Usl Separate Account Usl B – ‘485BPOS’ on 10/27/98 – EX-99.E.(2)

As of:  Tuesday, 10/27/98   ·   Effective:  10/27/98   ·   Accession #:  803401-98-38   ·   File #:  33-90686

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Document/Exhibit                   Description                      Pages   Size 

 1: 485BPOS     Registration Statement With Exhibits                   6     32K 
 2: EX-99.A     Exhibit A                                              2     18K 
 3: EX-99.B     Exhibit B                                              2     13K 
 4: EX-99.C.(1)  Exhibit C(1)                                         23     93K 
 5: EX-99.C.(2)  Exhibit C(2)                                         23     92K 
 6: EX-99.C.(3)  Exhibit C(3)                                          6     28K 
13: EX-99.D(7)  Exhibit D(7)                                           5     15K 
 7: EX-99.D.(1)  Exhibit D(1)                                          7±    28K 
 8: EX-99.D.(2)  Exhibit D(2)                                          4     24K 
 9: EX-99.D.(3)  Exhibit D(3)                                          5     14K 
10: EX-99.D.(4)  Exhibit D(4)                                          3     12K 
11: EX-99.D.(5)  Exhibit D(5)                                          5     14K 
12: EX-99.D.(6)  Exhibit D(6)                                          2     10K 
14: EX-99.E(1)  Exhibit E(1)                                           6     27K 
15: EX-99.E.(2)  Exhibit E(2)                                          2     10K 
16: EX-99.F     Exhibit F                                             10±    36K 

EX-99.E.(2)   —   Exhibit E(2)

EX-99.E.(2)
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EXHIBIT E(2)

Form of Supplemental Application (2VULSUP1294NY)            

EX-99.E.(2)
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AMERICAN INTERNATIONAL LIFE                            80 Pine Street           
ASSURANCE COMPANY OF NEW YORK                          New York, NY  10005      

                            Supplemental  Application  For
PLEASE  PRINT ALL ANSWERS              Flexible Premium Variable Life Insurance 

1. Proposed Insured                          2. Birth Date                      

----------------- ----- -----------------    ----- ---- ---                     
First Name         M.I.  Last Name           Month Day Year                     

3. Social Security Number                                                       

-     -                                                       
-------------------------                                                       

4.      Allocation of premium  (Must be in 1% increments  and no less than 5% to
any one fund. Total must equal 100%.)                           

Guaranteed Account           %     Fidelity:                    
     ----      ---------
                                 Asset Manager             %
                                                      ----
Alliance:                          Growth                    %  
--------                                                 ----   
Conservative Investors        %    High Income               %  
                     -----                            ----
Growth                        %    Investment Grade Bond     %  
                     -----                            ----
Growth & Income               %    Money Market              %  
                     -----                            ----
Growth Investors              %    Overseas                  %  
                     -----                            ----
                                                           %
Dreyfus:                           Van Eck:              ----   
Stock Index Fund        ----- %    Worldwide Hard Assets ---- % 
Zero Coupon             ----- %    World Wide Emerging          
                                 Markets              ---- %

NOTE:  The Premium will be allocated to the Fidelity Money Market Fund until the
end of the Right to Examine This Policy Period.                                 

5. Dollar Cost  Averaging  (Minimum of $2,000 must be  allocated to the Fidelity
Money  Market  Fund).  Yes No If  elected  you must  complete  the  Dollar  Cost
Averaging Plan Request Form.                                                    

6.   (a) Did the Owner receive current prospectuses? Yes ____  No ______        

(b)  Does the Owner understand that:                                  

          The death  benefit may increase or decrease  depending  on  investment
performance? Yes No                                         

          The cash value may increase or decrease  depending  on the  investment
performance? Yes No                                         

          The policy will lapse if the cash surrender value becomes insufficient
to cover policy charges? Yes No                             

     (c)  Does the Owner believe that this policy will meet insurance  needs and
financial objectives? Yes _____ No _____                    

7. Suitability                                                                  

What is the Owner's:                                            
Approximate net worth                                           
Income earned                                                   
Income unearned                                                 
Number of dependents                                            
Marginal tax bracket                                            
Investment Objective(s) (check all that apply):                 

Growth ________ Growth and Income ________ Income ________      
Capital Appreciation ________  Speculation ________             

I, the Owner,  represent that the  statements  and answers in this  supplemental
application  are written as made by me and are  complete and true to the best of
my knowledge and belief.                                                        

Signed on ______________ , 19___        _________________________               
                  Signature of Owner

at ____________, State of ______        _________________________               
                                    Signature of Proposed Insured if not
________________________________        Owner (Parent if Proposed Insured is    
Signature of Soliciting Agent           Age 15 or less)                         

An Illustration of Benefits, Including Death Benefits, Policy Values and
Cash Surrender Values is Available Upon Request.