215 ILCS 5/343
............, Illinois. Certificate Number .................. .............................. (A Burial Insurance Society) Incorporated under the Illinois Insurance Code. HEREBY INSURES the life of ...., hereinafter called the Member. The society hereby agrees to pay to .... Beneficiary, the sum of $...., upon receipt of due proof of the death of the member, such payment to be paid only in lawful money of the United States. This certificate is issued in consideration of the application and the payment in advance of a first .... premium of .... which maintains this certificate in force for a period ending .... following its date of issue, and the payment of a like sum on the .... day of each .... thereafter during the lifetime of the member. CHANGE OF BENEFICIARY. The member may change the beneficiary at any time by giving notice at the principal office of the society. INCONTESTABLE CLAUSE. This certificate shall be incontestable after it has been in force during the life-time of the member for 2 years except for non-payment of premiums provided herein. GRACE PERIOD. A grace period of 30 days shall be allowed for the payment of any premium after the first, during which time this certificate shall be continued in full force. Should the member die during such grace period, the unpaid premium may be deducted from the amount otherwise payable. This certificate shall be regarded and accepted by the society and the member as cancelled and terminated upon failure to pay any premium before the expiration of the grace period. REINSTATEMENT. This certificate, after default in payment of any premium, may be reinstated at the discretion of the Board of Directors upon the member furnishing to the society satisfactory evidence of good health and paying the delinquent premiums. CONTRACT. This certificate and the application therefor, a copy of which is attached hereto, shall constitute the entire contract with the member. MISSTATEMENT OF AGE. If the age of the member has been misstated, the amount payable under the certificate shall be such as the member would have been entitled to at the true age. IN WITNESS WHEREOF, the society has caused this certificate to be signed by its duly authorized officers, on (insert date), which shall be the effective date of this certificate. ................. (Secretary) ................. (President) This certificate is issued in consideration of the application and the payment in advance of the first .... assessment and the further payment of such assessments as may be levied from time to time during the lifetime of the member.
215 ILCS 5/343