Common use of RIGHT TO EXAMINE CONTRACT Clause in Contracts

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the sum of (1) gross payments, less any amounts allocated to the Variable Account, (2) the Accumulated Value of amounts allocated to the Variable Account on the date the returned contract is received at the Principal Office and (3) any fees or other charges imposed on the amounts allocated to the Variable Account. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or the gross payments. ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: Dover, Delaware Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the initial payment shown on the Specifications page. Additional payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefits beginning on the Annuity Date or to pay a death benefit to the Beneficiary if an Owner dies prior to the Annuity Date. FLEXIBLE PAYMENT DEFERRED VARIABLE AND FIXED ANNUITY NON-PARTICIPATING 1 TABLE OF CONTENTS SPECIFICATIONS........................................................... 3 DEFINITIONS.............................................................. 5

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the sum Accumulated Value, after application of (1) gross paymentsany Market Value Adjustment, less any amounts allocated to the Variable Account, (2) the Accumulated Value of amounts allocated to the Variable Account on the date the returned contract is received at the Principal Office and (3) plus any fees or other charges imposed on the amounts allocated to the Variable Accountimposed. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or the gross payments. ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: Dover, Delaware Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the initial payment Initial Payment shown on the Specifications page. Additional payments Payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefits benefit payments beginning on the Annuity Date or to pay a death benefit Death Benefit to the Beneficiary if an Owner dies prior to the Annuity Date. FLEXIBLE PAYMENT DEFERRED VARIABLE AND FIXED ANNUITY NON/s/ Xxxxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxx President Secretary Flexible Payment Deferred Variable and Fixed Annuity Annuity Benefit Payments Payable on the Annuity Date Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date Non-PARTICIPATING Participating Form A3036-01 1 BACS11 TABLE OF CONTENTS SPECIFICATIONS........................................................... SPECIFICATIONS ............................................................. 3 DEFINITIONS.............................................................. 5DEFINITIONS ................................................................ 9 OWNER, ANNUITANT AND BENEFICIARY ........................................... 11

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the sum Accumulated Value, after application of (1) gross paymentsany Market Value Adjustment, less any amounts allocated to the Variable Account, (2) the Accumulated Value of amounts allocated to the Variable Account on the date the returned contract is received at the Principal Office and (3) plus any fees or other charges imposed on the amounts allocated to the Variable Accountimposed. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or the gross paymentspayment. ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: Dover, Delaware Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the initial payment Initial Payment shown on the Specifications page. Additional payments Payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefits benefit payments beginning on the Annuity Date or to pay a death benefit Death Benefit to the Beneficiary if an Owner dies prior to the Annuity Date. FLEXIBLE PAYMENT DEFERRED VARIABLE AND FIXED ANNUITY NONFlexible Payment Deferred Variable and Fixed Annuity Annuity Benefit Payments Payable on the Annuity Date Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date Non-PARTICIPATING Participating FORM A3035-00 1 TABLE OF CONTENTS SPECIFICATIONS........................................................... Table of Contents SPECIFICATIONS .................................................................................3 DEFINITIONS.............................................................. 5.....................................................................................7

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the sum of (1) gross payments, less any amounts allocated to the Variable Account, (2) the Accumulated Value of amounts allocated to the Variable Account on the date the returned contract is received at the Principal Office and (3) any fees or other charges imposed on the amounts allocated to the Variable Account. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or the gross payments. ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: Dover, Delaware Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the initial payment shown on the Specifications page. Additional payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefits beginning on the Annuity Date or to pay a death benefit to the Beneficiary if an Owner dies prior to the Annuity Date. FLEXIBLE PAYMENT DEFERRED VARIABLE AND FIXED ANNUITY NON/s/Xxxxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxxxxx President Secretary Flexible Payment Deferred Variable and Fixed Annuity Non-PARTICIPATING 1 Participating TABLE OF CONTENTS SPECIFICATIONS........................................................... ...............................................3 DEFINITIONS.............................................................. ..................................................5

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the sum Accumulated Value, after application of (1) gross paymentsany Market Value Adjustment, less any amounts allocated to the Variable Account, (2) the Accumulated Value of amounts allocated to the Variable Account on the date the returned contract is received at the Principal Office and (3) plus any fees or other charges imposed on the amounts allocated to the Variable Accountimposed. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or the gross payments. ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: Dover, Delaware Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the initial payment Initial Payment shown on the Specifications page. Additional payments Payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefits benefit payments beginning on the Annuity Date or to pay a death benefit Death Benefit to the Beneficiary if an Owner dies prior to the Annuity Date. FLEXIBLE PAYMENT DEFERRED VARIABLE AND FIXED ANNUITY NONPresident Secretary Flexible Payment Deferred Variable and Fixed Annuity Annuity Benefit Payments Payable on the Annuity Date Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date Non-PARTICIPATING Participating Form A3033-00 1 TABLE OF CONTENTS SPECIFICATIONS........................................................... SPECIFICATONS ........................................................3 DEFINITIONS.............................................................. 5...........................................................7

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the sum of (1) gross payments, less any amounts allocated to the Variable Account, (2) the Accumulated Value of amounts allocated to the Variable Account on the date the returned contract is received at the Principal Office and (3) any fees or other charges imposed on the amounts allocated to the Variable Account. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or the gross payments. FIRST ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: DoverWorcester, Delaware Massachusetts Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between First Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the initial payment shown on the Specifications page. Additional payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefits beginning on the Annuity Date or to pay a death benefit to the Beneficiary if an Owner dies prior to the Annuity Date. FLEXIBLE PAYMENT DEFERRED VARIABLE AND FIXED ANNUITY NON-PARTICIPATING 1 TABLE OF CONTENTS SPECIFICATIONS........................................................... 3 DEFINITIONS.............................................................. 5

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the sum Accumulated Value, after application of (1) gross paymentsany Market Value Adjustment, less any amounts allocated to the Variable Account, (2) the Accumulated Value of amounts allocated to the Variable Account on the date the returned contract is received at the Principal Office and (3) plus any fees or other charges imposed on the amounts allocated to the Variable Accountimposed. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or the gross payments. ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: Dover, Delaware Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the initial payment Initial Payment shown on the Specifications page. Additional payments Payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefits benefit payments beginning on the Annuity Date or to pay a death benefit Death Benefit to the Beneficiary if an Owner dies prior to the Annuity Date. FLEXIBLE PAYMENT DEFERRED VARIABLE AND FIXED ANNUITY NON/s/ Xxxxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxx President Secretary Flexible Payment Deferred Variable and Fixed Annuity Annuity Benefit Payments Payable on the Annuity Date Death Benefit Payable to Beneficiary if Owner Dies prior to Annuity Date Non-PARTICIPATING Participating Form A3036-01 1 BACS11 TABLE OF CONTENTS SPECIFICATIONS........................................................... SPECIFICATIONS ............................................................. 3 DEFINITIONS.............................................................. 5DEFINITIONS ................................................................ 9

RIGHT TO EXAMINE CONTRACT. The Owner may cancel this contract by returning it to the Company or one of its authorized representatives within ten days after receipt. If returned, the Company will refund an amount equal to the sum of (1) gross payments, less any amounts allocated to the Variable Account, (2) the Accumulated Value of amounts allocated to the Variable Account on the date the returned contract is received at the Principal Office and (3) any fees or other charges imposed on the amounts allocated to the Variable Account. If, however, the contract is issued as an Individual Retirement Annuity (IRA), the Company will refund the greater of the above or the gross payments. ALLMERICA FINANCIAL LIFE INSURANCE AND ANNUITY COMPANY Home Office: Dover, Delaware Principal Office: 000 Xxxxxxx Xxxxxx, Xxxxxxxxx, Xxxxxxxxxxxxx 00000 This is a legal contract between Allmerica Financial Life Insurance and Annuity Company (the Company) and the Owner and is issued in consideration of the initial payment shown on the Specifications page. Additional payments are permitted. Payments may be allocated to Variable Sub-Accounts, the Fixed Account or Guarantee Period Accounts. While this contract is in effect, the Company agrees to pay annuity benefits beginning on the Annuity Date or to pay a death benefit to the Beneficiary if an Owner dies prior to the Annuity Date. /s/ Xxxxxxx X. Xxxxxxx /s/ Xxxxxxx X. Xxxxxxxxx --------------------- ---------------------- President Secretary FLEXIBLE PAYMENT DEFERRED VARIABLE AND FIXED ANNUITY NON-PARTICIPATING 1 TABLE OF CONTENTS SPECIFICATIONS........................................................... 3 DEFINITIONS.............................................................. 5