Simplified Reinstatement Offer

In this form, you and your refer to the life insured, policy owner and the plan holder while we, us, our and the Company refer to Sun Life of Canada (Philippines), Inc., and/or Sun Life Financial Plans, Inc., both are members of the Sun Life Financial group of companies. The grace period allowed for payment of the premium/installment has expired. If payment has not been made, your policy/plan lapsed and all benefits pertaining to it ceased. You may, however, take advantage of this simplified reinstatement offer and again be able to experience the security offered by your valuable policy/plan. To apply for this reinstatement, simply complete and sign this application for reinstatement and return the form to us with your payment no later than 90 days after the due date.

Please PRINT clearly. Use BLACK ink.

Policy Owner/Plan Holder Last Name, First Name, M.I

Age

Email Address

example@example.com

The following questions must be answered by: i. the life insured; ii. the plan holder if plan being reinstated has insurance benefit/s; iii. the owner of the policy if the policy includes a waiver of premium benefit.

Life Insured/ Owner Plan holder

Within the past year, have you had any symptoms of, sought advice for, or been treated forhigh blood pressure, stroke, heart trouble, diabetes, cancer or tumor, chest pain, bleeding fromthe bowel, or blood in your sputum, or has treatment for any of these been recommendedby a physician or other practitioner?

Within the past year, have you been admitted or been advised to be admitted to a hospital orother medical facility, or has surgery been performed or recommended, or has any medicaltest/laboratory procedure been scheduled or recommended?

Within the past year, have you had any abnormal test results, or had routine check-up, orhad ECG, x-ray, urine, blood tests or other tests which resulted in abnormal findings?

Within the past year, do you have any health symptoms or complaints for which a physicianhas not been consulted or treatment has not been received? For example: persistent fever,unexplained weight loss, loss of appetite, pain, mass or cyst or swelling in any parts of thebody, etc.?

Signature of Insured

Signature of Owner/Plan holder

Printed Name

Signature

Place and Date of Signing (day/month/year)

Date

Place of Signing