DELTA MUTUAL, INC.
6% PROMISSORY NOTE
FOR VALUE RECEIVED, DELTA MUTUAL INC., a Delaware corporation (the "Company"), with
offices at 111 North Branch Street, Sellersville, PA 18960, promises to pay to __________, (the
"Lender"), with a mailing address of __________, in lawful money of the United States of America, the
principal sum of __________Thousand Dollars ($_____), together with interest from the date of this
Note on the unpaid principal balance at a rate equal to six percent (6.0%) per annum, computed on the
basis of a year of 360 days. All unpaid principal, together with any then unpaid and accrued interest, shall
be due and payable at any time after the earlier of each of (i) the Maturity Date (as defined below), or (ii)
when, upon or after the occurrence of an Event of Default (as defined below), such amounts are declared
due and payable by the Lender or made automatically due and payable in accordance with the terms
The following is a statement of the rights of the Lender and the conditions to which this Note is subject,
and to which the Lender, by the acceptance of this Note, agrees:
1. Definitions. As used in this Note, the following capitalized terms have the following meanings:
1.1 "Company" includes the corporation initially executing this Note and any Person which shall succeed
to or assume the obligations of the Company under this Note.
1.2 "Event of Default" has the meaning given in Section 6 hereof.
1.3 "Lender" shall mean the Person specified in the introductory paragraph of this Note.
1.4 "Maturity Date" shall mean six months from the date hereof.
1.5 "Obligations" shall mean all obligations, owed by the Company to the Lender, now existing or
hereafter arising under or pursuant to the terms of this Note.
"Person" shall mean and include an individual, a partnership, a corporation (including a
business trust), a joint stock Company, a limited liability Company, an unincorporated associati