Minnesota Life Individual Variable Universal Life Account, et al. – ‘485BPOS’ on 4/26/16 – EX-99.26.E.7

On:  Tuesday, 4/26/16, at 10:00am ET   ·   Effective:  4/29/16   ·   Accession #:  1193125-16-555324   ·   File #s:  811-22093, 333-183590

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Post-Effective Amendment
Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 485BPOS     Post-Effective Amendment                             262   1.31M 
 3: EX-99.26.D.13  Miscellaneous Exhibit                               2     16K 
 2: EX-99.26.D.4  Miscellaneous Exhibit                                7     37K 
 4: EX-99.26.E.1  Miscellaneous Exhibit                                6     44K 
 5: EX-99.26.E.6  Miscellaneous Exhibit                                3     16K 
 6: EX-99.26.E.7  Miscellaneous Exhibit                                3     18K 
 7: EX-99.26.K  Miscellaneous Exhibit                                  2±     8K 
 8: EX-99.26.L  Miscellaneous Exhibit                                  2±     9K 
 9: EX-99.26.M  Miscellaneous Exhibit                                  2±    10K 
10: EX-99.26.N  Miscellaneous Exhibit                                  1      6K 
11: EX-99.26.R  Miscellaneous Exhibit                                  2     11K 

EX-99.26.E.7   —   Miscellaneous Exhibit

EX-99.26.E.7
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                                                             EXHIBIT 99.26(E)(7)

APPLICATION PART 2                                                              
INDIVIDUAL LIFE INSURANCE                                                       
                                                                          [LOGO]
MINNESOTA LIFE INSURANCE COMPANY - A Securian Company                           
Life New Business . 400 Robert Street North . St. Paul, Minnesota 55101-2098    

Proposed insured name (last, first, middle)                    Date of birth    

                                                        [Enlarge/Download Table]

                                                                                                            Yes    No           
                                                                                                                                
1. A. Have you smoked cigarettes in the past 12 months? (IF YES, COMPLETE THE TABLE BELOW.)                 [ ]    [ ]          
   B. Have you ever smoked cigarettes? (IF YES, COMPLETE THE TABLE BELOW.)                                  [ ]    [ ]          

      Current smoker     Past smoker     Packs per day     Date last cigarette smoked (mm, dd, yy)                              
           [ ]              [ ]                                                                                                 

   C. Have you used tobacco or nicotine of any kind, other than cigarettes, in any                          [ ]    [ ]          
      form, in the last 12 months? (IF YES, COMPLETE THE TABLE BELOW.)                                                          
   D. Have you ever used tobacco or nicotine of any kind, other than cigarettes in                          [ ]    [ ]          
      any form?  (IF YES, COMPLETE THE TABLE BELOW.)                                                                            

      What type     Current user     Past user     How much     Date of last use (mm, dd, yy)                                   
                         [ ]            [ ]                                                                                     

2. Are you taking or do you take any prescription or non-prescription medications or drugs?                 [ ]    [ ]          
   If so, please provide information below.                                                                                     
   ____________________________________________________________________________________________________                         
   ____________________________________________________________________________________________________                         

3. Have you ever been treated, diagnosed, tested positive for or given medical advice by a member of the medical profession for:

   A.   Epilepsy; Alzheimer's; Huntington's; Parkinson's; Mild Cognitive Impairment (MCI); dementia;        [ ]    [ ]          
        paralysis; sleep apnea; depression; stress disorders; anxiety disorder; or any other brain,                             
        nervous, mental, emotional or sleep disorder?                                                                           
   B.   High blood pressure; chest pain; chest discomfort or tightness; heart attack; heart murmur;         [ ]    [ ]          
        stroke; irregular heart beat; or any other disease or disorder of the heart or blood vessels?                           
   C.   Asthma; shortness of breath; bronchitis; pneumonia; emphysema; chronic cough; or any other          [ ]    [ ]          
        lung or respiratory disorder?                                                                                           
   D.   Abdominal pain; ulcer; colitis; cirrhosis; hepatitis; recurrent diarrhea; intestinal bleeding;      [ ]    [ ]          
        or any other disease of the liver, gallbladder, pancreas, stomach, or intestines?                                       
   E.   Kidney stone; protein, sugar, blood or blood cells in the urine; or any disorder of the urinary     [ ]    [ ]          
        tract, bladder or kidneys?                                                                                              
   F.   Disorder or abnormality of the prostate, uterus, ovaries, or breasts; pregnancy complication;       [ ]    [ ]          
        testicular disease; genital herpes, syphilis, gonorrhea, or other sexually transmitted disease?                         
   G.   Diabetes; thyroid disorder; lymph node enlargement; skin disorder; or disorder of any other         [ ]    [ ]          
        glands?                                                                                                                 
   H.   Cancer; tumor; or cyst?                                                                             [ ]    [ ]          
   I.   Anemia, leukemia, or other blood disorder?                                                          [ ]    [ ]          
   J.   Back or neck pain; spinal strain or sprain; sciatica; arthritis; gout; carpal tunnel syndrome; or   [ ]    [ ]          
        any bone, joint, or muscle disorder?                                                                                    
   K.   Disorder of the eyes, ears, nose or throat?                                                         [ ]    [ ]          
   L.   Any physical deformity or defect?                                                                   [ ]    [ ]          
   M.   Any immune system diseases or disorders except those related to the Human Immunodeficiency          [ ]    [ ]          
        Syndrome (HIV virus)?                                                                                                   
   N.   Any chronic or recurrent fever, fatigue or viral illness?                                           [ ]    [ ]          

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                                                                                                             Yes  No 
                                                                                                                     
 4.  Have you ever been diagnosed by a member of the medical profession or tested positive for the           [ ]  [ ]
     Human Immunodeficiency Virus (HIV virus) or Acquired Immune Deficiency Syndrome (AIDS)?                         

 5.  Do you consume alcoholic beverages? If yes, what kinds, how much and how often?                         [ ]  [ ]
     ______________________________________________________________________________________________________          

 6.  Have you ever been advised by a member of the medical profession to limit the use of alcohol or drugs;  [ ]  [ ]
     received medical treatment, advice, or counseling for alcohol or drugs; or joined a self-help group             
     because of alcohol or drug use?                                                                                 

 7.  Have you ever tried or used cocaine, heroin, marijuana, barbiturates or other controlled substances     [ ]  [ ]
     except as prescribed by a physician?                                                                            

 8.  Other than above, have you in the past five years:                                                              

     A.   Consulted or been advised by a member of the midical profession to consult a physician,            [ ]  [ ]
          psychiatrist, psychologist, therapist, counselor, chiropractor, or other health care                       
          practitioner? (Include regular check-ups.)                                                                 
     B.   Been treated, examined or advised by a member of the midical profession for a check-up, illness,   [ ]  [ ]
          or surgery, or been treated or evaluated at a hospital or any other health care facility?                  
     C.   Had an EKG, x-ray, stress test, echocardiogram, angiography, blood studies or any other            [ ]  [ ]
          diagnostic test?                                                                                           
     D.   Been advised by a member of the midical professoin to have any test, hospitalization, or           [ ]  [ ]
          surgery which was not completed?                                                                           
     E.   Had a CT Scan, MRI, EEG or any other diagnostic test for fainting spells, convulsions,             [ ]  [ ]
          seizures, headaches, or dizziness?                                                                         

9.  Height:_________FT_________IN     Weight:_________LBS.                                                           

     In the last 12 months have you had a change in weight?                                                  [ ]  [ ]

     A.   If yes, please provide how many pounds lost_______ or how many pounds gained                       [ ]  [ ]
     B.   Has your change in weight been attributed by a member of the medical profession to any of the              
          above medical conditions ?                                                                                 
     C.   If yes, which medical condition?________________________________________________                           
     D.   If no, please check all that apply to the last 12 months:                                                  
          [ ] Diet  [ ] Exercise  [ ] Surgery  [ ] Pregnancy  [ ] Unknown                                            

10.  Family History: Make a note if a family member has been diagnosed or treated by a member of the                 
     medical profession for diabetes, cancer, melanoma, heart, and kidney disease.                                   

                          Age(s)      Health History                Age(s)    Cause of Death                         
                          ------      --------------                ------    --------------                         
     Father                                                                                                          
     Mother                                                                                                          
                 Living                                 Deceased                                                     
     Siblings                                                                                                        
     Siblings                                                                                                        


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                                                                                                                Yes  No 
                                                                                                                        
11.    Do you have a personal physician or belong to an H.M.O. or clinic? If so, please provide information     [ ]  [ ]
       below.                                                                                                           

       Name                                                                      Phone number                           

       Street address                                                                                                   

       City                                                                      State            Zip code              

       Date last seen                 Reason                                                                            

GIVE DETAILS OF ALL YES ANSWERS, INCLUDING DOCTORS' NAMES, PHONE NUMBERS, ADDRESSES AND DATES.                          

I HAVE READ THE STATEMENTS AND ANSWERS RECORDED ON THIS APPLICATION PART 2; THEY ARE TO THE BEST OF MY KNOWLEDGE        
AND BELIEF TRUE, COMPLETE AND CORRECTLY RECORDED. I AGREE THAT THEY WILL BECOME PART OF THIS APPLICATION AND ANY        
POLICY ISSUED ON IT.                                                                                                    

Proposed insured signature                                              Date                                            
X                                                                                                                       
Witness                                                                                                                 

ICC14-59573 2-2014                                                        3 of 3

26 Subsequent Filings that Reference this Filing

  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

 4/26/24  Minnesota Life Individual V… Acct 485BPOS     5/01/24   26:7.7M                                   Donnelley … Solutions/FA
 4/26/24  Minnesota Life Individual V… Acct 485BPOS     5/01/24   26:10M                                    Donnelley … Solutions/FA
 4/26/24  Minnesota Life Individual V… Acct 485BPOS     5/01/24    7:2.2M                                   Donnelley … Solutions/FA
 4/26/24  Minnesota Life Individual V… Acct 485BPOS     5/01/24   26:10M                                    Donnelley … Solutions/FA
 4/26/24  Minnesota Life Individual V… Acct 485BPOS     5/01/24    8:2.6M                                   Donnelley … Solutions/FA
 8/30/23  Minnesota Life Individual V… Acct 485BPOS     8/30/23    5:1.9M                                   Donnelley … Solutions/FA
 8/30/23  Minnesota Life Individual V… Acct 485BPOS     8/30/23    5:2.3M                                   Donnelley … Solutions/FA
 4/27/23  Minnesota Life Individual V… Acct 485BPOS     5/01/23   25:6.6M                                   Donnelley … Solutions/FA
 4/27/23  Minnesota Life Individual V… Acct 485BPOS     5/01/23   22:8.4M                                   Donnelley … Solutions/FA
 4/27/23  Minnesota Life Individual V… Acct 485BPOS     5/01/23    6:2.1M                                   Donnelley … Solutions/FA
 4/27/23  Minnesota Life Individual V… Acct 485BPOS     5/01/23   23:8.8M                                   Donnelley … Solutions/FA
 4/27/23  Minnesota Life Individual V… Acct 485BPOS     5/01/23   15:2.9M                                   Donnelley … Solutions/FA
 2/23/23  Minnesota Life Individual V… Acct 485APOS               14:14M                                    Donnelley … Solutions/FA
11/08/22  Minnesota Life Individual V… Acct N-6/A                 11:5.1M                                   Donnelley … Solutions/FA
 8/01/22  Minnesota Life Individual V… Acct N-6                    8:2.4M                                   Donnelley … Solutions/FA
 4/27/22  Minnesota Life Individual V… Acct 485BPOS     4/29/22    6:2.2M                                   Donnelley … Solutions/FA
 4/27/22  Minnesota Life Individual V… Acct 485BPOS     4/29/22    6:1.3M                                   Donnelley … Solutions/FA
 4/27/22  Minnesota Life Individual V… Acct 485BPOS     4/29/22    7:2.2M                                   Donnelley … Solutions/FA
 4/27/22  Minnesota Life Individual V… Acct 485BPOS     4/29/22    6:1.6M                                   Donnelley … Solutions/FA
 2/23/22  Minnesota Life Individual V… Acct 485APOS                6:2.2M                                   Donnelley … Solutions/FA
12/15/21  Minnesota Life Individual V… Acct 485BPOS    12/15/21    6:1.2M                                   Donnelley … Solutions/FA
 4/28/21  Minnesota Life Individual V… Acct 485BPOS     5/01/21    9:2.5M                                   Donnelley … Solutions/FA
 4/28/21  Minnesota Life Individual V… Acct 485BPOS     5/01/21    5:1.2M                                   Donnelley … Solutions/FA
 4/28/21  Minnesota Life Individual V… Acct 485BPOS     5/01/21    9:2.4M                                   Donnelley … Solutions/FA
 4/28/21  Minnesota Life Individual V… Acct 485BPOS     5/01/21    9:1.9M                                   Donnelley … Solutions/FA
 2/23/21  Minnesota Life Individual V… Acct 485APOS¶    2/23/21    6:2.2M                                   Donnelley … Solutions/FA