AMENDMENT NO. 3 TO PARTICIPATION AGREEMENT
AMENDMENT NO. 3 TO PARTICIPATION AGREEMENT
Transamerica Financial Life Insurance Company (formerly, AUSA Life Insurance
Company, Inc.), Variable Insurance Products Fund III and Fidelity Distributors Corporation
hereby amend the Participation Agreement ("Agreement") dated August 31, 2000, as amended,
by doing the following:
Schedule A of the Agreement is hereby deleted in its entirety and replaced with
the Amended Schedule A attached hereto.
IN WITNESS WHEREOF, the parties have hereto affixed their respective authorized signatures,
intending that this Amendment be effective as of the 1st day of May, 2004.
TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY
By: /s/Xxxx X. Xxxxxx
Name: Xxxx X. Xxxxxx, Esq.
Title: Vice President
VARIABLE INSURANCE PRODUCTS FUND III
By: /s/Xxxxxxxxx Xxxxxxxx
Xxxxxxxxx Xxxxxxxx
Treasurer
FIDELITY DISTRIBUTORS CORPORATION
By: / s/Don Holbon
Don Holbom
Executive Vice President
SCHEDULE A
Separate Accounts and Associated Contracts
N ame of Separate Account and
Date Established by Board of Directors
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Policy Form Numbers of
Contracts Funded by Separate Account
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AUSA Series Life Account
(est. October 24, 1994)
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Form Number: VL03NY
Product: AUSA Financial Freedom Builder
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Form Number: VL95NY
Product: AUSA Freedom Elite Builder
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Form Number JLS02NY
Product: AUSA Freedom Wealth Protector
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Separate Account VA BNY
(est. September 27, 1994)
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Form Number AV343 101 90 396
Product: AUSA Landmark Variable Annuity
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AUSA Series Annuity Account
(est. March 20, 2001)
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Form Number: WL18NY
Product: AUSA Freedom Premier
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Separate Account VA QNY
(est. August 13, 1996)
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FormNumber: AV10241011791003
Product: Flexible Premium Variable Annuity- E
(No marketing name at this time)
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