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. [ ▇▇▇.▇▇▇▇▇▇▇▇▇▇.▇▇▇ ] [ ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇ ▇▇▇▇▇ 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 to youaddress shown above. Within seven days of receiving the Contract at its home office, with a written request for cancellation. If you Aetna will return it by mailthe amount of Certificate Holder Purchase Payment(s) received, effective date of the cancellation will be determined by the postmark date plus any increase, or minus any decrease, on the properly addressed amount, if any, allocated to the Separate Account fund(s). This page 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 pages that follow constitute the entire Contract. The amount returned may be more or less than your Purchase PaymentsSigned at the home office on the Effective Date. [ /s/▇▇▇.▇▇▇▇▇▇▇▇▇▇.▇▇▇ ] [ ▇▇▇▇ ▇▇▇▇▇▇▇ /s/▇▇▇▇▇ ▇▇▇▇▇, . ▇▇▇▇▇▇▇▇▇▇▇ President Secretary Group Variable, ▇▇▇▇▇▇▇ ▇▇▇▇▇ ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE Fixed, or Combination Annuity Contract Nonparticipating ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON INVESTMENT EXPERIENCE OF A DEFINITIONS 1 PARTIES 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 Interest Rate Payment(s) held in the AG Account. (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, 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 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 CAREFULLY. This Contract 3 Modification 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. 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 Schedule I Accumulation Period Separate Account -------------------------------------------------------------------------------- Separate Account: Variable Annuity Account B Charges to Separate A daily charge is deducted from any portion of the Variable Account 5 Variable Account Account: Current 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 allocated to the Separate Account. The deduction is the daily equivalent of the Annuitant 8 Death Benefit 8 Payment 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 return) Interest Rate: Separate Account and AG Account -------------------------------------------------------------------------------- Transfers: An unlimited number of Transfers are allowed during the Death Benefit 9 Suspension or Delay Accumulation Period. Aetna allows 12 free Transfers in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments any calendar year. Thereafter, Aetna reserves the 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 return this Contract Annuity to our Office or to the representative who solicited its purchase for a refund within [ 10 ] ten days after you receive it or longer if required by returning it to our administrative office, applicable law 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 Contractregulation. The amount returned may be more or of the refund will equal not less than the Account Value as of the date we receive the cancellation request plus any tax charge deducted. You bear the investment risk during this period. However, if required by applicable law or regulation, the amount we refund is the greater of; (1) the Purchase Payment and (2) the current Account Value of the Annuity plus any tax charge deducted. If under applicable law we are required to return not less than the Purchase Payment, we may elect to allocate your Purchase PaymentsAccount Value to a money-market investment option during the period this Right to Cancel provision applies to your Annuity. [ ▇▇▇.▇▇▇▇▇▇▇▇▇▇.▇▇▇ ] [ ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇ ▇▇▇▇▇Signed for PRUDENTIAL ANNUITIES LIFE ASSURANCE CORPORATION: ------------------------------ President INDIVIDUAL DEFERRED ANNUITY NON-PARTICIPATING VARIABLE AND FIXED INVESTMENT OPTIONS IN THE ACCUMULATION PERIOD IN THE ACCUMULATION PERIOD ANY PAYMENTS AND VALUES PROVIDED UNDER THE VARIABLE INVESTMENT OPTIONS ARE BASED ON THEIR INVESTMENT PERFORMANCE AND ARE, ▇▇▇▇▇▇▇▇▇▇THEREFORE, ▇▇▇▇▇▇▇ ▇▇▇▇▇ ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES 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 FIXED INVESTMENT 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 SubVALUE OF THE FIXED ALLOCATIONS" FOR A MORE COMPLETE EXPLANATION. N-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 12ASP/IND(04/02)-01 1 RBRND08 TABLE OF CONTENTS DEFINITIONS................................................................ 5

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 postage-paid return packageEffective Date. 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. [ /s/ ▇▇▇.▇ ▇. ▇▇▇▇▇▇▇ /s/ ▇▇▇▇.▇▇▇ ] [ ▇▇▇▇ . ▇▇▇▇▇▇▇ ▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇, . ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ ICC11▇. ▇▇▇▇▇▇▇ President Secretary Multiple Asset Portfolio (MAP) V-VDA-P-2006C-WW [ 12/11 ] SCHEDULE Allocated Group Annuity Contract Nonparticipating ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON INVESTMENT EXPERIENCE OF A DEFINITIONS 1 PARTIES SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. THIS CONTRACT CONTAINS MARKET VALUE ADJUSTMENT FORMULAS. APPLICATION OF A 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 THIS CONTRACTIf 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. You It may cancel be returned by delivering or mailing it to the Company. If returned, this Contract within [ 10 ] days after you receive it by returning it to our administrative office, or shall be deemed void from the Contract Date. The Company will refund any Purchase Payments made and allocated to the agent who sold it to you, with a written request for cancellation. If you return it by mail, effective date Fixed Account and will refund Separate Account Contract Value as of the cancellation will be determined date the returned policy is received by the postmark date Company. Signed for Security Benefit Life Insurance Company on the properly addressed and postage-paid return packageContract Date. 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. [ R▇▇▇.▇ ▇▇▇▇▇▇▇▇▇▇.▇▇▇ ] [ . V▇▇▇▇ ▇▇▇▇▇▇ R. ▇▇▇▇▇▇ Secretary President A BRIEF DESCRIPTION OF THIS CONTRACT This is a FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY CONTRACT. * Purchase Payments may be made until the earlier of the Annuity Start Date or termination of the Contract. * A Death Benefit may be paid prior to the Annuity Start Date according to the Contract provisions. * Annuity Payments begin on the Annuity Start Date using the 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 Security Benefit Group of Companies P.O. Box 750497, Topeka, KS 66675-0497 7▇▇ ▇▇ ▇▇▇▇▇▇▇▇ Street, Topeka, KS 66636-0001 1-▇▇▇-▇▇▇▇▇▇▇, ▇▇▇-▇▇▇▇ ▇▇▇▇▇ ICC11TABLE OF CONTENTS Page DEFINITIONS 4-VDA6 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 10 Purchase Payment Limitations 10 Purchase Payment Allocation 10 Place of Payment 10 CONTRACT VALUE AND EXPENSE PROVISIONS 10-P-2006C12 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, 13 Withdrawals 12, 13 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-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 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 to youaddress shown above. Within seven days of receiving the Contract at its home office, with a written request for cancellation. If you Aetna will return it by mailthe amount of Certificate Holder Purchase Payment(s) received, effective date of the cancellation will be determined by the postmark date plus any increase, or minus any decrease, on the properly addressed amount, if any, allocated to the Separate Account fund(s). This page 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 pages that follow constitute the entire Contract. The amount returned may be more or less than your Purchase PaymentsSigned at the home office on the Effective Date. [ /s/ ▇▇▇.▇▇▇▇▇▇▇▇▇▇.▇▇▇ ] [ ▇▇▇▇ ▇▇▇▇▇▇▇ /s/ ▇▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇, ▇. ▇▇▇▇▇▇ ▇▇▇▇▇ ICC11President 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. G-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE MP2(5/96) Specifications -------------------------------------------------------------------------------- Guaranteed There is a guaranteed interest rate for Purchase Interest Rate Payment(s) held in the AG Account. (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, 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 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 CAREFULLY. This Contract 3 Modification 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. 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 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 Variable Account 5 Variable Account Account: Current 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 allocated to the Separate Account. The deduction is the daily equivalent of the Annuitant 8 Death Benefit 8 Payment 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 return) Interest Rate: Separate Account and AG Account -------------------------------------------------------------------------------- Transfers: An unlimited number of Transfers are allowed during the Death Benefit 9 Suspension or Delay Accumulation Period. Aetna allows 12 free Transfers in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments any calendar year. Thereafter, Aetna reserves the 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 it by returning it to our administrative officethe agent from whom it was purchased, or to Aetna at the agent who sold it to youaddress shown above. Within seven days of receiving the Contract at its home office, with a written request for cancellation. If you Aetna will return it by mailthe amount of Certificate Holder Purchase Payment(s) received, effective date of the cancellation will be determined by the postmark date plus any increase, or minus any decrease, on the properly addressed amount, if any, allocated to the Separate Account fund(s). This page 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 pages that follow constitute the entire Contract. The amount returned may be more or less than your Purchase PaymentsSigned at the home office on the Effective Date. [ /s/▇▇▇.▇▇▇▇▇▇▇▇▇▇.▇▇▇ ] [ ▇▇▇▇ ▇▇▇▇▇▇▇ /s/▇▇▇▇▇ ▇▇▇▇▇, . ▇▇▇▇▇▇▇▇▇▇▇ President Secretary Individual Variable, ▇▇▇▇▇▇▇ ▇▇▇▇▇ ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE Fixed, or Combination Annuity Contract Nonparticipating ALL PAYMENTS AND VALUES PROVIDED BY THE CONTRACT, WHEN BASED ON INVESTMENT EXPERIENCE OF A DEFINITIONS 1 PARTIES 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 Interest Rate Payment(s) held in the AG Account. (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, 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 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 CAREFULLY. This Contract 3 Modification 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. 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 Schedule I Accumulation Period Separate Account -------------------------------------------------------------------------------- Separate Account: Variable Annuity Account B Charges to Separate A daily charge is deducted from any portion of the Variable Account 5 Variable Account Account: Current 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 allocated to the Separate Account. The deduction is the daily equivalent of the Annuitant 8 Death Benefit 8 Payment 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 return) Interest Rate: Separate Account and AG Account -------------------------------------------------------------------------------- Transfers: An unlimited number of Transfers are allowed during the Death Benefit 9 Suspension or Delay Accumulation Period. Aetna allows 12 free Transfers in Payment of Death Benefit 9 ANNUITY INCOME PAYMENTS 9 Annuity Date 9 Annuity Income Payments 9 Fixed Income Payments 9 Variable Income Payments any calendar year. Thereafter, Aetna reserves the 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 to youwas purchased. Within 7 days after it receives the notice of cancellation and this Contract at its Home Office, with a written request for cancellationAetna will return the entire consideration paid. If you return it by mailThis page, effective date of the cancellation will be determined by following pages, and the postmark date application make up the entire Contract. Signed at the Home Office on the properly addressed and postage-paid return packageEffective Date. 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. [ /s/▇▇▇.▇▇▇▇▇▇▇▇▇▇.▇▇▇ ] [ ▇▇▇▇ ▇▇▇▇▇▇▇ /s/▇▇▇▇▇ ▇▇▇▇▇, . ▇▇▇▇▇▇▇▇▇▇▇ President Secretary Group Variable, ▇▇▇▇▇▇▇ ▇▇▇▇▇ ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE Fixed, or Combination Annuity Contract Nonparticipating ALL PAYMENTS AND VALUES PROVIDED BY THE GROUP CONTRACT, WHEN BASED ON INVESTMENT EXPERIENCE OF A DEFINITIONS 1 PARTIES 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 a deduction for premium Purchase taxes, if any (see 3.01). Payment(s) -------------------------------------------------------------------------------- Surrender There will be a charge deducted upon surrender (see Contract Fee Schedule I). This Contract is a legal contract and constitutes the entire legal relationship between Aetna and the Contract Holder. READ THIS 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 CAREFULLY. This Contract 3 Modification sets forth, in detail, all of the rights and obligations of both you and Aetna. IT IS THEREFORE IMPORTANT THAT YOU READ THIS CONTRACT CAREFULLY. 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 Schedule I Accumulation Period Separate Account -------------------------------------------------------------------------------- Separate Account: Variable Annuity Account B Charges to Separate A daily charge is deducted from any portion of the Variable Account 5 Variable Account Account: Current 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 allocated to the Separate Account. The deduction is the daily equivalent of the Annuitant 8 Death Benefit 8 Payment of annual effective percentage shown in 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 12following chart: Administrative Charge 0.15% Mortality Risk Charge 0.35% Expense Risk Charge 0.90% ----- Total Separate Account Charges 1.40%

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 to you, with a written request for cancellationwas purchased. If you return it by mail, effective date 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 the Separate Account. Contributions to the Guaranteed Accumulation Account will be determined by returned, subject to a Market Value Adjustment, which may be positive or negative. Signed at the postmark date Home Office on the properly addressed and postage-paid return packageEffective Date. 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. [ /s/ ▇▇▇.▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ /s/ ▇▇.▇▇▇ ] [ ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇ ▇▇▇▇▇ ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES 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 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 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 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 VALUE. AMOUNTS ALLOCATED TO THE FIXED ANNUITY TABLES 12 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 TABLES 12ASSUMED 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 5.0% is not elected, we will use an assumed annual net return rate of 3.5%. The daily net return rate factor for an assumed annual net return rate of 3.5% per year is 0.9999058. The 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, the Annuity return factor under the Separate Account for that Fund must be:

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. [ ] [ ] [Marg▇▇▇.▇ ▇. ▇▇▇▇▇▇▇] [Jacq▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇] [President] [Secretary] PLEASE CONTACT SYMETRA AT [1-80▇-▇▇▇-▇▇▇▇] ▇YMETRA LIFE INSURANCE COMPANY Home Office: Administrative Office: [777 ▇▇▇▇▇ ▇▇▇ ▇▇ ▇▇▇▇▇ ▇▇▇▇ [PO Box 34690 Bellevue, WA 98004] Seattle, WA 98124] [Phone 1-80▇-▇▇▇-▇▇▇▇] [www.▇▇▇▇▇▇▇.▇▇▇ ▇] [ ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇ ▇▇▇▇▇EFINITIONS Accumulation Phase The period beginning on the Contract Date shown on your Contract Data Page and ending on the Annuity Date. Adjusted Index Return The Index Return, ▇▇▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇ ▇▇▇▇▇ 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 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 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. [ ▇▇▇.▇▇▇▇▇▇▇▇▇▇.▇▇▇ ] [ ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇ ▇▇▇▇▇Based on the maximum yearly Asset-Based Insurance Charges, ▇▇▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇ ▇▇▇▇▇ 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 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 and postage-paid return packageCompany at Boston, Massachusetts. 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. [ /s/ ▇▇▇.▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ /s/ ▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇.▇▇▇ ] [ ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇ ▇▇▇▇▇------------------- ----------------- 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 the Insurer. Read this contract carefully. THE BENEFITS, ▇▇▇▇▇▇▇▇▇▇PAYMENTS AND ACCUMULATED VALUE UNDER THIS CONTRACT, ▇▇▇▇▇▇▇ ▇▇▇▇▇ ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE WHEN BASED ON THE INVESTMENT EXPERIENCE OF A DEFINITIONS 1 PARTIES SEPARATE ACCOUNT, ARE VARIABLE AND NOT GUARANTEED AS TO DOLLAR AMOUNT. 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. [ ▇▇▇.▇▇▇▇▇▇▇▇▇▇.▇▇▇ ] [ ▇▇Signed for Kemp▇▇ ▇▇▇▇▇▇▇ ▇estors Life Insurance Company at its home office in Long Grove, Illinois. ALL BENEFITS, 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 VARIABLE ACCOUNT AND ANNUITY PERIOD PROVISIONS FOR A DETERMINATION OF ANY VARIABLE BENEFITS. This is a legal contract between the owner and Kemp▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇ ▇▇▇▇▇ ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE estors Life Insurance Company. READ YOUR 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 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 ] 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 to you, with a written request for cancellationwas purchased. If you return it by mail, effective date 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 the Separate Account. Contributions to the Guaranteed Accumulation Account will be determined by returned, subject to a Market Value Adjustment, which may be positive or negative. Signed at the postmark date Home Office on the properly addressed and postage-paid return packageEffective Date. 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. [ /s/ ▇▇▇.▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇ /s/ ▇▇.▇▇▇ ] [ ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇, -▇▇▇▇▇▇▇ ▇▇▇▇▇ ICC11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES 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 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 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 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 VALUE. AMOUNTS ALLOCATED TO THE FIXED ANNUITY TABLES 12 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 TABLES 12ASSUMED 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 5.0% is not elected, we will use an assumed annual net return rate of 3.5%. The daily net return rate factor for an assumed annual net return rate of 3.5% per year is 0.9999058. The 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, the Annuity return factor under the Separate Account for 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 to youaddress shown above. Within seven days of receiving the Contract at its home office, with a written request for cancellation. If you Aetna will return it by mailthe amount of Certificate Holder Purchase Payment(s) received, effective date of the cancellation will be determined by the postmark date plus any increase, or minus any decrease, on the properly addressed amount, if any, allocated to the Separate Account fund(s). This page 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 pages that follow constitute the entire Contract. The amount returned may be more or less than your Purchase PaymentsSigned at the home office on the Effective Date. [ /s/ ▇▇▇.▇▇▇▇▇▇▇▇▇▇.▇▇▇ ] [ ▇▇▇▇ ▇▇▇▇▇▇▇ /s/ ▇▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇, ▇. ▇▇▇▇▇▇ ▇▇▇▇▇ ICC11ALL 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-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE MP2(5/96) <PAGE> Specifications - -------------------------------------------------------------------------------- Guaranteed There is a guaranteed interest rate for Purchase 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 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 CAREFULLY. This Contract 3 Modification 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 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 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 Variable Account 5 Variable Account Account: Current 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 allocated to the Separate Account. The deduction is the daily equivalent of the Annuitant 8 Death Benefit 8 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 the Account's Current Value is $50,000 or more on the date the Maintenance Fee is to be deducted, the <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 as follows: Length of Time from Deposit of Net of Net Purchase Purchase Payment (Years) Payment) ------------------------ -------- Less than 2 years 7% 2 or more but less than 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 Death Benefit 9 Suspension or Delay in Payment Account's Current Value at time 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 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. [ ▇▇▇.▇▇▇▇▇▇▇▇▇▇.▇▇▇ Signed for Pruco Life Insurance Company: [___________________] [ ▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇ ▇▇▇▇▇[___________________] Secretary President INDIVIDUAL FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY NON-PARTICIPATING SUB-ACCOUNTS, ▇▇▇▇▇▇▇▇▇▇FIXED RATE OPTIONS, ▇▇▇▇▇▇▇ ▇▇▇▇▇ 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 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 PaymentsSigned for Security Benefit Life Insurance Company on the Contract Date. [ ▇▇▇.{J. Michael Keefer} {Kris A. Robbins} ▇▇▇▇▇▇▇▇▇ 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 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 Pl▇▇.▇, ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇ ] [ 1-800-888-2461 The vari▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇ ▇▇▇▇▇ ICC11overed by this Contract is the subject of a pending patent application in the United States Patent and Trademark Office. V6029 (11-VDA-P-2006C-WW [ 12/11 ] SCHEDULE A DEFINITIONS 1 PARTIES TO THE 00) -------------------------------------------------------------------------------- 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 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 12DATA PAGE................................... 25 DEFINITIONS.......................................... 4