Settlement Option Tables. The Option Tables show the payments that we will make at sample payment intervals for each $1,000 applied based on the guaranteed settlement option factors. Amounts may vary with the payment interval and the age of the person on whose life payments are based. Upon request, we will provide information on the payments that we will make for other payment intervals and ages.
Settlement Option Tables. 30 Additional benefits or riders, if any, will be listed in the Schedule. The additional provisions will be inserted in the Policy. SCHEDULE (Effective Date: July 2, 1997) POLICY INFORMATION Policy Number 1000540-001 Stated Death Benefit $100,000.00 Insured XXXX XXX Minimum Stated Death Benefit $ 50,000.00 Owner XXXX XXX Three Year Continuation Period May 1,1998 Ending Date Death Benefit Option Stated Death Benefit Option 1 Three Year Continuation Period Age And Sex 35, Male Minimum Annual Premium $631.62 Premium Class Standard, Non-Smoker Policy Date May 1, 1997 Scheduled Premium $3,000.00 Maturity Date May 15, 2060 Definition of Life Insurance Test: Guideline Premium CUSTOMER SERVICE CENTER: P.O. Box 173763, Denver, Colorado 80217-3763 Coverage may expire prior to the Maturity Date if Scheduled Premiums are paid in a timely manner, coverage may expire prior to the Maturity Date if said premiums are insufficient to continue coverage and the Three Year Continuation has ended. Coverage will also be affected by Partial Withdrawals, Policy Loans, changes in the current cost of insurance rates, the actual credited interest rate for the Guaranteed Interest Division and the investment experience of the Variable Account. FORM 1197 (VUL) - MD PAGE 5 SCHEDULE (CONTINUED) BENEFIT PROFILE ------------------------------------------------------------------------------------------------------------------------------------ Initial Segment Guideline Benefit Issue Age At Effective Annual Target Description Amount Age Maturity Date Date Premium Premium ------------------------------------------------------------------------------------------------------------------------------------ Stated Death Benefit (Segment #1) $100,000.00 35 100 May 1, 1995 $1,288.02 $800.00 ------------------------------------------------------------------------------------------------------------------------------------ Adjustable Term Insurance Rider (Segment #1) $50,000.00 35 100 May 1, 1995 $615,62 $0.00 ------------------------------------------------------------------------------------------------------------------------------------ A coverage segment is a block of Death Benefit coverage. The Stated Death Benefit shown on the schedule page at issue is the initial coverage segment. Additional segments are added to the policy after issue to increase the Death Benefit. Each individual coverage segment added to the policy has its own cost of insurance charges and expense loads as shown in the Sched...
Settlement Option Tables. (Per $1,000 of Net Proceeds)
Settlement Option Tables. 18 SPIVA99 01-99 2A POLICY DATA PAGE ------------------------------------------------------------------------------------------------------------------- CONTRACT DATE: SEPT 01, 1997 POLICY NUMBER: 00000001 NAME OF ANNUITANT: JXXX XXX INITIAL PREMIUM: 1,000,000.00 NAME OF OWNER: JXXX XXX ANNUITY DATE: SEPT 01, 2027 SEPARATE ACCOUNT: [AUL AMERICAN INDIVIDUAL VARIABLE ANNUITY UNIT TRUST] RIDERS ATTACHED: [NONE] MINIMUM PREMIUM ALLOCATION TO ANY INVESTMENT ACCOUNT OR THE FIXED ACCOUNT: [1% of the premium payment] All allocations must be in whole percentages. MINIMUM PREMIUM PAYMENT SUBSEQUENT TO THE INITIAL PREMIUM: [$500 ] MAXIMUM PREMIUM ACCEPTABLE IN A CONTRACT YEAR: [$1,000,000 in the first Contract Years] [$0 in any Contract Year thereafter] PREMIUM TAX CHARGE: [ 0%] ANNUAL CONTRACT FEE: [$30, waived for Contracts with Account Value in excess of $50,000] MONTHLY MORTALITY AND EXPENSE RISK CHARGE: 1/12 of the following percentage of the Variable Account Value: [1.00% during the first ten Contract Years] [0.90% thereafter] TRANSFER CHARGE: Current: [$0] Guaranteed: [$0] for the first [12] transfers in any Policy Year [$25] for each subsequent transfer in the Policy Year WITHDRAWAL CHARGES Withdrawal Charge as % Policy Year of Account Value Withdrawn 1 7% 2 6% 3 5% 4 4% 5 3% 6 2% 7 1% 8 and thereafter 0% FREE WITHDRAWAL AMOUNT: [12%] OF THE ACCOUNT VALUE AS OF THE MOST RECENT CONTRACT ANNIVERSARY INTEREST RATES FOR LOANS (if available): RATE CHARGED ON LOAN BALANCES: [6%] RATE CREDITED TO LOAN ACCOUNT: [4%] MINIMUM TRANSFER AMOUNT: [$500] MINIMUM LOAN AMOUNT: [$1,000] MINIMUM PARTIAL WITHDRAWAL AMOUNT: [$200] ASSUMED DATE OF DELIVERY OF THE POLICY, FOR PURPOSES OF THE TRANSFER AT THE END OF THE RIGHT TO EXAMINE PERIOD: [5] days after the Contract Date CONTRACT YEAR IN WHICH CONTRACT PROCEEDS EQUAL ACCOUNT VALUE: [5] SPIVA99 01-99 3A ______________________________________________________________________________ Definitions Account Value - The Account Value is the sum of your interest in the Variable Account, the Fixed Account, and the Loan Account.
Settlement Option Tables. Values for other ages, and for other payment periods, joint life combinations, or assumed investment rates that we offer (Tables below assume 3%) are available on request. Monthly payments are shown for each $1,000 applied. Settlement Option Table for a Fixed Period Monthly Monthly Monthly Fixed Period Payment Fixed Period Payment Fixed Period Payment of Years of Years ------- of Years ------- -------- -------- -------- -------- 11 $8.88 21 $5.33 12 8.26 22 5.16 13 7.73 23 5.00 14 7.28 24 4.85 5 $17.95 15 6.89 25 4.72 6 15.18 16 6.54 26 4.60 7 13.20 17 6.24 27 4.49 8 11.71 18 5.98 28 4.38 9 10.56 19 5.74 29 4.28 10 9.64 20 5.53 30 4.19
Settlement Option Tables. Additional benefit provisions or restrictions, if any, and a copy of the application follow page 18. Home Office: 0 Xxxxxx Xxxx Plaza Springfield, Illinois 62715-0001 0-000-000-0000 Individual Deferred Fixed And Variable Retirement Annuity Contract Flexible purchase payments Nonparticipating -- dividends not paid. All payments and values under this contract which are based on investment results of the Separate Account are variable and not guaranteed as to fixed dollar amount. SECTION 1 -- CONTRACT DATA Contract number: XXXXXXXXXX Annuitant: XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX Contract Date: XXXXXXXXXX Maturity Date: XXXXXXXXXX Renewal Date: XXXXXXXXXX Age at issue: XX Sex: XXXXXX Owner and beneficiary: as stated in the application unless changed.
Settlement Option Tables. 18 Page 2a POLICY DATA PAGE CONTRACT DATE: [Sept 01, 1997] POLICY NUMBER: [00000001] NAME OF ANNUITANT: [Xxxx Xxx] ANNUITY DATE: [Sept 01, 2027] NAME OF OWNER: [Xxxx Xxx] CONTRACT SPECIFICATIONS PLAN: [Flexible Premium Deferred Variable Annuity] INITIAL PREMIUM: [$1,000.00] PLANNED PREMIUM: [$1,000.00] MODE: [Annual] CONTRACT YEAR IN WHICH CONTRACT PROCEEDS EQUAL ACCOUNT VALUE: [5] EXTRA CREDIT PREMIUM OPTION:[4%, 5%, 6% or 7% of premiums received in first Contract Year] CONTRACT MINIMUM AND MAXIMUM SPECIFICATIONS Minimum Premium Payment Subsequent to the Initial Premium*:[$100 Monthly or $1000 Annually] *Must have deposited $5,000 by the end of the 5th policy year. MINIMUM ACCOUNT VALUE REQUIRED TO CONTINUE CONTRACT:[ $2,500] MINIMUM PREMIUM ALLOCATION TO ANY INVESTMENT ACCOUNT OR THE FIXED ACCOUNT: 1% of the premium payment. All allocations must be in whole percentages.
Settlement Option Tables. 25 Additional benefits or riders, if any, will be listed in the Schedule. The additional provisions will be inserted in the policy. SCHEDULE (Schedule Date: PolicyDate) POLICY INFORMATION Policy Number 65000001 Initial Stated Death Benefit $100,000.00 Insured JOHN DOE Death Xxxxxxx Option OPTION 1 Age And Sex 35, Male Minimum Annual Premium $365.76 Premium Class Non-Smoker Guarantee Period Annual Premium Policy Date May 1, 1998 Initial Scheduled Premium $1,600.00 Annually Definition of Life Insurance Test Guideline Premium/Cash Value Corridor Test CUSTOMER SERVICE CENTER: P.O. Box 173888, Denver, Colorado 80217-3888 [Coverage will expire prior to the policy anniversary nearest the insured's 100th birthday if premiums are insufficient to continue coverage. Coverage will also be affected by Partial Withdrawals, Policy Loans, changes in the current cost of insurance rates, the actual credited interest rate for the Guaranteed Interest Division and the investment experience of the Variable Account.] [ ] SCHEDULE (CONTINUED) BENEFIT PROFILE
Settlement Option Tables. 29 Additional benefits or riders, if any, will be listed in the Schedule. The additional provisions will be inserted in the Policy. SCHEDULE (Effective Date: January 1, 1996) POLICY INFORMATION Policy Number 6500001 Minimum Stated Death Benefit $50,000.00 Insured Mr XXXX XXX Death Benefit Option OPTION 1: GP/CVC LEVEL DB Three Year Continuation Period Ending Date January 1, 1999 Three Year Continuation Period Age And Sex 35, Male Minimum Annual Premium $529.00 Premium Class High Band Non-Smoker Policy Date January 1, 1996 Planned Premium $1,600.00, Annually Maturity Date January 1, 2061 Definition of Life Insurance Test Guideline Premium
Settlement Option Tables. Guaranteed Monthly Income Per $1,000 of Proceeds OPTION 1 - Income for Fixed Period Number Monthly Number Monthly of Years Income of Years Income 1 $84.47 11 $8.86 2 42.86 12 8.24 3 28.99 13 7.71 4 22.06 14 7.26 5 17.91 15 6.87 6 15.14 16 6.53 7 13.16 17 6.23 8 11.68 18 5.96 9 10.53 19 5.73 10 9.61 20 5.51 Quarterly Income is 2.993 times the monthly income and annual income is 11.839 times the monthly income. OPTION 2 - Life Annuity The amount of income is based on the adjusted age of the annuitant on the date of the first payment. Adjusted Number of Guaranteed Payments Adjusted Number of Guaranteed Payments Age None 120 Refund* Age None 120 Refund* 55 $4.34 $4.30 $4.17 63 $5.21 $5.10 $4.86 56 4.42 4.38 4.24 64 5.35 5.22 4.96 57 4.52 4.47 4.31 65 5.51 5.35 5.08 58 4.61 4.56 4.39 66 5.67 5.49 5.20 59 4.72 4.65 4.47 67 5.85 5.64 5.33 60 4.83 4.76 4.56 68 6.04 5.80 5.46 61 4.95 4.86 4.66 69 6.24 5.96 5.61 62 5.08 4.98 4.75 70 6.46 6.13 5.76 *The sum of all guaranteed payments will equal the amount applied under this option. OPTION 3 - Survivorship Annuity The amount of income is based on the adjusted age of each of the annuitants on the date of the first payment. 50% to Survivor 100% to Survivor 120 Guaranteed Payments 120 Guaranteed Payments Payee #2 Age Payee #2 Age Payee #1 Payee #1 Age 50 55 60 65 70 Age 50 55 60 65 70 50 $3.95 $4.12 $4.31 $4.55 $4.80 50 $3.56 $3.67 $3.76 $3.83 $3.88 55 4.12 4.30 4.52 4.77 5.05 55 3.67 3.83 3.97 4.08 4.17 60 4.31 4.52 4.76 5.04 5.36 60 3.76 3.97 4.17 4.36 4.51 65 4.55 4.77 5.04 5.35 5.72 65 3.83 4.08 4.36 4.64 4.90 70 4.80 5.05 5.36 5.72 6.13 70 3.88 4.17 4.51 4.90 5.28 Income for other combinations of ages will be furnished on request.
