Secretary President. (and Corporate Seal – either print stamped or embossed – if embossed, must be leaded sufficiently to be visible in a PDF file reproduction)
Secretary President. The value received_________________________________hereby sell, assign and transfer unto____________________________________________________________________ ________________________________________________________________Shares represented by the within Certificate, and do hereby irrevocable constitute and appoint ________________________________________________Attoney to transfer the said Stock on the books of the within named Corporation with full power of substitution in the premises. Dated__________, 20_____________. In presence of ________________________________
Secretary President. Endorsement Effective Date (If Other Than Issue Date) 00-00000-00 FSB212 (4-94) SP 02121
Secretary President. About This Booklet
Secretary President. A BRIEF DESCRIPTION OF THIS CONTRACT This is a Single Payment Joint and Last Survivor Life Annuity. Income is payable for the lifetime of either of the Annuitants. The Contract is nonparticipating. ALL INCOME PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT, WHEN BASED ON INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO FIXED DOLLAR AMOUNT. FORM 1174
Secretary President. Checked by Under this contract, flexible premium payments may be made in accordance with the Premiums section of this contract. On the Annuity Commencement Date, GIAC will begin to make annuity payments. Benefits depend, among other things, on the number and value of Accumulation Units and the annuity payout option elected. Death benefit proceeds are payable before the Annuity Commencement Date. ALL VALUES PROVIDED BY THIS CONTRACT WHICH ARE BASED ON THE INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT ARE VARIABLE, MAY INCREASE OR DECREASE DAILY, AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT. SEE THE ACCUMULATION VALUE AND PAYMENT OF CONTRACT PROCEEDS SECTIONS FOR A DESCRIPTION OF THE VARIABLE VALUES AND PAYMENTS PROVIDED UNDER THIS CONTRACT. FREE LOOK PERIOD: The Owner has the right to examine this contract and return it for cancellation to our Customer Service Office or to the agent from whom it was purchased within [10] days after receiving it. The contract and a cancellation notice must be delivered or mailed to cancel this contract. Any notice given by mail is effective upon being postmarked, properly addressed, and postage prepaid. If this contract is returned during this period, we will pay to the Owner the sum of (i) the difference between premium(s) paid and the amounts allocated to the Allocation Options and (ii) the Accumulation Value on the date we receive the returned contract and cancellation notice at our Customer Service Office. The contract will be void from the beginning. Individual Flexible Premium Deferred Variable Annuity Contract • Premiums payable before the Annuity Commencement Date, in accordance with contract provisions • Annuity payments begin on the Annuity Commencement Date • Benefits based on the investment experience of a Separate Account are variable and are not guaranteed • Non-participating - No dividends payable WE & YOU In this contract, the words “we”, “our” or “us” refer to GIAC, and the words “you” or “your” refer to the Owner of this contract. TABLE OF CONTENTS SECTION 1 - DEFINITIONS 4 SECTION 2 - OWNER AND BENEFICIARY 6 SECTION 3 - ANNUITY BENEFIT 7 SECTION 4 - DEATH BENEFITS 8 SECTION 5 - SPOUSAL CONTINUATION 10 SECTION 6 - PREMIUMS 10 SECTION 7 - THE SEPARATE ACCOUNT 11 SECTION 8 - TRANSFERS 12 SECTION 9 - ACCUMULATION VALUE 14 SECTION 10 - SURRENDERS AND WITHDRAWALS 15 SECTION 11 - PAYMENT OF CONTRACT PROCEEDS 16 SECTION 12 - GENERAL PROVISIONS 22 Any endorsements or additional benefit riders that are attached to the c...
Secretary President. Countersigned: Surety BY: Resident Agent Attorney-In-Fact Agent: Phone: CITY OF RICHMOND FORMAT FOR LETTERS OF CREDIT IRREVOCABLE STANDBY LETTER OF CREDIT Beneficiary: DATE: City of Richmond Department of Public Works AMOUNT: X.X. Xxx 00000 Xxxxxxxx, XX 00000 Applicant: Letter of Credit Number: Expiration Date: 5PM Local Time: We here by open our irrevocable standby letter of credit number effective on not to exceed U.S. Dollars $ , available by site drafts on Bank, attn: . This Letter of Credit is for the specific purposes as shown on the set of plans prepared by dated , or as show on all subsequent revisions thereof, for a certain development known as , Section , and drafts hereon shall be promptly honored when accompanied by documents specified below.
Secretary President. EMPLOYEE: /s/ Xxxxxx X. Xxxxxxx ----------------------------- XXXXXX X. XXXXXXX AMENDMENT TO SEVERANCE AGREEMENT This Amendment to Severance Payment Agreement (this "Amendment") is made as of August 31, 1987 between DERBY SAVINGS BANK (the "Bank") and Xxxxxx X. Xxxxxxx (the "Employee").
Secretary President. For the Actuary
Secretary President. For the Actuary 15 Day Free-Look The Participant may return his/her Participant Certificate within 15 days of its mailing and have all Contributions refunded to him/her if, after examination, the Participant is not satisfied with it for any reason. Group Deferred Tax-Sheltered Annuity for Association GATSMF 184 This Group Annuity Contract is a legal contract between the Group Policyholder, for the benefit of the Participants, and the Great-West Life & Annuity Insurance Company. PLEASE READ THIS CONTRACT CAREFULLY. IT IS A CONTRACT WHICH MAY PROVIDE FOR PAYMENTS OR VALUES WHICH ARE NOT GUARANTEED AS TO FIXED-DOLLAR AMOUNT BUT MAY VARY ACCORDING TO THE INVESTMENT EXPERIENCE OF A VARIABLE ANNUITY ACCOUNT. TABLE OF CONTENTS 15 DAY FREE-LOOK ..............................................................................................Page 1 DEFINITIONS ......................................................................................................5 OWNERSHIP PROVISIONS Ownership of Series Account ....................................................................................9 Ownership of Group Annuity Contract and Participant Annuity Account Value
