FORM OF APPLICATION

Exhibit 4(a)

Pruco Life Insurance Company, Strategic Partners(SM)
a Prudential Financial company Guaranteed Rate Annuity Application

On these pages, I, you, and your refer to the contract owner(s).
We,us, and our refer to the Pruco Life Insurance Company.

[1]CONTRACT
OWNER
INFORMATION

Contract number (if any)
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[ ] Individual [ ] Corporation [ ] UGMA/UTMA [ ] Other

TRUST: [ ] Grantor [ ] Revocable [ ] Irrevocable

TRUST DATE (mo., day, yr.)
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If a corporation or trust is indicated above, please check the
following as it applies. If neither box is checked, we will
provide annual tax reporting for the increasing value of the
contract.

[ ] Tax-exempt entity under IRS Code 501

[ ] Trust acting as agent for an individual under IRS Code 72(u)

Name of owner (first, middle initial, last name)

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Street Apt.

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City State ZIP code

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Social Security number/EIN Date of birth (mo., day, year)

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Telephone number

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A. [ ] Female B. [ ] U.S. citizen
[ ] Male [ ]Resident alien

[ ] I am not a U.S. person (including
resident alien). I am a citizen of

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Attach the applicable IRS Form W-8(BEN, ECI, EXP, IMY).



[2]JOINT
OWNER
INFORMATION
(if any)
Do not
complete if
you are
opening
an IRA.

Unmarried persons who wish to own the contract jointly should
consult with their tax adviser.

Name of joint owner, if any (first, middle initial, last name)

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Street (Leave address blank if same as owner.) Apt.

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City State ZIP code

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Social Security number/EIN Date of birth (mo., day, year)

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Telephone number

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A. [ ] Female B. [ ] U.S. citizen
[ ] Male [ ]Resident alien

[ ] I am not a U.S. person (including
resident alien). I am a citizen of

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[3]ANNUITANT
INFORMATION
Do not
complete this
section if you
are opening
an IRA.

This section must be completed only if the annuitant is not
the owner or if the owner is a trust or a corporation.

Name of annuitant (first, middle initial, last name)

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Street (Leave address blank if same as owner.) Apt.

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City State ZIP code

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Social Security number Date of birth (mo., day, year)

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Telephone number

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A. [ ] Female B. [ ] U.S. citizen
[ ] Male [ ] Resident alien

[ ] I am not a U.S. person (including
resident alien). I am a citizen of

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Pruco Corporate Office: Pruco Life Insurance Company, Phoenix, AZ 85014


ORD 99720 Page 1 of 5 Ed. 1/2003
[4] CO-ANNUITANT
INFORMATION
(if any)
Do not
complete
if you are
opening an IRA
or if the
contract
will be owned
by a
corporation
or trust.

Name of co-annuitant (first, middle initial, last name)

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Social Security number Date of birth (mo., day, year)

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Telephone number

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A. [ ] Female B. [ ] U.S. citizen
[ ] Male [ ] Resident alien

[ ] I am not a U.S. person (including resident
alien). I am a citizen of

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[5] BENEFICIARY
INFORMATION

If joint owners, do not designate a Primary Beneficiary. The
joint owners will be each other's sole Primary beneficiary.

[X]PRIMARY CLASS

Name of beneficiary (first, middle initial, last name) If trust,
include name of trust and trustee's name.

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TRUST: [ ] Revocable [ ]Irrevocable

Trust date (mo., day, year)

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Beneficiary's relationship to owner

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CHECK ONLY ONE: [ ] Primary class [ ]Secondary class

Name of beneficiary (first, middle initial, last name) If trust,
include name of trust and trustee's name.

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TRUST: [ ] Revocable [ ] Irrevocable

Trust date (mo., day, year)

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Beneficiary's relationship to owner

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PLEASE ADD ADDITIONAL BENEFICIARIES IN SECTION 12.



[6]TYPE OF
PLAN AND
SOURCE OF
FUNDS
Contract
minimum of
$5,000.
PLAN TYPE. Check only one:

[ ] Non-qualified [ ] Traditional IRA [ ] Roth IRA/Custodial
[ ] Custodial account (PSI only)

SOURCE OF FUNDS. Check all that apply:

[ ] Total amount of the check(s) included with this
application. (Make checks payable to Prudential.)

$ , , .
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[ ] IRA Rollover $ , , .
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If Traditional IRA or Roth IRA new contribution(s) for the
current and/or previous year, complete the following:

$ , . Year $ , . Year
---------------- -------- ---------------- --------
[ ] 1035 Exchange (non-qualified only), estimated amount:

$ , , .
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[ ] IRA Transfer (qualified), estimated amount:

$ , , .
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[ ] Direct Rollover (qualified), estimated amount:

$ , , .
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[ ] Roth Conversion IRA, establishment date:*

month day year
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*This is the date you originally converted from a traditional
IRA to a Roth Conversion IRA. (If omitted, the current tax year
will be used.) This is required for the IRA five-tax year,
holding period requirement.

A CONVERSION FROM A TRADITIONAL IRA TO A ROTH CONVERSION IRA WILL
RESULT IN A TAXABLE EVENT WHICH WILL BE REPORTED TO THE INTERNAL
REVENUE SERVICE.

[7] GUARANTEE Please choose only one:
PERIOD

[ ]3 years [ ] 7 years

[ ]5 years [ ] 10 years


ORD 99720 Page 2 of 5 Ed.1/2003
[8]REPLACEMENT
QUESTIONS AND
DISCLOSURE
STATEMENT



THIS DISCLOSURE STATEMENT SECTION MUST BE COMPLETED IF STATE
REPLACEMENT REGULATIONS REQUIRE. (Check one):

[ ] I do have existing life insurance policies or annuity
contracts. (You must complete the Important Notice Regarding
Replacement form (COMB 89216), whether or not this transaction
is considered a replacement.)

[ ] I do not have existing life insurance policies or annuity
contracts.

Will the proposed annuity contract replace any existing insurance
policy(ies) or annuity contract(s)?

[ ] Yes [ ] No

If "Yes," provide the following information for each policy or
contract and attach all applicable Prudential disclosure and state
replacement forms.

Company name

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Policy or contract number

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Year of issue (mo., day, year) Name of plan (if applicable)

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FOR VIRGINIA ONLY:
X
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Contract owner's signature and date month day year

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REPRESEN- THIS QUESTION MUST BE COMPLETED BY THE REPRESENTATIVE.
TATIVE'S
QUESTION Do you have, from any source, facts that any person named as the
owner or joint owner above is replacing or changing any current
insurance or annuity in any company?

[ ] Yes [ ] No

FOR VIRGINIA ONLY:
X
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Representative's signature and date month day year

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[9]SIGNATURE(S)

If applying for an IRA or Roth IRA, I acknowledge receiving an IRA
disclosure statement and understand that I will be given a
financial disclosure statement with the contract. I understand
that tax deferral is provided by the IRA, and acknowledge that I
am purchasing this contract for its features other than tax
deferral, including the lifetime income payout option, the Death
Benefit protection, and other features as described in the
prospectus.

No representative has the authority to make or change a contract
or waive any of the contract rights.

I understand that if I have purchased another non-qualified
annuity from Prudential or an affiliated company this calendar
year that they will be considered as one contract for tax
purposes.

I believe that this contract meets my needs and financial
objectives.

[ ] If this contract has a joint owner, please check this box to
authorize Prudential to act on the instruction(s) of either
the owner or joint owner with regard to transactions under the
contract.
[ ] If this application is being signed at the time the contract
is delivered, I acknowledge receipt of the contract.
[ ] Check here to request a Statement of Additional Information.

MINIMUM DISTRIBUTION UNDER AN IRA: IF YOU HAVE NOT MET THE
REQUIRED MINIMUM DISTRIBUTION FOR THE YEAR IN WHICH THE FUNDS ARE
PAID TO PRUDENTIAL:

I understand it is my responsibility to remove the minimum
distribution from the purchase payment PRIOR TO sending money to
Prudential with this application. Unless we are notified
otherwise, Prudential will assume that the owner has satisfied the
required minimum distributions from other IRA funds.

By signing this form, the trustee(s)/officer(s) hereby represents
that the trustee(s)/officer(s) possess(es) the authority, on
behalf of the non-natural person, to purchase the annuity contract
and to exercise all rights of ownership and control over the
contract.

(continued)

ORD 99720 Page 3 of 5 Ed. 1/2003
[9] SIGNATURE(S)
(continued)

I UNDERSTAND THAT THE PURCHASE PAYMENT WILL BE SUBJECT TO A MARKET
VALUE ADJUSTMENT IF THERE IS A WITHDRAWAL, ANNUITIZATION, OR
SETTLEMENT ON ANY DATE OTHER THAN WITHIN THE 30 DAY PERIOD
IMMEDIATELY PRECEDING THE END OF THE GUARANTEE PERIOD. A MARKET
VALUE ADJUSTMENT CAN BE A POSITIVE OR NEGATIVE ADJUSTMENT. THERE
IS NO MARKET VALUE ADJUSTMENT AT DEATH.

I hereby represent that my answers to the questions on this
application are correct and true to the best of my knowledge and
belief. I have read the applicable fraud warning for my state
listed in section 11.

I acknowledge receipt of the current prospectus.

SIGNED BY THE CONTRACT OWNER AT: (City, State)

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X
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Contract owner's signature and date

month day year

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X
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Joint owner's signature (if applicable) and date

month day year

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X
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Annuitant's signature (if applicable) and date

month day year

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X
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Co-annuitant's signature (if applicable) and date

month day year

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OWNER'S TAX CERTIFICATION

Under penalty of perjury, I certify that the taxpayer
identification number (TIN) I have listed on this form is my
correct TIN. I further certify that the citizenship/residency
status I have listed on this form is my correct
citizenship/residency status. I [ ] HAVE/[ ] HAVE NOT (select one)
been notified by the Internal Revenue Service that I am subject to
backup withholding due to underreporting of interest or dividends.

X
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Contract owner's signature and date

month day year

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[10]REPRESEN-
TATIVE'S
SIGNATURE(S)

This application is submitted in the belief that the purchase of
this contract is appropriate for the applicant based on the
information provided and as reviewed with the applicant.
Reasonable inquiry has been made of the owner concerning the
owner's overall financial situation, needs, and investment
objectives.

The representative hereby certifies that all information contained
in this application (including the representative's replacement
question in section 8) is true to the best of his or her
knowledge.

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Representative's name (Please print)

Agency code Rep's contract/FA number

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X
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Representative's signature and date

month day year

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Second representative's name (Please print)

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Rep's contract/FA number

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X
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Second representative's signature and date

month day year

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Branch/field office name and code

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Representative's telephone number

FOR FLORIDA ONLY:

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Rep's Florida license number Second rep's Florida license number


ORD 99720 Page 4 of 5 Ed. 1/2003
[11] FRAUD
WARNINGS

CONNECTICUT: Any person who knowingly gives false or deceptive
information when completing this form for the purpose of
defrauding the company may be guilty of insurance fraud. This is
to be determined by a court of competent jurisdiction.

COLORADO: It is unlawful to knowingly provide false, incomplete,
or misleading facts or information to an insurance company for the
purpose of defrauding or attempting to defraud the company.
Penalties may include imprisonment, fines, denial of insurance,
and civil damages. Any insurance company or agent of an insurance
company who knowingly provides false, incomplete, or misleading
facts or information to a policy holder or claimant for the
purpose of defrauding or attempting to defraud the policy holder
or claimant with regard to a settlement or award payable from
insurance proceeds shall be reported to the Colorado Division of
Insurance within the Department of Regulatory Agencies.

FLORIDA: Any person who knowingly and with intent to injure,
defraud, or deceive any insurer, files a statement of claim or an
application containing any false, incomplete, or misleading
information, is guilty of a felony of the third degree.

NEW JERSEY: Any person who includes any false or misleading
information on an application for an insurance policy is subject
to criminal and civil penalties.

NEW MEXICO: Any person who knowingly presents a false or
fraudulent claim for payment of a loss or benefit or knowingly
presents false information in an application for insurance is
guilty of a crime and may be subject to civil fines and criminal
penalties.

OKLAHOMA: WARNING - Any person who knowingly, and with intent to
injure, defraud or deceive any insurer, makes any claim for the
proceeds of an insurance policy containing any false, incomplete
or misleading information is guilty of a felony.

PENNSYLVANIA: Any person who knowingly and with intent to defraud
any insurance company or other person files an application for
insurance or statement of claim containing any materially false
information or conceals for the purpose of misleading, information
concerning any fact material thereto commits a fraudulent
insurance act, which is a crime and subjects such person to
criminal and civil penalties.

VIRGINIA: Any person who, with the intent to defraud or knowing
that he is facilitating a fraud against an insurer, submits an
application or files a claim containing a false or deceptive
statement may have violated state law.

ALL OTHER STATES: Any person who knowingly gives false or
deceptive information when completing this form for the purpose of
defrauding the company may be guilty of insurance fraud.

[11] ADDITIONAL
REMARKS

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