VA Form 29-8701c Application Letter 3 for Ordinary Life Insurance (Age 70

IN REPLY REFER TO:

FILE NUMBER:

You are now approaching your 70th birthday, and we would like to take this opportunity to
remind you about a very important provision of the Government life insurance policy you
selected. Your policy,
, is known as a Modified Life policy. This means that the
amount of your insurance coverage will automatically reduce by one-half from its present face
value of $
to $
on the day before your birthday. Even though you will have
only half the coverage you had before, your premiums will remain the same as before your
70th birthday. This reduction feature is explained in all of our pamphlets and applications
describing the Modified Life plans and it is clearly stated on the first page of your policy that
there is an "Initial Face Amount" and an "Ultimate Face Amount" of insurance. This is also
explained in the policy’s first paragraph.
The idea behind a Modified Life policy is that you receive the maximum coverage for the
minimum price up to age 70. Premium costs are kept low because of the face value reduction by
one-half at a later date. The low rates of the Modified Life plans are determined by actuarial
tables and made possible only because of this reduction. This is considered ideal coverage for
the many veterans who find that their insurance needs are less as they grow older. For many
individuals this happens because because of such factors as mortgages being paid off, children
having grown, accumulated savings or entitlement to pensions, and so forth.
If you find that you still need the same amount of coverage, we do offer additional whole life
insurance coverage. You may purchase this policy at an additional cost to replace the insurance
that will be lost when your policy reduces. You can buy the replacement policy without
answering any health questions. Just complete the application on the reverse side of this letter
and return it before your 70th birthday. Since your premiums are currently being paid by
deduction from VA benefits, no payment is required with your application, if your
compensation payments are sufficient to cover the additional premium. We will take the
necessary action to increase your deduction.
You do not have to buy the full amount of the coverage you lose when your policy reduces.
Replacement insurance may be purchased in multiples of $250, but not less than $500. You may
buy any amount of replacement insurance coverage up to the amount that will be lost. The
monthly premium required to restore full coverage is $
. If you wish to buy less than full
replacement coverage, please call our toll free number below for the correct premium rate.
Remember - you must apply for the replacement policy before your 70th birthday.
QUESTIONS ABOUT YOUR INSURANCE? CALL US TOLL FREE AT 1-800-669-8477
OUR HOURS OF OPERATION ARE 8:30AM TO 6:00PM EASTERN TIME.
THE BEST DAYS TO CALL ARE WEDNESDAY AND THURSDAY.

INFORMATION ABOUT MODIFIED LIFE REDUCTION
VA FORM
JUN 2008

29-8701b

OMB Approved No. 2900-0166
Respondent Burden: 5 minutes
1A. INSURANCE FILE NUMBER

APPLICATION FOR ORDINARY LIFE INSURANCE
REPLACEMENT INSURANCE FOR MODIFIED LIFE REDUCED
AT AGE 70
NATIONAL SERVICE LIFE INSURANCE

1B. NEW POLICY NO. (Assigned by VA)

PRIVACY ACT NOTICE: VA will not disclose information collected on this form to any source other than what has been authorized under the Privacy Act of 1974
or Title 38, Code of Federal Regulations 1.576 for routine uses identified in the VA system of records, 36VA00, Veterans and Armed Forces Personnel U.S.
Government Life Insurance Records - VA, and published in the Federal Register. Your obligation to respond is required to obtain this benefit.
RESPONDENT BURDEN: We need this information to determine your eligibility for an insurance benefit. Title 38, United States Code, allows us to ask for this
information. We estimate that you will need an average of 5 minutes to review the instructions, find the information, and complete the form. VA cannot conduct or
sponsor a collection of information unless a valid OMB Control Number is displayed. Valid OMB Control Numbers can be located at the OMB Internet Page at:
www.whitehouse.gov/omb/library/OMBINV.VA.EPA.html#VA. If desired, you can call 1-800-827-1000 for mailing information on where to send your comments.

IMPORTANT - This application and the first premium must be submitted to the
Department of Veterans Affairs BEFORE your 70th birthday.
2. FIRST NAME, MIDDLE NAME AND LAST NAME OF INSURED

3. DAYTIME TELEPHONE NUMBER

(

)

4. MAILING ADDRESS FOR INSURANCE PURPOSES (Number and street or rural route, city or post office, State and ZIP Code)
(COMPLETE ONLY IF DIFFERENT THAN THAT SHOWN ON REVERSE)

5. AMOUNT OF INSURANCE APPLIED FOR

I wish to apply for the amount of insurance shown in the block to the right
as replacement for the insurance coverage that will end on the day before
my 70th birthday.

$

i UNDERSTAND that the beneficiary designation and optional settlement under this new policy will be the same as
on my Modified Life policy and will remain the same until I submit a change in writing to VA.
6. SIGNATURE OF INSURED (Do not print, sign in ink)

7. DATE OF APPLICATION

When completed, mail this application and the first premium to the Department of Veterans Affairs at the address
shown on the reverse.