Separate Account II of AGL, et al. – ‘485BPOS’ on 5/1/06 – EX-99.(E)(5)

On:  Monday, 5/1/06, at 2:17pm ET   ·   Effective:  5/1/06   ·   Accession #:  1193125-6-94793   ·   File #s:  333-34199, 811-04867

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Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 485BPOS     485B (Form N-6) Pea 17 Aig Life Executive            243   1.20M 
                          Advantage Vul                                          
 2: EX-99.(E)(2)  Supplemental Application                             2     13K 
 3: EX-99.(E)(3)  Subaccount Transfer Request Form                     2±    11K 
 4: EX-99.(E)(4)  Premium Allocation Form                              2±    11K 
 5: EX-99.(E)(5)  Loan/Surrender Request Form                          2     12K 
 6: EX-99.(E)(6)  Dollar Cost Averaging Request Form                   2     12K 
 7: EX-99.(E)(8)  Reallocation and Rebalancing Request Form            2±    11K 
 8: EX-99.(E)(9)  Automatic Rebalancing Request                        2±    10K 
 9: EX-99.(H)(7)(D)  Amendment No. 3 to Franklin Templeton             9     27K 
                          Participation Agreement                                
10: EX-99.(N)(1)  Pricewaterhousecoopers LLP Consent                   1      7K 

EX-99.(E)(5)   —   Loan/Surrender Request Form

EX-99.(E)(5)
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[LOGO]The AIG Life Companies (U.S.)                              EXHIBIT (e)(5) 

EXECUTIVE ADVANTAGE/SM/ 

LOAN / SURRENDER REQUEST  

Policy Number: ____________ Policyholder: _____________________________________ 
                                        (Last Name, First Name, Middle Name)

Insured: ____________________________________ Social Security No.: ____-___-___ 
(Last Name, First Name, Middle Name)                          

LOAN REQUEST                                                                    

.   Interest will accrue daily on any outstanding loan at an annual interest
rate as indicated in the specifications.                            

[_] Maximum Amount Available (may vary by Subaccount)             

[_] $ ______ in cash or maximum amount available, if less         

SURRENDER REQUEST                                                               

  [_] Full surrender (original policy or lost policy affidavit must be
enclosed)                                                         

   [_] Partial surrender in the amount of $ ________ or for ________% of
cash surrender value                                              

 .   No more than two (2) surrenders may be made during each Certificate Year.

.   An expense charge and/or a surrender charge may be assessed according to
the Certificate.                                                    

.   You can direct below how the loan or partial surrender will be deducted 
    from the unloaned portion of the Guaranteed Account and the Subaccounts.
   If you provide no directions, the loan or partial surrender amount will
   be deducted from the unloaned portion of the Guaranteed Account and the
Subaccounts on a pro rata basis.                                    

                                                               Amount  Percent
                                                              -------- -------
Guaranteed Account............................................ $_______  ____%  
AllianceBernstein Variable Product Series Fund, Inc.                            
 Americas Government Income................................. $_______  ____%
 Growth Portfolio........................................... $_______  ____%
 Growth and Income Portfolio................................ $_______  ____%
 Large Cap Growth Portfolio................................. $_______  ____%
 Small Cap Growth Portfolio................................. $_______  ____%
American Century Variable Portfolios, Inc.                                      
 VP Income & Growth Fund.................................... $_______  ____%
 VP International Fund...................................... $_______  ____%
Credit Suisse Trust                                                             
 Emerging Markets Portfolio................................. $_______  ____%
 Global Small Cap Portfolio................................. $_______  ____%
 International Focus Portfolio.............................. $_______  ____%
 Large Cap Value Portfolio.................................. $_______  ____%
 Mid-Cap Growth Portfolio................................... $_______  ____%
 Small Cap Growth Portfolio................................. $_______  ____%
Fidelity Variable Insurance Products                                            
 VIP Balanced Portfolio..................................... $_______  ____%
 VIP Contrafund Portfolio................................... $_______  ____%
 VIP Index 500 Portfolio.................................... $_______  ____%
Franklin Templeton Variable Insurance Products Trust                            
 Developing Markets Securities Fund - Class 2............... $_______  ____%
 Growth Securities Fund - Class 2........................... $_______  ____%
 Foreign Securities Fund - Class 2.......................... $_______  ____%
Money Market Fund - Class 1................................               
Goldman Sachs Variable Insurance Trust                                          
 Structured U.S. Equity Fund................................ $_______  ____%
 International Equity Fund.................................. $_______  ____%
J.P. Morgan Series Trust II                                                     
 Small Company Portfolio.................................... $_______  ____%
FAM Variable Series Funds                                                       
 Mercury Basic Value V.I. Fund.............................. $_______  ____%
 Mercury Fundamental Growth V.I. Fund....................... $_______  ____%
 Mercury Government Bond V.I. Fund.......................... $_______  ____%
 Mercury Value Opportunities V.I. Fund...................... $_______  ____%
Morgan Stanley Universal Institutional Funds                                    
 Core Plus Fixed Income Portfolio........................... $_______  ____%
 Emerging Markets Equity Portfolio.......................... $_______  ____%
 High Yield Portfolio....................................... $_______  ____%
 Mid Cap Growth Portfolio................................... $_______  ____%
 U.S. Mid Cap Value Portfolio............................... $_______  ____%
NeubergerBerman Advisers Management Trust                                       
 AMT Partners Portfolio..................................... $_______  ____%
PIMCO Variable Insurance Trust                                                  
 High Yield Portfolio....................................... $_______  ____%
 Long Term U.S. Government Portfolio........................ $_______  ____%
 Real Return Portfolio...................................... $_______  ____%
 Short-Term Portfolio....................................... $_______  ____%
 Total Return Bond Portfolio................................ $_______  ____%
Vanguard Variable Insurance Fund                                                
 Total Bond Market Index Portfolio.......................... $_______  ____%
 Total Stock Market Index Portfolio......................... $_______  ____%
VALIC Company I                                                                 
 International Equities Fund................................ $_______  ____%
 Mid Cap Index Fund......................................... $_______  ____%
 Small Cap Index Fund....................................... $_______  ____%

Loan / Surrender, Executive Advantage/SM/, 04/05, Page 1 of 2                   

EX-99.(E)(5)
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As Policyholder, I represent that the statements and answers in this Loan /     
Surrender request are written as made by me and are complete and true to the    
best of my knowledge and belief. In the event of a full surrender, I surrender  
all rights to this policy and state that no bankruptcy or insolvency proceeding 
is pending with respect to me.                                                  

----------------------------------------  ------------------------------------- 
Signature of Insured                      Signature of Policyholder (If other   
                     than Insured)

______________________   ______, 20____                                         
Date Signed                                                                     

Loan / Surrender, Executive Advantage/SM/, 04/05, Page 2 of 2