Common use of Right to Cancel Clause in Contracts

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within [ 10 ] days after you receive it by returning it to our administrative office, or to the agent who sold it to you, with a written request for cancellation. If you return it by mail, effective date of the cancellation will be determined by the postmark date on the properly addressed and postage-paid return package. We will promptly return the Contract Value plus any amounts deducted from your Purchase Payments before they were applied to this Contract. The amount returned may be more or less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You The Group Contract Holder may cancel this Contract within [ 10 ] days after you receive it by returning it to our administrative officethe agent from whom it was purchased, or to Aetna at the agent who sold it address shown above. Within seven days of receiving the Contract at its home office, Aetna will return the amount of Certificate Holder Purchase Payment(s) received, plus any increase, or minus any decrease, on the amount, if any, allocated to youthe Separate Account fund(s). This page and the pages that follow constitute the entire Contract. Signed at the home office on the Effective Date. /s/Xxxxxx Xxxxxxx /s/Xxxxx X. Xxxxxxxxx President Secretary Group Variable, with Fixed, or Combination Annuity Contract Nonparticipating ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. THIS CONTRACT CONTAINS A MARKET VALUE ADJUSTMENT FORMULA. APPLICATION OF A MARKET VALUE ADJUSTMENT MAY RESULT IN EITHER AN INCREASE OR DECREASE IN THE CURRENT VALUE. THE MARKET VALUE ADJUSTMENT FORMULA DOES NOT APPLY TO A GUARANTEED TERM AT THE TIME OF ITS MATURITY. Specifications -------------------------------------------------------------------------------- Guaranteed There is a written request guaranteed interest rate for cancellationPurchase Interest Rate Payment(s) held in the AG Account. If you return it by mail(See Contract Schedule I). -------------------------------------------------------------------------------- Deductions from There will be deductions for mortality and expense the Separate risks and administrative fees. (See Contract Account Schedule I and II). -------------------------------------------------------------------------------- Deduction from Purchase Payment(s) are subject to a deduction for Purchase premium taxes, effective date if any. (See 3.01.) Payment(s) -------------------------------------------------------------------------------- Surrender There will be a charge deducted upon surrender. (See Fee Contract Schedule I). This Contract is a legal contract and constitutes the entire legal relationship between Aetna and the Contract Holder. READ THIS CONTRACT CAREFULLY. This Contract sets forth, in detail, all of the cancellation will be determined by the postmark date on the properly addressed rights and postage-paid return packageobligations of both you and Aetna. We will promptly return the THEREFORE, IT IS IMPORTANT THAT YOU READ THIS CONTRACT CAREFULLY. Contract Value plus any amounts Schedule I Accumulation Period Separate Account -------------------------------------------------------------------------------- Separate Account: Variable Annuity Account B Charges to Separate A daily charge is deducted from your Purchase Payments before they were applied any portion of the Account: Current Value allocated to this Contractthe Separate Account. The amount returned may be more or less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification deduction is the daily equivalent of the Contract 3 Non-Participating 3 Incontestability 3 Application annual effective percentage shown in the following chart: Administrative Charge 0.15% Mortality Risk Charge 0.35% Expense Risk Charge 0.90% ----- Total Separate Account Charges 1.40% ALIAC Guaranteed Account (AG Account) -------------------------------------------------------------------------------- Minimum Guaranteed 3.0% (effective annual rate of Law 3 Form Approval 3 Assignment 3 Protection return) Interest Rate: Separate Account and AG Account -------------------------------------------------------------------------------- Transfers: An unlimited number of Proceeds 4 Minimum Values 4 Reports 4 Error Transfers are allowed during the Accumulation Period. Aetna allows 12 free Transfers in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of any calendar year. Thereafter, Aetna reserves the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments right to charge $10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12for each subsequent Transfer.

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You The Contract Holder may cancel this Contract within [ 10 ] days after you receive of receiving it by returning it this Contract along with a written notice to our administrative office, Aetna at the above address or to the agent who sold from whom it was purchased. Within 7 days after it receives the notice of cancellation and this Contract at its Home Office, Aetna will return the entire consideration paid plus any increase or minus any decrease in the current value of any funds allocated to youthe Separate Account. This page, with a written request for cancellationthe following pages, and the application make up the entire Contract. If you return it by mail, effective date of Signed at the cancellation will be determined by the postmark date Home Office on the properly addressed and postageEffective Date. /s/ Xxxx X. Xxxxxxx /s/ Xxxxxx X. Xxxxxxx Xxxx X. Xxxxxxx Xxxxxx X. Xxxxxxx President Secretary Multiple Asset Portfolio (MAP) V-paid return packageAllocated Group Annuity Contract Nonparticipating ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. We will promptly return the Contract Value plus any amounts deducted from your Purchase Payments before they were applied to this ContractTHIS CONTRACT CONTAINS MARKET VALUE ADJUSTMENT FORMULAS. The amount returned may be more or less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE APPLICATION OF A DEFINITIONS 1 PARTIES MARKET VALUE ADJUSTMENT TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of GAA MAY RESULT IN EITHER AN INCREASE OR DECREASE IN THE CURRENT VALUE. THE MARKET VALUE ADJUSTMENT FORMULA DOES NOT APPLY TO A GUARANTEED TERM AT THE TIME OF ITS MATURITY. APPLICATION OF A MARKET VALUE ADJUSTMENT TO THE FIXED ACCOUNT MAY RESULT IN A DECREASE IN THE CURRENT VALUE. SPECIFICATIONS (continued) GUARANTEED There are guaranteed interest rates for amounts held INTEREST RATE in the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of Fixed Account and the Variable Account 5 Variable Account Value 6 Guaranteed Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12Account. (See 4.02 and 4.03(d).)

Right to Cancel. YOU HAVE THE RIGHT TO RETURN If for any reason the owner is not satisfied with this Contract, he or she may return it to the Company within 10 days from the date of receipt. It may be returned by delivering or mailing it to the Company. If returned, this Contract shall be deemed void from the Contract Date. The Company will refund any Purchase Payments made and allocated to the Fixed Account and will refund Separate Account Contract Value as of the date the returned policy is received by the Company. Signed for Security Benefit Life Insurance Company on the Contract Date. RXXXX X. VXXXX XXXXXX R. XXXXXX Secretary President A BRIEF DESCRIPTION OF THIS CONTRACT This is a FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY CONTRACT. You * Purchase Payments may cancel this Contract within [ 10 ] days after you receive it by returning it to our administrative office, be made until the earlier of the Annuity Start Date or termination of the Contract. * A Death Benefit may be paid prior to the agent who sold it Annuity Start Date according to you, with a written request for cancellationthe Contract provisions. If you return it by mail, effective date of the cancellation will be determined by the postmark date * Annuity Payments begin on the properly addressed and postage-paid return package. We will promptly return Annuity Start Date using the Contract Value plus any amounts deducted from your Purchase Payments before they were applied to method specified in this Contract. * This Contract is Participating. ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND MAY INCREASE OR DECREASE IN ACCORDANCE WITH THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT. THERE ARE NO GUARANTEED MINIMUM PAYMENTS OR CASH VALUES. (SEE "CONTRACT VALUE AND EXPENSE PROVISIONS" AND "ANNUITY PAYMENT PROVISIONS" FOR DETAILS.) SECURITY BENEFIT LIFE INSURANCE COMPANY A Member of The amount returned may be more or less than your Security Benefit Group of Companies P.O. Box 750497, Topeka, KS 66675-0497 700 XX Xxxxxxxx Street, Topeka, KS 66636-0001 1-000-000-0000 TABLE OF CONTENTS Page DEFINITIONS 4-6 GENERAL PROVISIONS 7, 8 The Contract 7 Compliance 7 Misstatement of Age 7 Evidence of Survival 7 Incontestability 7 Assignment 7 Transfers 8 Claims of Creditors 8 Nonforfeiture Values 8 Participation 8 Statements 8 OWNERSHIP, ANNUITANT AND BENEFICIARY PROVISIONS 9 Ownership 9 Joint Ownership 9 Annuitant 9 Primary and Secondary Beneficiaries 9 Ownership and Beneficiary Changes 9 PURCHASE PAYMENT PROVISIONS 10 Flexible Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 XxxxxPayments 10 Purchase Payment Limitations 10 Purchase Payment Allocation 10 Place of Payment 10 CONTRACT VALUE AND EXPENSE PROVISIONS 10-12 Contract Value 10 Fixed Account Contract Value 10 Fixed Account Interest Crediting 11 Separate Account Contract Value 11 Accumulation Unit Value 11 Determining Accumulation Units 11 Mortality and Expense Risk Charge 12 Premium Tax Expense 12 Administrative Charge 12 Mutual Fund Expenses 12 WITHDRAWAL PROVISIONS 12, Xxxxxxxxxx13 Withdrawals 12, Xxxxxxx 00000 ICC1113 Withdrawal Value 13 Systematic Withdrawals 13 Date of Request 13 Payment of Withdrawal Benefits 13 DEATH BENEFIT PROVISIONS 14, 15 Death Benefit 14 Proof of Death 14 Distribution Rules 14, 15 ANNUITY PAYMENT PROVISIONS 15-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 18 Annuity Start Date 15 Change of Owner 2 Beneficiary 2 Annuity Start Date 15 Annuity Start Amount 15 Annuity Tables 16 Annuity Payments 16 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Annuity Option 16 Fixed Annuity Payments 5 Allocation of Purchase 16 Variable Annuity Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 16 Annuity Units 16, 17 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment 17 Alternate Annuity Option Rates 17 Annuity Options 18 ANNUITY TABLES 19 AMENDMENTS OR ENDORSEMENTS, if any DEFINITIONS (Continued) SEPARATE ACCOUNT Variable Annuity Account VIII (the "Separate Account") is a separate account established and maintained by the Company under Kansas law. The Separate Account is registered with the Securities and Exchange Commission under the Investment Company Act of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death 1940 as a Unit Investment Trust. It was established by the Company to support variable annuity contracts. The Company owns the assets of the Annuitant 8 Death Benefit 8 Payment Separate Account and maintains them apart from the assets of its general account and its other separate accounts. The assets held in the Separate Account equal to the reserves and other Contract liabilities with respect to the Separate Account may not be charged with liabilities arising from any other business the Company may conduct. Income and realized and unrealized gains and losses from assets in the Separate Account are credited to, or charged against, the Separate Account without regard to the income, gains or losses from the Company's general account or its other separate accounts. The Separate Account is divided into Subaccounts shown on page 3. Income and realized and unrealized gains and losses from assets in each Subaccount are credited to, or charged against, the Subaccount without regard to income, gains or losses in the other Subaccounts. The Company has the right to transfer to its general account any assets of the Death Benefit 9 Suspension or Delay Separate Account that are in Payment excess of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity the reserves and other Contract liabilities with respect to the Separate Account. The value of the assets in the Separate Account on each Valuation Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection are determined at the end of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12each Valuation Date.

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within [ 10 ] days after you receive it by returning it to our administrative office, or to the agent who sold it to you, with a written request for cancellation. If you return it by mail, effective date of the cancellation will be determined by the postmark date on the properly addressed and postage-paid return package. We will promptly return the Contract Value plus any amounts deducted from your Purchase Payments before they were applied to this Contract. The amount returned may be more or less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 1212 [ VA00000001 ] [ February 1, 2012 ]

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within [ 10 ] days after you receive it by returning it to our administrative office, or to the agent who sold it to you, with a written request for cancellation. If you return it by mail, effective date of the cancellation will be determined by the postmark date on the properly addressed and postage-paid return package. We will promptly return the Contract Value plus any amounts deducted from your Purchase Payments before they were applied to this Contract. The amount returned may be more or less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW WX [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12

Right to Cancel. YOU HAVE THE RIGHT TO RETURN If for any reason the Owner is not satisfied with this Contract, he or she may return it to the Company within 10 days from the date of receipt. It may be returned by delivering or mailing it to the Company. If returned, this Contract shall be deemed void from the Contract Date. The Company will refund any Purchase Payment made and allocated to the Fixed Account and will refund Separate Account Value (including any premium taxes) as of the date the returned policy is received by the Company. Signed for Security Benefit Life Insurance Company on the Contract Date. XXXXX X. XXXXX XXXXXX X. XXXXXX Secretary President A BRIEF DESCRIPTION OF THIS CONTRACT This is a SINGLE PREMIUM IMMEDIATE VARIABLE ANNUITY CONTRACT. You may cancel this Contract within [ 10 ] days after you receive it by returning it to our administrative office, or to the agent who sold it to you, with a written request for cancellation. If you return it by mail, effective date of the cancellation will be determined by the postmark date * Annuity Payments begin on the properly addressed and postage-paid return package. We will promptly return Annuity Payout Date using the Contract Value plus any amounts deducted from your Purchase Payments before they were applied to method specified in this Contract. ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT WHEN BASED ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND MAY INCREASE OR DECREASE IN ACCORDANCE WITH THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT. (SEE "ACCOUNT VALUE AND EXPENSE PROVISIONS" AND "ANNUITY PAYMENT PROVISIONS" FOR DETAILS.) (SBL LOGO) SECURITY BENEFIT LIFE INSURANCE COMPANY A Member of The amount returned may be more or less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ Security Benefit Group of Companies 000 XX Xxxxxxxx Street, Topeka, KS 66636-0001 0-000-000-0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11for Customer Service V6027 (8-VDA98) -------------------------------------------------------------------------------- TABLE OF CONTENTS -------------------------------------------------------------------------------- Page CONTRACT SPECIFICATIONS..................................... 3 DEFINITIONS................................................. 4-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 127

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You The Contract Holder may cancel this Contract within [ 10 ] calendar days after you receive of receiving it by returning it to our administrative officeALIAC at the address shown above, or to the agent who sold from whom it was purchased. Within seven calendar days of receiving the cancellation request at its Home Office, ALIAC will return any Contributions received, plus any increase, or minus any decrease in value, on the amount, if any, allocated to youthe Separate Account. Contributions to the Guaranteed Accumulation Account will be returned, with subject to a written request for cancellationMarket Value Adjustment, which may be positive or negative. Signed at the Home Office on the Effective Date. /s/ Xxxxxx X. XxXxxxxxx /s/ Xxxxx Xxxxxxx Xxxxxxx President Secretary THE VARIABLE FEATURES OF THIS CONTRACT ARE DESCRIBED IN SECTIONS 3 AND 11. ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. AMOUNTS ALLOCATED TO THE GUARANTEED ACCUMULATION ACCOUNT, IF WITHDRAWN BEFORE A GUARANTEED TERM MATURITY DATE, MAY BE SUBJECT TO A MARKET VALUE ADJUSTMENT. THE MARKET VALUE ADJUSTMENT MAY RESULT IN AN INCREASE, OR A DECREASE, IN THE INDIVIDUAL ACCOUNT VALUE. AMOUNTS ALLOCATED TO THE FIXED PLUS ACCOUNT ARE NOT AVAILABLE AS A LUMP SUM WITHDRAWAL, OTHER THAN DUE TO DEATH, SEPARATION FROM SERVICE, OR RETIREMENT, OR AS OTHERWISE ALLOWED BY THE CONTRACT. VARIABLE ANNUITY ASSUMED ANNUAL NET RETURN RATE - ANNUITY PHASE If a Variable Annuity is chosen, an assumed annual net return rate of 5.0% may be elected. If you 5.0% is not elected, we will use an assumed annual net return it by mail, effective date rate of the cancellation will be determined by the postmark date on the properly addressed and postage-paid return package. We will promptly return the Contract Value plus any amounts deducted from your Purchase Payments before they were applied to this Contract3.5%. The amount returned may be more or less than your Purchase Paymentsdaily net return rate factor for an assumed annual net return rate of 3.5% per year is 0.9999058. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 XxxxxThe daily net return rate factor for an assumed annual net return rate 5.0% per year is 0.9998663. If the portion of a Variable Annuity payment for any Fund is not to decrease, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of Annuity return factor under the Variable Separate Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12for that Fund must be:

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You The Owner may cancel surrender this Contract within [ 10 ] days after you receive it contract by returning delivering or mailing it to our administrative officethe Company at its Servicing Office (or, or if applicable, to the agent who sold or agency office through which it was delivered) within 10 days after receipt by the Owner of this contract. Receipt by the Owner of this contract will be deemed to youoccur (i) on the date the Company sends an electronic mail message ("e-mail") to the Owner's address as provided confirming that this contract is available to be viewed on the website used by the Company for document delivery or (ii) if applicable, with a written request for cancellationon the fifth day after this contract has been placed in the U.S. Mail, first class postage prepaid, addressed to the Owner. If you return it by mailUpon exercise of this Right to Cancel, effective date We will refund the sum of (i) the Accumulated Value at the end of the Valuation Period immediately preceding cancellation notice and (ii) the sum of all charges made with respect to this contract. Any Premium(s) received during this Right to Cancel period will be determined by allocated to the postmark date on Money Market Variable Investment Option. Signed for the properly addressed Company at Boston, Massachusetts. /s/ Xxxxxxxx X. Xxxxxxx /s/ Xxxxx Xxxxxxxxxxx ------------------- ----------------- President Secretary Flexible Premium Variable Deferred Annuity Nonparticipating Initial premium is shown in Section 1. This form is a legal contract between the Applicant and postage-paid return packagethe Insurer. We will promptly return the Contract Value plus any amounts deducted from your Purchase Payments before they were applied to Read this Contractcontract carefully. The amount returned may be more or less than your Purchase PaymentsTHE BENEFITS, PAYMENTS AND ACCUMULATED VALUE UNDER THIS CONTRACT, WHEN BASED ON THE INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND NOT GUARANTEED AS TO DOLLAR AMOUNT. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE VALUES OF THE VARIABLE INVESTMENT OPTIONS MAY INCREASE OR DECREASE. SEE SECTION 8 FOR DETAILS. 00DVA VA0100 CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12Numerical Guide Section

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You FREE LOOK PROVISION -- At any time within 10 days of receiving this contract you may cancel this Contract within [ 10 ] days after you receive it by returning return it to our administrative office, us or to the agent who sold through whom it was purchased. Immediately upon our receipt, this contract will be voided as if it had never been in force. All purchase payments allocated to you, with a written request for cancellation. If you return it by mail, effective date the General Account plus the Separate Account contract value computed at the end of the cancellation valuation period following our receipt of this contract will then be refunded within ten days. We agree to pay an annuity to the annuitant provided the annuitant is living and this contract is in force on the annuity date. We further agree to pay the death benefit prior to the annuity date upon the death of the owner or the annuitant when a death benefit is payable. Payment will be determined by made upon our receipt of due proof of death and the postmark date on return of this contract. This contract is issued in consideration of the properly addressed attached application and postage-paid return package. We will promptly return payment of the Contract Value plus any amounts deducted from your Purchase Payments before they were applied to this Contractinitial purchase payment. The amount returned may be more or less than your Purchase Paymentsprovisions on this cover and the pages that follow are part of this contract. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 XxxxxSigned for Kempxx Xxxestors Life Insurance Company at its home office in Long Grove, XxxxxxxxxxIllinois. ALL BENEFITS, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED UPON THE INVESTMENT EXPERIENCE OF THE SUBACCOUNTS, ARE VARIABLE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. REFER TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of AND ANNUITY PERIOD PROVISIONS FOR A DETERMINATION OF ANY VARIABLE BENEFITS. This is a legal contract between the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 owner and Kempxx Xxxestors Life Insurance Company. READ YOUR CONTRACT CAREFULLY L-1000 (6/93) L-1000 (6/93) INDEX PAGE ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12OPTION TABLE ......................................... Follows Page 7

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You The Contract Holder may cancel this Contract within [ 10 ] days after you receive it by returning it to our administrative officethe agent from whom it was purchased, or to Aetna at the agent who sold it address shown above. Within seven days of receiving the Contract at its home office, Aetna will return the amount of Certificate Holder Purchase Payment(s) received, plus any increase, or minus any decrease, on the amount, if any, allocated to youthe Separate Account fund(s). This page and the pages that follow constitute the entire Contract. Signed at the home office on the Effective Date. /s/Xxxxxx Xxxxxxx /s/Xxxxx X. Xxxxxxxxx President Secretary Individual Variable, with Fixed, or Combination Annuity Contract Nonparticipating ALL PAYMENTS AND VALUES PROVIDED BY THE CONTRACT, WHEN BASED ON INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. THIS CONTRACT CONTAINS A MARKET VALUE ADJUSTMENT FORMULA. APPLICATION OF A MARKET VALUE ADJUSTMENT MAY RESULT IN EITHER AN INCREASE OR DECREASE IN THE CURRENT VALUE. THE MARKET VALUE ADJUSTMENT FORMULA DOES NOT APPLY TO A GUARANTEED TERM AT THE TIME OF ITS MATURITY. Specifications -------------------------------------------------------------------------------- Guaranteed There is a written request guaranteed interest rate for cancellationPurchase Interest Rate Payment(s) held in the AG Account. If you return it by mail(See Contract Schedule I). -------------------------------------------------------------------------------- Deductions from There will be deductions for mortality and expense the Separate risks and administrative fees. (See Contract Account Schedule I and II). -------------------------------------------------------------------------------- Deduction from Purchase Payment(s) are subject to a deduction for Purchase premium taxes, effective date if any. (See 3.01.) Payment(s) -------------------------------------------------------------------------------- Surrender There will be a charge deducted upon surrender. (See Fee Contract Schedule I). This Contract is a legal contract and constitutes the entire legal relationship between Aetna and the Contract Holder. READ THIS CONTRACT CAREFULLY. This Contract sets forth, in detail, all of the cancellation will be determined by the postmark date on the properly addressed rights and postage-paid return packageobligations of both you and Aetna. We will promptly return the THEREFORE, IT IS IMPORTANT THAT YOU READ THIS CONTRACT CAREFULLY. Contract Value plus any amounts Schedule I Accumulation Period Separate Account -------------------------------------------------------------------------------- Separate Account: Variable Annuity Account B Charges to Separate A daily charge is deducted from your Purchase Payments before they were applied any portion of the Account: Current Value allocated to this Contractthe Separate Account. The amount returned may be more or less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification deduction is the daily equivalent of the Contract 3 Non-Participating 3 Incontestability 3 Application annual effective percentage shown in the following chart: Administrative Charge 0.15% Mortality Risk Charge 0.35% Expense Risk Charge 0.90% ----- Total Separate Account Charges 1.40% ALIAC Guaranteed Account (AG Account) -------------------------------------------------------------------------------- Minimum Guaranteed 3.0% (effective annual rate of Law 3 Form Approval 3 Assignment 3 Protection return) Interest Rate: Separate Account and AG Account -------------------------------------------------------------------------------- Transfers: An unlimited number of Proceeds 4 Minimum Values 4 Reports 4 Error Transfers are allowed during the Accumulation Period. Aetna allows 12 free Transfers in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of any calendar year. Thereafter, Aetna reserves the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments right to charge $10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12for each subsequent Transfer.

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You This Contract may cancel this Contract be returned for any reason within [ 10 [10] days after you receive it by returning it mailing or delivering the Contract to our administrative office, either us or to the agent insurance producer who sold it to youit. Return of this Contract by mail is effective on being postmarked, with a written request for cancellation. If you return it by mail, effective date of the cancellation will be determined by the postmark date on the properly addressed and postage-paid return packagepostage prepaid. We will promptly return the refund your [Contract Value plus any amounts fees or charges deducted from under the Contract] as of the Business Day we receive your Purchase Payments before they were applied to this Contract. The amount returned Your Contract Value may be more or less than your Purchase PaymentsPayment. VALUES AND DETERMINATION OF ANNUITY PAYMENTS PROVIDED BY THIS CONTRACT, WHEN BASED ON THE VALUE OF THE INDEX ACCOUNT OPTIONS, ARE VARIABLE, MAY INCREASE OR DECREASE, AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. INDIVIDUAL SINGLE PREMIUM DEFERRED ANNUITY CONTRACT WITH INDEX-LINKED INTEREST OPTION Signed for Symetra Life Insurance Company, at its Bellevue, Washington office on the Issue Date. [ xxx.Xxxxxxxxxx.xxx ] [ ] [Margxxxx X. Xxxxxxx] [Jacqxxxxxx X. Xxxxxxxxx] [President] [Secretary] PLEASE CONTACT SYMETRA AT [1-800-000-0000] XYMETRA LIFE INSURANCE COMPANY Home Office: Administrative Office: [777 000xx Xxx XX Xxxxx 0000 Xxxxxxx 000 Xxxxx[PO Box 34690 Bellevue, XxxxxxxxxxWA 98004] Seattle, Xxxxxxx 00000 ICC11WA 98124] [Phone 1-VDA800-P-2006C000-WW [ 12/11 0000] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire [www.xxxxxxx.xxx] XEFINITIONS Accumulation Phase The period beginning on the Contract 3 Modification Date shown on your Contract Data Page and ending on the Annuity Date. Adjusted Index Return The Index Return, after the application of the Indexed Interest Cap and either the Indexed Interest Buffer or the Indexed Interest Floor. Allocation Date The date when the Purchase Payment is allocated to the Fixed Account or one or more Indexed Account(s) for the initial Interest Term. The Allocation Date will be the next 7th or 21st calendar day of a month, whichever occurs first after the Contract 3 Non-Participating 3 Incontestability 3 Application Date. If this date is not a Business Day, the Allocation Date will be the next Business Day. Annuitant The natural person(s) on whose life (or lives) Annuity Payments under the Contract are based and is shown on your Contract Data Page. You are the Annuitant unless you designate someone else before the Annuity Date. If there is a joint Annuitant, the term Annuitant as used in the Contract includes the joint Annuitant named on the application, unless changed. Annuity Date The date that the Income Phase begins. Annuity Payments A series of Law 3 Form Approval 3 Assignment 3 Protection periodic payments under the Contract that begins on the Annuity Date and continues for a specified period of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts time. Base Value The amount used to calculate an Indexed Account’s (a) Interim Value, and (b) Indexed Interest at the end of the Variable Interest Term. On the first day of the Interest Term, the Base Value is the amount allocated to the Indexed Account. During the Interest Term the Base Value equals the amount allocated to the Indexed Account 5 Variable on the first day of the Interest Term reduced for any partial withdrawals from the Indexed Account based on the proportion of the Indexed Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender that was withdrawn. The Base Value 8 Suspension is not a cash value under the Contract. Beneficiary The person(s) or Delay in Payment of Surrender entity (or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of entities), designated by the Annuitant 8 Death Benefit 8 Payment of Owner(s) to receive the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12Benefit. Business Day Any day that the New York Stock Exchange (“NYSE”) is open for regular trading. A Business Day ends at the same time that regular trading on the NYSE closes (typically, 4:00 pm Eastern Time).

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You The Group Contract Holder may cancel this Contract within [ 10 ] days after you receive it by returning it to our administrative officethe agent from whom it was purchased, or to Aetna at the agent who sold it address shown above. Within seven days of receiving the Contract at its home office, Aetna will return the amount of Certificate Holder Purchase Payment(s) received, plus any increase, or minus any decrease, on the amount, if any, allocated to youthe Separate Account fund(s). This page and the pages that follow constitute the entire Contract. Signed at the home office on the Effective Date. /s/ Xxxxxx Xxxxxxx /s/ Xxxxx X. XxXxxx ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, with WHEN BASED ON INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. THIS CONTRACT CONTAINS A MARKET VALUE ADJUSTMENT FORMULA. APPLICATION OF A MARKET VALUE ADJUSTMENT MAY RESULT IN EITHER AN INCREASE OR DECREASE IN THE CURRENT VALUE. THE MARKET VALUE ADJUSTMENT FORMULA DOES NOT APPLY TO A GUARANTEED TERM AT THE TIME OF ITS MATURITY. G-MP2(5/96) <PAGE> Specifications - -------------------------------------------------------------------------------- Guaranteed There is a written request guaranteed interest rate for cancellationPurchase Interest Rate Payment(s) held in the AG Account. (See Contract - -------------------------------------------------------------------------------- Deductions from There will be deductions for mortality and expense the Separate risks and administrative fees. (See Contract Account Schedule I and II). - -------------------------------------------------------------------------------- Deduction from Purchase Payment(s) are subject to a deduction for Purchase premium taxes, if any. (See 3.01.) Payment(s) - -------------------------------------------------------------------------------- Surrender There will be a charge deducted upon surrender. (See Fee Contract Schedule I). This Contract is a legal contract and constitutes the entire legal relationship between Aetna and the Contract Holder. READ THIS CONTRACT CAREFULLY. This Contract sets forth, in detail, all of the rights and obligations of both you and Aetna. THEREFORE, IT IS IMPORTANT THAT YOU READ THIS CONTRACT CAREFULLY. <PAGE> Contract Schedule I Accumulation Period Separate Account - -------------------------------------------------------------------------------- Separate Account: Variable Annuity Account I Charges to Separate A daily charge is deducted from any portion of the Account: Current Value allocated to the Separate Account. The deduction is the daily equivalent of the annual effective percentage shown in the following chart: Administrative Charge 0.15% Mortality Risk Charge 0.35% Expense Risk Charge 0.90% ----- Charges 1.40% AICA Guaranteed Account (AG Account) - -------------------------------------------------------------------------------- Minimum Guaranteed 3.0% (effective annual rate of return) Interest Rate: Separate Account and AG Account - -------------------------------------------------------------------------------- Transfers: An unlimited number of Transfers are allowed during the Accumulation Period. Aetna allows 12 free Transfers in any calendar year. Thereafter, Aetna reserves the right to charge $10 for each Maintenance Fee: The annual Maintenance Fee is $30. If you return it by mailthe Account's Current Value is $50,000 or more on the date the Maintenance Fee is to be deducted, effective date of the cancellation <PAGE> Contract Schedule I (Continued) Accumulation Period Separate Account and AG Account (Cont'd) - -------------------------------------------------------------------------------- Surrender Fee: For each surrender, the Surrender Fee will be determined by the postmark date on the properly addressed and postage-paid return package. We will promptly return the Contract Value plus any amounts deducted as follows: Length of Time from your Deposit of Net of Net Purchase Payments before they were applied to this Contract. The amount returned may be Purchase Payment (Years) Payment) ------------------------ -------- Less than 2 years 7% 2 or more or but less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification 4 years 6% 4 or more but less than 5 years 5% 5 or more but less than 6 years 4% 6 or more but less than 7 years 3% 7 years or more 0% Systematic Withdrawal The specified payment or specified percentage may Option (SWO): not be greater than 10% of the Contract 3 Non-Participating 3 Incontestability 3 Application Account's Current Value at time of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12election. See 1. GENERAL DEFINITIONS for explanations. <PAGE>

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel return this Contract within [ 10 ] days after you receive it by returning it to our administrative office, or to the agent who sold it to you, with a written request for cancellationit. If you return it by mail, effective date of the cancellation will be determined by the postmark date on the properly addressed and postage-paid return package. We will promptly You may return the Contract Value plus by delivering or mailing it to SBL. This Contract will then be deemed void from the beginning. No withdrawal charge will be imposed, and we will refund your Contract Value, including any amounts fees and/or charges for Premium tax that were deducted from your Purchase Payments before they were applied to this that Contract Value, less the value of any Credit Enhancements made into the Contract, as of the date we receive the returned Contract. The amount returned may be more or less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Signed for Security Benefit Life Insurance Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of on the Contract 3 Date. {J. Michael Keefer} {Kris A. Robbins} Xxxxxxxxx President A BRIEF DESCRIPTION OF THIS CONTRACT This is a FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY CONTRACT. * Investment Experience is Reflected in Benefits * Variable and Fixed Accumulation Before the Annuity Start Date; Variable and Fixed Annuity Payments Thereafter * Death Benefit Proceeds are Payable Before the Annuity Start Date * This Contract is Non-Participating 3 Incontestability 3 Application BENEFITS AND VALUES PROVIDED BY THIS CONTRACT MAY BE ON A VARIABLE BASIS. AMOUNTS DIRECTED INTO ONE OR MORE OF THE SUBACCOUNTS WILL REFLECT THE INVESTMENT EXPERIENCE OF THOSE SUBACCOUNTS. THESE AMOUNTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. (SEE "CONTRACT VALUE AND EXPENSE PROVISIONS" AND "ANNUITY PAYMENT PROVISIONS" FOR DETAILS.) Security Benefit Life Insurance Company One Security Benefit Plxxx, Xxxxxx, XX 00000-0000 1-800-888-2461 The varixxxx xxxxxxx xovered by this Contract is the subject of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error a pending patent application in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Subthe United States Patent and Trademark Office. V6029 (11-Accounts of the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 1200) -------------------------------------------------------------------------------- TABLE OF CONTENTS -------------------------------------------------------------------------------- Page CONTRACT DATA PAGE................................... 25 DEFINITIONS.......................................... 4

Right to Cancel. YOU HAVE THE RIGHT TO RETURN If for any reason the Owner is not satisfied with this Contract, he or she may return it to the Company within 10 days from the date of receipt. It may be returned by delivering or mailing it to the Company. If returned, this Contract shall be deemed void from the Contract Date. The Company will refund any Purchase Payment made and allocated to the Fixed Account and will refund Separate Account Value (including any premium taxes) as of the date the returned policy is received by the Company. Signed for Security Benefit Life Insurance Company on the Contract Date. ROGER K. VIOLA XXXXXX X. XXXXXX Secretary President A BRIEF DESCRIPTION OF THIS CONTRACT This is a SINGLE PREMIUM IMMEDIATE VARIABLE ANNUITY CONTRACT. You may cancel this Contract within [ 10 ] days after you receive it by returning it to our administrative office, or to the agent who sold it to you, with a written request for cancellation. If you return it by mail, effective date of the cancellation will be determined by the postmark date * Annuity Payments begin on the properly addressed and postage-paid return package. We will promptly return Annuity Payout Date using the Contract Value plus any amounts deducted from your Purchase Payments before they were applied to method specified in this Contract. ALL PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT WHEN BASED ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND MAY INCREASE OR DECREASE IN ACCORDANCE WITH THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT. (SEE "ACCOUNT VALUE AND EXPENSE PROVISIONS" AND "ANNUITY PAYMENT PROVISIONS" FOR DETAILS.) (SBL LOGO) SECURITY BENEFIT LIFE INSURANCE COMPANY A Member of The amount returned may be more or less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 XxxxxSecurity Benefit Group of Companies 700 SW Harrison Strexx, XxxxxxxxxxXxxxxx, Xxxxxxx 00000 ICC11XX 66636-VDA0001 1-P-2006C800-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE 469-6587 for Cxxxxxxx Xxxxxxe V6027 (8-98) -------------------------------------------------------------------------------- TABLE OF CONTENTS -------------------------------------------------------------------------------- Page CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant SPECIFICATIONS..................................... 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of the Contract 3 NonDEFINITIONS................................................. 4-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 127

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within [ 10 ] days after you receive it by returning it to our administrative office, or to the agent who sold it to you, with a written request for cancellation. If you return it by mail, effective date of the cancellation will be determined by effective on the postmark date on the properly addressed and postage-paid return packageenvelope. We will promptly return the your Contract Value plus any amounts deducted from your Purchase Payments before they were applied to this ContractValue. The This amount returned may be more or less than your Purchase PaymentsPayment. In states where specifically required, we will promptly return the greater of your Purchase Payment, or the Contract Value. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11SG-VDARILA-P-2006C-WW P-2017 [ 12/11 4/20 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 3 Annuitant 2 3 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 4 Separate Account 4 Assignment 3 4 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 5 Settlement 4 5 Receipt of Payment 4 5 Premium Tax 4 Written 5 Notice 4 5 PURCHASE PAYMENTS PAYMENT AND ALLOCATION INSTRUCTIONS 5 Purchase Payments Payment 5 Allocation of Purchase Payments 5 VARIABLE Instructions 6 Reallocating Contract Value on Maturity Dates 6 HOLDING ACCOUNT 5 7 Holding Account 7 Crediting Interest 7 Holding Account Value 7 THE STRATEGIES 8 Strategies, Generally 8 Strategy Elements 8 Confirming Your Strategy Elections 9 HOW WE USE THE REFERENCE INDEXES 9 Reference Index 9 Unavailability of, or Substantial Change to an Index 9 Index Performance 9 STRATEGY PERFORMANCE AND VESTING 9 Strategy Performance 9 Vesting Factor 10 STRATEGY BASE AND STRATEGY VALUE 10 General Description 5 Sub-Accounts of the Variable Account 5 Variable Account 10 Base (Strategy Base) 10 Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 (Strategy Value) 11 XXXXXXXXXXX AND SURRENDERS AND WITHDRAWALS 8 Surrenders 8 11 Withdrawals 8 Surrender 11 Important Considerations Regarding Withdrawals 11 Market Value 8 Adjustment (“MVA”) and Withdrawal Charge 12 MVA and Withdrawal Charge Waivers 12 Calculating Amounts Associated with a Withdrawal (or Surrender) Request 12 Prompt Payment and Suspension or Delay in Payment of Withdrawal or Surrender or Withdrawal 8 13 DEATH BENEFIT 8 13 Death of an Owner 8 13 Death of the Annuitant 8 13 Death Benefit 8 13 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY 13 INCOME PAYMENTS 9 14 Annuity Date 9 Annuity 14 Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 14 Selection of the Annuity Option 10 14 Annuity Options 11 14 Minimum Amounts 11 15 Guaranteed Purchase Rates 11 15 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 1215 ENDORSEMENTS AND RIDERS following contract page 15 [ IMG00000001 ] [ August 20, 2018 ] [ $50,000.00 ] [ Non-Qualified ] [ Xxxx Xxx ] [ October 15, 1952 ] [ None ] [ Not Applicable ] [ Xxxx Xxx ] [ October 15, 1952 ] As contained in our records [ Optional — Return of Purchase Payment ] [ Xxxxx Agent ] [ October 15, 2047 ] [ Brisk Financial Services ] [ 0000 Xxxx Xxxxxx ] INSURANCE REGULATORY AUTHORITY [ Anycity, Anystate 12345 ] [ Anystate Department of Insurance ] [ 000-000-0000 ] [ 000-000-0000 ] [ xxxxxxx.xxx@xxxxxxxx.xxx ]

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within [ 10 ] days after you receive it by returning it to our administrative office, or to the agent who sold it to you, with a written request for cancellation. If you return it by mail, effective date of the cancellation will be determined by the postmark date on the properly addressed and postage-paid return package. We will promptly return the Contract Value plus any amounts deducted from your Purchase Payments before they were applied to this Contract. The amount returned may be more or less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You This Contract may cancel this Contract be returned for any reason within [ 10 [10] days after you receive it by returning it mailing or delivering the Contract to our administrative office, either us or to the agent who sold it to youit. Return of this Contract by mail is effective on being postmarked, with a written request for cancellationproperly addressed and postage prepaid. If you return it by mailWe will promptly refund your Account Value, plus the sum of all fees, taxes, and charges deducted from the Purchase Payment as of the effective date of the cancellation will be determined by the postmark date Free Look on the properly addressed and postage-paid return package. We will promptly return the Contract Value plus any amounts deducted from Business Day we receive your Purchase Payments before they were applied to this Contract. The amount returned Your Account Value may be more or less than your Purchase PaymentsPayment. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 XxxxxBased on the maximum yearly Asset-Based Insurance Charges, Xxxxxxxxxx, Xxxxxxx 00000 ICC11the smallest yearly rate of investment return required to ensure that the dollar amount of variable annuity payments does not decrease is [4.35%]. The smallest yearly rate of investment return is equal to the assumed interest rate (AIR) plus the maximum yearly Asset-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification Based Insurance Charge during the payout phase of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 Contract. Signed for the Company. [/s/ Illegible Secretary] [/s/ Illegible President] ------------- ------------- 6010 (3/07) NOTICE: ------- DETAILS OF THE SEPARATE ACCOUNT PROVISIONS ON PAGE 6 INDIVIDUAL FLEXIBLE PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 PAYMENT DEFERRED VARIABLE ANNUITY TABLES 12CONTRACT NONPARTICIPATING READ YOUR CONTRACT CAREFULLY ANNUITY PAYMENTS, DEATH BENEFITS, WITHDRAWAL VALUES AND ANY OTHER CONTRACT VALUE PROVIDED BY THIS CONTRACT, WHEN BASED ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE, MAY INCREASE OR DECREASE IN ACCORDANCE WITH FLUCTUATIONS IN THE NET INVESTMENT FACTOR, AS APPLICABLE, AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT, UNLESS OTHERWISE SPECIFIED. 6010 (3/07) TABLE OF CONTENTS Contract Schedule........................................................... [3 Definitions................................................................. 4

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You The Contract Holder may cancel this Contract within [ 10 ] calendar days after you receive of receiving it by returning it to our administrative officeALIAC at the address shown above, or to the agent who sold from whom it was purchased. Within seven calendar days of receiving the cancellation request at its Home Office, ALIAC will return any Contributions received, plus any increase, or minus any decrease in value, on the amount, if any, allocated to youthe Separate Account. Contributions to the Guaranteed Accumulation Account will be returned, with subject to a written request for cancellationMarket Value Adjustment, which may be positive or negative. Signed at the Home Office on the Effective Date. /s/ Xxxxxx X. XxXxxxxxx /s/ Xxxxx Xxxxxxx-Xxxxxxx President Secretary THE VARIABLE FEATURES OF THIS CONTRACT ARE DESCRIBED IN SECTIONS 3 AND 11. ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. AMOUNTS ALLOCATED TO THE GUARANTEED ACCUMULATION ACCOUNT, IF WITHDRAWN BEFORE A GUARANTEED TERM MATURITY DATE, MAY BE SUBJECT TO A MARKET VALUE ADJUSTMENT. THE MARKET VALUE ADJUSTMENT MAY RESULT IN AN INCREASE, OR A DECREASE, IN THE INDIVIDUAL ACCOUNT VALUE. AMOUNTS ALLOCATED TO THE FIXED PLUS ACCOUNT ARE NOT AVAILABLE AS A LUMP SUM WITHDRAWAL, OTHER THAN DUE TO DEATH, SEPARATION FROM SERVICE, OR RETIREMENT, OR AS OTHERWISE ALLOWED BY THE CONTRACT. VARIABLE ANNUITY ASSUMED ANNUAL NET RETURN RATE - ANNUITY PHASE If a Variable Annuity is chosen, an assumed annual net return rate of 5.0% may be elected. If you 5.0% is not elected, we will use an assumed annual net return it by mail, effective date rate of the cancellation will be determined by the postmark date on the properly addressed and postage-paid return package. We will promptly return the Contract Value plus any amounts deducted from your Purchase Payments before they were applied to this Contract3.5%. The amount returned may be more or less than your Purchase Paymentsdaily net return rate factor for an assumed annual net return rate of 3.5% per year is 0.9999058. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 XxxxxThe daily net return rate factor for an assumed annual net return rate 5.0% per year is 0.9998663. If the portion of a Variable Annuity payment for any Fund is not to decrease, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of Annuity return factor under the Variable Separate Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12for that Fund must be:

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You The Group Contract Holder may cancel this Contract within [ 10 ] days after you receive it by returning it to our administrative officethe agent from whom it was purchased, or to Aetna at the agent who sold it address shown above. Within seven days of receiving the Contract at its home office, Aetna will return the amount of Certificate Holder Purchase Payment(s) received, plus any increase, or minus any decrease, on the amount, if any, allocated to youthe Separate Account fund(s). This page and the pages that follow constitute the entire Contract. Signed at the home office on the Effective Date. /s/ Xxxxxx Xxxxxxx /s/ Xxxxx X. XxXxxx President Secretary Group Variable, with Fixed, or Combination Annuity Contract Nonparticipating ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. THIS CONTRACT CONTAINS A MARKET VALUE ADJUSTMENT FORMULA. APPLICATION OF A MARKET VALUE ADJUSTMENT MAY RESULT IN EITHER AN INCREASE OR DECREASE IN THE CURRENT VALUE. THE MARKET VALUE ADJUSTMENT FORMULA DOES NOT APPLY TO A GUARANTEED TERM AT THE TIME OF ITS MATURITY. G-MP2(5/96) Specifications -------------------------------------------------------------------------------- Guaranteed There is a written request guaranteed interest rate for cancellationPurchase Interest Rate Payment(s) held in the AG Account. If you return it by mail(See Contract Schedule I). -------------------------------------------------------------------------------- Deductions from There will be deductions for mortality and expense the Separate risks and administrative fees. (See Contract Account Schedule I and II). -------------------------------------------------------------------------------- Deduction from Purchase Payment(s) are subject to a deduction for Purchase premium taxes, effective date if any. (See 3.01.) Payment(s) -------------------------------------------------------------------------------- Surrender There will be a charge deducted upon surrender. (See Fee Contract Schedule I). This Contract is a legal contract and constitutes the entire legal relationship between Aetna and the Contract Holder. READ THIS CONTRACT CAREFULLY. This Contract sets forth, in detail, all of the cancellation will be determined by the postmark date on the properly addressed rights and postage-paid return packageobligations of both you and Aetna. We will promptly return the THEREFORE, IT IS IMPORTANT THAT YOU READ THIS CONTRACT CAREFULLY. Contract Value plus any amounts Schedule I Accumulation Period Separate Account -------------------------------------------------------------------------------- Separate Account: Variable Annuity Account I Charges to Separate A daily charge is deducted from your Purchase Payments before they were applied any portion of the Account: Current Value allocated to this Contractthe Separate Account. The amount returned may be more or less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification deduction is the daily equivalent of the Contract 3 Non-Participating 3 Incontestability 3 Application annual effective percentage shown in the following chart: Administrative Charge 0.15% Mortality Risk Charge 0.35% Expense Risk Charge 0.90% ----- Total Separate Account Charges 1.40% AICA Guaranteed Account (AG Account) -------------------------------------------------------------------------------- Minimum Guaranteed 3.0% (effective annual rate of Law 3 Form Approval 3 Assignment 3 Protection return) Interest Rate: Separate Account and AG Account -------------------------------------------------------------------------------- Transfers: An unlimited number of Proceeds 4 Minimum Values 4 Reports 4 Error Transfers are allowed during the Accumulation Period. Aetna allows 12 free Transfers in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of any calendar year. Thereafter, Aetna reserves the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments right to charge $10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12for each subsequent Transfer.

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within [ 10 ] ten days after you receive it by returning it the Contract to our administrative office, or to the agent who sold it to youthe Contract, with a written request for cancellation. If you return it Return of this Contract by mailmail is effective on being post-marked, effective date of the cancellation will be determined by the postmark date on the properly addressed and postagepostage pre-paid return packagepaid. We will promptly return the Contract Value plus any amounts amount deducted from your Purchase Payments before they were applied to this Contractfor premium taxes. The This amount returned may be more or less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ Xxxxxxx X. Xxxx Secretary Xxxx X. Xxxxx President Administrative Office: PROTECTIVE LIFE INSURANCE COMPANY 0000 Xxxxxxx 000 XxxxxXxxxx X. X. Box 10648 Birmingham, XxxxxxxxxxAlabama 35202-0648 (000) 000-0000 CONTRACT NUMBER PVA20000001 EFFECTIVE DATE May 15, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE 2001 OWNER Xxxx X. Xxx BIRTH DATE OF OWNER November 5, 1953 JOINT OWNER N/A DEFINITIONS BIRTH DATE OF JOINT OWNER N/A ANNUITANT Xxxx X. Xxx BIRTH DATE OF ANNUITANT November 5, 1953 BENEFICIARY As contained in our records ANNUITY COMMENCEMENT DATE November 5, 2043 INITIAL PURCHASE PAYMENT: {$100,000.00} ANNUAL EFFECTIVE INTEREST RATE FOR THE FIXED ACCOUNT ON THE EFFECTIVE DATE: {4.00%} ANNUAL EFFECTIVE INTEREST RATE FOR DCA FIXED ACCOUNT 1 PARTIES TO ON THE EFFECTIVE DATE: {5.00%} ANNUAL EFFECTIVE INTEREST RATE FOR DCA FIXED ACCOUNT 2 ON THE EFFECTIVE DATE: {4.50%} BENEFIT PACKAGE: {Standard} CONTRACT MAINTENANCE FEE: $30 The contract maintenance fee is deducted prior to the Annuity Commencement Date on each Contract Anniversary, and on any day that the Contract is surrendered other than the Contract Anniversary. The contract maintenance fee will be deducted from the Allocation Options in the same proportion as their values are to the Contract Value. The contract maintenance fee will be waived by the Company in the event the Contract Value or the aggregate Purchase Payments reduced by surrenders equals or exceeds $50,000 on the date the contract maintenance fee is to be deducted. MORTALITY AND EXPENSE RISK CHARGE: {1.25%} per annum prior to the Annuity Commencement Date, and 1.25% per annum on or after the Annuity Commencement Date. ADMINISTRATION CHARGE: 0.15% per annum. TRANSFER FEE: $25 per transfer in excess of 12 in any Contract Year. 1 6 % 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 5 % 3 Payee 3 GENERAL PROVISIONS 3 5 % 4 4 % 5 + 0 % {Fixed Account} {DCA Fixed Account 1} {DCA Fixed Account 2} {International Equity} {Small Cap Value} {Capital Growth} {CORE U.S. Equity} {Growth and Income} {Global Income} {Internet Tollkeeper} {New Discovery} {Emerging Growth} {Research} {Investors Growth Stock} {Utilities} {Investors Trust} {Growth Series} {Aggressive Growth} {Global Securities} {Capital Appreciation} {Main Street Growth & Income} {High Income} {Strategic Bond} {Money Fund} {Aggressive Growth} {Emerging Growth} {Enterprise} {Xxxxxxxx} {Growth and Income} {Strategic Stock} {Asset Allocation} {Social Small Cap Growth} {Social Balanced} {Worldwide Hard Assets} {Worldwide Real Estate} 4 TABLE OF CONTENTS Definitions 7 General Provisions 8 Entire Contract 3 8 Modification of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 8 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 8 Notice 8 Error in Age or Gender 4 8 Settlement 4 8 Receipt of Payment 4 8 Protection of Proceeds 8 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 8 Non-Participating 8 Minimum Values 9 Application of Law 9 Reports 9 Parties to the Contract 9 Company 9 Owner 9 Change of Owner 9 Beneficiary 9 Change of Beneficiary 9 Annuitant 9 Change of Annuitant 9 Payee 9 Purchase Payments 5 10 Purchase Payment 10 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 10 No Default 10 Guaranteed Account 10 Guaranteed Account Value 10 Variable Account 10 General Description 5 10 Sub-Accounts of the Variable Account 5 11 Variable Account Value 6 11 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 12 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 12 Surrenders 8 Withdrawals 8 13 Free Withdrawal Amount 13 Determining the Surrender Value 8 Charge 13 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 13 5 Death Benefit 13 Death of an Owner 8 13 Death of the Annuitant 8 13 Death Benefit 8 14 Suspension of Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 14 Annuitization 14 Annuity Commencement Date 9 14 Annuity Income Payments 9 14 Fixed Income Payments 9 14 Variable Income Payments 10 15 Annuity Unit Values 10 15 Selection of Annuity Option 10 Options 15 Annuity Options 11 15 Minimum Amounts 11 16 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 1216 Fixed Annuity Tables 16

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel return this Contract Annuity to our Office or to the representative who sold it to you for a refund within [ 10 ] ten days after you receive it it, or longer if required by returning it applicable law or regulation. It can be mailed or delivered either to us, at our administrative officeOffice, or to the agent representative who sold it to you. Return of this Annuity by mail is effective on being postmarked, with a written request for cancellation. If you return it by mail, effective date of the cancellation will be determined by the postmark date on the properly addressed and postage-paid return packagepostage prepaid. Unless otherwise required by applicable law or regulation, we determine the amount of the refund as of the Valuation Day we receive your refund request at our Office. We will promptly return the Contract Value plus recover any amounts deducted from your Purchase Payments before they were applied to Credits upon exercise of this Contractright. The amount of the refund will be the amount required to be returned may be more or less than your Purchase Paymentsin accordance with applicable law. [ xxx.Xxxxxxxxxx.xxx Signed for Pruco Life Insurance Company: [___________________] [ 0000 Xxxxxxx 000 Xxxxx[___________________] Secretary President INDIVIDUAL FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY NON-PARTICIPATING SUB-ACCOUNTS, XxxxxxxxxxFIXED RATE OPTIONS, Xxxxxxx 00000 ICC11AND MARKET VALUE ADJUSTED ("MVA") OPTIONS ALL MAY BE MADE AVAILABLE IN THE ACCUMULATION PERIOD ANY PAYMENTS AND VALUES PROVIDED UNDER THE SUB-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES ACCOUNTS ARE BASED ON THEIR INVESTMENT PERFORMANCE AND ARE, THEREFORE, NOT GUARANTEED. PLEASE REFER TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of the Contract 3 NonSECTION ENTITLED "ACCOUNT VALUE IN THE SUB-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE ACCOUNTS" FOR A MORE COMPLETE EXPLANATION. IN THE ACCUMULATION PERIOD ANY PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE AND VALUES PROVIDED UNDER THE MVA OPTIONS MAY BE SUBJECT TO A MARKET VALUE ADJUSTMENT. SUCH A MARKET VALUE ADJUSTMENT MAY INCREASE OR DECREASE ANY SUCH PAYMENTS OR VALUES. PLEASE REFER TO THE SECTION ENTITLED "ACCOUNT 5 General Description 5 Sub-Accounts of the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12VALUE OF THE MVA OPTIONS" FOR A MORE COMPLETE EXPLANATION. PAYOUT OPTIONS ARE SPECIFIED IN THE ANNUITY. OTHER OPTIONS MAY BE MADE AVAILABLE. TABLE OF CONTENTS

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within [ 10 ] days after you receive it by returning it to our administrative office, or to the agent who sold it to you, with a written request for cancellation. If you return it by mail, effective date of the cancellation will be determined by the postmark date on the properly addressed and postage-paid return package. We will promptly return the Contract Value plus any amounts deducted from your Purchase Payments before they were applied to this Contract. The amount returned may be more or less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ WX 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 1212 [ Contract Number ] [ Month Day, Year ] [ Owner 1 Name ] [ Month Day, Year ] [ Owner 2 Name or “None” ] [ Month Day, Year or “Not Applicable” ] [ Annuitant Name ] [ Month Day, Year ] As contained in our records [ Month Day, Year ] [ “Contract Value” or “Return of Purchase Payments” ] [ Agent Name ] [ State Department of Insurance Name ] [ Agency Name ] [ State DOI Phone ] [ Agency Street Address ] [ State DOI Email or Website ] [ Agency City State ZIP ] [ Agency Phone ] [ $nnn,nnn.nn ] [ Type of Qualified Plan or “Non-Qualified” ]

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You may cancel this Contract within [ 10 ] days after you receive it by returning it to our administrative office, or to the agent who sold it to you, with a written request for cancellation. If you return it by mail, effective date of the cancellation will be determined by the postmark date on the properly addressed and postage-paid return package. We will promptly return the Contract Value plus any amounts deducted from your Purchase Payments before they were applied to this Contract. The amount returned may be more or less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] Administrative Office: PROTECTIVE LIFE SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of the Variable Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12

Right to Cancel. YOU HAVE THE RIGHT TO RETURN THIS CONTRACT. You The Contract Holder may cancel this Contract within [ 10 ] days after you receive of receiving it by returning it this Contract along with a written notice to our administrative office, Aetna at the above address or to the agent who sold from whom it was purchased. Within 7 days after it receives the notice of cancellation and this Contract at its Home Office, Aetna will return the entire consideration paid. This page, the following pages, and the application make up the entire Contract. Signed at the Home Office on the Effective Date. /s/Xxxxxx Xxxxxxx /s/Xxxxx X. Xxxxxxxxx President Secretary Group Variable, Fixed, or Combination Annuity Contract Nonparticipating ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. THIS CONTRACT CONTAINS A MARKET VALUE ADJUSTMENT FORMULA. APPLICATION OF A MARKET VALUE ADJUSTMENT MAY RESULT IN EITHER AN INCREASE OR DECREASE IN THE CURRENT VALUE. THE MARKET VALUE ADJUSTMENT FORMULA DOES NOT APPLY TO A GUARANTEED TERM AT THE TIME OF ITS MATURITY. Specifications -------------------------------------------------------------------------------- Guaranteed There is a guaranteed interest rate for Purchase Payment(s) Interest Rate held in the ALIAC Guaranteed Account (see Contract Schedule I). -------------------------------------------------------------------------------- Deductions from There will be deductions for mortality and expense risks and the Separate administrative fees (see Contract Schedule I and II). Account -------------------------------------------------------------------------------- Deduction from Purchase Payment(s) are subject to youa deduction for premium Purchase taxes, with if any (see 3.01). Payment(s) -------------------------------------------------------------------------------- Surrender There will be a written request for cancellationcharge deducted upon surrender (see Contract Fee Schedule I). If you return it by mailThis Contract is a legal contract and constitutes the entire legal relationship between Aetna and the Contract Holder. READ THIS CONTRACT CAREFULLY. This Contract sets forth, effective date in detail, all of the cancellation will be determined by the postmark date on the properly addressed rights and postage-paid return packageobligations of both you and Aetna. We will promptly return the IT IS THEREFORE IMPORTANT THAT YOU READ THIS CONTRACT CAREFULLY. Contract Value plus any amounts Schedule I Accumulation Period Separate Account -------------------------------------------------------------------------------- Separate Account: Variable Annuity Account B Charges to Separate A daily charge is deducted from your Purchase Payments before they were applied any portion of the Account: Current Value allocated to this Contractthe Separate Account. The amount returned may be more or less than your Purchase Payments. [ xxx.Xxxxxxxxxx.xxx ] [ 0000 Xxxxxxx 000 Xxxxx, Xxxxxxxxxx, Xxxxxxx 00000 ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE CONTRACT 2 Company 2 Owner 2 Change of Owner 2 Beneficiary 2 Change of Beneficiary 2 Annuitant 2 Change of Annuitant 3 Payee 3 GENERAL PROVISIONS 3 Entire Contract 3 Modification deduction is the daily equivalent of the Contract 3 Non-Participating 3 Incontestability 3 Application of Law 3 Form Approval 3 Assignment 3 Protection of Proceeds 4 Minimum Values 4 Reports 4 Error annual effective percentage shown in Age or Gender 4 Settlement 4 Receipt of Payment 4 Premium Tax 4 Written Notice 4 PURCHASE PAYMENTS 5 Purchase Payments 5 Allocation of Purchase Payments 5 VARIABLE ACCOUNT 5 General Description 5 Sub-Accounts of the Variable following chart: Administrative Charge 0.15% Mortality Risk Charge 0.35% Expense Risk Charge 0.90% ----- Total Separate Account 5 Variable Account Value 6 Accumulation Unit Values 6 Net Investment Factor 7 TRANSFERS 7 Transfers 7 Limitation on Frequent Transfers 7 Dollar Cost Averaging 7 SURRENDERS AND WITHDRAWALS 8 Surrenders 8 Withdrawals 8 Surrender Value 8 Suspension or Delay in Payment of Surrender or Withdrawal 8 DEATH BENEFIT 8 Death of an Owner 8 Death of the Annuitant 8 Death Benefit 8 Payment of the Death Benefit 9 Suspension or Delay in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments 10 Annuity Unit Values 10 Selection of Annuity Option 10 Annuity Options 11 Minimum Amounts 11 Guaranteed Purchase Rates 11 FIXED ANNUITY TABLES 12 VARIABLE ANNUITY TABLES 12Charges 1.40%