of the Company. The assets of the Separate Account will be valued on each valuation day. They are the property of the Company. The portion of these assets equal to policy reserves and liabilities will not be charged with liabilities arising out of any other business the Company may conduct. The Company reserves the right to transfer assets of the Separate Account in excess of these reserves and liabilities to its general account. The Owner may exchange this policy for a fixed benefit joint life insurance policy being offered at that time by the Company if the Fund changes its investment advisor or if a Portfolio has a material change in its investment objectives or restrictions. The Company will notify the Owner if there is any such change. The Owner may exchange this policy within 60 days after the notice or the effective date of the change, whichever is later. If, in the judgment of the Company, a Portfolio no longer suits the purposes of this policy due to a change in its investment objectives or restrictions, the Company may substitute shares of another Portfolio of the Fund or shares of another mutual fund. Any such substitution will be subject to any required approval of the Securities and Exchange Commission (SEC), the Wisconsin Commissioner of Insurance or other regulatory authority. The Company also may, to the extent permitted by applicable laws and regulations (including any order of the SEC), make changes as follows: - the Separate Account or a Division may be operated as a management company under the Investment Company Act of 1940, or in any other form permitted by law, if deemed by the Company to be in the best interest of the policyowners. - the Separate Account may be deregistered under the Investment Company Act of 1940 in the event registration is no longer required. - the provisions of this and other policies may be modified to comply with any other applicable federal or state laws. In the event of a substitution or change, the Company may make appropriate endorsement of this and other policies having an interest in the Separate Account and take other actions as may be necessary to effect the substitution or change. 6.2 VALUATION DAY AND VALUATION PERIOD A valuation day is any day on which the assets of the Separate Account are valued. A valuation period is a valuation day and any immediately preceding days which are not valuation days. Assets are valued as of the close of trading on the New York Stock Exchange on each day the Exchange is open. Each Division's share of amounts allocated, transferred or added to a Division or deducted, loaned, transferred or withdrawn from a Division, on any day, will be determined as of the end of the valuation period that contains that day. RR.VJL.(1298) 14 SECTION 7. DETERMINATION OF VALUES 7.1 POLICY VALUE On the Policy Date, the Policy Value is equal to the net premium less the Monthly Policy Charge. On any day after that, the Policy Value is equal to what it was on the previous day plus any of these items applicable on that day: - any increase due to investment results as described in Section 7.4 for the portion of the Policy Value invested in Divisions with a positive rate of return for the current valuation period; - interest on the policy debt at an annual effective rate of 5%; - the net premium, if a premium is paid; - any policy dividend directed to increase the Policy Value; and minus any of these items applicable on that day: - any decrease due to investment results as described in Section 7.4 for the portion of the Policy Value invested in Divisions with a negative rate of return for the current valuation period; - the Monthly Policy Charge; - any withdrawals; and - any transaction charges that may result from a withdrawal, a transfer, a change in the Specified Amount or a change in the death benefit option. The Monthly Policy Charge, any withdrawals, and any transaction charges will be deducted from the Policy Value. The deduction will be allocated to each Division in proportion to the amounts in each Division. 7.2 MONTHLY POLICY CHARGE A Monthly Policy Charge is deducted from the Policy Value on each monthly processing date until the second death and is equal to the sum of the following: - the Administrative Charge; - the Underwriting and Issue Charge; - the Mortality and Expense Risk Charge; - the Deferred Sales Charge; - the Cost of Insurance Charge; and - if there is policy debt, a charge for expenses and taxes associated with that debt. The maximum Administrative, Underwriting and Issue, Mortality and Expense Risk, and Deferred Sales charges are shown on page 4. 7.3 COST OF INSURANCE CHARGE A Cost of Insurance Charge is deducted from the Policy Value on each monthly processing date as part of the Monthly Policy Charge. The Cost of Insurance Charge is the cost of insurance rate times the net amount at risk. The maximum cost of insurance rates are shown on page 6. The net amount at risk is (a) minus (b) where: (a) is the death benefit on the monthly processing date (after deduction of the Administrative Charge, the Underwriting and Issue Charge, the Mortality and Expense Risk Charge, the Deferred Sales Charge, and, if there is policy debt, a charge for expenses and taxes associated with that debt) divided by 1.0032737; and (b) is the Policy Value on the monthly processing date, after deduction of the Administrative Charge, the Underwriting and Issue Charge, the Mortality and Expense Risk Charge, the Deferred Sales Charge, and, if there is policy debt, a charge for expenses and taxes associated with that debt. 7.4 INVESTMENT RESULTS Investment results are reflected in the Policy Value each valuation period. The investment results for each Division of the Policy Value equal the Division's share of the Policy Value at the end of the previous valuation period times the rate of return for that Division for the current valuation period. The rate of return of a Division for a valuation period is obtained by dividing the result of (a) minus (b) by (b) where: (a) is the sum of: - the value of a share of the corresponding Portfolio of the Fund at the close of the current valuation period; plus - the per share amount of any investment income and capital gains distributed by the Fund for the current valuation period; and (b) is the value of the share at the close of business for the immediately preceding valuation period. The rate of return and corresponding investment results may be positive or negative. If the rate of return is positive, there will be an increase in values for the Division; if it is negative, there will be a decrease in values for the Division. RR.VJL.(1298) 15 SECTION 8. CASH VALUE AND SURRENDER 8.1 CASH VALUE The cash value of this policy is equal to: - the Policy Value; less - the surrender charge; less - any policy debt. 8.2 SURRENDER The Owner may surrender this policy for its cash value. A written surrender of all claims, satisfactory to the Company, will be required. The date of surrender will be the date of receipt at the Home Office of the written surrender. The policy will terminate, and the cash value will be determined, as of the end of the valuation period which includes the date of surrender. The Company may require that the policy be sent to it. 8.3 SURRENDER CHARGE There is a surrender charge if this policy is surrendered during the first ten policy years. The surrender charge is a percentage of the total premiums paid during the first policy year, subject to the maximum surrender charge. The surrender charge percentage and maximum surrender charge are shown on page 5. 8.4 BASIS OF VALUES A detailed statement of the method of calculation of all values for this policy has been filed with the insurance supervisory official of the state in which this policy is delivered. All values are at least as great as those required by that state. 8.5 DEFERRAL OF PAYMENTS The Company reserves the right: - to defer determination of the cash value and payment of the cash value; - to defer payment of a loan or withdrawal; and - to defer determination of a change in the amount of variable insurance or other variable amounts payable on the second death, and, if such determination has been deferred, to defer payment of the death benefit; during any period when: - the New York Stock Exchange is closed or trading on the New York Stock Exchange is restricted as determined by the SEC; or - the SEC declares that an emergency exists as a result of which the sale or determination of investment results is not reasonably practicable; or - the SEC, by order, permits deferral for the protection of the Company's policyowners. RR.VJL.(1298) 16 SECTION 9. LOANS AND WITHDRAWALS 9.1 POLICY LOANS The Owner may obtain a loan from the Company in an amount that, when added to existing policy debt, is not more than the loan value. On the date a loan is made, the amount of the loan will be transferred from the Separate Account to the general account of the Company. This amount will be deducted from each Division in proportion to the amounts in each Division. On the date a loan repayment is made, or the date accrued interest is paid, the amount of the payment will be transferred from the general account of the Company to the Separate Account. This amount will be allocated to the Divisions of the Separate Account according to the allocation of net premiums then in effect. 9.2 LOAN VALUE The loan value is 90% of: - the Policy Value on the date of the loan; less - the surrender charge on the date of the loan. 9.3 POLICY DEBT Policy debt consists of all outstanding loans and accrued interest. Loan repayments may be made, or accrued interest paid, at any time. Any policy debt will be deducted from the policy proceeds. If the policy debt equals or exceeds the Policy Value less the surrender charge on a monthly processing date, the policy will terminate with no value subject to the conditions of the Grace Period (Section 4.5). 9.4 LOAN INTEREST Interest accrues on a daily basis from the date of the loan. Unpaid interest is added to the loan. Interest is payable at an annual effective rate of 5%. 9.5 PARTIAL WITHDRAWALS The Owner may withdraw a portion of the cash value. However, the Owner may not: - withdraw an amount which would reduce the loan value to less than the policy debt; - withdraw an amount which would reduce the death benefit to less than the minimum amount the Company would issue on this plan of insurance at the time of withdrawal; - withdraw an amount which would reduce the cash value to less than three times the most recent Monthly Policy Charge; - withdraw less than the minimum withdrawal amount shown on page 3; or - make more than four withdrawals in a policy year. When a portion of the cash value is withdrawn, the amount invested for this policy in the Separate Account will be reduced by the amount of the withdrawal. The reduction will be allocated to each Division in proportion to the amounts in each Division. If the death benefit option in effect at the time of withdrawal is either Option A or Option C, the Specified Amount will be reduced by the lesser of: - the amount of the withdrawal; or - the excess, if any, of the Specified Amount for Option A or the Specified Amount plus the sum of the premiums paid for Option C, over the result of (a) minus (b) where: (a) is the death benefit immediately prior to the withdrawal; and (b) is the amount of the withdrawal. The Company reserves the right to charge for withdrawals. This charge will be deducted from the Policy Value and will not exceed the amount shown on page 5. SECTION 10. BENEFICIARIES 10.1 DEFINITION OF BENEFICIARIES The term "beneficiaries" as used in this policy includes direct beneficiaries, contingent beneficiaries and further payees. 10.2 NAMING AND CHANGE OF BENEFICIARIES CONDITIONS. The Owner may name and change the beneficiaries of death proceeds: - before the second death. - during the first 60 days after the date of the second death, if the second Insured to die was not the Owner immediately prior to the second death. A change made during this 60 days may not be revoked. EFFECTIVE DATE. A naming or change of a beneficiary will be made on receipt at the Home Office of a written request that is acceptable to the Company. The request will then take effect as of the date that it was signed. The Company is not responsible for any payment or other action that is taken by it before the receipt of the request. The Company may require that the policy be sent to it to be endorsed to show the naming or change. 10.3 SUCCESSION IN INTEREST OF BENEFICIARIES DIRECT BENEFICIARIES. The proceeds of this policy will be payable in equal shares to the direct beneficiaries who survive and receive payment. If a direct beneficiary dies before receiving the direct beneficiary's share, that share will be payable in equal shares to the other direct beneficiaries who survive and receive payment. CONTINGENT BENEFICIARIES. At the death of all of the direct beneficiaries, the proceeds will be payable in equal shares to the contingent beneficiaries who survive and receive payment. If a contingent beneficiary dies before receiving the contingent beneficiary's share, that share will be payable in equal shares to the other contingent beneficiaries who survive and receive payment. FURTHER PAYEES. At the death of all of the direct and contingent beneficiaries, the proceeds will be paid: - in equal shares to the further payees who survive and receive payment; or - if no further payees survive and receive payment, to the estate of the last to die of all of the direct and contingent beneficiaries who survive both Insureds. OWNER OR THE OWNER'S ESTATE. If no beneficiaries are alive on the date of the second death, the proceeds will be paid to the Owner or to the Owner's estate. 10.4 GENERAL TRANSFER OF OWNERSHIP. A transfer of ownership of itself will not change the interest of a beneficiary. CLAIMS OF CREDITORS. So far as allowed by law, no amount payable under this policy will be subject to the claims of creditors of a beneficiary. RR.VJL.(1298) 17 THE NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY 720 E. WISCONSIN AVENUE, MILWAUKEE, WISCONSIN 53202 JOINT LIFE PROTECTION INSURANCE APPLICATION ------------------------------------ POLICY NUMBER - ----------------------------------------------------------------------------------------------------------------------------------- / / Companion policies / / Life & Disability Application / / LTC Application Plan Group Number / / APB Option / / Exam (NM, PME, MD) in Home Office ------------------------------------ - ----------------------------------------------------------------------------------------------------------------------------------- FIRST INSURED (YOUNGER) ON PAGES 1,2,3 AND 4, "INSURED" REFERS TO THE FIRST INSURED. - ----------------------------------------------------------------------------------------------------------------------------------- Has an application or informal inquiry ever been made to Northwestern Mutual Life for annuity, life, long term care, or disability insurance on the life of the insured? / / Yes /X/ No If yes, the last policy number is --------- 1. A. /X/ Mr. / / Mrs. / / Ms. / / Dr. / / Other B. /X/ MALE ----------------- / / FEMALE NAME: JOHN J DOE --------------------------------------------------------- (FIRST, MIDDLE INITIAL, LAST) - ----------------------------------------------------------------------------------------------------------------------------------- C. BIRTHDATE: (MONTH, DAY, YEAR) D. STATE OF BIRTH (or Foreign Country): E. TAXPAYER IDENTIFICATION NUMBER: 12 /31 / 1963 Wisconsin # ###-##-#### ---------------------------- ----------------------------------- ------------------------------ - ----------------------------------------------------------------------------------------------------------------------------------- F. PRIMARY RESIDENCE: STREET OR PO BOX: 1234 Main Street --------------------------------------------------------------------------- CITY, STATE, ZIP (Country if other than U.S.A.): Milwaukee, WI 53200 --------------------------------------------------------------------------- E-MAIL ADDRESS: --------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- APPLICANT - ----------------------------------------------------------------------------------------------------------------------------------- 2. Select ONLY ONE: /X/ First Insured @ First Insured's address / / Other (Complete A, B and C) A. / / Mr. / / Mrs. / / Ms. / / Dr. / / Other ----------------- PERSONAL NAME: / / MALE --------------------------------------------------------------- / / FEMALE (FIRST, MIDDLE INITIAL, LAST) BIRTHDATE: | | ------------------------- MONTH DAY YEAR OR BUSINESS/TRUST NAME: --------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- B. TAXPAYER IDENTIFICATION NUMBER: C. DAYTIME TELEPHONE NUMBER: Area Code ( ) -------------------------------------- ---------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- Send premium and other notices regarding this policy to: D. ADDRESS: /X/ First Insured's Address / / Applicant's Address OR STREET OR PO BOX: ---------------------------------------------------------------------------- CITY, STATE, ZIP (Country if other than U.S.A.): ---------------------------------------------------------------------------- E-MAIL ADDRESS: ---------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- 90-1 JCL (0198) 90-1934-50 (page 1) - ------------------------------------------------------------------------------------------------------------------------ CAUTION: A MINOR OWNER CANNOT EXERCISE POLICY RIGHTS. 4. Select ONLY ONE: /X/ First Insured (Complete C only) / / Applicant (Complete C only) / / Other (Complete A, B and C) / / See attached supplement form A. / / Mr. / / Mrs. / / Dr. / / Other --------------------- PERSONAL / / MALE NAME: / / FEMALE ---------------------------------------------------- (FIRST MIDDLE INITIAL LAST) RELATIONSHIP TO INSURED: BIRTHDATE: | | ---------------------------------- --------------------- OR BUSINESS/TRUST MONTH DAY YEAR NAME: ---------------------------------------------------- RELATIONSHIP TO INSURED: ------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ B. TAXPAYER IDENTIFICATION NUMBER: -------------------------- - ------------------------------------------------------------------------------------------------------------------------ C. ADDRESS: /X/ First Insured's Address / / Applicant's Address / / Premium Payer's Address OR STREET OR PO BOX: ----------------------------------------------------------------- CITY, STATE, ZIP (Country if other than U.S.A.): ----------------------------------------------------------------- E-MAIL ADDRESS: ----------------------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------ 5.-7. (Reserved) SPECIAL DATE (COMPLETE THIS SECTION ONLY IF A SPECIAL POLICY DATE IS BEING REQUESTED) - ------------------------------------------------------------------------------------------------------------------------ 8. A. Prepaid: / / Short-Term - Policy Date will coincide with ISA Payment Date (For monthly ISA only) / / Short-Term to: | | / / Backdate to | | --------------------- --------------------- MONTH DAY YEAR MONTH DAY YEAR B. Nonprepaid: / / Specified future date: | | / / Backdate to | | --------------------- --------------------- MONTH DAY YEAR MONTH DAY YEAR - ------------------------------------------------------------------------------------------------------------------------ POLICY APPLIED FOR - ------------------------------------------------------------------------------------------------------------------------ 9. Joint Life Protection (See attached supplement) 10. If an additional benefit cannot be approved, should the company issue a policy without the benefit? / / Yes / / No 11. Shall the PREMIUM LOAN provision, if available, become operative according to its terms? /X/ Yes / / No 12.-13. (Reserved) 14. PREMIUM FREQUENCY: /X/ Annually / / Semiannually / / Quarterly - ------------------------------------------------------------------------------------------------------------------------ BENEFICIARY - ------------------------------------------------------------------------------------------------------------------------ 15. A. DIRECT BENEFICIARY First, Middle Initial, Last Relationship to Insured (1) Mary J. Doe Daughter ----------------------------------------------------------------------------------- ----------------------- (2) ----------------------------------------------------------------------------------- ----------------------- (3) ----------------------------------------------------------------------------------- ----------------------- Business organization or trust --------------------------------------------------------- ----------------------- --------------------------------------------------------- B. CONTINGENT BENEFICIARY: First, Middle Initial, Last Relationship to Insured (1) ----------------------------------------------------------------------------------- ----------------------- (2) ----------------------------------------------------------------------------------- ----------------------- (3) ----------------------------------------------------------------------------------- ----------------------- Box (1) or (2) may be selected to include all of the children or brothers and sisters without naming them, or to add to the contingent beneficiaries named. Box (3) may be selected to provide for the children of a deceased contingent beneficiary; use only if contingent beneficiaries are named and/or Box (1) or (2) is checked. NOTE: The word "children" includes child and any legally adopted child. /X/ (1) and all (other) children of the Insured. / / (2) and all (other) brothers and sisters of the Insured born of the marriage of or legally adopted by and before the Insured's death. -------------------------- ----------------------------- / / (3) any amount that would have been paid to a deceased contingent beneficiary, if living, will be paid in one sum and in equal shares to the children of that contingent beneficiary who survive and receive payment. C. FURTHER PAYEES First, Middle Initial, Last Relationship to Insured (1) ----------------------------------------------------------------------------------- ----------------------- (2) ----------------------------------------------------------------------------------- ----------------------- D. / / SEE ATTACHED SUPPLEMENT FORM (To be used in place of designations above.) - ------------------------------------------------------------------------------------------------------------------------ 90-1 JCL (0198) (page 2) 16. (Reserved) CONDITIONAL LIFE INSURANCE AGREEMENT - --------------------------------------------------------------------------------------------------------------------------- 17. Has the premium for the policy applied for been given to the agent in exchange for the Conditional Life Insurance Agreement with the same number as this application? /X/ Yes / / No - --------------------------------------------------------------------------------------------------------------------------- INSURANCE HISTORY - --------------------------------------------------------------------------------------------------------------------------- 18. Has the insured ever had life, disability or health insurance declined, rated, modified, issued with an exclusion rider, cancelled, or not renewed? If yes, explain in REMARKS. / / Yes /X/ No 19. When was the Insured's last examination or application for life, disability or accidental death insurance? Month Year Company --------------- ------------ --------------------------------------------------- OR /X/ NONE 20. Does the Insured have any other life insurance in force, pending or contemplated in other companies? / / Yes /X/ No If yes, indicate Company Name, Individual (Ind) or Group (Grp) and identify the amount of in Force, Pending or Contemplated. LIFE INSURANCE AMOUNTS ----------------------------------------------------------------------------------------------------------------------- Company Name Ind/Grp In Force Pending Contemplated Accidental Amount Amount Amount Death Amount ----------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------- 21. As a result of this purchase will the values or benefits of any other life insurance policy or annuity contract, on any life, be affected in any way? / / Yes /X/ No NOTE TO AGENT: VALUES OR BENEFITS ARE AFFECTED IF ANY QUESTION ON THE DEFINITION OF REPLACEMENT SUPPLEMENT COULD BE ANSWERED "YES". If "yes", this transaction is a replacement of life insurance or annuity. The agent must: - submit required papers and sale materials AND - provide required disclosure notices to the applicant. The applicant must answer the questions: - on the Definition of Replacement Supplement AND - A, B, and C below. Will this insurance: A. replace Northwestern Mutual Life? / / Yes /X/ No B. replace other Companies? / / Yes /X/ No C. result in 1035 exchange? / / Yes /X/ No - --------------------------------------------------------------------------------------------------------------------------- 22. (Reserved) REMARKS - --------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------- 90-1 JCL (0198) (page 3) ------------------------------------------------------------ FIRST MIDDLE INITIAL LAST PERSONAL HISTORY QUESTIONNAIRE - FIRST INSURED - ----------------------------------------------------------------------------------------------------------------------------------- 23. Insured's Marital Status: / / Single, Widowed or Divorced /X/ Married 24. a. Insured is a citizen of: /X/ U.S.A. / / Other If other: Type of Visa: Visa Number: ------------------- ---------------- b. How many years has the insured resided in the U.S.A. immediately prior to completing this application? 35 years ------ 25. Does the Insured regularly travel outside the U.S.A. or have plans to leave the U.S.A. for travel or residence? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ./ /Yes /X/ No If yes, explain in the chart below. ------------------------------------------------------------------------------------------------------------------------------- Destination Number of Trips Duration of Departure Date Purpose of Trip (List all Cities and Countries) Last 12 Next 12 Each Trip (Month/Year) Months Months (No. of Days) ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- 26. a. What is the Insured's occupation(s)? Attorney --------------------------------------------------------------------------------------- What are the Insured's duties? Office Duties --------------------------------------------------------------------------------------------- b. Employer's Name: ABC Corporation ----------------------------------------------------------------------------------------------------------- Address: 1000 Company Ave. ------------------------------------------------------------------------------------------------------------ City, State, Zip Code: Milwaukee, WI 53200 ----------------------------------------------------------------------------------------------------- c. How long has the insured been employed? 7 years (if less than 2 years, explain in REMARKS) ---------- QUESTIONS 27 THROUGH 30 ARE NOT REQUIRED IF THE INSURED IS UNDER AGE 16. 27. Is the Insured a member of, or does the Insured plan on joining any branch of, the Armed Forces or reserve military unit? If yes, complete the Military Section . . . . . . . . . . . . . . . . . . ./ / Yes /X/ No 28. Except as a passenger on a regularly scheduled flight, has the Insured flown within the past 2 years, or does the Insured have plans to fly in the future? If yes, complete the Aviation Section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ./ / Yes /X/ No 29. In the past 2 years, has the Insured participated in or does the Insured have plans to participate in: racing (automobile, snowmobile, motorcycle, boat or go-cart), underwater or sky diving, hang gliding, bungee jumping, mountain or rock climbing, or rodeos? If yes, complete the Avocation Section. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . ./ / Yes /X/ No 30. a. What is the Insured's automobile driver's license number? # D555-5555-5555-55 State WI or, / / the Insured does not have a driver's license. ------------------ -------------- b. In the past 5 years, has the Insured been in a motor vehicle accident, has the Insured been charged with a moving violation of any motor vehicle law, or has the Insured's driver's license been restricted, suspended or revoked? If yes, complete the chart below . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ./ / Yes /X/ No ------------------------------------------------------------------------------------------------------------------------------- Type and Details Action Accident Date (Speeding, Reckless Driving, Driving While Intoxicated, Etc.) (Citation, Fine, Etc.) (Yes or No) ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- REMARKS - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- 90-1 JCL (0198) (page 4) / / / / / / / / / / / --------------------- POLICY NUMBER SECOND INSURED (OLDER) / / Companion policies / /Life & Disability Application / / LTC Application / / Exam (NM, PME, MD) in Home Office ON PAGES 5 AND 6, "INSURED" REFERS TO THE SECOND INSURED. - --------------------------------------------------------------------------------------------------------------------------------- Has an application or informal inquiry ever been made to Northwestern Mutual Life for annuity, life, long term care, or disability insurance on the life of the insured? / / Yes /X/ No If yes, the last policy number is _________ 1. A. / / Mr. /X/ Mrs. / / Ms. / / Dr. / / Other_________ B./ / MALE Name: JANE J DOE /X/ FEMALE ----------------------------------------------------------------------------------------------- FIRST MIDDLE INITIAL LAST - --------------------------------------------------------------------------------------------------------------------------------- C. BIRTHDATE: (MONTH, DAY, YEAR) D. STATE OF BIRTH (Or Foreign Country): E. TAXPAYER IDENTIFICATION NUMBER: 12-31-1963 Wisconsin ###-##-#### ---------- ----------- - --------------------------------------------------------------------------------------------------------------------------------- F. PRIMARY RESIDENCE: /X/ First Insured's Address OR STREET OR PO BOX: -------------------------------------------------------------------------- CITY, STATE, ZIP (Country if other than U.S.A.): -------------------------------------------------------------------------- E-MAIL ADDRESS: -------------------------------------------------------------------------- This address will be used for all of the Second Insured's policies. - --------------------------------------------------------------------------------------------------------------------------------- 2.-9. (Reserved) - --------------------------------------------------------------------------------------------------------------------------------- 10. If an additional benefit cannot be approved should the Company issue the policy without the benefit? / / Yes / / No - --------------------------------------------------------------------------------------------------------------------------------- 11.-17. (Reserved) INSURANCE HISTORY - --------------------------------------------------------------------------------------------------------------------------------- 18. Has the Insured ever had life, disability or health insurance declined, rated, modified, issued with an exclusion rider, cancelled, or not renewed? If yes, explain in REMARKS. / /Yes /X/ No 19. When was the Insured's last examination or application for life, disability or accidental death insurance? Month Year Company OR /X/ None ----------------------- ------------------------ ------------------------------ 20. Does the Insured have any other life insurance in force, pending or contemplated in other companies? / / Yes /X/ No If yes, indicate Company Name, Individual (Ind) or Group (Grp) and identify the amount of In Force, Pending, or Contemplated. LIFE INSURANCE AMOUNTS ------------------------------------------------------------------------------------------------------------------------------ Company Name Ind/Grp In Force Pending Contemplated Accidental Amount Amount Amount Death Amount ------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------ 21. As a result of this purchase will the values or benefits of any other life insurance policy or annuity contract, on any life, be affected in any way? / / Yes /X/ No NOTE TO AGENT: VALUES OR BENEFITS ARE AFFECTED IF ANY QUESTION ON THE DEFINITION OF REPLACEMENT SUPPLEMENT COULD BE ANSWERED "YES". If "yes", this transaction is a replacement of life insurance or annuity. The agent must: - submit required papers and sale materials and - provide required disclosure notices to the applicant. The applicant must answer the questions: - on the Definition of Replacement Supplement and - A, B, and C below. Will this insurance: A. replace Northwestern Mutual Life? / / Yes /X/ No B. replace other Companies? / / Yes /X/ No C. result in 1035 exchange? / / Yes /X/ No - --------------------------------------------------------------------------------------------------------------------------------- 22. (Reserved) REMARKS - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- 90-1 JCL (0198) (page 5) - --------------------------------------------------------------------------------------------------------------------------------- 23. Insured's Marital Status: / / Single, Widowed or Divorced /X/ Married 24. a. Insured is a citizen of: /X/ U.S.A. / / Other If other: Type of Visa: Visa Number: -------------------------- ----------------- b. How many years has the Insured resided in the U.S.A. immediately prior to completing this application? 35 years ----- 25. Does the Insured regularly travel outside the U.S.A. or have plans to leave the U.S.A. for travel or residence? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ./ / Yes /X/ No If yes, explain in the chart below. ------------------------------------------------------------------------------------------------------------------------------ Destination Number of Trips Duration of Departure Date Purpose of Trip (List all Cities and Countries) Last 12 Next 12 Each Trip (Month/Year) Months Months (No. of Days) ------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------ ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- 26. a. What is the Insured's occupation(s)? Housewife -------------------------------------------------------------------------------------- What are the Insured's duties? -------------------------------------------------------------------------------------------- b. Employer's Name: ---------------------------------------------------------------------------------------------------------- Address: ---------------------------------------------------------------------------------------------------------- City, State, Zip Code: ---------------------------------------------------------------------------------------------------- c. How long has the Insured been employed? years (If less than 2 years, explain in REMARKS) ---------- QUESTIONS 27 THROUGH 30 ARE NOT REQUIRED IF THE INSURED IS UNDER AGE 16. 27. If the Insured a member of, or does the Insured plan on joining any branch of, the Armed Forces or reserve military unit? If yes, complete the Military Section. . . . . . . . . . . . . . . . . . . . . . ./ / Yes /X/ No 28. Except as a passenger on a regularly scheduled flight, has the Insured flown within the past 2 years, or does the Insured have plans to fly in the future? If yes, complete the Aviation Section. . . . . ./ / Yes /X/ No 29. In the past 2 years, has the Insured participated in or does the Insured have plans to participate in: racing (automobile, snowmobile, motorcycle, boat or go-cart), underwater or sky diving, hang gliding, bungee jumping, mountain or rock climbing, or rodeos? If yes, complete the Avocation Section. . . ./ / Yes /X/ No 30. a. What is the Insured's automobile driver's license number? # D333-3333-3333-33 State WI or, / / the Insured does not have a driver's license. ------------------ ---- b. In the past 5 years, has the Insured been in a motor vehicle accident, has the Insured been charged with a moving violation of any motor vehicle law, or has the Insured's driver's license been restricted, suspended or revoked? If yes, complete the chart below . . . . . . . . . . . ./ / Yes /X/ No ----------------------------------------------------------------------------------------------------------------------------- Type and Details Action Accident Date (Speeding, Reckless Driving, Driving While Intoxicated, Etc.) (Citation, Fine, Etc.) (Yes or No) ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- REMARKS - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- 90-1 JCL (0198) (page 6) - -------------------------------------------------------------------------------- EACH INSURED CONSENTS TO THIS APPLICATION AND ATTACHED SUPPLEMENTS AND DECLARES THAT THE ANSWERS AND STATEMENTS MADE ON THIS APPLICATION AND ATTACHED SUPPLEMENTS ARE CORRECTLY RECORDED, COMPLETE AND TRUE TO THE BEST OF EACH INSURED'S KNOWLEDGE AND BELIEF. ANSWERS AND STATEMENTS BROUGHT TO THE ATTENTION OF THE AGENT, MEDICAL EXAMINER OR PARAMEDICAL EXAMINER ARE NOT CONSIDERED INFORMATION BROUGHT TO THE ATTENTION OF THE COMPANY UNLESS STATED IN THE APPLICATION. STATEMENTS IN THIS APPLICATION ARE REPRESENTATIONS AND NOT WARRANTIES. It is agreed that: (1) If the premium is not paid when the application is signed, no insurance will be in effect. The insurance will take effect at the time the policy is delivered and the premium is paid, if: both Insureds are living at that time; and the answers and statements in the application are then true to the best of each Insured's knowledge and belief. (2) If the premium is paid when the application is taken, no insurance will be in effect except as provided in the Conditional Life Insurance Agreement with the same number as this application. (3) No agent is authorized to make or alter contracts or to waive any of the Company's rights or requirements. ------------------------------------------------------------------------------- THE OWNER OF THE POLICY APPLIED FOR HEREIN CERTIFIES, UNDER PENALTIES OF PERJURY, (1) THAT THE TAXPAYER IDENTIFICATION NUMBER GIVEN FOR THE OWNER ON THE SECOND PAGE OF THIS APPLICATION IS THE OWNER'S CORRECT TAXPAYER IDENTIFICATION NUMBER (OR THE OWNER IS WAITING FOR A NUMBER TO BE ISSUED) AND (2) THE OWNER IS NOT SUBJECT TO BACKUP WITHHOLDING EITHER BECAUSE THE OWNER HAS NOT BEEN NOTIFIED BY THE INTERNAL REVENUE SERVICE (IRS) THAT THE OWNER IS SUBJECT TO BACKUP WITHHOLDING AS A RESULT OF A FAILURE TO REPORT ALL INTEREST OR DIVIDENDS, OR THE IRS HAS NOTIFIED THE OWNER THAT THE OWNER IS NO LONGER SUBJECT TO BACKUP WITHHOLDING. (SEE TAXPAYER IDENTIFICATION NUMBER INSTRUCTIONS.) THE INTERNAL REVENUE SERVICE DOES NOT REQUIRE YOUR CONSENT TO ANY PROVISION OF THIS DOCUMENT OTHER THAN THE CERTIFICATIONS REQUIRED TO AVOID BACKUP WITHHOLDING. ------------------------------------------------------------------------------- THE SIGNATURES BELOW APPLY TO THE APPLICATION, THE POLICY APPLICATION SUPPLEMENT AND THE CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER. (Signed) John J. Doe (Signed) Jane J. Doe - -------------------------------------- ----------------------------------------- Signature of FIRST INSURED Signature of SECOND INSURED (Signed) John J. Doe - -------------------------------------- ----------------------------------------- Signature of APPLICANT Signature of OWNER (If other than Applicant, First or Second Insured) Signed by APPLICANT at Milwaukee, Milwaukee WI Date signed by APPLICANT 12 | 31 | 1998 ------------------------ ---------------- CITY, COUNTY & STATE MONTH DAY YEAR (Signed) Norm W. Western ------------------------------ Signature of LICENSED AGENT - -------------------------------------------------------------------------------- INSTRUCTIONS FOR TAXPAYER IDENTIFICATION NUMBER INFORMATION 1. Under federal income tax law you will be subject to a withholding tax of 31% imposed upon certain reportable payments, if any, and to certain penalties if you do not certify under penalties of perjury that the Taxpayer Identification Number which you have provided us is correct and that you are not subject to backup withholding due to notified payee underreporting. Generally speaking, for individuals, the Taxpayer Identification Number is the Social Security Number. 2. If you don't have a Taxpayer Identification Number, obtain Form SS-5, Application for a Social Security Number Card, at the local office of the Social Security Administration or the Internal Revenue Service and apply for a number. Write "Applied for" in the space available for your Taxpayer Identification Number on the first page of this application. If we do not receive your Taxpayer Identification Number within 60 days, we are required to withhold 31% of all reportable payments, if any, thereafter made to you until we receive a number from you. 3. If the Internal Revenue Service has notified you that you are subject to backup withholding and you have not received notice from the Service that backup withholding has terminated, you should strike out the language on page 9 that you are not subject to backup withholding due to notified payee underreporting. 90-1 JCL (0918) (page 7) POLICY APPLICATION SUPPLEMENT FOR FLEXIBLE PREMIUM VARIABLE JOINT LIFE INSURANCE POLICY INSURANCE PAYABLE ON SECOND DEATH THE NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY 720 East Wisconsin Avenue Milwaukee, Wisconsin 53202 INSUREDS: John J. Doe and Jane J. Doe -------------------- ---------------------- POLICY: Specified Amount: $ 1,000,000 -------------------------------------------- Death Benefit Option: Specified Amount (Option A) -------------------------------------------- Definition of Life Insurance Test: Guideline Premium/Cash Value Corridor Test -------------------------------------------- Minimum Initial Premium: $ 5,000 -------------------------------------------- Guideline Premium Maximum: $ 8,960 -------------------------------------------- Reminder Premium: $ 5,000 -------------------------------------------- Reminder Mode: Annual -------------------------------------------- - -------------------------------------------------------------------------------- For Home Office Use Only Underwriting Amount: $ 1,000,000 ----------- Illustrated Cumulative Premiums: Years 1- 5: $ 25,000 Years 1- 15: $ 75,000 ---------- ----------- Years 1- 10: $ 50,000 Years 1- 20: $ 100,000 ---------- ----------- First Insured: 35, Male, Select Second Insured: 35 Female Select ------------------------- ------------------- WI - ------- - -------------------------------------------------------------------------------- Illustration No. 123-456-789 90-1 VJL. Supp. (1298) Page 1 of 4 ------------------ ALLOCATION OF NET PREMIUMS This allocation will apply to all net premiums and loan repayments. USE WHOLE PERCENTAGES ONLY. If monthly dollar cost averaging is desired, complete both this section and the monthly dollar cost averaging section below. Only allocations to the Money Market Division are utilized for dollar cost averaging purposes. Money Market Division % ---------- Aggressive Growth Stock Division % ---------- Balanced Division % ---------- Growth and Income Stock Division % ---------- Growth Stock Division % ---------- High Yield Bond Division % ---------- Index 500 Stock Division % ---------- International Equity Division % ---------- Select Bond Division % ---------- Total 100 % ---------- MONTHLY DOLLAR COST AVERAGING To elect monthly dollar cost averaging, choose one of the following options and indicate the desired allocation of transfers below. USE WHOLE PERCENTAGES ONLY. _____Option One: Transfer in monthly installments so that on the policy anniversary the Money Market balance will be zero. _____Option Two: Transfer a level amount of $______________until the Money Market balance is zero. Aggressive Growth Stock Division % ---------- Balanced Division % ---------- Growth and Income Stock Division % ---------- Growth Stock Division % ---------- High Yield Bond Division % ---------- Index 500 Stock Division % ---------- International Equity Division % ---------- Select Bond Division % ---------- Total 100 % ---------- Insureds: John J. Doe and ---------------- Jane J. Doe ---------------- Illustration No. 123-456-789 ------------------- 90-1 VJL. Supp. (1298) Page 2 of 4 SUITABILITY Northwestern Mutual Life is required to make the following inquiries for purposes of determining the suitability of this purchase. Responses will be kept confidential. 1. In addition to providing a death benefit upon the death of the second of the Insureds, what is the purpose for the purchase? To fund a trust. Purpose of the trust: - ----- ------------------------------------ To supplement retirement income - ----- To supplement education funding - ----- Other (specify): - ----- --------------------------------------------------------- 2. By whom will the purchase be funded? ----------------------------------------- Annual income (all sources) of person/trust funding the purchase:$ --------- Net worth of person/trust funding the purchase: $ -------------------------- 3. Applicant's experience with the following: (If the purpose for the purchase is to fund a trust, describe the trust's or trustee's experience) None Up to 5 or More 5 Years Than 5 Years Mutual Funds ------ ------ ------ Individual Common Stocks ------ ------ ------ Bonds ------ ------ ------ Variable Annuities ------ ------ ------ Variable Life Insurance ------ ------ ------ 4. Describe the information the applicant has provided regarding his/her portfolio, tax status and variable life insurance purchase objectives and needs (if the purpose for the purchase is to fund a trust, describe the information the trust has provided regarding its portfolio, tax status and variable life insurance purchase objectives and needs): Insureds: John J. Doe and ---------------- Jane J. Doe ---------------- Illustration No. 123-456-789 ------------------- 90-1 VJL. Supp. (1298) Page 3 of 4 I UNDERSTAND THAT THE DEATH BENEFIT FOR A FLEXIBLE PREMIUM VARIABLE JOINT LIFE POLICY IS VARIABLE AND MAY INCREASE OR DECREASE TO REFLECT THE INVESTMENT EXPERIENCE OF NORTHWESTERN MUTUAL VARIABLE LIFE ACCOUNT. THE AMOUNT OF THE DEATH BENEFIT IS NOT GUARANTEED. I UNDERSTAND THAT THE CASH VALUE FOR A FLEXIBLE PREMIUM VARIABLE JOINT LIFE POLICY IS VARIABLE AND MAY INCREASE OR DECREASE TO REFLECT THE INVESTMENT EXPERIENCE OF NORTHWESTERN MUTUAL VARIABLE LIFE ACCOUNT. THE AMOUNT OF THE CASH VALUE IS NOT GUARANTEED. I understand that any illustrations of death benefits and cash values I have been shown demonstrate how the policy operates under a given set of assumptions and are not estimates or guarantees of future results. Actual experience will be different than assumed, resulting in death benefits and cash values higher or lower than illustrated. The assumptions incorporated in an illustration include, but are not limited to, the following: premium payment amounts and frequencies, investment returns, expense charges, cost of insurance charges, loans, and withdrawals. I acknowledge receipt of the _____/_____/_____ Flexible Premium Variable MO. DAY YR. Joint Life Insurance Policy prospectus. DATE: 12 / 31 / 98 SIGNATURE OF APPLICANT: (Signed) John J. Doe ---- ---- ---- --------------------------- MO. DAY YR. Based on the information furnished by the Applicant in this application, I certify that I have reasonable grounds for believing the purchase of the policy applied for is suitable for the Applicant. I further certify that a current prospectus was delivered and that no written sales materials other than those furnished by the Northwestern Mutual Life home office were used. Signature of Licensed Agent: (Signed) Norm W. Western ---------------------------------------------------- (REGISTERED REPRESENTATIVE) Based on the information furnished by the applicant in this application, I certify that I have reasonable grounds for believing the purchase of the policy applied for is suitable for the Applicant. Signature of General Agent: (Signed) Norma W. Western ----------------------------------------------------- Insureds: John J. Doe and ---------------- Jane J. Doe ---------------- Illustration No. 123-456-789 ------------------- 90-1 VJL. Supp. (1298) Page 4 of 4 It is recommended that you ... read your policy. notify your Northwestern Mutual agent or the Company at 720 East Wisconsin Avenue, Milwaukee, WI 53202, of an address change. call your Northwestern Mutual agent for information--particularly on a suggestion to terminate or exchange this policy for another policy or plan. ELECTION OF TRUSTEES The members of The Northwestern Mutual Life Insurance Company are its policyholders of insurance policies and deferred annuity contracts. The members exercise control through a Board of Trustees. Elections to the Board are held each year at the annual meeting of members. Members are entitled to vote in person or by proxy. FLEXIBLE PREMIUM VARIABLE JOINT LIFE INSURANCE POLICY INSURANCE PAYABLE ON SECOND DEATH ELIGIBLE FOR ANNUAL DIVIDENDS Flexible premiums. Benefits reflect investment results. Variable benefits described in Sections 1, 3, 6, 7 and 8. THE DEATH BENEFIT AND CASH VALUE UNDER THIS POLICY ARE VARIABLE. THEY MAY INCREASE OR DECREASE DAILY DEPENDING ON THE INVESTMENT RESULTS OF THE SEPARATE ACCOUNT. THE AMOUNT OF THE DEATH BENEFIT AND THE AMOUNT OF THE CASH VALUE ARE NOT GUARANTEED. RR.VJL.(1298) POLICY SPLIT PROVISION POLICY SPLIT RIGHT. While both Insureds are alive, the Owner may exchange this policy for two policies (the "new policies"), one on the life of each Insured, if there is a change in federal estate tax law which results in either: a. the repeal of the unlimited marital deduction provision; or b. at least a 50% reduction in the maximum percentage rate set forth in the federal estate tax schedule in effect on the Date of Issue of this policy. This exchange may be made without evidence of insurability. CONDITIONS. The exchange may be made by meeting any conditions set by the Company, including the following: a. the Company must receive a written request from the Owner no more than 180 days after the earlier of the date of enactment of the law repealing the unlimited marital deduction or the date of enactment of the law reducing the maximum percentage rate of federal estate tax by 50%; and b. any required costs are paid. TERMS OF THE NEW POLICIES. The new policies will be issued on any life insurance plan agreed to by the Owner and the Company. The new policies will have the same Date of Issue and Policy Date as this policy. The new policies will take effect on the date the written request to exchange this policy for the new policies is received at the Home Office. This policy will terminate when the new policies take effect. The amount of the death benefit of each new policy will be one-half the amount of the death benefit of this policy. The Policy Value of this policy will be allocated to each new policy as determined appropriate by the Company. Any policy debt will be divided between the new policies in proportion to their cash values. Any assignment will continue on the new policies. SECRETARY THE NORTHWESTERN MUTUAL LIFE INSURANCE COMPANY RR.VJL.PS.(1298) HOL03 105423