DAY RIGHT TO EXAMINE CONTRACT Sample Clauses

DAY RIGHT TO EXAMINE CONTRACT. During a period of 10 days from the date this contract is delivered to the Owner, it may be surrendered to the Company together with a written request for cancellation of the contract and, in such event, the Company will pay to the Owner an amount equal to the sum of (i) the difference between the Single Purchase Payment made under this Contract and the amount allocated to the Separate Account under this Contract and (ii) the Accumulated Value of this Contract on the date of surrender. If the request for cancellation of the contract is made prior to the actual delivery of the contract, the amount of refund will be the entire Single Purchase Payment. THE ANNUAL INVESTMENT RETURN REQUIRED TO MAINTAIN LEVEL VARIABLE ANNUITY PAYMENTS IS 5.65% (AFTER ANY APPLICABLE TAXES, BUT BEFORE ASSET CHARGES TOTALING 1.4% FOR MORTALITY RISKS, EXPENSE RISKS AND CONTRACT MAINTENANCE CHARGES AND MANAGEMENT FEES WHICH WILL NOT EXCEED .75% OF NET ASSETS OF MUTUAL FUND IN WHICH SEPARATE ACCOUNT ASSETS ARE INVESTED). ANNUITY PAYMENTS AND OTHER VALUES PROVIDED BY THIS CONTRACT, WHEN BASED ON THE INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED-DOLLAR AMOUNT. CONTRACT DATA CONTRACT NUMBER 310000 ANNUITANT ▇▇▇▇ ▇. ▇▇▇ DATE OF ISSUE MARCH 14, 1997 ISSUE AGE 35 PURCHASE PAYMENT $25,000.00 MATURITY DATE MARCH 14, 2052 SEPARATE ACCOUNT FIRST INVESTORS LIFE SEPARATE ACCOUNT D MUTUAL FUND FIRST INVESTORS LIFE SERIES FUND PURCHASE PAYMENT WILL BE ALLOCATED AS FOLLOWS: 25% to High Yield Series 25% to Discovery Series 25% to Growth Series 25% to Blue chip Series UNIT EFFECTIVE DATE MARCH 1, 1997 OWNER ANNUITANT BENEFICIARY DESIGNATION REFER TO ENCLOSED APPLICATION CONTINGENT DEFERRED SALES CHARGE UPON SURRENDER ALPHABETICAL GUIDE

DAY RIGHT TO EXAMINE CONTRACT. IF THE CONTRACT IS ISSUED AS A REPLACEMENT OF EXISTING LIFE INSURANCE OR ANNUITY COVERAGE, THE RIGHT TO EXAMINE PERIOD IS EXTENDED TO 60 DAYS FROM THE DATE OF RECEIVING IT. IF NOT SATISFIED WITH THE CONTRACT, RETURN IT TO FGWL&A OR THE ANNUITY SERVICE CENTER WITHIN 10 DAYS OF RECEIVING IT. THE CONTRACT WILL BE VOID FROM THE START, AND FGWL&A WILL REFUND THE GREATER OF: 1) CONTRIBUTIONS (LESS ANY WITHDRAWALS AND DISTRIBUTIONS TAKEN DURING THE FREE LOOK PERIOD); OR 2) THE ANNUITY ACCOUNT VALUE. FLEXIBLE PREMIUM VARIABLE ANNUITY. Contributions may be made until the Payout Commencement Date or until the death benefit is payable to a Beneficiary. The Owner is as shown on the Contract Data Page unless changed as provided for in this Contract. FGWL&A will pay the Annuitant the first of a series of annuity payouts on the Annuity Commencement Date by applying the Owner’s Annuity Account Value according to the Payout Options Provisions. Subsequent payouts will be paid on the same day of each frequency period according to the provisions of this Contract. Any paid-up annuity, cash surrender value or death benefits that may be available under this contract will not be less than the minimum benefits required by any statute in which this contract is delivered. Non-Participating. Not eligible to share in FGWL&A’s divisible surplus. Signed for First Great-West Life & Annuity Insurance Company on the issuance of this Contract. [R▇▇▇▇▇▇ ▇▇▇▇▇▇▇,] [Secretary] [W.▇. ▇▇▇▇▇▇▇▇,] [President and Chief Executive Officer] J444NY (07) Annuity Contract Number: [1234567] Owner: [J▇▇▇ ▇. ▇▇▇] Effective Date: [March 1, 2004] Date of Birth: [April 1, 1969] Status of Annuity: Non-Qualified Tax ID Number: [1▇▇-▇▇-▇▇▇▇] Initial Contribution: [$50,000] Joint Owner: [J▇▇▇ ▇. ▇▇▇] Annuity Commencement Date: [March 1, 2014] Date of Birth: [November 12, 1973] Tax ID Number: [###-##-####] Annuitant: [J▇▇▇ ▇. ▇▇▇] Date of Birth: [June 6, 1989] Date of Birth: [March 22, 1967] Tax ID Number: [###-##-####] Tax ID Number: [###-##-####] Date of Birth: [January 17, 1981] Tax ID Number: [###-##-####] Date of Birth: [January 17, 1981] Tax ID Number: [###-##-####] J444NY Page 1

DAY RIGHT TO EXAMINE CONTRACT. You have the right to return this Contract. Examine it carefully. You may return it and ask us to cancel it. Your request must be made in writing within ten (10) days of the date you receive this Contract. We will refund any premium you paid. If you return this contract, we will not provide you with any benefits.

DAY RIGHT TO EXAMINE CONTRACT. Within 10 days after this Contract is first received, it may be cancelled for any reason without penalty (e.g., no Contingent Deferred Sales Charge and no Market Value Adjustment will apply) by delivering or mailing it to the representative through whom it was purchased or to the Home Office of LNL. Upon cancellation, LNL will return the Contract Value as of the Valuation Date on which LNL receives the cancellation request. UPON A TRANSFER, WITHDRAWAL, OR SURRENDER, PAYMENTS AND VALUES FROM THE FIXED ACCOUNT MAY BE SUBJECT TO A MARKET VALUE ADJUSTMENT WHICH MAY RESULT IN UPWARD OR DOWNWARD ADJUSTMENTS IN AMOUNTS TRANSFERRED, WITHDRAWN, OR SURRENDERED BY THE OWNER. ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED ON INVESTMENT EXPERIENCE OF THE VARIABLE ACCOUNT, ARE VARIABLE (THE AMOUNT MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT (SEE ARTICLE 3 and Section 7.05). Signed for The Lincoln National Life Insurance Company at its Home Office located at ▇▇▇▇ ▇. ▇▇▇▇▇▇▇ St. in Fort ▇▇▇▇▇, Indiana 46802. /s/ ▇▇▇ ▇. ▇▇▇▇▇▇ /s/ ▇▇▇▇▇ ▇. ▇▇▇▇▇▇ ▇▇▇ ▇. ▇▇▇▇▇▇, President ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, Vice President Form 30422 Table of Contents Article Page 1 Definitions............................................................................................. 4

DAY RIGHT TO EXAMINE CONTRACT. Within 10 days of the date of receipt of this Contract by the Owner, it may be returned by delivering or mailing it to SAFECO or to the agent through whom it was purchased. When this Contract is received by SAFECO, it will be voided as if it had never been in force, and SAFECO will refund the Contract Value. This may be more or less than Purchase Payments. In states where required SAFECO will refund the Purchase Payments rather than the Contract Value. SAFECO reserves the right to allocate all payments to the Money Market Sub-Account until the expiration of 15 days from the date the first Purchase Payment is received. If SAFECO so allocates payments, SAFECO will refund the greater of Purchase Payments or the Contract Value. Signed for the Company /s/ R.A. ▇▇▇▇▇▇▇ /s/ R.E. Zunk▇▇ ---------------------------------------------- -------------------------- R.A. ▇▇▇▇▇▇▇, ▇▇. ▇▇▇e President and Secretary R.E. Zunk▇▇, ▇▇esident BRIEF DESCRIPTION Individual Variable Annuity, Single Premium Deferred Annuity, Non-Participating, Monthly Income at Annuity Date, Cash Value Payable at Death of Owner before Annuity Date. VALUES PROVIDED BY THIS CONTRACT ARE BASED ON THE INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT AND ARE, THEREFORE, VARIABLE AND NOT GUARANTEED AS TO DOLLAR AMOUNT. SEE SECTION D OF YOUR CONTRACT FOR DETAILS REGARDING THE SEPARATE ACCOUNT PROVISIONS.

DAY RIGHT TO EXAMINE CONTRACT. WITHIN 10 DAYS AFTER THIS CONTRACT IS FIRST RECEIVED, IT MAY BE CANCELLED FOR ANY REASON WITHOUT PENALTY (E.G., NO SURRENDER CHARGE WILL BE DEDUCTED) BY DELIVERING OR MAILING IT TO THE HOME OFFICE OF LNL, OR BY CANCELING THE CONTRACT THROUGH LNL'S INTERNET SERVICE CENTER. THE PURCHASE PAYMENT WILL BE INVESTED IN THE LINCOLN NATIONAL MONEY MARKET FUND DURING THIS FREE LOOK PERIOD. UPON CANCELLATION, LNL WILL RETURN THE VALUE OF ANY PAYMENTS MADE TO THE VARIABLE ACCOUNT. ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT (SEE SECTIONS 2 AND 3). Signed for the Lincoln National Life Insurance Company at its Home Office in Fort ▇▇▇▇▇, Indiana. ▇▇▇ ▇ ▇▇▇▇▇▇, PRESIDENT ▇▇▇▇▇ ▇. ▇▇▇▇▇▇, VICE PRESIDENT CONTRACT NUMBER: XX-0123456 CONTRACT OWNER INFORMATION PRIMARY JOINT ------- ----- CONTRACT OWNER: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇▇ CONTRACT OWNER ADDRESS: ▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ CONTRACT OWNER SSN/TAX ID: ▇▇▇-▇▇-▇▇▇▇ ▇▇▇-▇▇-▇▇▇▇ ANNUITANT INFORMATION ANNUITANT: ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ DATE OF BIRTH: 2/17/1938 SEX: Male CONTINGENT ANNUITANT: ▇▇▇▇ ▇▇▇▇▇▇▇ DATE OF BIRTH: 4/12/1938 SEX: Female CONTRACT INFORMATION TYPE OF CONTRACT: Non-Qualified EFFECTIVE DATE: July 1, 1998 MATURITY DATE July 1, 2048 PRODUCT: [eAnnuity] PURCHASE PAYMENT: $1,500.00 PURCHASE PAYMENT FREQUENCY: Monthly PURCHASE PAYMENT ALLOCATION: 25% Lincoln National Managed Fund, Inc. 75% Lincoln National Growth and Income Fund, Inc. BENEFICIARY INFORMATION Beneficiary Name: ▇▇▇▇ ▇▇▇▇▇▇▇ Relationship: son LINCOLN NATIONAL LIFE INSURANCE COMPANY CONTACT INFORMATION Lincoln National Life Insurance Company P.O. Box 2340 Fort ▇▇▇▇▇, IN 46801 URL: http:\\www.[annuitynet].com Form 28977 VARIABLE ACCOUNT There are currently [fourteen] Subaccounts in the Variable Account available to the Owner. The Owner may direct Purchase Payments under the Contract to any of the available Subaccounts, subject to limitations. The amounts allocated to each Subaccount will be invested at net asset value in the shares of one of the regulated investment companies (the Funds or Series). The Funds or Series are:

DAY RIGHT TO EXAMINE CONTRACT. WITHIN 10 DAYS AFTER THIS CONTRACT IS FIRST RECEIVED, IT MAY BE CANCELLED FOR ANY REASON BY DELIVERING OR MAILING IT TO THE HOME OFFICE OF LNL. UPON CANCELLATION, THIS CONTRACT WILL BE VOID FROM THE BEGINNING AND LNL WILL RETURN THE VALUE OF ANY PAYMENTS MADE TO THE VARIABLE ACCOUNT AND/OR ANY PURCHASE PAYMENT PAID UNDER THE FIXED PORTION OF THE CONTRACT. ALL PAYMENTS AND VALUES PRO VIDED BY THIS CONTRACT, WHEN BASED ON INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT SEE PAGES 4 AND 6. Signed for The Lincoln National Life Insurance Company at its Home Office in Fort ▇▇▇▇▇, Indiana. /s/ ▇▇▇ ▇. ▇▇▇▇▇▇ /s/ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇ ▇▇▇ ▇. ▇▇▇▇▇▇, PRESIDENT ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇, SECOND VICE PRESIDENT TABLE OF CONTENTS ARTICLE PAGE CONTRACT DATA CONTRACT NUMBER XX-0123456 ANNUITANT ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ AGE AT ISSUE 35 CONTRACT DATE APRIL 1,1989 PURCHASE PAYMENT $1,500.00 PURCHASE PAYMENT FREQUENCY MONTHLY MATURITY DATE APRIL 1, 2039 OWNER ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇▇ BENEFICIARY DESIGNATION AS NAMED IN APPLICATION OR SUBSEQUENT WRITTEN DESIGNATION ARTICLE I PURCHASE PAYMENTS

DAY RIGHT TO EXAMINE CONTRACT. Please examine this contract carefully. If you are not satisfied, you may return the contract to us or to your agent within 10 days of its receipt. If returned, the contract will be void from the beginning and we will refund the contract value as of the earlier of the date the returned contract is received by us at our Home Office or the date the returned contract is received by the Kansas City Life representative who sold you the contract.

DAY RIGHT TO EXAMINE CONTRACT. Please examine this Contract closely. If for any reason you are not satisfied with this Contract, you may return it to us for cancellation by delivering or mailing it to: