FORELI

FORETHOUGHT@ FE'"

LICENSING
AND APPOINTMENTS

Licensingand Appointment Documents

A3072-01

Thispacketcontains:
. FinalExpenseLifeInsurance SellingAgreement- FormA3073-01
. Forethought'University
Certification- FormA3075-01
. Scheduleof Commission for FinalExpense Sales- FormM2112
LifeInsurance

rcRE
I S S U EB
DYF O R E T H O U GLH CEO M P A N YT
I FTEI N s U R A N C FroUGHT'
o 2008 Forethought
0 10 8
 ForethoughtLife InsuranceGompany/Forethought
NationalLife InsuranceCompany
reRE FINALEXPENSELIFE INSURANCE
TFIOUCHT
This Agreementis entered into by and between ForethoughtLife
InsuranceCompany,a corporationorganizedunder the laws of the
State of Indiana,or ForethoughtNationalLife InsuranceCompany,a
corporationorganizedunderthe lawsof the Stateof Texasfor all sales
transactedin Texas, having its principaloffice at One Forethought
Center, Batesville, Indiana 47006 (hereinafter referred to as
"Company,""us," "we," or "our."),and the Agency/Agentidentifiedin
the AppointmentData and Informationsection of this Agreement
(hereinafterreferredto as "Agent","you" or "your"). This Agreement
shallbe effectiveupon its acceptanceby Companyat its administrative
officeslocatedin Batesville,Indiana. lt is agreed by the partiesas
follows:
APPOINTMENTS,
AGENTSAND INDEPENDENT
CONTRACTOR
STATUS
APPOINTMENT.Companyappointsyou as one of its Agentsfor the
purposeof procuring,throughagentsappointedby us or assignedto
you by us, applications for individualand group life insurancepolicies
(hereinafterreferredto as "policy"or "policies")
whichwill be issuedby
Company. For the purposesof this Agreement,the term "application"
shall include enrollmentof personsfor individualor group policies.
Unless previouslyapprovedby us in writing,you and your agents
appointedby us may not beginsolicitation of policiesuntilsuchtime as
we haveissueda letterconfirmingthe appointment(s).
INDEPENDENT CONTRACTOR, TAXES AND OTHER
OBLIGATIONS. You are an independentcontractorand nothing
contained in this Agreement shall be construed to create the
relationshipof employerand employeebetweenyou, or any other
agent,and us. You shall be free to exerciseindependent judgmentas
to the personsfrom whom applications for policieswill be solicitedand
the time and place of such solicitations.You shall make and file all
reports and returns required by any federal or state statute or
regulationpertainingto withholdingtaxes, unemploymentinsurance,
pensionand profitsharingplans,and shallpay all taxes,contributions,
interest,or penaltiesthereunderin connectionwiththe wages,salaries,
or other remunerationpaid or allowed by you to employeesor
appointeesof yours or to others. You assumefull responsibility and
exclusiveliabilityfor failureto complywithany suchapplicablestatutes
or regulations.
As an independentcontractorand not an employeeof ours,all agency
expenses,includingbut not limitedto rentals,transportation, salaries,
attorney or legal fees which pertain to the administrationof your
business, postage, advertising,agent licensingfees and/or agent
occupational taxes,shallbe yourliabilityand notours.
APPOINTMENTOF AGENTS. Your subordinateagents(hereinafter
referredto as "agent"or "agents")include:(a) agentsassignedto you
by us and (b) agentsappointedby you and subjectto the termsof this
Agreement,providedyou maintain(to the extentrequiredby applicable
statelaw)a validlicenseand appointment as our agentin eachstatein
which you appointany such agents. Each agent whom you appoint
must be validly licensedand executea written agent's agreement
directlywith us, and such agreementshallbe effectiveonly when also
executedby us. You haveno authorityto modifyor amendany part of
such agreement. We reservethe followingrights at our discretion
without liabilityto you: (a) to refuse to contractwith any proposed
agent and (b) to terminateour agreementwith any of your agents
underthe termsof suchagreement.
NONEXCLUSIVETERRITORY. You are authorizedto do business
underthe conditionsof this Agreementin any state in which we are
authorizedto do businessand to issuethe specificpolicyyou intendto
sell providedyou are properlylicensedin suchstateto sell suchpolicy.
No territoryis exclusivelyassigned.We reservethe rightto withdraw
A3073-01 Page 1 of 6
SEttING AGREEMENT
from all or any portionof any state(s)at our discretionwithoutliability
to you.
RESPONSIBILITIES OF AGENCY/AGENT.You shall be resDonsible
for the fidelityand honestyof all of your agents. All moniescollected,
received,or which otherwisecome into your controlor the controlof
your agents, which belong to us, our policy or certificateowners
(hereinafterreferredto as a "policyowner"or as "policyowners")or
applicantsshall be securelyheld in a fiduciarycapacityand shall not
be used for any personalor other purposeswhatsoever,but shall be
immediatelypaid over to us. You guaranteethe paymentto us of all
monies intendedfor or owing to us, our policy owners,prospective
policyowners,or applicantsthat are collected,received,or otherwise
comeintoyourcontrolor the controlof your agents.
RESTRICTED AUTHORITYOF AGENCY/AGENT.Your right,power,
or authorityon our behalfshall exist only as expresslystated in this
Agreement. No right,power,or authorityshall be impliedeitherfrom
the grant or denial of powers specificallymentionedherein or the
failureto mentionany right or power herein. You agreethat you and
your agentsare withoutauthorityto do or performand expresslyagree
not to do or performthe followingacts on our behalf: (a) incur any
indebtednessor liability;(b) make, alter, or dischargecontracts;(c)
waive forfeitures;(d) quote rates other than as quoted by us; (e)
extendthe time for paymentof any premium;(f) waive paymentin
cash; (g) guaranteedividends;or (h) deliverany policymore than ten
days after issuanceby us or fail to promptlyreturnthe deliveryreceipt
to us. Further,you agreethat you and your agentsshallnot: (i) violate
the insurancelaws of any state in which you may be soliciting
applicationsfor policies;fi) withholdany of our, the policy owner's,
prospective policyowner'sor applicant'smoniesor property;(k) rebate
or offer to rebateall or any part of a premiumon our policies; (l)
induceor attemptto induceany of our policyownersto discontinue
paymentof premiumsor to relinquishany policy;(m) induceor attempt
to induceany of our agentsto leave our service;(n) perpetrateany
fraud against us, or policy owners, prospectivepolicy owners or
applicants;(o) fail to providecontractdisclosuredocumentsto policy
applicantsas requiredby the Companyor applicablestatelaw; (p) fail
to providecompensation disclosureto policyapplicantsas requiredby
statelaw;or (q) violateany Policiesand Proceduresof the Company.
COMMISSIONS
AND CHARGEBACKS
COMMISSIONS. You shallbe paidcommissions on premiumspaidto
and receivedby us, in accordancewith the Scheduleof Commissions
attachedheretoand made a part hereof.We reservethe right,in our
sole discretion,to amend the Scheduleof Commissionsat any time;
provided,however,that any such change shall only be effectivefor
commissionspayableon applicationsdatedafter the effectivedate of
suchchange.Commissions shallbe paidhereunder onlyfor so longas
you or your agentare the agentof record.Commissions are subjectto
chargebackin accordancewith the Scheduleof Commissions.Your
commissionsshall be reducedby the amountof any commissionsto
which your agents are entitledand we pay directlyto such agents.
Commissionsshallbe payablehereunderonly in accordancewith the
Scheduleof Commissionsand shall not be allowed on premiums
waived or commutedby reason of death, disability,or exerciseof
policyoptions. Commissionsthat become payableshall be paid to
you, your executors,administrators, or assigns;however,neitherthis
Agreementnor any benefitsto accruehereundermay be assignedor
transferred,eitherin wholeor in part,withoutour writtenconsent. In
no eventwill you be entitledto receivecommissionsthat revertto you
from your terminatedagentsin excessof the amountsuch terminated
agents would have received under the provisionsof their agent
agreementswith us; providedhowever,that this shall not impairany
right you may have to receiveoverridecommissionson any policies
@2008 Forethought
0 10 B
writtenby the terminatedagentwhich remainin forceafterthe date of
suchagent'stermination.
SET-OFFSAND CHARGEBACKS AGAINSTCOMMISSIONSYou
agreethat we may, at any time, set-offagainstcommissions due or to
becomedue to you, or to anyoneclaimingthroughor underyou, any
amountdue from you or your agentsto us includingany chargebacks.
lf not set-off,all such amountsshall be paid to us within 30 days of
writtenrequesttherefor.We do not waive any of our rightsto pursue
collectionof any indebtednessowed by you or youragentsto us. In the
eventwe initiatelegalactionto collectany indebtedness of you or your
agents, you shall reimburseus for reasonableattorney'sfees and
expensesin connectiontherewith. This provisionshall remainin full
forceand effectregardlessof any terminationof this Agreement.
STATEMENTOF ACCOUNT. We will furnishyou a copy of your
commissionaccountweekly providedthat transaclionsoccur in your
account during the previousweek. Unless you notify us in writing
within30 days of the issue date of each statementof any differences
betweensuch statementand your account,you shallhave waivedthe
rightto contestthe accuracy,correctness, and basisof the statement.
Such statementshall be comoetentand conclusiveevidenceof the
statusof your account.
ADVERTISING
ANOADMINISTRATION
REPRESENTATION.You and your agentswill nol representyourself
as holdingany professional that impliesexperlise
or lrade certification
in financial matters relating specificallyto persons 65 or older,
includingbut not limitedto "certifiedsenioradvisor,"until and unless
you provideus with completeinformationregardingthe natureof such
certificationand we approvein writingthe use of such certificationin
connectionwiththe saleof our product.
RESERVATIONS.We reservethe followingrightsat our discretion
withoutliabilityto you: (a) to changecommissionson any policyform
or riderupon furnishingnoticeto you, but such changeshallnot affect
applicationsreceivedby us prior to such notice,(b) lo withdrawany
policy forms; (c) to change our premiumrates, (d) lo reject policy
applicationsor premiumswithoutspecifyingcause,and (e) to adopt
policiesand proceduresfrom time to time relatingto any matter nol
otherwisecoveredin this Agreement.
ADVERTISING.You and your agentsshall not use or authorizeany
advertisement, circular,news releaseor other communicationusing
our nameor our productnames(whetherwritten,oral,audio,or visual)
withoutpriorwrittenapprovalby us.
PERSONALPROPERW AND FUNDS. All application and policy
forms,relatedadvertisingand marketingmaterials,books,documents,
vouchers,receipts,lists,notices,or other papersof any kind used by
you in any transactioninvolvingus and any other personalproperty
furnishedby us shall remainour property,shallbe open to inspection
by us at all times, and shall be returnedto us at terminationof this
Agreement along with all uncollected premium receipts and
undelivered policiessentto you for deliveryand collection.
REIMBURSEMENT.You agreeto pay directlyor reimburseus for the
followingexpenses: (a) all agent taxes, municipallicensefees, and
localand statetaxesfor the territorycoveredby this Agreement,(b) all
chargesprovidedin our policiesand procedures, and (c) the premium
for an indemnitybond in a satisfactoryamountto secureyour fidelity
and faithful performanceunder this Agreement,if such bond is
requestedby us.
MISCELLANEOUS
LEGAL ACTION. You may not instituteany administrative or legal
proceedingson our behalf without our written approval. lf any
administrativeor legal action is broughtagainstyou or us, or both
jointly, by reason of any alleged act, fault, or failure by you in
connectionwith your activitieshereunder,we may require you to
defendsuch actionat your expense. lf we bringany administrative or
legalaction,or both,by reasonof an allegedact,fault,or failureby you
A3073-01 Page 2 of 6
in connectionwithyouractivitieshereunder,we may requireyou to pay
for an attorneywho we selectto representus. However,at our option,
we may defendor instituteany such actionand expend such sums,
includingattorneyfees,as may in our judgmentbe necessary,and you
will be requiredto reimburseus for all suchamounts.
INDEMNIFICATION.You hereby agree to, at all times hereafter,
defend,indemnifyand hold harmlessthe Company,its affiliatesand
their respectiveemployees,officers,directorsand shareholdersfrom
all claims, liabilityor loss which result from your real or alleged
negligentor willfulacts, or your errors,omissionsor breach of any
provisionof this Agreementand such acts, errors, omissions or
breachesof your servants,agentsor employees,in the performanceof
dutiesunderthis Agreement.Claims,liabilityor loss includes,but is
not limitedto, all costs,expenses,attorneyfees and other legal fees,
penalties,fines, direct or consequentialdamages, assessments,
verdicts(including punitivedamagesto the extentpermissible under
the law of the state where any claim or suit is filed which seeks
recoveryof punitivedamagesagainstus) and any other expenseor
expenditureincurredby us as a result of your performance,or the
performance of your agent(s),underthe termsof this Agreement.This
indemnification will be in additionto any liabilityyou may otherwise
have.
We herebyagreeto, at all timeshereafter,defend,indemnifyand hold
you and youremployees,officers,directorsand shareholders harmless
from all claims,liabilityor loss which result from our real or alleged
negligentor willfulacls, or our errors,omissionsor breachof any
provisionof this Agreemenl,and such acts, errors, omissionsor
breachesof our servants,agentsor employees,in the performanceof
dutiesunderthisAgreement.Claims,liabilityor loss includesall costs,
expenses,attorneyfees and other legalfees,penalties,fines,director
consequentialdamages, assessments,verdicts (including punitive
damagesto the extenl permissibleunderthe law of the state where
any claim or suit is filed which seeks recoveryof punitivedamages
againstyou) and any olherexpenseor expenditureincurredby you as
a resultof our performanceunderthe terms of this Agreement. We
agree to provideyou with policiesthat to the best of our knowledge
and beliefmeetall applicable minimuminsurance codeand regulatory
compliance requirements.
TERMINATION. This Agreementmay be terminatedwithoutcause by
eitherpartyuponat least 15 days priorwrittennotice,or immediately,
upon writtennotice,for cause. This Agreementshall terminatefor
cause in the eventof your breachof any provisionof this Agreement.
Such terminationshallnot impairyour rightto receivecommissionson
policiespreviouslyprocuredexcept if terminationis becauseof your
breachof any provisionof this Agreementin whichcase commissions
will not be paid after date of termination.Commissionspayable
hereunderafterthe termination of this Agreementshallbe paid only so
long as such commissionsexceed $300 during any calendaryear.
Afterterminationof this Agreement,all amountsowed to us hereunder
are due and payableimmediately withoutfurthernoticeor demand.
COMPLAINTSAND INVESTIGATIONS. You shallcooperatefully in
or proceedingor judicial
any insuranceregulaloryinvestigation
proceedingsarisingin connectionwiththe policiesmarketedunderthis
Agreement.Withoutlimitingthe foregoing:
(a) You will promptlynotifythe Companyof any written
customercomplaintor noticeof any regulatoryinvestigation
or proceedingor judicialproceedingreceivedby you or your
agentin connection withany policymarketedunderthis
Agreementor any activityin connectionwith any such policy.
(b) In the caseof a customercomplaint,you will cooperatein
suchcomplaintand any responseby you to
investigating
suchcomplaintwill be sentto the Companyfor approvalnot
lessthanfive businessdayspriorto its beingsentto the
customeror regulatory authority,exceptthat if a more
promptresponseis required,the proposedresponseshallbe
communicated by telephoneor facsimile.
(c) The provisionsof this sectionshallremainin full forceand
effectregardlessof any termination of thisAgreement.
O 2008 Forethought
0 10 8
CUSTOMERINFORMATION.You shalltreatcustomerinformation as
confidentialas requiredby applicablelaw and by the Company,as
describedin the Company'sprivacynoticesand in accordancewiththe
Companypoliciesand procedures. You shall also take reasonable
and appropriatesteps to establish and implementadministrative,
physical and technical proceduresto ensure the confidentiality,
security and integrityof customer informationin accordancewith
applicablelaw. You agreeto complywith the Company'stermsof use,
policiesand procedureswith respectto use of Companyelectronic
systemsand databasesprovidingaccessto customerinformationby
you, your employees,and agents and shall promptlyreport to the
Company any breach of security related to such systems and
databasesof which you becomesaware. You may use customer
informationonly for the purposeof fulfillingyour obligationsunderthis
Agreement. You will limil access to customerinformationlo your
employees,agentsand otherpartieswho needto knowsuchcustomer
information to permit you to fulfill your obligations under this
Agreementand who haveagreedto treatsuchcustomerinformation in
accordancewiththe termsof this Agreement.You shallnot discloseor
otherwisemake accessiblecustomerinformation to anyoneotherthan
to the individualto whomthe information relates(or to his or her legally
authorizedrepresentative) or to other persons pursuantto a valid
authorization signedby the individualto whom the informationrelates
(or by his or her legallyauthorizedrepresentalive), exceptas required
for you to fulfillyour obligationsunder this Agreement,as otherwise
directedby the Company,or as expresslyrequiredby applicablelaw.
For purposes of this Agreement, "customer information"means
informationin electronic,paper or any other form that you or your
agents obtained,had access to or createdin connectionwith your
obligationsunderthisAgreement regardingindividualswho appliedfor
or purchased policies. Customer informationincludes nonpublic
personalinformation,and protectedhealthinformation,as definedin
applicablelaw. Customerinformationmay also include,bul is not
limited to, informationsuch as the individual'sname, address,
telephonenumber,socialsecuritynumber,as well as the fact that the
individualhas appliedfor, is insuredunder,or has purchased a policy
issued by the Company. Customerinformationdoes not, however,
includeinformation that is ('1)generally
availablein the publicdomain
and is derived or receivedfrom such public sources by you; (2)
received,obtained,developedor createdby you independently from
the performanceof your obligationsunder this Agreement; (3)
disclosedto you by a third party,providedsuch disclosurewas made
to you without any violation of any independentobligation of
or applicablelaw of whichyou are aware.
confidentiality
For purposesof this Agreement,"applicablelaw" meansany state or
federal law, rule or regulationsincluding,but not limited to, state
insurancelaw and regulations and the Gramm-Leach-Bliley Act and
relatedfederalregulations.
for any amendmentof the Scheduleof Commissionspursuantto the
terms of this Agreement,may not be modifiedin any way unless by
writtenagreementsignedby the partiesto thisAgreement.
All agreementsbetweenyou and us are containedin this Agreement,
includingthe followingexhibitwhich is attachedheretoand made a
oarthereof: Scheduleof Commissions.
In the event that any provisionor clause of this Agreement is
determinedto be invalid,illegal,or unenforceablein any respect,the
validity, legality and enforceabilityof the remaining provisions
containedhereinshallnot in any way be affectedor impairedthereby.
ASSIGNMENTS;RIGHTS AND REMEOIESARE CUMULATIVE.
Neitherpartyto this Agreementmay assignits rightsor duties under
this Agreementwithoutthe prior wrilten consentof the other parly.
The rights,remediesand obligationscontainedin this Agreementare
cumulative and are in additionto any and all rights,remediesand
at law or in equity,whichthe partiesheretoare entitledto
obligations,
understateand federallaws.
NOTICES. Any noticesrequiredunder the terms of this Agreement
shallbe sent,if to the Agentat the addressset forthin the Appointment
Dataand Information sectionof saidAgreement,and if to Companyat:
Forethought Financial Services Inc., One Forethought Center,
Batesville,Indiana47006,or at such other addressesas either party
may fromtimeto time designateto the otherin writing.
CONTACTINFORMATION.
Forethought LifeInsuranceCompanyor
Forethought NationalLifeInsuranceCompany
c/o AgentContracting and Licensing
P . O .B o x2 1 6
Batesville, Indiana47006-0216
Phone: 888-606-6372
Fax: 800-675-7542

ANTI-MONEYLAUNOERINGPROGRAM. You agree that you will

remain in compliancewith all applicableanti-moneylaunderinglaws
and regulations.You furtheragree to fully cooperateand assistthe
Companyin implementing and carryingout its anti-moneylaundering
programas applicableto youractivitiesunderthisAgreementincluding
providing requested customer information, following customer
procedures,and cooperating
identification with the requiredtrainingof
agentsand employeesincludingprovidingany requestedcertification
and informationregardingsuchtraining.

ENTIREAGREEMENTAND CHOICEOF LAWS. Forbearance or

negligenceby us to insist upon complianceby you with any of the
terms and provisionsin this Agreementshall not be construedas or
constitutea waiver thereof. This Agreementshall be interpretedin
accordancewith, and governedby, the laws of the State of Indiana..
Unlessotherwiseprovided,all mattersto be performedby us under
this Agreementshallbe performable al our officein Batesville,Indiana.
Any amountdue to eitherpartyunderthisAgreement shallbe payable
at our office in Batesville,Indiana. Any suit arising under this
Agreementbetweenyou and us shall be institutedand tried in Ripley
County,Indiana.
This Agreementsupersedesall prioragreements,eitheroral or written,
betweenthe partiesrelatingto the subjectmatterhereof,and except
A3073-01 Page3 of 6 @2008 Forethought
0108
 IMOCompleteSolutions
Inc055901
JT

DATAAND INFORMATION
APPOINTMENT Please Print or Type Clearly

PREFERENCES
COMMUNICATION
Preferred method of communication (Choose One) E Cell Phone ! Business Phone E Residence Phone
Preferred method of receiving information (Choose One) tl Email ! Fax D Mail

AGENTSTATEMENTS(lf vou answer Yes to details on a separate sheet and attach

. Have you ever plead no contest or been convicted of a crime, including felony, misdemeanor or military offense?
Yes fl No D
. Have you ever had a license refused/suspended/revokedor currently restricted or under investigation?
Yes! Notr
. Has an insurance carrier cancelled your contract or appointmenl for any reason other than lack of productivity?
YesD NoD
. Do you have any knowledge of an indebtedness to an insurance carrier or financial organization that involves yourself or an organization you
h a v e b e e n a s s o c i a t e dw i t h , o r d o y o u h a v e a n y u n s a t i s f i e dl i e n s o r j u d g m e n t s ?
YesE NoU

ACT DISCLOSURE
FAIRCREDITREPORTING TO PROSPECTIVE
AGENTS
In compliancewiththe FairCreditReportingAct (FCRA)you are herebynotifiedthatthe Companymay obtaina consumerreport,or investigative
consumerreport,includinginformation as lo your creditworthiness,creditstanding,creditcapacity,character,generalreputation,personal
characteristics, modeof living,criminalrecords,and employmenthistory.Suchinquirywill be madeuponour receiptof your compleledAgreement.
By signingthisAgreement, youauthorize us to maketheseinquiries.
You havethe rightto obtaina completeand accuratedisclosureof the natureand scopeof the invesligation requestedand a summaryof your rights
underthe FCRA. Uponwrittenrequestto us withina reasonable time afterour receiptof this document,suchadditionaldisclosureshallbe madeto
you in writing.
Pleaseforwardyour requestto.
Forethought Life lnsuranceCompanyor
Forethought NationalLife InsuranceCompany(foragentsseekingappointments in Texas)
Attention:AgentContracting and Licensing
P . O .B o x2 1 6
Batesville, lN 47006-0216
Or Fax To: 800-675-7542
For additionalinformationconcerningthe FCRA,you can findthe completetextof the FCRA,15 U.S.C.1681et seq,at the FederalTrade
Commission's web site (http:www.ftc.gov.)

Inc055901
IMOCompleteSolutions

A3073-01 Page 4 of 6 @2008 Forethought

0108
 IMOCompleteSolutions
Inc055901

FORAUTOMATICDIRECTDEPOSIT(ACHCREDITS
AUTHORIZATION

I herebyauthorize E Forethought Life InsuranceCompanyor E Forethought NationalLife InsuranceCompanyto initiateautomaticcreditentries,

and the financialinstitution
namedbelowto creditthe sameto suchaccount.I acknowledge that the origination
of ACH transactions
to my account
mustcomplywiththe provisionsof U.S.law.
This authorityis to remainin fullforceand effectuntilthe insurancecompanydesignatedabovehas receivedwrittennotificationfrom me of its
termination,allowingsaidcompanyenoughtimeto act on it.
AccountName(print): AccountType. D CheckingAccount E SavingsAccounl

PLEASEATTACHYOURVOIDEDCHECKOR SAVINGSDEPOSITSLIPHERE
oR coMPLETETHE FtNANCTAL (BANK)TNFORMATTON
TNST|TUT|ON BELOW:

Bank Name: BankTelephone:(_)

Bank Address

City,State,Zip:

AccountNumber: BankTransiU
RoutinoNumber:

ACKNOWLEDGEMENTS
AND SIGNATU
RE
WRITINGAGENTCERTIFICATION
ACKNOWLEDGEMENT
I certify that I have read and understand Forethought'sAnti-Money Laundering Guidelines for Agents and Brokers and
t h a t I w i l l f o l l o wt h e G u i d e l i n e s .I u n d e r s t a n dt h a t m y f a i l u r et o f o l l o wt h e G u i d e l i n e sc o u l d r e s u l t i n t h e i m m e d i a t e
termination of my appointment to sell policies on behalf of Forethought Life Insurance Company or Forethought National
L i f e l n s u r a n c eC o m p a n y .
lnitials

TAXPAYERACKNOWLEDGEMENTS

Under penaltiesof perjury,I certify that:

1. The numbershownon this form is my correctTaxpayerldentification
Number;and,
2. I am not subjectto backupwithholdingeitherbecause:(a) | am exemptfrom backupwithholding;(b) | have not been notifiedby the Internal
RevenueService(lRS) that I am subjectto backupwithholdingas a resultof a failureto reportall interestor dividends;or (c) the IRS has
notifiedme that I am no longersubjectto backupwithholding.
3. I am a U.S.citizen(including
resident
alien).

CertificationInstructions- You mustcrossout item2 aboveif you havebeennotifiedby the IRSthat you are currentlysubjectto backup
withholdingyou havefailedto reportall interestand dividendson yourtax return.

I herebycertifythat my answersto the questionscontainedin thisAgreementare trueand correct.I acknowledge thatthe Companyhas informed
me of its practiceto conductroutineinvestigative reportson me and my agentsfor licensingpurposes,initialand renewalstateappointments, and at
any time Company,at its discretion, deemsit necessaryto conductbackground investigations.
I expresslyauthorizeCompanyto conductthese
investigations and authorizeall personsand entities(includingpastand presentemployers)to provideCompanyall requestedinformation.I hereby
releasefrom liabilityall personsand entitieswhichsupplysaidinformation to Companyand agreeto holdCompanyharmlessfrom any liabilityfor
conductingthis investigation.I herebyauthorizeCompanyto use theseinvestigative reportsand to providethesereportsand any otherpertinent
information to any affiliatedcompaniesand to thirdpartieswherethe thirdparties'legalinterestsand/orobligations are involved.I alsoauthorize
Companyto distributeany financial,business,legal,tax or work performance historyregardingme that it receivesfromthirdparties,from any
affiliatedcompaniesor whichis generatedby Companyor fromany affiliatedcompanies'datasourcethat is not partof the investigative report,to all
affiliatedcompaniesor to thirdpartiesincludingbul not limitedto agentsor agenciesthat assumeyourdebitbalanceresponsibilities.
I furthercertifythat I havereviewedthis Agreementand furtherunderstand that if any informationprovidedin saidAgreementis foundlo be incorrect
or incomplete, it will be groundsfor rejectingthisAgreementor for termination
of saidAgreement,all at the solediscretionof Company.I alsocertify
thatthis Agreementhas not beenaltered,modifiedor changedby me in any mannerand that I agreeto be boundby the provisionsof said
Agreement.

A3073-0'1 Page 5 of 6 O 2008 Forethought

0108
IMOCompleteSolutions
Inc055901
 IMOCompleteSolutions
Inc055901

SIGNATURE
lN WITNESSWHEREOF,Agency/Agenthas caused this Agreementto be executedeither individuallyor by its duly authorized
representativesas of the date set forth below.

AGENCY/AGENT E ForethoughtLife InsuranceCompany

0 ForethoughtNationalLife InsuranceCompany

Print Name / Title

Date

AGENTCHECKLIST- Submit RequiredDocumentsto Your Retaina Copy For Your

Checklist: ! FullyCompletedand SignedFinalExpenseLifeInsurance (43073-0'1
SellingAgreement )
D Copyof License/sfor ALL StatesWhereAppointmentis Requested
D VoidedCheckAttachedif Section#5 is NotCompleted
D SignedCommission Schedule(M2112)

tr CompleteHierarchy Sheet(43074-01)
Information
tr SubmitAll RequiredDocuments to Forethought
LifeInsurance NationalLifeInsurance
Companyor Forethought Companyat Fax
or AddressBelow.

MarketingOrganizationSignature: Date:

Fax All Paqes of AqreementTo: Mail All Paqesof AgreementTo:

ForethoughtLifeInsurance Companyor Forethought LifeInsuranceCompanyor
ForethoughtNationalLifeInsuranceCompany Forethought NationalLifeInsurance
Company
c/oAgentContracting and Licensing c/oAgentContracting and Licensing
800-675-7542 P.O.Box 216
Batesville,lN 47006-0216

IMOCompleteSolutions
Inc055901

43073-01 Page 6 of 6 @2008 Forethought

0 10 B
 Forethought@University Certification
For Forethought@ForelifesM Representatives
Partnering With Member Funeral Homes

Section L - t@Uni Certification am

The educators of Forethought Life Insurance Company want to ensure you have
the information you need to get off to a great start and continue to succeedwith
us. This program will show the industry and your clients your expertise and
commitment to Forethought's values of personal principles, standards and
professionalism.

Section 2 - R irements for Certification

When you sign up to sell the Forethought@ ForelifesM product, follow this
simple process:
1. Review the Code of ProfessionalResponsibility.
2. Sign this certification. This confirms that you have read, understood,
and will comply with Forethought's Code of Professional
Responsibility.
3. Remain in good standing with Forethought.

Section 3 - Code of Professional ibili

PnorrssroLiar Rrspo NStBtLrwro CorusuurRs
1 . Discuss coverage benefits with every consumer including funeral
expensesand other end-of-life expensesand the unique rapid claims
process. Forethought Life Insurance Company provides an easy
process to set aside funds to pay for funeral and other end-of-life
expenses. This unique plan includes a rapid claims process,providing
your families with much needed funds at an extremely difficult time.

2. Introduce the complete Forethought@ForelifesM value offering

including the ForeHelpsu Family Representatives and the planning
tools available via the web. Explain to your clients that Forethought
also provides end of life educatiory assistance,and planning tools
through the ForeHelptt Family Representative and on the
forethought.com website.

3 . Connect the consumer to a member of the Forethought Funeral

Planning NetworksM for completion of the end-of-life planning
process. Direct your client to work with a Forethought Funeral
Planning NetworksM partner to select actual goods and services before
or at the time of need. You or your client can find a funeral home
professional in the area by using the forethought.com website, or by
contacting the ForeHelpsu line at 1-800-959-5885.

A3075-01 @ 2008 Forethousht

 4. Remain ethical in all aspectsof business so as to serve each client in
a professional and caring manner. Operate your business with the
highest principles of honesty, integrity, and professionalism.

PnorrssroNAl REspoN stBtLrrv ro F oRETHoUcHTFTINERAL PraLrrinric

NrrwonxsM
1. Clearly represent yourself as a Forethought Forelife Representative
and a partner to the Forethought Funeral Planning NetworksM so the
consumer is able to distinguish your offerings from the funeral homes
'iitr:
offerings. L i ' \ l ' r , i , . ti i t,i, jr\ \\(i\ tt ittr\gt-il ;i ltllt('Ial htitrtg, it
. i t , , . . t (i t ( l t t r l t s t , t t t S r ' l V i t € S
Iiltlt,t.ti li.'ltit,: irlli t,:, 1ri{ltrr i,,i l',,riit
Phrasesthat contain the word "guarantee" MUST BE avoided when
discussing the funeral arrangement process. For example, "Your
funeral plan will be guaranteed if you take it to a funeral home." Orly
a licensed funeral director can arrange and/or guarantee the details
and handle the logistics of a funeral.

2. Promote the Forethought Funeral Planning NetworksM, Discuss

accessto the largest end-oflife assistancenetwork in the United States
with each client. Our trusted network of more than 5,000funeral
homes and cemeteries are committed to helping families at their time
of need and can assistthem in selectingfuneral merchandise and
services prior to the time of need.

PRorrssrorual REspoNstBtLtry ro F oRETHoUGI{TLIFEIrusunarucr CotupeNy

1,. Comply with AML Laws and Regulations, Agents must remain in
compliance with all applicable anti-money laundering laws and
regulations. Agents must fully cooperate and assist the Company in
implementing and carrying out its anti-money laundering program as
applicable to your activities including providing requested customer
informatiory following customer identification procedures, and
cooperating with the required training including providing any
requested certification and information regarding such training.

I CERTIFYthat I luae read,understandand will follow Forethought'sCodeof

Professional Responsibility
for ForethoughtForeLifeRepresentatiaes.
I understandthat
my failure tofollow the Codeof Professional
Responsibilitymay result in the termination
of my appointmentwith ForethouglttLife InsuranceCompany.

Forethought Forelife Representative Signature

Printed Name

Date
A3075-01 @ 2008 Forethought
FORETHOUGHT@
FORELIFE"
S C H E D U LO
E FCOMMISSIONS

A G E N TS C H E D U L E
The Schedule of Commissions ("Schedule")is an addendum to Final Expense lnsurance Selling Agreement ("Agreement"). This Schedule is for
Forethought Life Insurance Company and Forethought National Life Insurance Company ("Company")insurance policies sold under the attached
Agreement which are issued on or after the Schedule Effectiv.eDate. No commissionswill be earned or paid unless the correspondingform of
insurance policy is available for sale by Company in the applicablestate.

ScheduleEffectiveDate: Seotember
15.2008

CommissionAdvancePeriod: 9 Months

ForeLifesM
Life Pay Ten Pay
Year 1 Years2 - 10 Year 1 Years2 - 10
Full Graded Full Graded Full Graded Full Graded
lssue Death Death Death Death Death Death Death Death Single
Ages Benefit Benefit Benefit Benefit Benefit Benefit Benefit Benefit Premium
0-70 90.0% 90.0% 4.O% 2.0% 80.0% 80.0% 2.0o/o 1.0% 13.O%
7 1- 7 5 90.0% 90.0% 4.0% 2.0% 80.0% 80.0% 2.QYo 1.0% 8.0%
76-80 90.0% 4.O% 80.0% 2.O% 6.0%

Commission Payments
Commissions are expressed as a percentage of premiums paid unless otherwise noted. First Year commissions for monthly mode policies are
c a l c u l a t e da s a p e r c e n t a g eo f t h e m o d a l p r e m i u m ,m u l t i p l i e db y t h e n u m b e ro f m o n t h si n t h e C o m m i s s i o nA d v a n c e P e r i o d ,a n d a r e p a i d a t a
frequency consislent with the Commission Advance Period. First Year commissionsfor all other premium modes will be paid as earned
regardlessof the advance commission period selected.

Renewal commissionsare calculated as a percentage of premiums credited to a policy after all premium payments due and owing the Company
during the first policy year have been received. No commissionsare paid after the tenth policy year.

In its sole discretionCompany may pay directly to any sub-agent any commission due the sub-agent from the agent and it may also set-off such
payment or payments against any commissions due or to become due to the agent.

Commission Chargebacks
All commissions will be charged back 100% when coverage is rescinded due to a contested death claim.
'100%
Year 1 commissionswill be charged back at any time coverage is not taken, voided, or coverage is converted and first year commission is
paid on the new coverage, or if non-accidentaldeath occurs during the firsl policy year on a graded death benefit or single premium coverage.

When terminationoccurs during the first policy year due to non-accidentaldeath, surrender,or lapse for nonpayment of premiums due,
chargeback of commissions paid in the first policy year will be prorated monthly based on earned premiums.

Termination of the Agreement shall not terminate Company's right to chargeback commissionsthat were paid by Company under the terms of said
Agreement.

No commissionshallbe paidon the sale of a policy which involves the total or partialreplacementof a policy
issuedby Gompanyor any of its affiliates unless specifically provided for in writing.
ACCEPTED
ANDAGREEDTO:

AuthorizedSignature- Agent Date

@:
Forethought LifeInsuranceCompanyor Forethought
NationalLifeInsurance
Company
PO Box216
lN 47006-02'l
Batesville, 6
Fax: 800-675-7542 Final.Expense@forethought.com

AgentC3
M2112-02 @2008Forethought
0908