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olicy Number Date Issued Applicant: Leon D. Black Beneficiary(les) Face Value Annual Premiums Cash Surrender Value Prudential 4/28/1999 Leon D. Black Insurance Trust 42 $20.000.000.00 $179.595.00 $3.962.435.79 New York Life 4/28/1999 Leon D. Black Insurance Trust 42 $20.000.000.00 $196.080.00 4,139.064.14
rust 42 $20.000.000.00 $196.080.00 4,139.064.14 Pacific Life 4/28/1999 Leon D. Black Insurance Trust 42 65.000.000.00 $33.218.00 666.260.80 John Hancock 4/28/1999 Leon D. Black Insurance Trust 42 $30.000.000.00 $359.022.00 7.780.251.8:3 AXA E. tillable 4/28/1999 Leon D. Black Insurance Trusl 4
Name, Address & Telephona# _, of Insurance Carrier Face Value Annual _ Cash Surrender I Beneficia ies _.._. Premium Prudential 9/1/1999 Leon D. Black Insurance Trust #1 AXA Equitable 9/1/1999 Leon D. Black Insurance Trust #1 Security Life of Denver 9/1/1999 Leon 0 Black Insurance Trust #1 Prudential 4/26/1
n D. Black Insurance Trust #2 New York Life 4/28/1999 Leon D. Black Insurance Trust #2 Pacific Life 4/28/1999 Leon D. Black Insurance Trust #2 John Hancock 4/28/1999 Leon D. Black Insurance Trust #2 AXA Equitable 4/28/1999 Leon D. Black Insurance Trust #2 I T h TOTAL: i EFTA00616063 Page 8 o
Face Annual Cash Surrender Premiums Value Date of Insurance Carrier Number Issued Beneficiary(les) Value Prudential V1 016 844 9/1/1999 Leon D. Black Insurance Trust #1 $30,000.000.00 $502,335.00 $4.737,189.00 AXA Equitable 49 232 126 9/1/1999 Leon D. Black Insurance Trust #1 $15,000,000.00 $264.894.00 $
0,000.00 $196,080.00 $3,395&24.00 Pacific Life VP 6089 7390 4/28/1999 Leon D. Black Insurance Trust #2 $5,000,000.00 $33.218.00 $495,683.00 John Hancock 20 039 301 4/28/1999 Leon D. Black Insurance Trust #2 $30,000,000.00 $359,022.00 $5,416,560.00 AXA Equitable 49 232 123 4/28/1999 Leon D. B
er Date Issued Applicant: Leon D. Black Beneflciary(les) Face Value Annual Cash Surrender Premiums Value Prudential V0 001 958 4/28/1999 Leon D. Black Insurance Trust N2 620,000,000.00 S179.595.00 63,962,435.79 New York Life 75 500 858 4/28/1999 Leon D. Black Insurance Trust N2 $20.000,000.00 $196,080.00
0,000.00 $196,080.00 4,139,064.14 Pacific Life VP 6089 7390 4/28/1999 Leon D. Black Insurance Trust /12 $5,000,000.00 $33,218.00 666.260.80 John Hancock 20 039 301 4/28/1999 Leon D. Black Insurance Trust N2 630,000,000.00 $359.022.00 7.780,251.83 AXA Equitable 49 232 123 4/28/1999 Leon D. Bl
Entities connected to both Leon D. Black Insurance Trust and John Hancock
Pacific Life
LOCATIONLeon Black
PERSON
JPMorgan Chase
ORGANIZATION
Chevrolet
ORGANIZATIONMercedes Benz S 600
ORGANIZATIONArt Collections
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Honda
ORGANIZATIONPrudential
ORGANIZATIONAXA Equitable
ORGANIZATIONNew York Life
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American Express
ORGANIZATION
Charlotte
LOCATION
Joshua
PERSONSecurity Life
ORGANIZATIONHamlet Holdings LLC
ORGANIZATIONyour Dependent Children
ORGANIZATIONBlack Family Partners
ORGANIZATION
United States
LOCATIONBlack Family 1997
ORGANIZATIONLeon Black Family Foundation
ORGANIZATION