PRENEED FUNERAL AGREEMENT AND ASSIGNMENT-FUNDED BY AMERICAN CENTURY LIFE INSURANCE/ ANNUITY BENEFITS
Exhibit 1: Statement of Funeral / Cremation Services and Merchandise
An irrevocable election is not valid for 30 days from the date of this contract
GUARANTEED PROFESSIONAL SERVICES
Funeral Ceremony
Cremation Ceremony
Vehicles / Transportation
TOTAL GUARANTEED SERVICES
NON-GUARANTEED CASH ADVANCES
TOTAL NON-GUARANTEED CASH ADVANCE ITEMS
GUARANTEED MERCHANDISE
Funeral Merchandise
Cremation Merchandise
Other Guaranteed Merchandise
Printing
Catering/Celebration/Gatherings
GUARANTEED MERCHANDISE
TOTAL GUARANTEED MERCHANDISE
TOTAL FUNERAL PACKAGE
*Required purchase-charges only for those items that are selected
by the funeral purchaser or that are required. If any are required
by law or by a cemetery or crematory or if embalming is required,
the reasons will be explained in writing below:
Exhibit 1 above and the PRENEED FUNERAL AGREEMENT and assignment
on the reverse side shall constitute the terms and conditions of
this agreement.
Agreement and Assignment by:
PRENEED FUNERAL AGREEMENT
AGREEMENT - The provider agrees to provide the funeral service as specified on Exhibit 1 in consideration of an assignment of death benefits of life insurance or annuity coverage with a face amount at least equal to the now-current total retail price for the items selected. All benefits under the coverage will become available for disbursement upon the death of the funeral recipient. The contract shall be funded by a life insurance policy or annuity issued in the face amount of the current purchase price of the contract for prepaid funeral benefits. The recipient shall be the same individual under the contract as the insured under the life insurance policy or annuity, and the disbursement of life insurance proceeds to the organization shall constitute payment to the organization for the services and merchandise contracted for. The prices shown on Exhibit 1 are the now-current retail prices. The excess will be paid to the beneficiaries. The beneficiaries may authorize payment of excess proceeds for additional items which are desired but not specified on Exhibit 1.
GUARANTEE - This contract is a price guarantee. However, it may not be effective immediately depending upon the type of coverage purchased. If the purchaser funds the agreement with life insurance or annuity coverage with an initial death benefit that is at least equal to the face amount, the guarantee becomes effective only when the limited benefit provisions of the coverage expire.
LIMITATIONS OF GUARANTEE - If the purchaser funds this agreement with limited benefit life insurance coverage and the funeral recipient dies during the limited benefit period, the party responsible for the funeral must pay any difference between the available death benefits and the then-current prices.
CASH ADVANCES - Cash advances are amounts established to pay for items which are not guaranteed. At the time those items are provided, those responsible for payment for funeral expenses must pay any difference between the current retail price and the advanced amount.
FREEDOM OF CHOICE - This agreement may be cancelled at any time prior to the performance by the provider. Charges are only for those items that are used. If required by law to use any items, the provider will explain the reasons in writing. The purchaser, during his/her lifetime and thereafter, the purchaser's next-of-kin or legal representative retains the right to select the provider that will supply the services and merchandise. However, if any alternative provider is so selected, this agreement shall become null and void and the original provider agrees to then relinquish all claims to the life insurance or annuity proceeds.
CANCELLATION - The cancellation of this agreement does NOT cancel the life insurance or annuity, which may only be cancelled according to the terms of the life insurance or annuity.
SUBSTITUTION - If the provider is unable to perform due to the unavailability of merchandise or other factors beyond its control, it may substitute merchandise of like quality in lieu of the merchandise selected. If the provider is unable to perform or another provider is chosen, the life insurance or annuity proceeds may be available for use with that provider. However, prices and guarantees would be at the discretion of that alternative provider.
OBLIGATIONS - This agreement shall be void unless the purchaser applies for and has been issued the life insurance coverage, pays all premiums due, fully maintains the cash values intact, and the death benefits thereof are assigned to the provider.
FTC DISCLOSURE REQUIREMENT - If a funeral is selected that may require embalming, such as a funeral with viewing, the funeral purchaser may have to pay for embalming. The funeral purchaser does not have to pay for embalming that was not approved if arrangements such as direct cremation or immediate burial were selected. If a charge is made for embalming, the reason will be explained in writing.
PURCHASER ACKNOWLEDGEMENTS - By his/her signature on this agreement, the purchaser acknowledges the receipt of a completed copy of this agreement and the accompanying assignment and acknowledges that a current General Price List, a current Casket Price List, and a current Outer Burial Container Price List, and each of said documents were made available to him/her prior to his/her selection of services and merchandise.
ASSIGNMENT - In fulfillment of the consideration required under this agreement, the purchaser must assign to the provider the right to receive death benefits contingent upon the performance by the provider as specified on Exhibit 1.
