RICAN AUTOMOBILE INSURANCE COMPANY Pru iry PII IkACICD COMPANY CODE _ 09025 PERSONAL INJURY PROTECTION BENEFITS/PROPERTY DAMAGE LIABILITY NAMED INSURED(S) EFFECTIVE DATE 02-07-13 BODILY INJURY LIABILITY Not valid more than one year from effective date. 300324 10-94 EFTA00558889

t-Owned Split - Dollar Life Insurance Coverage COLLATERAL ASSIGNMENT SPLIT-DOLLAR PLAN WEALTH TRANSFER PLAN There are Four Parties to this plan: INSURED(S) IRREVOCABLE LIFE INSURANCE TRUST (ILIT) ENTITY* (Corporation or Family Limited Partnership) O Split-Dollar Agreement INSURED(S) Rights of