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Submission Procedures for NWL® Lifetime Returns Solutions

The Applications

You must apply for NWL Lifetime Returns Solutions, a concept for wealth transfer sales, with life application ICC14 01-9063-14 (and state variations) and the Single Premium Immediate Annuity (SPIA) application ICC10 01-9062-10 (and state variations). Application ICC14 01-9063-14 (and state variations) is a comprehensive life application used during the interview process performed by Elite Sales Processing, Inc. (ESP), in conjunction with our Rules Based Point-of-Sale Program. Please see the NWL Lifetime Returns Solutions Agent Reference Guide Form DM-1145 (and state variations) for guideline instructions for the Rules Based Program. Life application ICC14 01-9063-14 (and state variations) and SPIA application ICC10-01-9062-10 can be submitted with cash premium, as a 1035 Exchange or a direct transfer depending on the non-qualified or qualified status of the funds.

Life application form ICC14 01-9063-14 may not yet be approved in your state. If the application is not approved in your state, you will not be eligible for the Rules Based Point of Sale Program. If the SPIA application form ICC10 01-9062-10 is not approved in your state, please use application form 01-9021. Please check application approvals on MyNWL® by logging in to www.mynwl.com for current updates.

Keep reading to learn how to make Solutions happen for your client.

Tips For Completing Applications and Transfer Form: SPIA Application Form ICC10-9062-10 (and state variations) • Write the word “SOLUTIONS” in the top center portion of the ICC10 01-9062-10 SPIA application. • Complete ALL the fields in the Annuitant section including the DOB and SSN. • Complete the Owner section if owner is someone “other than” the annuitant. • DO NOT COMPLETE THE BENEFICIARY SECTION. THE SPIA CEASES AT THE DEATH OF ANNUITANT

AND ALL BENEFITS ARE DETERMINED FROM THE LIFE POLICY. • Complete the Single Premium amount and anticipated transfer amount in the Premiums section. Check “Yes” or “No” to

indicate whether this is a replacement of an existing insurance or annuity policy. • Complete the Plan section, checking “Non-Qualified or Qualified” tax status box. Check the Single Life Annuity Temporary

Limited Pay box and write in either 5 or 10 years. • Include agent, annuitant, owner and joint owner, if applicable. • Agent signature, agent’s LIFE AGENT NUMBER and commission split (if applicable) is required on page 2. For Agent Use Only – This document has not been approved under the advertising laws of your state for dissemination to individual purchasers. Single Premium Immediate Life Annuity (Policy Form The 01-1159-10 and state variations) and NWL Lifetime Returns Solutions (Policy 01-1143-07 and state variations), a flexible premium life insurance policy with equity index options, are issued by National Western Life Insurance Company®, Austin, Texas. DM-1149.Rev.8.17

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Life Application Form ICC14 01-9063-14 (and state variations) • Fully complete all applicable sections of the life application. • Complete Plan of Insurance in Section II as NWL Lifetime Returns Solutions or NWL LTR Solutions and include Face

Amount. • Complete Single Premium amount in Section III and check box for 5 Pay or 10 Pay Modal Premium. Check box for Annual

and indicate the annual amount. For Method and Source of Premium, check box for other and write in SPIA payout. • Complete Beneficiary Information in Section V. • Be sure to get the appropriate Proposed Insured, Owner and Agent signature(s) on page 3. • The agent’s signature, LIFE AGENT NUMBER and split of commission (if applicable) are required on page 4. A

Helpful Hints When Reviewing Medical Questions

1. COPD/COLD: Chronic obstructive pulmonary or lung disease: This health condition includes chronic bronchitis, emphysema, pulmonary fibrosis, pulmonary granulomatosis, pulmonary edema, active tuberculosis, pneumoconiosis (black lung, farmer’s lung, asbestosis, silicosis), bronchiectasis, pulmonary sarcoidosis, histoplasmosis and cryptococcosis.

2. Asthma by itself is not considered COPD/COLD. 3. Question 10b: Heart Disease: The following are considered diseases or disorders of the heart occurring/discovered within

the last 2 years. Heart attack, heart blocks, PVD (Peripheral vascular disease), valvular surgery, pacemaker, pacemaker replacement, abdominal aortic aneurysm, cerebral vascular disease, arrhythmias, carditis, abnormal resting and exercise EKG’s, cardiac ischemia, enlarged heart, angina, coronary artery aneurysm, coronary artery bypass grafrting, heart replacement, uncontrolled high blood pressure, heart or circulatory surgery, angioplasty, cardiac or vascular stent placement, coronary artery disease of any type and any procedure to improved the circulation to the heart or brain or extremities.

4. Question 10b: Prescription drug use for maintenance of health conditions originally diagnosed over 2 years ago, does not apply to question 10b.

5. Taking medication (prescription drug use) is considered treatment and if taking medication currently or within the last 2 years for listed medical conditions, applicant should answer the question Yes.

6. Uncontrolled high Blood Pressure: If the applicant feels their blood pressure is uncontrolled, they should answer the question Yes. If they are confident their blood pressure is controlled and their physician has assured them that it is controlled they should answer the question No. Controlled blood pressure is defined as – if they are taking the medication and if the average blood pressure reading does not exceed 140/90 they can consider their blood pressure under control.

7. Treatment/Treated: Treatment is defined as receipt of medical services, surgery, or therapeutic care due to disease or injury, this does not include routine check ups.

APPLICATION FOR INDIVIDUAL LIFE INSURANCE850 East Anderson Lane • Austin, Texas 78752-1602

__________________________________________ ____________________ ______ ______________________________Name of Proposed Insured (First, Middle, Last) Date of Birth (mm/dd/yyyy) Age Place of Birth (State and Country)! Male ! Female Marital Status ! Married ! Single ! Widowed ! Divorced ! Tobacco Use ! Tobacco Free__________________________________ ______________________________ ________________ __________________Home Address (number and street) City State Zip

Best time and place to call____________________________ ____________________________ ____________________ ! Home______ !AM !PMSocial Security Number or Tax ID Drivers License Number and State Home Phone Number ! Work ______ !AM !PMCitizenship ! U.S. Citizen ! Foreign National Email _____________________________________If Non US Citizen: Type of Visa__________________ Exp date ____________ Country of Citizenship______________________________________________________ __________________________________________ ________________________Current Employer Occupation and Duties Work Phone Number__________________________________ ______________________________ ________________ __________________Employer Address (number and street) City State Zip

I. PRIMARY INSURED (Please Print Clearly Using Black Ink)

Single Premium $ __________________Modal Premium: ! 5 pay $ ___________ to be paid: ! Annual ! Semi-annual ! Quarterly ! Monthly

! 10 payMethod: ! Direct Billing ! Bank Draft ! Other ______________________________Amount collected with application: $ __________________________ Source of Premium: ! Salary ! Savings ! Investments ! 1035 Exchange ! Loan (premium financing)

! Other (specify) __________________________________________________________________________

III. PREMIUMS

____________________________________________ ________________________ __________________________________Owner / Applicant / Trust Name Date of Birth (mm/dd/yyyy) SSN / TINPhone Number ______________________________ Relationship to Proposed Insured ________________________________________________________________ ______________________________ ________________ __________________Address (number and street) City State Zip CodeIf the owner is a trust, please submit the Trust Information Form.

IV. OWNERSHIP INFORMATION (Complete only if Owner is other than the Proposed Insured)

Plan of Insurance (Name of Product) ______________________________________ Face Amount $ ____________________Riders: ! Accelerated Benefit Rider (Not available in all states) ! Return of Premium Rider (Not available in all states)

Riders are only available for single-premium

II. COVERAGE APPLIED FOR

Primary BeneficiariesFull Name SSN Relationship % Share1.________________________________________________________________________________________________________2.________________________________________________________________________________________________________3.________________________________________________________________________________________________________Contingent BeneficiariesFull Name SSN Relationship % Share1.________________________________________________________________________________________________________2.________________________________________________________________________________________________________3.________________________________________________________________________________________________________

V. BENEFICIARY INFORMATION (If percentages are not given, the shares will be divided equally)

ICC14 01-9063-14 Page 1

John H. Doe 01/01/45 65 TX/USA

123 Main Street Home Town TX 77047

111-22-3333 01234567 512-999-8888

Jane Doe

X X

X

NWL LIFETIME RETURNS SOLUTIONS

X X X

X

X SPIA PAYOUT

SPOUSE 100%

SOLUTIONSEach of the undersigned: Declares that all answers in this application are true and complete to the best of their knowledge and belief,and understands that: (a) all statements and answers in this application will be relied upon by the Company to determine insurability andto issue the policy; (b) no information will be considered given to the Company unless it is stated in the application; (c) the agent doesnot have the Company’s authorization to accept risk, pass on insurability, or make, void, waive, or change any conditions or provisionsin the application, policy or receipt, as applicable; and (d) a material misrepresentation may void the policy during the contestable period.This policy will take effect when: (1) the application is approved at National Western’s Office in Austin, Texas; (2) National Western deliv-ers the policy; (3) the initial premium has been paid; and (4) each of the prior three conditions is satisfied while the proposed insuredsare alive and their health and insurability are as described herein.

Proposed Insured: I am not currently taking, or under the influence of, any medications or drugs that would affect my ability to fully under-stand and to fully and accurately complete this application. I authorize any licensed physician, medical practitioner, hospital, other healthcare provider, insurance company or MIB, or other organization or person to give any information about me or my mental or physicalhealth to the Company and/or its authorized agents to determine my eligibility for life insurance coverage. The Company may disclosesuch information to its reinsurers and MIB. National Western or its reinsurers may also release such information to other life or healthinsurance companies to whom an application for insurance or to whom a claim for benefits is submitted. This authorization also appliesto any member of my family proposed for coverage in the application and is valid for 2 years after the date shown below. A photocopy ofthis form is as valid as the original. I may have a copy of this form upon request.

Each of the undersigned acknowledges receipt of the Notice under the Fair Credit Reporting Act (Consumer Report Notice), MIBDisclosure Notice, and Notice of Information Practices (if applicable).

FRAUD WARNING: ANY PERSON WHO KNOWINGLY PRESENTS A FALSE STATEMENT IN AN APPLICATION FOR INSURANCEMAY BE GUILTY OF A CRIMINAL OFFENSE AND SUBJECT TO PENALTIES UNDER STATE LAW.

Signed at ________________________________________________________ Date __________________________________ City and State

____________________________________________________ __________________________________________________ Signature of Proposed Insured (parent if age 17 or less) Signature of Owner if other than Proposed Insured

(If a Trust, signature of trustee) (If business or corporation, officer, other than Proposed insured, and Title)

____________________________________________________ __________________________________________________ Agent Name (please print) License No. Signature of Agent

ICC14 01-9063-14 Page 4

HOMETOWN, TX 7/15/17

John H. Doe

John Q. Agent

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Authorization to Transfer Funds Form SA-8600 • Fully complete the Proposed Insured/Annuitant section. Include a street address and telephone number for the transferring

company. This enables NWL to mail the transfer requests via overnight delivery. • Verify the account to be exchanged is a Qualified or Non-Qualified Annuity/Account. • Be sure to complete the Minimum Required Distribution in Qualified Account section if applicant is 70 or older. • Ownership must remain the same for each policy “Like” to “Like”. • Check the box indicating federal tax will not be withheld. • The client must sign as the Insured/Annuitant as well as the Owner. The signature(s) must match the other transfer

company’s application. • Completed state replacement forms may be required. Forms must be submitted before the transfer paperwork can be mailed. When the applicant has been accepted for the NWL Lifetime Returns Solutions, the exchange or transfer of funds will be initiated for the SPIA policy. The life policy premium will be paid with 5 or 10 annual payments from the SPIA policy. This process allows the taxable income to be spread over a 5 or 10 year annuity payout period.

Collecting the Premium by Other Than 1035 Exchange

Once the NWL Lifetime Returns Solutions application has been accepted, the agent can begin assisting the client in funding the SPIA policy from other assets. If the funds are qualified funds from an annuity or otherwise, the same payment process as indicated above will allow the client to spread the taxable income over a 5 or 10 year payment period.

Page 1 of 2 SA-8600.Rev.7.16

This form can be used to initiate an exchange of policies (full or partial) pursuant to Internal Revenue Code Section 1035 ("1035 Exchange"). The form may also be used to conduct Qualified Transfers and Direct Rollovers. Please refer to the application and any other state required forms for specific disclosures and information. Please consult with the distributing company for any specific form requirements for the transaction being initiated. Once complete, please sign and date this form and return to your agent. Some transactions may require a medallion signature or signature of other third parties.

PLEASE COMPLETE ONLY ONE FORM FOR EACH DISTRIBUTING COMPANY AND POLICY OR CONTRACT

SECTION 1: NWL INFORMATION Existing Policy/Contract Number _______________________ (if no number provided, funds will be applied to a new account.)

Owner Information Annuitant or Proposed Insured

1) Owner Name: _________________________________ 2) Annuitant/Proposed Insured Name: ________________________

1a) SSN/Tax ID: _________________________________ 2a) SSN/Tax ID: ______________________________

3) Joint Owner Name: _________________________________ 4) Joint/Co-Annuitant or

3a) SSN/Tax ID: _________________________________ Proposed Insured Name: ______________________________

4a) SSN/Tax ID: ______________________________

SECTION 2: DISTRIBUTING COMPANY Note: This form may not be accepted by a 401k or other employer-sponsored retirement plans. The applicant may need to complete a phone liquidation/transfer or other plan-specific paperwork.

_________________________________________ _________________________________________ __________________________ 5) Policy/Contract Owner(s) Name(s) 6) Distributing Company Name 7) Distributing Company

Policy/Contract Number

______________________________________________________ ______________________ ___________________ ___________ 8) Distributing Company Overnight Address 9) City 10) State 11) Zip

(P.O. Box addresses are not accepted)

______________________________________________________ _______________________________________________________ 12) Distributing Company Phone Number 13) Distributing Company Fax Number

SECTION 3: EXISTING ACCOUNT INFORMATION

14) Account Type:

! Annuity (Attach account statement within last 12 months) ! Brokerage Account Number(s) ___________________________

! Life Policy (Attach account statement within last 12 months) (If not a full liquidation, specify accounts to be liquidated)

! Mutual Funds/Stocks/Bonds ! Money Market

! Certificate of Deposit (CD)* ! Other (Specify) _______________________________________

*The CD maturity date must occur within 60 days of transfer. To specify liquidation date, please refer to section 5. Liquidations prior tomaturity may incur a penalty.

SECTION 4: TRANSACTION INSTRUCTION PLEASE complete only ONE of the following sections: Qualified Funds Transfer or Rollover (15), Non-Qualified 1035 Exchange (16), or Non-Qualified Transfer (17)

15) Qualified Funds Transfer or Rollover

15a) ! Full Transfer or Rollover, or Partial Transfer or Rollover: ! Penalty Free Withdrawal, or ! Transfer Amount: $_____________ or _______%

15b) Existing Qualified Funds Transfer or Rollover FROM: 15c) Existing Qualified Funds Transfer or Rollover TO: ! Traditional IRA ! Inherited/Beneficiary IRA ! Traditional IRA ! Inherited/Beneficiary IRA

! Roth IRA ! Other (Specify)____________ ! Roth IRA (please attach death certificate)

! SEP IRA ! Employer-Sponsored Plan* ! SEP IRA ! Other (Specify) ______________

*Employer-Sponsored Retirement Plans Only

! 401(k) ! 401(a) ! 403(b)/TSA/457

Qualifying Event

! Age 59½ ! Separated fromservice (Date ____/____/____)

! Other: ___________________________________

15d) If Owner is age 70½ or older, please mark one:

! Send policyholder the RMD amount for the current tax year prior to processing this transaction.

! Policyholder will (or already has) satisfied current year RMD.

AUTHORIZATION TO TRANSFER/EXCHANGE FUNDS

0123456789

John H. Doe

X

X

ABC Insurance Company 1234567890John H. Doe

123 Somewhere Street Anywhere TX 77777

(800) 222-0000

Page 2 of 2 SA-8600.Rev.7.16

16) Non-Qualified 1035 Exchange (life insurance policy or annuity contract) Please check only ONE.! Full Exchange, or Partial Exchange (check only one below)

! Penalty Free Exchange, or ! Exchange Amount: $_____________ or _________%

AUTHORIZATION TO PERFORM 1035 EXCHANGE – By signing below, Owner assigns and transfers to NWL all rights, title, interest, options, and privileges to the life insurance policy, annuity contract, or part of the annuity contract or life policy identified in Section 2, as specified by this form. The Owner represents that he/she is executing this assignment solely to effect a 1035 Exchange, and acknowledges that NWL intends to surrender the policy or contract for its cash value—or, if this is a partial surrender, then for the portion assigned—subject to the contract’s terms and conditions. By signing below, the Owner directs that the distributing company send the proceeds directly to National Western, and that National Western use the surrendered proceeds as purchase payment for a contract or policy issued by National Western. The Owner acknowledges that fees and charges may apply as a result of this surrender.

17) Non-Qualified Transfer (NOT for 1035 Exchange) Please check only ONE.! Full Non-Qualified Transfer (NOT for 1035 Exchange) ! Partial Non-Qualified Transfer (NOT for 1035 Exchange)

$__________ or _________%

AUTHORIZATION TO LIQUIDATE AND TRANSFER – By signing below, Owner directs that the Distributing Company liquidate and transfer the full value or the partial value of the Distributing Company account identified in Section 2. The Owner further directs National Western apply all such funds received to an annuity or life contract issued to Owner. The Owner further acknowledges and accepts responsibility for any charges or fees that may be imposed as a result of this liquidation.

FEDERAL INCOME TAX WITHOLDING – Notwithstanding the election made below, the Owner acknowledges that National Western assumes no responsibility for the tax treatment of this transaction, and that fees or charges may apply if the account is surrendered before the maturity date. In the event the payments of estimated tax payment and withholding, if any, are not adequate, any resulting tax penalties are the responsibility of the Owner. If no selection is made, NWL assumes no withholdings are required.

! Please withhold federal income tax from my surrender ($__________ or _________%) ! Do not withhold federal income tax.

SECTION 5: TIMING AND ADDITIONAL REQUESTS By signing below, Owner authorizes full or partial liquidation of his/her funds: ! Immediately OR ! On a specific date _____/_____/_____ If neither box is checked, transaction is to be processed immediately.

Additional Requests

______________________________________________________________________________________________________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

SECTION 6: ACKNOWLEDGEMENTS AND SIGNATURES RELEASE OF INFORMATION -- In addition to the authorization and acknowledgements provided above, the undersigned grants permission to release all information pertaining to this requested transaction to National Western Life Insurance Company as long as the transaction is pending.

LOST POLICY/CONTRACT -- If the life insurance policy or annuity contract identified in Section 2 is not attached, the undersigned certifies that the contract or policy has been lost or destroyed, and to the best of their knowledge, is not in anyone's possession.

Dated:__________________________________________________ this __________ of _________________________, ______________ (City, State) (Day) (Month) (Year)

_______________________________________________________ _______________________________________________________ Owner/Applicant/Trustee Signature Joint Owner / Applicant / Trustee Signature

_______________________________________________________ Spouse/Domestic Partner Signature

If you reside in one of the following states, Your spouse/domestic partner must also sign.

(AZ, CA, ID, LA, NM, TX, WA, and WI)

National Western Life insurance Company® 850 East Anderson Lane • Austin, TX 78752-1602

www.nationalwesternlife.com Phone 1-800-531-5442 • Fax 512-719-8507

Signature Guarantee (if applicable. Contact distributing company)

Hometown, TX 15th July 2017

John H. Doe

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Quick Guideline to the “Solutions” Process

NWL Lifetime Returns Solutions Required Forms* ICC14 01-9063-14 – Application for Life Insurance ICC14 01-S028 – Equity Index Life Application Supplement SA-9838-04 – Disclosure and Benefit Summary – ABR ** SA-8717 – Agent Certification & Application Acknowledgement SU-6412 – Notice of Information Practices* SU-6592 – Authorization for Release of Health Related Information DM-1144 – NWL Lifetime Solutions Illustrations Disclosure DM-1146 – NWL Lifetime Returns Solutions Consumer Brochure *Form Numbers and requirements vary by State ** If applicable

Temporary Life SPIA Required Forms* ICC10 01-9062-10 – SPIA Application**, DM-1081 – Annuity Suitability Questionnaire or DM-1174 depending on state SA-8505 – Social Security Verification (W-9) SA-8600 – Authorization to Transfer Funds SA-8629 – SPIA Quote Form SA-8699 – SPIA Disclosure SA-8714 – Minimum Distribution Requirements Disclosure SA-8934 – Replacement of Life Insurance or Annuities SA-9205 – Replacement Worksheet W-4P – Withholding Information for Pension or Annuity Payments*** *Form Numbers and requirements vary by State ** If applicable ***Withholding taxes from the SPIA payment to the Life Insurance policy has an adverse affect on the performance of NWL Lifetime Returns Solutions, so any and all taxes owed must be paid using other funds. NWL will not accept applications where Item 1., located in the Withholding Certificate for Pension or Annuity Contracts in the W-4P, is not checked.

Rules Based Program - NWL® Lifetime Returns Solutions

EliteSalesProcessing1-888-367-9008Monday–T hursday8:00a.m.–9:30p.m.(C ST )

Friday–8:00a.m.–5:00p.m.(C ST )

Afterthesaleismadeandtheapplicationsarecompleted–AgentandApplicantcallESP

During Business Hours ours

After Business Hours

Agent calls ESP with applicant at point of sale. Applicants that require an interpreter will be handled at point of call

Agent will leave a voice message at 1-888-367-9008. Indicate agent name and applicants full name and telephone numbers for both agent and applicant. ESP will call applicant next business day.

The agent indentifies themselves and is asked a few questions by ESP. Interviewer will then ask to speak to applicant

ESP will obtain applicant’s permission to record the interview and authorization to check MIB and IntelliScript (Prescription History). Both MIB and IntelliScript will be completed during the interview.

The Agent will be contacted by ESP during regular business hours and informed of the application decision.

Agent will be told if applicant is accepted or declined

If the applicant is accepted, the agent sends to National Western the applications, payment, and any other required forms

If the applicant is declined, Agent sends to National Western the application only indicating that application was declined. The agent can submit an application for a deferred annuity