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Home , Air racing, Diving (sport), Parasailing

Please check appropriate underwriting company:  The Lincoln National Life Insurance Company, Service Office: PO Box 21008, Greensboro, NC 27420-1008  Lincoln Life & Annuity Company of New York, Service Office: PO Box 21008, Greensboro, NC 27420-1008  First Penn-Pacific Life Insurance Company, Service Office: PO Box 21008, Greensboro, NC 27420-1008 (hereinafter referred to as the “Company”) Avocation Supplement

/ / / Proposed Insured Name: (First) (Middle) (Last) (Suffix)

Date of Birth (mm/dd/yyyy): / / Section I— 1. Are you a certified diver? h Yes h No 2. What is your level of certification? (Check all that apply.): h Basic h Open Water h Advanced Open Water h Master Scuba Diver h Adventure Diver h Rescue Diver h Other: 3. Indicate type(s) of water in which you have dived in the past 2 years, and that you plan to dive in the next 2 years. (Check all that apply.): h Lakes h Rivers h Oceans h Deep Sea h Pits/Quarries h Coastal Waters h Other: 4. Indicate type(s) of diving in which you have participated in the past 2 years, and that you plan to participate in over the next 2 years. (Check all that apply.): h Night Diving h Pot Holes h Diving Bells h Rescue Diving h Yucatan Caverns h Ice Diving h Free Diving h Cavern Diving h Spear h Caves h Wreck Diving h Treasure Diving h Depth Record Attempts 5. What is the deepest dive you have made in the past 2 years? (ft.): a. Do you plan to dive deeper in the next two years? h Yes h No If yes, how deep (ft.): For any “Yes” answers to Questions 6 through 8, provide details in the space provided. 6. Have you ever had the bends, air embolism, or loss of consciousness from diving? h Yes h No 7. Have you ever dived alone? h Yes h No a. Do you plan to dive alone in the next two years? h Yes h No 8. Have you ever dived for pay? h Yes h No a. Do you plan to dive for pay in the next two years? h Yes h No

Section II—Mountain 9. Indicate type(s) of climbing you participate in (Check all that apply.): h Rock h Trail/Trekking h Ice h Scrambling h h Hiking/Tramping h ACW Climbing h Climbing/Top Rope h h Free Solo h Snow/Ice h Water/Ice h Mixed h /Potholing h Other: 10. How many climbs do you do per year? 11. Indicate maximum elevation climbed (ft.): a. Do you plan to climb higher in the next 2 years? h Yes h No If yes, how high (ft.): 12. Indicate maximum technical grade you have achieved: a. Grading system (Check one): h YDS h UK h UIAA h WI h M b. Number/Rating: c. Do you plan to attempt a higher grade in the next 2 years? h Yes h No If yes, what grade? 13. Check all areas where you have climbed or plan to climb: h Mt. McKinley/Denali h Other Alaska h Other North America h Andes h Other: 14. Have you ever climbed for pay? h Yes h No a. Do you plan to climb for pay in the next 2 years? h Yes h No If either of above is “Yes,” b. Number of climbs per year for pay: c. Role: h Guide/Instructor h Search and Rescue h Other: Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Page 1 of 3 LFF11701 CMPL 2/18 DRAFT Section III—Aerial Sports 15. Are you a: h Stunt person h Instructor h Amateur h Other professional 16. Are you a member of a club associated with your ? h Yes h No (If “Yes,” provide details.): 17. Choose usual location: h Over land h Over cliffs and ridges h Over water 18. Have you ever or do you plan to, within the next 2 years, do any experimental jumping or delayed chute openings? h Yes h No (If “Yes,” provide details.):

19. Complete the following table regarding the type of activity and number of flights or jumps: Total Number 12 to 24 Expected to Date Months Ago Last 12 Months Next 12 Months Aerobatic flying* Air * record attempts* Autogyros or gyroplanes* Ballooning (free flight)* Ballooning (tethered)* BASE Jumping Glider or sailplane flying* Hang or or paragliding (powered) Homebuilt aircraft* Surplus military or other high performance aircraft* Skydiving/ or sky Static line jumping Ultralights* Other: ______* Also requires completion of Supplement. 20. In the past three years, have you performed any of the above activity(ies) in shows, , or record attempts, or do you plan to do so in the next two years? (If “Yes”, provide details.) h Yes h No 21. Have you ever had an accident while performing any of the above activity(ies)? (If “Yes”, provide details.) h Yes h No

Section IV—Motor Sport Racing 22. Under what sanctioning body do you normally compete? (AMA, NHRA, USAC, etc.): 23. Indicate make and model of each vehicle including horsepower, displacement, and any special equipment added or modifications made: 24. Indicate locations where vehicle is raced including course type: 25. a. Choose the Motor Racing Classification from the list below: h ARCA h ASA h Auto Crash h Autocross h Indy/Formula 1 h Demolition Derby h Drift Racing h -indicate type: h IMSA – US Based Series-indicate type: h -indicate type: h Midgets-indicate type: h Modified-indicate type: h NASCAR-indicate type: h Sand and Dune Buggy-indicate type: h Cars-indicate type: h Sportscar Racing-indicate type: h Sportscar Vintage Racing-indicate type: h SCCA-indicate type: h Other: Page 2 of 3 LFF11701 CMPL 2/18 DRAFT . b Choose the Racing Classification from the list below: h Offshore and Sportboat Racing h Drag Racing h Hydroplanes-indicate type: h Record Attempts h Sailboat Racing-indicate type: h Other:

. c Choose the Classification from the list below: h Dirt h Veteran and Vintage h Stunt Racing h Ice Racing h Marshals h Enduro Racing h Hill Climbs h Speedway h Sprint Events h Sand Racing h Trails Riding h Trials h Supercross, Arenacross (both motorcycle and ATV) h -indicate type: h Circuit Racing-indicate type: h International Events-indicate type: h Drag Racing-indicate type: h Other: 26. Complete the following table for all forms of racing: 12 to 24 Expected Months Ago Last 12 Months Next 12 Months Number Number Average Fastest Number of of Distance of Speed of Races Total Races Total Miles Each Race Attained Races Total Miles Automobile Motorcycle Boat Other: ______

Section V—Additional Avocations and Additional Details 27. Provide details if you participate in any of the following hazardous avocations: heli-skiing, rodeo sports, , equine sports or extreme sports. Also use this space for any additional details for avocations listed in any of the sections of this Supplement. (Specify to which question numbers the details pertain to, and if more space is required, use the Continuation of Details Supplement). Ques. # Date Details

Signatory Section The Undersigned declares that: I have read or have had read to me the completed Avocation Supplement before signing below. All statements and answers in this Avocation Supplement are correctly recorded and are full, complete and true. I agree that this Avocation Supplement constitutes a part of my application for insurance. I understand that if any answers provided on this Avocation Supplement are incorrect or untrue, the Company may have the right to deny benefits or rescind coverage under the policy and any riders attached to it.

Signed in: / / (State) Date (MM/DD/YYYY)

Signature of Proposed Insured (Parent or Guardian if under 14 years of age)

Signature of Licensed Agent, Broker or Registered Representative Printed Name of Licensed Agent, Broker or Registered Representative Page 3 of 3 LFF11701 CMPL 2/18 DRAFT