Annuitant: XXXX XXX
Contract Number: 00 000 000
Issue Date: FEB 28, 1992
Contract Date: FEB 28, 1992
Retirement Date: JAN 1, 2020
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York,
New York 10116
AGREES
o TO ALLOCATE the Contributions made to this Contract, after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division of the Separate Account (referred to
in this Contract as the "Investment Divisions") or to the Guaranteed Interest
Division, in accordance with Sections 2.02, 2.03 and 2.04, as directed by the
Owner, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide you with
an Annuity Benefit or a Cash Value if you are then living, and
o TO PROVIDE the Owner with the other rights and benefits of this Contract.
This is the entire Contract. In this Contract, "we", "our" and "us" mean The
Equitable Life Assurance Society of the United States. "You" and "your" mean the
Annuitant, with respect to a right exercised by the Owner on behalf of the
Annuitant.
TEN DAYS TO EXAMINE CONTRACT--The Owner may cancel this Contract by returning it
to us within ten days after receipt of it. Upon such cancellation, we will
refund any Contribution made to us under this Contract.
/s/ Xxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxxxx
Vice President and Secretary Chairman of the Board
and Chief Executive Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASED RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE
MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL
ACCOUNTING, DEATH BENEFITS, MORTALITY RISKS, EXPENSES AND EXPENSE RISK, PLUS THE
INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE
TRUST.
No. 92CTRA
This Contract is issued in consideration of the payment to us of the
Contributions made under the terms of this Contract.
The provisions on the following pages are part of this Contract.
--------------------------------------------------------------------------------
TABLE OF CONTENTS
DEFINITIONS Page
Section 1.01 - Annuitant..........................................4
1.02 - Annuity............................................4
1.03 - Annuity Account Value..............................4
1.04 - Annuity Benefit....................................4
1.05 - Cash Value.........................................4
1.06 - Class of Contracts.................................4
1.07 - Code...............................................4
1.08 - Contract Date......................................4
1.09 - Contract Year......................................4
1.10 - Contribution.......................................4
1.11 - Divisions..........................................4
1.12 - Eligible Annuity Certain...........................5
1.13 - Employer...........................................5
1.14 - Guaranteed Interest Rate...........................5
1.15 - Joint and Survivor Life
Annuity Form....................................5
1.16 - Life Annuity Form..................................5
1.17 - Normal Form........................................5
1.18 - Owner..............................................5
1.19 - Period Certain Annuity.............................5
1.20 - Plan...............................................5
1.21 - Processing Office..................................5
1.22 - Retirement Date....................................5
1.23 - Separate Account...................................5
1.24 - Separate Account Definitions.......................6
1.25 - Transaction Date...................................7
1.26 - Trust..............................................7
1.27 - Trustee............................................7
1.28 - Trusteed Plan......................................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions......................................7
2.02 - Separate Account Investment
Divisions.......................................7
2.03 - Guaranteed Interest Division.......................8
2.04 - Allocation to Divisions............................8
2.05 - Transfers Among Divisions..........................8
2.06 - Termination of this Contract.......................8
2.07 - Partial Withdrawals................................9
2.08 - Charges for Partial Withdrawals....................9
2.09 - Free Corridor Amount...............................9
2.10 - Loans.............................................10
2.11 - Annual Administrative Charge......................11
2.12 - Death Benefit.....................................11
ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit.............................12
3.02 - Variable Annuity Benefit..........................12
3.03 - Election and Commencement
of Xxxxxxx Xxxxxxxx............................12
3.04 - Amount of Annuity Benefits........................13
3.05 - Payment of Annuity Benefits.......................13
3.06 - Special Annuity and Spousal
Consent Provisions.............................16
GENERAL PROVISIONS
Section 4.01 - Contract..........................................16
4.02 - Statutory Compliance..............................16
4.03 - Assignments and
Nontransferability................................17
4.04 - Beneficiary.......................................17
4.05 - Disqualification..................................17
4.06 - Future Contributions..............................17
4.07 - Deferment.........................................17
4.08 - Annual Notice.....................................17
4.09 - Trustee's Responsibility..........................17
4.10 - Age...............................................18
No. 92CTRA Page 2
OWNER: TRUSTEES OF THE ABC PLAN
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 000 000 000
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28, 1992
RETIREMENT DATE: JAN 1, 2020
INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992
MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992
3.00% AFTER DEC 31, 1992
BENEFICIARY: XXXX XXX
FORM NUMBER: 92CTRA
********************************************************************************
TABLE OF GUARANTEED VALUES
ISSUE AGE 38 MALE $1,000 ANNUAL CONTRIBUTION
NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY
SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65
-------------------------- ---------- -------------------------
1 983 6.62
2 1,958 16.20
3 2,963 26.67
4 3,998 36.83
5 5,064 46.70
6 6,162 56.28
7 7,349 65.58
8 8,580 74.61
9 9,848 83.38
10 11,154 91.89
11 12,500 100.16
12 13,886 108.18
13 15,313 115.97
14 16,783 123.53
15 18,298 131.18
16 19,857 138.63
17 21,464 145.90
18 23,118 152.80
19 24,853 159.69
20 26,639 166.03
24 (Age 62) 34,697 189.57
27 (Age 65) 41,098 205.49
THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000
CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT
DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE
(SEE SECTION 2.11) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE CONTRIBUTIONS MADE
IN THE CURRENT AND 5 PRIOR CONTRACT YEARS (SEE SECTION 1.05). THE TABLES ASSUME
THAT 100% OF ALL CONTRIBUTIONS AND EARNINGS ARE ALLOCATED TO AND REMAIN IN THE
GUARANTEED INTEREST DIVISION.
YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON
THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS.
THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE
WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY
BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A
SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04).
* ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO
SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT.
No. 92CTRA Page 3
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PART I - DEFINITIONS
SECTION 1.01 ANNUITANT. The term "Annuitant" means the individual shown on Page
3 of this Contract for whom this Contract has been purchased.
SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in
accordance with the terms of a Plan.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts in the Guaranteed Interest Division, and the Investment
Divisions of the Separate Account pursuant to Sections 2.02 and 2.03 and any
loan reserve provision, described in Section 2.10.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by us pursuant to Section 3.04 of this Contract. Various Sections of this
Contract (Sections 1.15, 1.16, 1.17, 3.01 and 3.02) refer to "monthly payments"
to be made under an Annuity Benefit. The Owner may wish to have your Annuity
Benefit paid at other intervals, such as quarterly, semi-annually, or annually,
instead of monthly. The Owner may elect this at the time the Annuity Benefit
form is elected as described in Section 3.03; in that event, all references in
this Contract to "monthly payments" will be deemed to mean payments at the
frequency you elect subject to our rules at the time of election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means an amount equal to the
greater of (i) or (ii), less any outstanding loan, where
(i) is the Annuity Account Value less 6% of the Contributions made during the
current and five prior Contract Years, which had not been previously
withdrawn pursuant to Section 2.07, and
(ii) is the sum of (a) the Free Corridor Amount as defined in Section 2.09 and
(b) 94% of the Annuity Account Value less the Free Corridor Amount.
NO WITHDRAWAL CHARGE: If you have attained the age of 59 years and 6 months, the
term "Cash Value" means an amount equal to he Annuity Account Value for
withdrawals due to retirement or termination of employment. Your retirement or
termination of employment must be verified by the Trustee. Such verification
should be in the form of a statement signed by the Trustee and accompanying the
request for withdrawal. The request for withdrawal must be signed by both you
and the Trustee. The withdrawal charge will be imposed if this verification is
not received at our Processing Office together with the withdrawal request.
However, if the Annuitant is age 60 or older on the Contract Date and it is
Contract Year 5, item (ii)(b) above will be 95% of the Annuity Account Value
less the Free Corridor Amount.
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same calendar year. The term "Contract"
means this Contract.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as
now or hereafter amended, or any corresponding provisions of prior or subsequent
United States revenue laws.
SECTION 1.08 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both the application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.09 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.10 CONTRIBUTION. The term "Contribution" means a payment made to us on
your behalf with respect to this Contract. We are under no obligation to accept
any Contribution less than $20.00.
SECTION 1.11 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following divisions described in this
Contract:
(i) the Guaranteed Interest Division, and
(ii) the Investment Divisions of the Separate Account.
No. 92CTRA Page 4
SECTION 1.12 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
an annuity not involving life contingencies issued by us which extends beyond
your attainment of age 59 years and 6 months and does not permit any prepayment
of the unpaid principal (that is, no withdrawal or single sum payment) prior to
your attainment of age 59 years and 6 months.
SECTION 1.13 EMPLOYER. The term "Employer" means the corporate employer adopting
the Plan, or any such employer that assumes in writing the obligations of the
Plan.
SECTION 1.14 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the interest that we credit at effective annual rates in the Guaranteed Interest
Division. The initial rate to apply is shown on Page 3 of this Contract. Section
2.03 describes the determination of the rate to apply thereafter.
SECTION 1.15 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected. The payments commence on the date as of which the Joint and Survivor
Life Annuity Form is purchased and terminate with the last payment due before
the death of the survivor.
SECTION 1.16 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us providing monthly payments during the lifetime of the person upon
whose life such payments depend. The payments commence on the date as of which
the Life Annuity Form is purchased and terminate with the last payment due
before the death of such person.
SECTION 1.17 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means, (i) if you have a living spouse at your Retirement Date,
the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form
with your spouse as the contingent annuitant (with 100% of the monthly payment
continued to your spouse), and (ii) if you do not have a living spouse at your
Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form.
SECTION 1.18 OWNER. The term "Owner" of the Contract is the person or entity as
stated on Page 3 of this Contract. Notwithstanding any provisions in this
Contract to the contrary, only the Owner can exercise all the rights under this
Contract while you are living. When exercising such right, the Owner does not
need the consent of anyone who has only a conditional or future ownership
interest in this Contract unless the Owner delegates rights to such person.
Under this Contract the Owner is the Trustee, defined in Section 1.27.
While you are living, the Owner of this Contract on your behalf may change the
Owner by written notice satisfactory to us. The change will take effect on the
date the Owner signs the notice, except it will not apply to any payment we make
or other actions we take before we receive the notice.
SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us which does not permit any
prepayment of the unpaid principal, (that is, you cannot elect to receive part
of your payments as a single sum payment with the remainder paid in monthly
annuity payments).
SECTION 1.20 PLAN. The term "Plan" means a defined contribution plan adopted by
the Employer that is intended to meet the requirements for qualification under
Section 401(a) of the Code.
SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116, or
such other location as we shall designate by advance written notice to the
Owner, the Employer or the Plan's trustee, as applicable, and to you.
SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which
you attain the retirement age as shown on Page 3 of this Contract. Before the
Retirement Date an election may be made to change the Retirement Date to another
Retirement Date permitted under the Plan, which may be any date after the filing
of the election other than the 29th, 30th or 31st day of any month. The
Retirement Date selected, either initially, or by later change, must be in
accordance with the terms of the Plan. No Retirement Date shall be later than
the date you attain age 70 years and 6 months. Any election for such change must
be made in writing by you and shall not take effect until received by us at our
Processing Office.
SECTION 1.23 SEPARATE ACCOUNT. The term "Separate Account" means Separate
Account A which is organized as a unit investment trust, a type of investment
company. We established the Separate Account and it is maintained in accordance
with the laws of New York State. Realized and unrealized gains and losses from
the assets of the Separate Account are credited to or charged against it without
regard to our other income, gains or losses. Assets are put in the Separate
Account to support this Contract and other variable annuity contracts and
No. 92CTRA Page 5
certificates. Assets may be put in the Separate Account for other purposes, but
not to support contracts or policies other than variable annuities or variable
life insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust or investment company where each class (or series) represents a
separate portfolio in the Trust. We reserve the right to change the designated
trust or investment company or to add designated trusts or investment companies.
The Investment Divisions available are the Stock Division, the Money Market
Division, the Balanced Division and the Aggressive Stock Division. The
Guaranteed Interest Division is not part of the Separate Account, but rather is
an asset of our General Account.
We will value the assets of each Investment Division on each business Day. A
business day is any day on which we are open, the New York Exchange is open for
trading and there is a sufficient degree of trading in the portfolio securities
in which an Investment Division is invested to materially affect the
Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments we are
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under the
Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such committee at any time;
(iii) restrict or eliminate any of the Owner's voting rights as to the Separate
Account;
(iv) operate the Separate Account by making direct investments, or in any other
form;
(v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or
remove Investment Divisions (or sub-divisions of Investment Divisions)
from the Separate Account (the term "Investment Division" in this Contract
shall then refer to any other Investment Division in which the assets, of
a class of contracts to which this Contract belongs, were placed);
(vi) combine any two or more Investment Divisions (or sub-divisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
class of contracts to which this contract belongs.
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, the Owner and you will be notified of
such exercise, as required by law.
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for applicable tax
charge) at a rate not to exceed 1.49% per year for each of the Stock, Money
Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock
Division, for financial accounting, death benefits, mortality risk, expenses and
expense risk. The charge shall be made in accordance with Subsection (c) of the
Net Investment Factor provision in Section 1.24. The relative proportion of
these charges may be modified. This daily charge, plus the investment advisory
fee charges and direct operating expense charges of the Trust, shall not exceed
a total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract.
SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any consecutive preceding
nonbusiness days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
No. 92CTRA Page 6
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment
Division for the Valuation Period. For this purpose, we use the share value
reported to us by the Trust.
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period (after
any amounts allocated or withdrawn for that Valuation Period).
(c) is the daily Separate Account charge for the expenses of this Contract
times the number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is the unit which is purchased in an
Investment Division where Contributions are invested and which is used in
determining the amount in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for such Valuation Period.
ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity
Benefits as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first contribution was put into the Stock
Division, the Annuity Unit Value was at $1.26 and $1.52 for contracts with
Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively.
The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit
Value for the immediately preceding Valuation Period multiplied by the Adjusted
Net Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for a Valuation Period is the Net Investment Factor for such
period reduced for each calendar day in such subsequent Valuation Period by the
Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net
Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net
Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall
be 5%, except in states where the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar
month is equal to the average of the Annuity Unit Value for all Valuation
Periods ending in such month.
SECTION 1.25 TRANSACTION DATE. The term "Transaction Date" means the business
day we receive a Contribution or a written contract transaction request
providing the information we need at the Processing Office. In the case of a
transfer request initiated through the use of a touch tone telephone, as
described in Section 2.05, the Transaction Date is the business day the
telephone transaction is received.
SECTION 1.26 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
SECTION 1.27 TRUSTEE. The term "Trustee" means the person or persons named as
trustee under a Trusteed Plan and such trustee's successors. Under this
Contract, the Trustee is the Owner.
SECTION 1.28 TRUSTEED PLAN. The term "Trusteed Plan" means a Plan under which
there is maintained a trust forming a part of the Plan.
-------------------------------------------------------------------------------
PART II - ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. The Employer or the Trustee, as applicable, is to
make Contributions from time to time on such dates and in such amounts as
determined by the Employer pursuant to the terms of the Plan. The Employer or
the Trustee is to specify the amount allocated to each Division. Each
contribution, received by us will, before its allocation under this Contract, be
reduced by the amount of any applicable tax charge as determined by us.
Contributions will be allocated to the Division in accordance with instructions
received on the application unless later changed.
Pursuant to the terms of the Plan, we will accept rollover contributions and
transfers made on your behalf from a plan qualified under 401(a) of the Code or
from a conduit individual retirement arrangement as described in Section 408 of
the Code.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to, or withdrawn or transferred from, an Investment
Division, the Annuity Account Value will be credited or charged, as the case may
be, with the number of Accumulation Units determined by dividing
No. 92CTRA Page 7
said amount by the Accumulation Unit Value for the appropriate Investment
Division for the Valuation Period which includes that date. The number of units
in an Investment Division on any date is equal to (i) the sum of any
Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii)
the sum of any Accumulation Units that have been withdrawn pursuant to Section
2.07, 2.08, 2.10 or 2.11 or transferred from the Investment Division pursuant to
Section 2.05. The amount in an Investment Division on any date is equal to the
product of (i) the number of Accumulation Units in the Investment Division on
that date and (ii) the Accumulation Unit Value for the Investment Division for
the Valuation Period which includes that date.
Participation in the Separate Account under this Contract terminates on the
earliest of (i) Election and Commencement of Annuity Benefits pursuant to
Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of
this Contract pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets which support
the guarantees of this Contract and other contracts.
The amount in the Guaranteed Interest Division at any time is equal to the sum
of all amounts that have been allocated to the Guaranteed Interest Division
pursuant to Section 2.04 or Section 2.10 plus the amount of any interest accrued
but not allocated, less the sum of all amounts that have been withdrawn from the
Guaranteed Interest Division pursuant to Section 2.07, 2.08, 2.10 or 2.11 or
transferred from the Guaranteed Interest Division pursuant to Section 2.05.
Interest is allocated to the Guaranteed Interest Division on a Transaction Date
pursuant to Section 2.04.
We will credit the amount in the Guaranteed Interest Division with interest at
effective annual rates that we determine. For each Class of Contracts we
determine a yearly guaranteed interest rate that will remain in effect
throughout the next year. We guarantee that this yearly guaranteed interest rate
will never be less than 3%.
Participation in the Guaranteed Interest Division under this Contract terminates
on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to
Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of
this Contract pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction of any applicable tax charge) to one or more
Divisions, as specified to us in writing. Allocation percentages must be in
whole numbers and the sum must equal 100. The allocation is made as of the
Transaction Date on which we have received both such Contribution and such
direction. Contributions made to an Investment Division purchase Accumulation
Units in that Investment Division, using the Accumulation Unit Value next
computed after the Transaction Date.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon termination of this Contract pursuant to Section 2.06, and (vi)
upon your death pursuant to Section 2.12.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. Upon written request or through the use
of a touch tone telephone, the Owner may transfer all or part of the amounts in
a Division to one or more of the Divisions as follows: (1) amounts in the
Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive
Stock Division may be transferred among such Divisions; and (2) amounts in the
Money Market Division may be transferred to other Divisions. Written
authorization for touch tone telephone initiated transfers is only required when
authorization for telephone transfers is requested. (Upon advance written notice
to the Owner, we reserve the right to discontinue the acceptance of transfer
requests through the use of a touch tone telephone.) All transfers will be made
on the Transaction Date and will be subject to our rules in effect at the time
of transfer. With respect to the Investment Divisions, the transfer will be made
at the Accumulation Unit Value next computed after the Transaction Date. No
transfers are permitted to the Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the
terms of the Plan, including the spousal consent rules set forth in Section
3.06, the Owner may elect by written notice to terminate this Contract. We will
determine the Cash Value of this Contract as of the Transaction Date.
If this Contract is terminated, surrendered or exchanged prior to the Retirement
Date, any applicable tax charges we have paid may be deducted. If we have
previously deducted charges for applicable taxes from Contributions pursuant to
Section 2.01, we will not again deduct charges for the same taxes on
terminations, unless a change in applicable law has occurred with respect to
this Contract.
The payment of such Cash Value may be deferred by us in accordance with the
provisions of Section 4.07.
No. 92CTRA Page 8
Subject to the terms of the Plan, we reserve the right to pay the Annuity
Account Value less any outstanding loan under this Contract and terminate this
Contract if (i) no Contributions are made on your behalf during the last three
completed Contract Years, and the Annuity Account Value is less than $500 or
(ii) a partial withdrawal is made that would result in your Annuity Account
Value falling below $500. We reserve the right to terminate this Contract if no
contributions have been made within 120 days of the Contract Date.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount in the Divisions under this Contract and the Annuity Account Value
with respect to this Contract shall be zero. We will be released from any and
all liability for payments with respect to the Contributions from which the
Annuity Account Value arose.
SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any restrictions under the terms of
the Plan, the Owner may elect, by written notice to us, to make a partial
withdrawal from the Divisions. Partial withdrawals are subject to the spousal
consent rules set forth in Section 3.06.
On the Transaction Date, we will pay the lesser of the Cash Value or the amount
of partial withdrawal requested to the Owner (or such other person designated by
the Owner to us in advance via written instructions). The amount paid plus any
withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the
amounts in the Divisions. Unless instructed otherwise, the amount withdrawn
(including any withdrawal charge) will be allocated among the Divisions in
proportion to the amounts in such Divisions.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300.
If a withdrawal made under this Section would result in an Annuity Account Value
of less than $500, we will so advise the Owner and reserve the right to pay the
Annuity Account Value less any outstanding loan, and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. There will be no partial
withdrawal charge if the amount of the partial withdrawal requested is not
greater than the Free Corridor Amount defined in Section 2.09.
However, if the amount of partial withdrawal requested is greater than the Free
Corridor Amount, we will (i) first withdraw from the Divisions an amount equal
to the excess of the amount requested over the Free Corridor Amount, and (ii)
then withdraw an amount equal to the excess of the amount requested over the
Free Corridor Amount, plus a withdrawal charge, if applicable. Such withdrawal
charge will be calculated in the following manner:
(a) Withdrawals of Contributions made on your behalf during the current and
five prior Contract Years will be subject to a charge of 6% of the amount
withdrawn (including such charge).
(b) Withdrawals of other amounts will not be subject to any withdrawal charges.
For purposes of determining withdrawal charges described in this Section,
amounts withdrawn up to the Free Corridor Amount will not be considered a
withdrawal of any Contributions. Any excess withdrawals, i.e. those pursuant to
item (ii) above, shall be considered withdrawals of Contributions in the order
received, with the older Contributions first.
With respect to partial withdrawals requested by the Owner, there will be no
partial withdrawal charge if (i) you have completed at least 5 Contract Years
and you have attained the age of 59 years and 6 months or (ii) you have attained
age 59 years and 6 months and have retired or terminated employment. Your
retirement or termination of employment must be verified by the Trustee. Such
verification should be in the form of a statement signed by the Trustee and
accompanying the request for withdrawal. The request for withdrawal must be
signed by both you and the Trustee. The partial withdrawal charge will be
imposed if this verification is not received at our Processing Office together
with the withdrawal request.
If withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to this Contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means an
amount equal to the excess, if any, of (i) 10% of the Annuity Account Value on
the Transaction Date over (ii) cumulative prior withdrawals made pursuant to
Section 2.07 in the current Contract Year.
No. 92CTRA Page 9
SECTION 2.10 LOANS. Unless otherwise restricted by the Plan, or the Code, the
Owner may get a loan under this Contract on your behalf before the Election and
Commencement of Annuity Benefits, if an agreement between the Owner and us
relating to such loan ("Trustee Agreement") has been executed and is in effect
on the "Loan Effective Date", as defined below. Plan loans are subject to the
spousal consent rules set forth in Section 3.06. Future restrictions in the Code
may require revision or withdrawal of the loan provisions as provided below. The
Annuity Account Value (including the loan reserve account as described below)
will be the sole security for the loan.
If your loan agreement and application form ("Loan Agreement") is properly
completed and signed by you, approved by the Owner, accepted by us and received
at the Processing Office by the 15th of the month, the loan is effective on the
first day of the following month. If your Loan Agreement is properly completed
and signed by you, approved by the Owner, accepted by us and received at the
Processing Office after the 15th of the month, the loan is effective on the
first day of the second month following.
The Owner may establish a reasonable interest rate for the loan provided that
such rate is not (1) less than an effective annual rate of 6% or (2) greater
than the maximum rate permitted by applicable laws.
Beginning the first day of the third month following the effective date of the
loan and quarterly on the first day of the month thereafter, loan repayments
must be made to us. Loan requests shall be amortized in substantially level
payments over the term of the loan. If the effective annual rate of the loan is
6%, such repayments will be equal to the sum of (a) and (b) where
(a) is the loan interest, calculated at an effective annual rate of 6%; and
(b) is an amortized portion of the loan principal.
If the effective annual rate of the loan is greater than 6%, such payments will
be equal to the sum of (a), (b) and (c) where
(a) is the loan interest, calculated at an effective annual rate of 6%,
(b) is an amortized portion of the loan principal, and
(c) is the loan interest, calculated at the effective annual rate determined by
the Owner less the loan interest calculated at an effective annual rate of
6% ("Excess Interest").
Any Excess Interest received by us will be allocated among the Divisions in
accordance with Section 2.04 and may be withdrawn, transferred or annuitized as
described in this Contract.
By each due date, if the amount of the loan payment is less than the amortized
loan interest and principal due calculated at an effective annual rate of 6% or
the loan repayment is not received at our Processing Office, we will deduct and
treat as a partial withdrawal from the loan reserve account an amount equal to
the amortized interest and principal payments due plus any applicable withdrawal
charges and any required income tax withholding. Specifically, an amount equal
to the principal payment will be deducted from the portion of the loan reserve
account which earns interest at an effective annual rate of 4%, and an amount
equal to the interest payment, calculated at the effective annual rate of 6%,
plus any applicable withdrawal charges and required income tax withholding will
be deducted from the portion of the loan reserve account which earns interest at
the Guaranteed Interest Rate.
Amounts deducted, if the amount of the loan repayment is less than the amount
due or the loan payment is not received at our Processing Office, may be
reportable to the IRS and other appropriate government authorities as taxable
distributions. In addition, you may be subject to a 10% penalty tax on the
taxable portion of the amounts deducted.
The amount of the loan may not be more than 50% of the Annuity Account Value. In
no event shall the loan amount exceed $50,000 less the highest outstanding
balance under this Contract during the one year period ending the day before the
effective date of the loan. The minimum loan permitted is $1,000. For this
purpose, the Annuity Account Value is taken as of the Loan Effective Date. Only
one outstanding loan is permitted at a time under this Contract. As a condition
for granting a loan, we will require you to represent that the loan amount
requested, when aggregated with loans (principal plus interest) from all
qualified plans of your Employer, does not exceed 50% of the value of your
nonforfeitable accrued benefits, and in no event exceeds $50,000 less the
highest outstanding balance of all loans from qualified plans during the one
year period ending on the day before the effective date of the loan. The
provisions of this Contract require spousal consent in order to receive a loan
if you are married.
No. 92CTRA Page 10
The loan term will be either (i) ten years, if you represent that the purpose of
the loan is to acquire, build or substantially rehabilitate a dwelling unit
which, within a reasonable period of time, is to be used as your principal
residence or (ii) five years. In any event, the loan term may not extend beyond
the earlier of
(i) the Election and Commencement of Annuity Benefits pursuant to Section
3.03,
(ii) the date we receive written notice to terminate this Contract pursuant to
Section 2.06,
(iii) the date we pay a death benefit pursuant to Section 2.12, and
(iv) any date provided for such loans by future Federal tax rules including
acceleration of the loan repayment in order that the operation of the
loan provisions do not adversely affect the tax treatment of this
Contract.
Future Federal tax rules may also impose certain additional requirements to
obtain the ten year loan period described above which may apply to existing ten
year loans.
On the Loan Effective Date, we will transfer to a loan reserve account an amount
equal to the sum of (i) the loan amount, which will earn interest at the
effective annual rate of 4% during the loan term and (ii) 25% of the loan
amount, which will earn interest at the Guaranteed Interest Rate, as defined in
this Contract. With the Owner's approval you may specify from which Divisions
these amounts are to be transferred. In the absence of direction from the Owner,
or if your directions cover only part of the amount required to be transferred
to the loan reserve account, we will transfer the required (or additional
required) amounts from each Division in proportion to the amount that you have
in such Division. On the first day of the third month following the effective
date of the loan and quarterly thereafter (or first business day thereafter, if
such day is not a business day), the amount of interest earned at 4% annually
during the prior quarter will be transferred to the portion of the loan reserve
account that earns interest at the Guaranteed Interest Rate.
The loan must be repaid in part on each quarterly due date and may be repaid in
full at any time on or after the first loan anniversary and must include the
full interest due. Any payments received will first be applied to interest due,
with the balance applied towards repayment of the loan. Any partial loan
repayment will result in a transfer of the amount equal to the principal repaid
from (i) the portion of the loan reserve account that earns interest at the
effective annual rate of 4% to (ii) the Guaranteed Interest Division and may be
withdrawn, transferred or annuitized as described in this Contract.
Partial withdrawals or transfers may not be made from the loan reserve account.
Upon full repayment of the loan, any amounts remaining in the loan reserve
account will be transferred to the Guaranteed Interest Division and may be
withdrawn, transferred or annuitized as described in this Contract.
Upon termination of this Contract pursuant to Section 2.06 or 2.12 or
annuitization pursuant to Section 3.04 prior to the full repayment of the loan,
the loan reserve account shall be zero.
SECTION 2.11 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $25,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts in the Divisions.
For this purpose, any loan reserve account is included within the Guaranteed
Interest Division. The portion of the charge attributable to the Guaranteed
Interest Division and any loan reserve account will be first withdrawn from the
Guaranteed Interest Division and then, if the amount in the Guaranteed Interest
Division is not sufficient, the remaining allocation will be withdrawn from the
portion of the loan reserve account that earns interest at the Guaranteed
Interest Rate.
If the Annuity Account Value is less than $25,000 on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03
or (b) the date of termination of this Contract pursuant to Section 2.06 or
2.12, we will prorate the Annual Administrative Charge applicable to the
completed portion of the current Contract Year and withdraw such amount in lieu
of the Annual Administrative Charge described in this Section for the applicable
part of that Contract Year.
If the Annuity Account Value is $25,000 or greater at the end of a Contract
Year, the Annual Administrative charge is zero.
SECTION 2.12 DEATH BENEFIT. If we ascertain that you have died while you have
amounts in the Divisions, we will, upon receipt of due proof of your death, and
subject to the terms of the Plan including the spousal survivor benefit rules
set forth in Section 3.06, pay to the beneficiary designated to receive such
payment under Section 4.04 of this Contract, the death benefit payable.
If the beneficiary under this Contract is the Trustee, the Trustee may, subject
to the terms of the Plan, change the beneficiary within 31 days after we receive
due proof of your death. The change shall be made in the same manner and subject
to the same provisions as apply to a change of beneficiary during your lifetime.
No. 92CTRA Page 11
If the Trustee changes the beneficiary of this Contract after your death
according to the terms of the Plan, the Trustee may elect an Annuity Benefit on
any annuity form offered by us or one of our affiliated or subsidiary life
insurance companies, subject to our rules then in effect, for the benefit of the
beneficiary. The beneficiary may not revoke or change any election made by the
Trustee. If the Trustee does not make an election, the beneficiary may make such
election for the beneficiary's own benefit. Any election of an Annuity Benefit
must meet the minimum distribution requirements as described in Section 3.05.
If the beneficiary under this Contract is not the Trustee, and you are married
at the time of your death, we will pay the death benefit under this Contract to
your spouse in the form of a Life Annuity, unless your spouse makes an election
for a single sum payment or for an Annuity Benefit on any other annuity form
offered by us, subject to our rules then in effect. Any election of an Annuity
Benefit must meet the minimum distribution requirements as described in Section
3.05.
The amount of the death benefit is equal to the greater of (i) the Annuity
Account Value less any outstanding loan and (ii) the minimum death benefit. Such
minimum death benefit is the sum of all Contributions made pursuant to Section
2.01 (before reduction for any applicable tax charge) less any outstanding loan
and less any withdrawals made pursuant to Section 2.07. Any such withdrawal will
reduce the minimum death benefit (as adjusted by any previous such withdrawal)
by an amount which is in the same proportion as the amount being withdrawn is to
the Annuity Account Value.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value shall be zero. We will be released from any and all
liability from which the Annuity Account Value arose.
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PART III - ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under the terms of this Contract with respect to a payee is the amount provided
pursuant to Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division of the Separate Account.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of Net
Investment Return referred to in Section 1.24 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to
provide for any applicable tax charge. These charges include a daily charge for
financial accounting, death benefits, mortality risk, expenses and expense risk,
plus the investment advisory fee charges and direct operating expense charges of
the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under the terms of this Contract with respect to a payee is the
monthly amount provided with respect to a payee pursuant to the fourth paragraph
of Section 3.04. The amount of the fourth and each subsequent payment under a
Variable Annuity Benefit will be equal to the number of Annuity Units with
respect to such benefit, multiplied by the Average Annuity Unit Value for the
second calendar month immediately preceding the due date of the payment. The
number of Annuity Units with respect to a benefit is the number determined by
dividing the amount of the first monthly payment under such benefit by the
Annuity Unit Value for the Valuation Period which includes the due date of the
first monthly payment. (As described in Section 3.05, we will notify the payee
how each Variable Annuity payment is determined.)
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. Subject to the terms
of the Plan, including the spousal consent and survivor rules described in
Section 3.06, as of your Retirement Date, provided you are then living, the
Annuity Account Value less any outstanding loan shall be applied to provide the
Normal Form of Annuity Benefit, unless an election is made (i) to receive the
Cash Value of this Contract in a single sum, (ii) to apply the Annuity Account
Value, (less any outstanding loan as set forth in Section 2.10) or Cash Value,
whichever is applicable pursuant to the first paragraph of Section 3.04, to
provide an Annuity Benefit on any other form offered by us or one of our
affiliated or subsidiary life insurance companies, or (iii) to take partial
withdrawals in amounts and at times as required by the minimum distribution
rules of Section 401(a)(9) of the Code and applicable Treasury Regulations,
pursuant to Section 3.05, subject to our rules then in effect and any other
applicable requirements under the Code.
No. 92CTRA Page 12
We will provide notice and election forms to the Owner not more than six months
before your Retirement Date.
If an election is made to terminate this Contract pursuant to Section 2.06, an
election may be made to receive an Annuity Benefit in lieu of the Cash Value.
We will have the right to require pertinent information to provide an Annuity
Benefit, and will be fully protected in relying on such information and need not
inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary
life insurance companies.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If, pursuant to the first or third
paragraph of Section 3.03, an election is made to receive an Annuity Benefit in
lieu of the Cash Value, the amount applied to provide the Annuity Benefit will
be (i) the Annuity Account Value less any outstanding loan if the annuity form
elected involves life contingencies or (ii) the Cash Value if the annuity form
elected does not involve life contingencies.
The amount applied to provide an Annuity Benefit may be reduced by any
applicable tax charge on annuity considerations, as we determine. If we have
previously deducted any applicable tax charges from Contributions as provided in
Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to this Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your Contract will be governed by our
supplementary contract then in effect.
The amount to be applied to provide an Annuity Benefit will, in addition to any
tax charge reduction, be reduced by an administrative charge. The amount of such
charge will be determined from time to time in accordance with our general
practices applicable on a uniform basis to all contracts of the same type as
this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts in
the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under the terms of this
Contract, as indicated, on the Joint and Survivor Life Annuity Form (with 100%
of the amount of your payment continued to your spouse). The amount of income
provided under the Fixed Annuity Benefit payable on the Joint and Survivor Life
Annuity Form, is based on 3.5% interest and the 1983 Individual Annuity
Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males
and females at age zero. The amounts of income initially provided under the
Variable Annuity Benefit payable on the Life Annuity Form are based on a 50-50
split of males and females at age zero and an Assumed Base Rate of Net
Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.24.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us on 3.5% interest and the 1983 Individual Annuity Mortality
Table "a" adjusted to a unisex basis based on a 50-50 split of males and females
at age zero if such annuity form provides for a Fixed Annuity Benefit, and on
the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50
split of males and females at age zero and an Assumed Base Rate of Net
Investment Income Return of 5% or 3.5%, whichever applies pursuant to Section
1.24, if such annuity form provides for a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract
will be distributed or begin to be distributed, in accordance with Section
401(a)(9) of the Code and the applicable Treasury Regulations thereunder, no
later than the first day of April following the calendar year in which you
attain age 70 years and 6 months ("Required Beginning Date") or such later date
as specified in such Section or regulations. Your entire interest may be
distributed, as you elect, over (a) your life, or the lives of you and your
designated beneficiary, or (b) a period certain not extending beyond your life
expectancy, or the joint and last survivor expectancy of you and your designated
beneficiary. Distributions must be made in periodic payments at intervals of no
longer than one year. In addition, payments must be either nonincreasing or they
may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the
Proposed Treasury Regulations, or any successor Regulation thereto.
All distributions made hereunder shall be made in accordance with the
requirements of Section 401(a)(9) of the Code, including the incidental death
benefit requirements of Section 401(a)(9)(G) of the Code, and applicable
Treasury Regulations, including the minimum distribution incidental benefit
requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or
any successor Regulation thereto.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.05, while any distribution shall be subject to such requirements of
the Code and regulations, any distribution shall also be subject to the terms of
this Contract. That is, the forms of distribution shall be those which are made
available by us at the time of your election.
No. 92CTRA Page 13
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Table V and VI of Treasury Regulation Section 1.72-9. Unless
you otherwise elect prior to the time distributions are required to begin, those
life expectancies shall be recalculated annually. Such election shall be
irrevocable and shall apply to all subsequent years. The life expectancy of a
non-spouse beneficiary may not be recalculated. Instead, life expectancy will be
calculated using the attained age of such beneficiary during the calendar year
in which you attain age 70 years and 6 months, and payments for subsequent years
shall be calculated based on such life expectancy reduced by one for each
calendar year which has elapsed since the calendar year life expectancy was
first calculated.
If you die after distribution of your interest described in this Contract has
begun, the remaining portion of such interest will continue to be distributed as
rapidly as under the method of distribution being used prior to your death.
If you die before distribution of your interest begins, distribution of your
entire interest shall be completed no later than December 31 of the calendar
year containing the fifth anniversary of your death, except to the extent that
an election is made to receive death benefit distributions in accordance with
(1) or (2) below:
(1) If your interest is payable to a designated beneficiary, then your entire
interest may be distributed over the life of, or over a period certain not
greater than the life expectancy of, the designated beneficiary. Such
distributions must commence on or before December 31 of the calendar year
immediately following the calendar year of your death.
(2) If the designated beneficiary is your surviving spouse, the date
distributions that are required to begin in accordance with (1) above shall
not be earlier than the later of (A) December 31 of the calendar year
immediately following the calendar year of your death or (B) December 31 of
the calendar year in which you would have attained age 70 years and 6
months.
For purposes of determining the "period certain" referred to in the
immediately preceding paragraph, life expectancy is computed by use of the
expected return multiples in Tables V and VI of Treasury Regulation Section
1.72-9. For purposes of distributions beginning after your death, unless
otherwise elected by the surviving spouse by the time distributions are
required to begin, life expectancies shall be recalculated annually. Such
election shall be irrevocable by the surviving spouse and shall apply to
all subsequent years. In the case of any other designated beneficiary, life
expectancies shall be calculated using the attained age of such beneficiary
during the calendar year in which distributions are required to begin
pursuant to this Section, and payments for any subsequent calendar year
shall be calculated based on such life expectancy reduced by one for each
calendar year which has elapsed since the calendar year life expectancy was
first calculated.
Distributions under this Section are considered to have begun if distributions
are made because you have reached your Required Beginning Date or if prior to
the Required Beginning Date distributions irrevocably commence to you over a
period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1
of the Proposed Treasury Regulations or any successor Regulation thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under the terms of this Contract was based on information
that is subsequently found to be incorrect, benefits will not be invalidated,
but an adjustment on the basis of the correct information will be made in the
amount of the benefit payments, or any amount used to provide the benefit, or
any combination thereof. Overpayments by us will be charged against and
underpayments will be added to any payments thereafter falling due under the
terms of this Contract with respect to a payee, affecting as many such payments
as are necessary to correct the overpayment or underpayment. Our liability with
respect to a payee is limited to the correct information and the actual amounts
used to provide the benefits then in force with respect to the payee under this
Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under the terms of this Contract is physically or mentally
incompetent to receive such payment or is a minor, (ii) another person or an
institution is then maintaining or has custody of such payee, and (iii) no
guardian, committee, or other representative of the estate of such payee has
been appointed, we may, unless the Plan provides to the contrary, make the
payments (in the case of a minor, at a rate not exceeding $200 a month) to such
other person or institution, and will thereupon be fully discharged from all
liability with respect thereto.
If a variable annuity form made available by us provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one of two persons, a payee for payments
thereunder may elect, without the concurrence of any other person, to receive
the commuted value of any remaining payments, provided no person upon whose life
the income depends is surviving.
No. 92CTRA Page 14
Upon an election, pursuant to Section 3.03, of an annuity form providing
payments for a period certain, such Owner may designate (in accordance with the
terms of the Plan and with the right to change such designation in accordance
with the terms of the Plan) a payee to receive any payments that may become due
after the death of the person or persons upon whose life or lives the income may
depend.
The payee may designate (with the right to change such designation and without
the concurrence of any other person unless the Plan provides to the contrary) a
person or persons to receive any payments or installments payable after such
payee's death, if the absence of such a designation would result in a single sum
payment to such payee's estate in accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments. The commuted value of any such remaining payments will be
determined on the basis of compound interest at the rate utilized in the
actuarial rate basis applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
------------------------------------------------------------------------------
TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT
AND SURVIVOR LIFE ANNUITY FORM
100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE
(Minimum Monthly Income per $1,000 of Annuity Account Value)
----------------------------------------------------------------------------------------------------------------------------------
Age 60 61 62 63 64 65 66 67 68 69 70
----------------------------------------------------------------------------------------------------------------------------------
60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88
61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96
62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03
63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11
64 4.89 4.94 5.00 5.05 5.10 5.14 5.19
65 5.00 5.06 5.11 5.17 5.22 5.27
66 5.12 5.18 5.24 5.29 5.35
67 5.24 5.31 5.37 5.43
68 5.37 5.44 5.51
69 5.52 5.59
70 5.67
----------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE
ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1,000 of Annuity Account Value)
-------------------------------------------------------------
VARIABLE ANNUITY BENEFIT
IF ASSUMED BASE RATE OF NET
INVESTMENT RETURN IS
Age 3.5% 5%
-------------------------------------------------------------
60 5.27 6.16
61 5.39 6.28
62 5.52 6.41
63 5.66 6.55
64 5.81 6.70
65 5.97 6.86
66 6.15 7.03
67 6.33 7.21
68 6.53 7.41
69 6.74 7.62
70 6.97 7.85
-------------------------------------------------------------
We will, with respect to each payment under a Variable Annuity Benefit, notify
the payee of the number of Annuity Units and the Average Annuity Unit Value used
in determining the amount of each variable payment. Such notice will be mailed
with each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary as
described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
No. 92CTRA Page 15
SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If you are married,
your interest in this Contract shall be paid in the Normal Form joint and
survivor annuity, and if you are unmarried, your interest shall be paid in the
Normal Form life annuity, unless you elect otherwise as described in this
Section. If you are married and die before payment of your interest has
commenced, your interest shall be paid to your surviving spouse in the form of a
life annuity, unless at the time of your death there was a contrary election
made pursuant to this Section. The foregoing notwithstanding, your surviving
spouse may elect, before payment is to commence, to have payment made in any
form permitted under the terms of this Contract.
You may elect, at any time within the 90 consecutive day period before the first
day of the first period for which your interest is paid as an annuity or in any
other form, not to have your interest paid in the Normal Form in which case it
shall be paid in any other form elected under the terms of this Contract. If
such interest is to be paid to your spouse upon your death, you may elect,
during the period beginning on the first day of the plan year of the Plan in
which you attain age 35 (or, if you separate from service prior to that plan
year, beginning on the date of separation) and ending with your death, for a
beneficiary other than your spouse to receive payment of the value of your
interest. In addition, if you will not yet attain age 35 by the end of any
current plan year, you may make a special qualified election to designate a
beneficiary other than your spouse to receive payment of the value of your
interest. Such special qualified election shall be effective for the period
beginning on the date of such election and ending on the first day of the plan
year in which you will attain age 35. Amounts payable in accordance with this
Section will be automatically reinstated as of the first day of the plan year in
which you attain age 35 unless a new election designating a beneficiary other
than the spouse is made in accordance with the requirements of this Section.
Any election described in the foregoing paragraph must be consented to by your
spouse in writing before a notary public or a representative of the Plan, unless
you can prove that there is no spouse or that the spouse cannot be located.
Also, if you have become legally separated from your spouse or have been
abandoned (within the meaning of local law) and have a court order to such
effect, spousal consent is not required unless a qualified domestic relations
order provides otherwise. Your election must designate a specific beneficiary
(including any class of beneficiaries or any contingent beneficiaries) that may
not be changed without further consent of the spouse, unless the spouse's
consent expressly permits designation by you without further consent of the
spouse. The spouse's consent under this Section shall acknowledge the effect of
the election. In addition, the spouse's consent (or the establishment that the
consent of the spouse may not be obtained) shall only be valid with respect to
such spouse. Your waiver of the Normal Form joint and survivor annuity shall not
be effective unless the election designates a form of benefit payment which may
not be changed without spousal consent (or the spouse expressly permits
designations by you without any further spousal consent). A consent that permits
designations by you without any requirement of further consent by such spouse
must acknowledge that the spouse has the right to limit consent to a specific
beneficiary, and a specific form of benefit where applicable, and that the
spouse voluntarily elects to relinquish either or both of such rights. If you
make an election under this Section you may revoke that election, without
spousal consent, at any time before the first day of the first period for which
an amount is paid as an annuity or in any other form.
The provision requiring spousal consent in this Section shall also apply with
regard to your election to terminate this Contract or make partial withdrawals
pursuant to Sections 2.06 and 2.07 and with respect to a beneficiary designation
set forth in Section 4.04. Spousal consent, as described in this Section, is
also required in the 90 day period before a Plan loan is granted to you pursuant
to Section 2.10.
If the Annuity Account Value applied to provide the spousal benefits on the date
payment is to commence is in the aggregate less than $3,500, we may choose to
make payment in a single sum rather than in the form of a Qualified Joint and
Survivor Annuity or Life Annuity as described herein. Upon any payment made
pursuant to this Section, we will be released from any and all liability for
payment with respect to the Contributions made for you.
-------------------------------------------------------------------------------
PART IV - GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the
parties and the terms of this Contract alone will govern with respect to our
rights and obligations. A copy of the application is incorporated in and made
part of this Contract.
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by our authorized officer. The terms of this
Contract may be changed by amendment or replacement upon agreement between the
Owner and us without the consent of any other person, provided the change does
not reduce any annuity benefit.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of
this Contract without the consent of any other person in order to comply with
applicable laws and regulations. Such right shall
No. 92CTRA Page 16
include, but not be limited to, the right to conform this Contract to reflect
changes in the Code, applicable Treasury Regulations or in regulations or
published rulings of the Internal Revenue Service so that this Contract will
continue to be an Annuity under a qualified plan.
SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY. No interest of yours or of a
beneficiary under this Contract may be transferred to any person other than us
upon the surrender of this Contract. Except as permitted under Section
401(a)(13) of the Code, no right or interest of you or any other payee or
beneficiary in this Contract shall be (a) assignable; (b) subject to any lien;
or (c) liable for, or subject to, any obligation or liability of any person. The
preceding sentence shall not apply to an assignment, transfer or attachment
pursuant to a qualified domestic relations order, as defined in Section 414(p)
of the Code.
SECTION 4.04 BENEFICIARY. The Owner, as of the Contract Date, is to provide us
with an initial designation of the beneficiary entitled to receive any death
benefit payable with respect to you pursuant to Section 2.12. Subject to the
Plan and spousal consent and survivor rules of Section 3.06, you may change such
designation from time to time during your lifetime and while this Contract is in
force. If the beneficiary is the Trustee, the Trustee will have the right within
31 days of the day we receive due proof of your death and pursuant to the
provisions of the Plan, to change the beneficiary entitled to receive your death
benefits.
If the Trustee is not the beneficiary, the beneficiary will be your spouse
unless he or she has given duly witnessed written consent to the designation of
another beneficiary as described in Section 3.06, or you establish prior to your
death that he or she cannot be located. Such spousal consent must be on file
with the Trustee while this Contract is owned by the Trustee. If the Trustee is
not the Owner, such spousal consent must be presented to us with the change of
beneficiary request or with proof of your death and election of an Xxxxxxx
Xxxxxxx.
SECTION 4.05 DISQUALIFICATION. In the event that the Plan fails to qualify as a
Plan under Section 401(a) of the Code and applicable Treasury Regulations, we
reserve the right, upon receiving notice of such fact, to transfer the Annuity
Account Value under this Contract to another annuity contract issued by us on
your life, or one of our affiliated subsidiary life insurance corporations, or
to terminate this Contract and pay to the Owner the Annuity Account Value less
deduction for applicable taxes, solely at our option.
In the event that this Contract fails to qualify as an Annuity under a qualified
Plan as described in Section 1.02, we shall have the right, upon receiving
notice of such fact, to terminate this Contract and pay at the direction of the
Owner the Annuity Account Value less any outstanding loan and less a deduction
for the appropriate part attributable to the Owner of any Federal income tax
payable which would not have been payable if you had an Annuity.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Employer, we
reserve the right at our sole discretion to limit Contributions under this
Contract.
SECTION 4.07 DEFERMENT. Applications of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of your Annuity Account Value
(less any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities Exchange
Commission, by order, permits us to defer payments in order to protect persons
with interests in the Investment Divisions. We can defer payment of any portion
of your Annuity Account Value in the Guaranteed Interest Division for up to six
months while you are living.
SECTION 4.08. ANNUAL NOTICE. At the end of each Contract Year, we will furnish
you with a notice showing the following:
(1) the amount in the Guaranteed Interest Division,
(2) the total number of Accumulation Units in the Stock Division, Balanced
Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Value,
(4) the amount in the Stock Division, Balanced Division, Aggressive Stock
Division and Money Market Division,
(5) the amount in the loan reserve account,
(6) the Cash Value, and
(7) the amount of death benefit.
No. 92CTRA Page 17
We will also furnish annual calendar year reports concerning the status of the
annuity and any other reports required by the Code or applicable Treasury
Regulations.
After your Retirement Date, we will notify you of the number of Annuity Units
and the Average Annuity Unit Value used in determining the amount of each
Variable Annuity Benefit payment, if any.
SECTION 4.09 TRUSTEE'S RESPONSIBILITY. The Trustee shall hold this Contract on
your behalf and your beneficiaries as an asset of the trust, unless this
Contract is distributed to you pursuant to the terms of the Plan. The Trustee
shall be responsible for transferring all payment made under this Contract to
the Annuitant and the Annuitant's beneficiaries in accordance with the terms of
the Plan and the applicable provisions of the Code. We shall make no payment
hereunder without written instructions from the Trustee, and we shall be fully
discharged of any liability therefor to the extent such payments are made to and
at the direction of the Trustee.
SECTION 4.10 AGE. If your age has been misstated, any benefits will be those
which would have been purchased at the correct age. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
No. 92CTRA Page 18
-------------------------------------------------------------------------------
APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P.O. Box 2996,
New York, New York 10116-2996
QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR:
EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY
-------------------------------------------------------------------------------
1. TYPE OF PURCHASE (Complete One Plan Only)
a. | | TSA Public School (GV-PS-I)
b. | | TSA 501(c)(3) Organization (GV-501-I)
c. | | TSA University (GV-PS-U-I)
d. | | IRA Individual (including IRA to IRA transfers)
(XX-XXX 4971)
e. | | IRA Unit Billed (including IRA to IRA transfers) (XX-XXX 4971)
f. | | IRA QUALIFIED PLAN ROLLOVER--(QP IRA)
(Distribution from a Qualified Plan)
(XX-XXX 4971-71)
g. | | EDC (Public Employee Deferred Compensation (GV-EDC 4991)
h. | | EDC (Tax Exempt Organization)(GV-EDC 4991-SU-080)
i. | | SEP (Simplified Employee Pension)(GV-SEP 4981)
j. | | SARSEP (Salary Reduction SEP) ____________
k. |x| CORPORATE TRUSTEED (GV-CORP 4941-41)
l. | | XXXXX/HR-10 TRUSTEE (GV HR-10 4911-11)
(trustee owned)
m. | | Xxxxx/HR-10 (GV-HR-10 4911)
(not trustee owned) (issued to existing units only)
-------------------------------------------------------------------------------
DO NOT COMPLETE THIS SECTION IF BOX 1.d OR 1.f CHECKED ABOVE
2. EMPLOYER/PLAN NAME
|A|B|C| | C|O|M|P|A|N|Y| | | | | | | | | | | | | | | | | | | | | | | | | | |
3. | | EXISTING UNIT NO. | | | | | | | - | | |X| NEW UNIT |0|0|0|1|2|3|-|4|5|6|
(FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP,
OR TRUSTEED PLANS. FORM 983-135B IS REQUIRED.)
-------------------------------------------------------------------------------
4. PROPOSED ANNUITANT Print name to appear on Contract.
|J|o|h|n| | | | | | | | | | | | | | | | | | |O|E | | | | | | |
First Middle Initial Last
a. |x| Mr. | | Mrs. | | Miss | | Ms. | | Other _______
b. Date of Birth: Year 1954 Month JANUARY Day 27
----- -------- ----
c. Age at Nearest Birthday: 38 d. |x| Male | | Female
------
e. Annuitant's Mailing Address: f. State of Residence: N.J.
----
No., St. |1|7| |E|L|M| |S|T|R|E|E|T| | | | | | | | | | | | |
City |A|N|Y|T|O|W|N| | | | | | | | | | | | | | | | | |
State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1|
g. Telephone Number (000) 000-0000 |x| Home | | Work
h. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9|
i. Are you associated with or employed by a member of National Association
of Securities Dealers, Inc. (NASD)? | | Yes |x| No
5. OWNER (Print Name) - If Trusteed or EDC Plan Print Name of Owner; for all
other Markets Print Name of Annuitant.
XXXX XXX
------------------------------------------------------------
a. Title
----------------------------------------------------
6. RETIREMENT AGE 65
--------------------------------------------
7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death
Benefit upon Xxxxxxxxx's death before Retirement Date.) BENEFICIARY MUST BE
THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.)
XXXX XXX - WIFE
-----------------------------------------------------------
-----------------------------------------------------------
-----------------------------------------------------------
8. CONTRIBUTION ALLOCATION
Guaranteed Interest Division 20%
--
Stock Division 20%
--
Money Market Division 20%
--
Balanced Division 20%
--
Aggressive Stock Division 20%
--
(PERCENTAGES IN WHOLE NUMBERS) Total 100%
9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F)
a. Reminder Notice (Billing) Required | | Yes |x| No
IF YES, complete b-c-d-e
b. REMINDER DATE Required for Individual IRA or
otherwise must agree with existing unit or attached
983-135B. MONTH _________ DAY _________
c. REMINDER FREQUENCY
| | Annual | |Semi-Annual
| | Quarterly | |Monthly
Available for TSA, EDC, SARSEP AND CORPORATE
TRUSTEED AND UNIT BILLED IRA ONLY:
| | Semi-Monthly | | Bi-Weekly
d. REMINDER AMOUNT $______________________
e. BILLING MONTHS TO BE EXCLUDED - TSA ONLY
----------------------------------------------------------
----------------------------------------------------------
----------------------------------------------------------
10. EXPECTED FIRST CONTRACT YEAR
CONTRIBUTION. $ 1000
-----------
If an advanced billing and/or contract date are requested, complete #9b and
#12.
--------------------------------------------------------------------------------
(FOR PROCESSING OFFICE USE)
Unit Name ____________________________ Reminder Date__________________________
Cert. or App# ________________________ Amendment Required_____________________
EDC Emp. Add._________________________ Emp. Fed. ID # ________________________
Frequency ____________________________ Contract Date _________________________
Receipt Date Batch # Inquiry # Processor
--------------------------------------------------------------------------------
180-1000
10. Did you receive the Separate Account Prospectus? |x|Yes | |No
Date shown on Prospectus January 1, 1992
-----------------------------
Date of any supplement to Prospectus
--------------------
11. Items (a) through (f) are to be answered by the annuitant. We are required
by the NASD to ask these questions.
(a) Name of Employer: ABC COMPANY
----------------------------------
(b) Address of Employer:
00 XXXX XXXXXX
------------------------------------------------------
ANYTOWN, NJ
------------------------------------------------------
(c) Occupation SALES
-------------------------------------------
(d) Assuming the contract applied for will be issued, will any existing
insurance or annuity be replaced or changed (or has it been)?
| | Yes |x| No
(e) Estimated Family Annual Income $100,000
-----------------------
(f) Estimated Net Worth $250,000
-----------------------
(g) Investment Objective: | | Income |x| Income & Growth
| | Aggressive Growth | | Growth | | Safety Of Principal
12. SPECIAL INSTRUCTIONS
--------------------------------------------------------------
--------------------------------------------------------------
--------------------------------------------------------------
--------------------------------------------------------------
--------------------------------------------------------------
13. AMOUNT PAID WITH THIS FORM: $ 1000
---------
(If a check is submitted with this request, no advanced Contract Date is
permitted.) BACKDATING IS NOT PERMITTED.
NOTE: Xxxxxx paid will be credited upon receipt at Equitable's Processing
Office, subject to return if the contract is not issued. The Contract Date
will be the date of receipt by Equitable of this application, properly
signed and completed, and Contribution at Equitable's Processing Office.
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
AGREEMENT
All information and statements furnished in this application are true and
complete to the best of my knowledge and belief. I understand and acknowledge
that no Agent has the authority to make or modify any contract on Equitable's
behalf, or to waive or alter any of Equitable's rights and regulations.
IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO
THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT
PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT.
UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S)
OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND
COMPLETE.
--------------------------------------------------------------------------------
LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR
ANNUITY APPLICATION WITH INFORMATION YOU KNOW IS FALSE
OR TO LEAVE OUT MATERIAL FACTS
--------------------------------------------------------------------------------
X_________________________________ Date __________ City ___________ State_______
Signature of Annuitant
X_________________________________ Date __________ City ___________ State_______
Signature of Authorized Individual (REQUIRED FOR EDC AND
TRUSTEED) OR OWNER
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
AGENT'S SECTION
Will any existing Insurance or annuity be replaced or changed (or has it been),
assuming the Contract will be issued? | | Yes | | No | |
| | I (we) certify that a prospectus for the Contract has been given to the
proposed Annuitant and that no written sales materials other than those approved
by The Equitable have been used.
EQUI-VEST issues must adequately reflect the commission interest of all Agents
on previous contracts.
------------------------------------------------------------------------------------------------------------------------------------
Print Agent's Name(s) Initial of Last Agent Agent Agency District Agent's
(Service Agent first) Name Number % Code Manager Code Signature
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
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------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS ______ Date ______ District EQS ________ Date ________
------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------
(For ASU Use)
ASU Code and App. No ________________________________
ASU Rec'd ___________________________________________
ASU Rec'd ___________________________________________
Date to Proc. Off ________________________Campaign | |
Agent(s) shown above is Equity Qualified and is licensed in the state where the
request is signed. Above Agent information verified by XXX (Registered Rep)
--------------------------------------------------------------------------------
Application reviewed by _________________________________
--------------------------------------------------------------------------------
180-1000
[EQUITABLE LOGO]
Owner:
Annuitant:
Contract Number:
Issue Date:
Contract Date:
Retirement Date:
--------------------------------------------------------------------------------
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P O Box 2996, New York,
New York 10116-2996
AGREES
o TO ALLOCATE the Contributions made to the Contract, after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division of the Separate Account (referred to
in this Contract as the "Investment Divisions")or to the Guaranteed Interest
Division, in accordance with Sections 2.02, 2.03 and 2.04, as directed by the
Owner, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide you with
an Annuity Benefit or a Cash Value benefit if you are then living, and
o TO PROVIDE the Owner with the other rights and benefits of this Contract.
This is the entire Contract. In this Contract, "we", "our" and "us" mean The
Equitable Life Assurance Society of the United States. "You" and "your" mean the
Annuitant, with respect to a right exercised by the Owner on behalf of the
Annuitant.
TEN DAYS TO EXAMINE CONTRACT - The Owner may cancel this Contract by returning
it to us within ten days after receipt of it. Upon such cancellation, we will
refund any Contribution made to us under this Contract, plus or minus any
investment gain or loss experienced in the Investment Divisions of the Separate
Account from the date such Contribution is allocated to such Investment Division
to the date we receive the returned Contract.
/s/ Xxxxxxx Xxxxxxx /s/ Xxxxxx X. Xxxxxx
Xxxxxxx Xxxxxxx, Vice President, Secretary & Xxxxxx X. Xxxxxx
Associate General Counsel President and Chief
Executive Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE
MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL
ACCOUNTING, DEATH BENEFITS, MORTALITY RISKS, EXPENSES AND EXPENSE RISK, PLUS THE
INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE
TRUST.
No. 92CTRB
This Contract is issued in consideration of the payment to us of the
Contributions made under the terms of this Contract.
The provisions on the following pages are part of this Contract.
--------------------------------------------------------------------------------
TABLE OF CONTENTS
DEFINITIONS Page
Section 1.01 - Annuitant....................................................4
1.02 - Annuity......................................................4
1.03 - Annuity Account Value........................................4
1.04 - Annuity Benefit..............................................4
1.05 - Cash Value...................................................4
1.06 - Class of Contracts...........................................4
1.07 - Code.........................................................4
1.08 - Contract Date................................................4
1.09 - Contract Year................................................4
1.10 - Contribution.................................................4
1.11 - Divisions....................................................4
1.12 - Eligible Annuity Certain.....................................5
1.13 - Employer.....................................................5
1.14 - Guaranteed Interest Rate.....................................5
1.15 - Joint and Survivor Life
Annuity Form.................................................5
1.16 - Life Annuity Form............................................5
1.17 - Normal Form..................................................5
1.18 - Owner........................................................5
1.19 - Period Certain Annuity.......................................5
1.20 - Plan.........................................................5
1.21 - Processing Office............................................5
1.22 - Retirement Date..............................................5
1.23 - Separate Account.............................................5
1.24 - Separate Account
Definitions..................................................6
1.25 - Transaction Date.............................................7
1.26 - Trust........................................................7
1.27 - Trustee......................................................7
1.28 - Trusteed Plan................................................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions................................................7
2.02 - Separate Account
Investment Divisions.........................................7
2.03 - Guaranteed Interest
Division.....................................................8
2.04 - Allocation to Divisions......................................8
2.05 - Transfers Among Divisions....................................8
2.06 - Termination of this Contract.................................8
2.07 - Partial Withdrawals..........................................9
2.08 - Charges for Partial Withdrawals..............................9
2.09 - Free Corridor Amount.........................................9
2.10 - Loans.......................................................10
2.11 - Annual Administrative Charge................................11
2.12 - Death Benefit...............................................11
ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit.......................................12
3.02 - Variable Annuity Benefit....................................12
3.03 - Election and Commencement
Of Annuity Benefits.........................................12
3.04 - Amount of Annuity Benefits..................................13
3.05 - Payment of Xxxxxxx Xxxxxxxx.................................13
3.06 - Special Annuity and Spousal
Consent Provisions..........................................16
GENERAL PROVISIONS
Section 4.01 - Contract....................................................16
4.02 - Statutory Compliance........................................16
4.03 - Assignments and
Nontransferability..........................................17
4.04 - Beneficiary.................................................17
4.05 - Disqualification............................................17
4.06 - Future Contributions........................................17
4.07 - Deferment...................................................17
4.08 - Annual Notice...............................................17
4.09 - Trustee's Responsibility....................................18
4.10 - Age.........................................................18
No. 92CTRB Page 2
--------------------------------------------------------------------------------
PART I - DEFINITIONS
SECTION 1.01 ANNUITANT. The term "Annuitant" means the individual shown on Page
3 of this Contract for whom this Contract has been purchased.
SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in
accordance with the terms of a Plan.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts in the Guaranteed Interest Division, and the Investment
Divisions of the Separate Account pursuant to Sections 2.02 and 2.03 and any
loan reserve provision, described in Section 2.10.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by us pursuant to Section 3.04 of this Contract. Various Sections of this
Contract (Sections 1.15, 1.16, 1.17, 3.01 and 3.02) refer to "monthly payments"
to be made under an Annuity Benefit. The Owner may wish to have your Annuity
Benefit paid at other intervals, such as quarterly, semi-annually, or annually,
instead of monthly. The Owner may elect this at the time the Annuity Benefit
form is elected as described in Section 3.03; in that event, all references in
this Contract to "monthly payments" will be deemed to mean payments at the
frequency you elect subject to our rules at the time of election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means an amount equal to the
greater of (i) or (ii), less any outstanding loan, where
(i) is the Annuity Account Value less 6% of the Contributions made during the
current and five prior Contract Years, which had not been previously
withdrawn pursuant to Section 2.07, and
(ii) is the sum of (a) the Free Corridor Amount as defined in Section 2.09 and
(b) 94% of the Annuity Account Value less the Free Corridor Amount.
NO WITHDRAWAL CHARGE: If you have attained the age of 59 years and 6 months, the
term "Cash Value" means an amount equal to the Annuity Account Value for
withdrawals due to retirement or termination of employment. Your retirement or
termination of employment must be verified by the Trustee. Such verification
should be in the form of a statement signed by the Trustee and accompanying the
request for withdrawal. The request for withdrawal must be signed by both you
and the Trustee. The withdrawal charge will be imposed if this verification is
not received at our Processing Office together with the withdrawal request.
However, if the Annuitant is age 60 or older on the Contract Date and it is
Contract Year 5, item (ii)(b) above will be 95% of the Annuity Account Value
less the Free Corridor Amount.
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same calendar year. The term "Contract"
means this Contract.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as
now or hereafter amended, or any corresponding provisions of prior or subsequent
United States revenue laws.
SECTION 1.08 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both the application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.09 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.10 CONTRIBUTION. The term "Contribution" means a payment made to us on
your behalf with respect to this Contract. We are under no obligation to accept
any Contribution less than $20.00.
SECTION 1.11 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following divisions described in this
Contract:
(i) the Guaranteed Interest Division, and
(ii) the Investment Divisions of the Separate Account.
No. 92CTRB Page 4
SECTION 1.12 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
an annuity not involving life contingencies issued by us which extends beyond
your attainment of age 59 years and 6 months and does not permit any prepayment
of the unpaid principal (that is, no withdrawal or single sum payment) prior to
your attainment of age 59 years and 6 months.
SECTION 1.13 EMPLOYER. The term "Employer" means the corporate employer adopting
the Plan, or any such employer that assumes in writing the obligations of the
Plan.
SECTION 1.14 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the interest that we credit at effective annual rates in the Guaranteed Interest
Division. The initial rate to apply is shown on Page 3 of this Contract. Section
2.03 describes the determination of the rate to apply thereafter.
SECTION 1.15 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected. The payments commence on the date as of which the Joint and Survivor
Life Annuity Form is purchased and terminate with the last payment due before
the death of the survivor.
SECTION 1.16 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us providing monthly payments during the lifetime of the person upon
whose life such payments depend. The payments commence on the date as of which
the Life Annuity Form is purchased and terminate with the last payment due
before the death of such person.
SECTION 1.17 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means, (i) if you have a living spouse at your Retirement Date,
the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form
with your spouse as the contingent annuitant (with 100% of the monthly payment
continued to your spouse), and (ii) if you do not have a living spouse at your
Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form.
SECTION 1.18 OWNER. The term "Owner" of the Contract is the person or entity as
stated on Page 3 of this Contract. Notwithstanding any provisions in this
Contract to the contrary, only the Owner can exercise all the rights under this
Contract while you are living. When exercising such right, the Owner does not
need the consent of anyone who has only a conditional or future ownership
interest in this Contract unless the Owner delegates rights to such person.
Under this Contract the Owner is the Trustee, defined in Section 1.27.
While you are living, the Owner of this Contract on your behalf may change the
Owner by written notice satisfactory to us. The change will take effect on the
date the Owner signs the notice, except it will not apply to any payment we make
or other actions we take before we receive the notice.
SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us which does not permit any
prepayment of the unpaid principal, (that is, you cannot elect to receive part
of your payments as a single sum payment with the remainder paid in monthly
annuity payments).
SECTION 1.20 PLAN. The term "Plan" means a defined contribution plan adopted by
the Employer that is intended to meet the requirements for qualification under
Section 401(a) of the Code.
SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such
other location as we shall designate by advance written notice to the Owner, the
Employer or the Plan's trustee, as applicable, and to you.
SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which
you attain the retirement age as shown on Page 3 of this Contract. Before the
Retirement Date an election may be made to change the Retirement Date to another
Retirement Date permitted under the Plan, which may be any date after the filing
of the election other than the 29th, 30th or 31st day of any month. The
Retirement Date selected, either initially or by later change, must be in
accordance with the terms of the Plan. No Retirement Date shall be later than
the date you attain age 70 years and 6 months. Any election for such change must
be made in writing by you and shall not take effect until received by us at our
Processing Office.
SECTION 1.23 SEPARATE ACCOUNT. The term "Separate Account" means Separate
Account A which is organized as a unit investment trust, a type of investment
company. We established the Separate Account and it is maintained in accordance
with the laws of New York State. Realized and unrealized gains and losses from
the assets of the Separate Account are credited to or charged against it without
regard to our other income, gains or losses. Assets are put in the Separate
Account to support this Contract and other variable annuity contracts and
certificates. Assets may be put in the Separate Account for other purposes, but
not to support contracts or policies other than variable annuities or variable
life insurance.
No. 92CTRB Page 5
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust or investment company where each class (or series) represents a
separate portfolio in the Trust. We reserve the right to change the designated
trust or investment company or to add designated trusts or investment companies.
The Investment Divisions available are the Stock Division, the Money Market
Division, the Balanced Division and the Aggressive Stock Division. The
Guaranteed Interest Division is not part of the Separate Account, but rather is
an asset of our General Account.
We will value the assets of each Investment Division on each business day. A
business day is any day on which we are open, the New York Stock Exchange is
open for trading and there is a sufficient degree of trading in the portfolio
securities in which an Investment Division is invested to materially affect the
Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments we are
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under the
Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such committee at any time;
(iii) restrict or eliminate any of the Owner's voting rights as to the Separate
Account;
(iv) operate the Separate Account by making direct investments, or in any other
form;
(v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or
remove Investment Divisions (or sub-divisions of Investment Divisions)
from the Separate Account (the term "Investment Division" in this Contract
shall then refer to any other Investment Division in which the assets, of
a class of contracts to which this Contract belongs, were placed);
(vi) combine any two or more Investment Divisions (or sub-divisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
class of contracts to which this Contract belongs.
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, the Owner and you will be notified of
such exercise, as required by law.
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for applicable tax
charge) at a rate not to exceed 1.49% per year for each of the Stock, Money
Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock
Division, for financial accounting, death benefits, mortality risk, expenses and
expense risk. The charge shall be made in accordance with Subsection (c) of the
Net Investment Factor provision in Section 1.24. The relative proportion of
these charges may be modified. This daily charge, plus the investment advisory
fee charges and direct operating expense charges of the Trust, shall not exceed
a total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract.
SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any consecutive preceding
nonbusiness days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
No. 92CTRB Page 6
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment Division
for the Valuation Period. For this purpose, we use the share value reported
to us by the Trust.
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period (after
any amounts allocated or withdrawn for that Valuation Period).
(c) is the daily Separate Account charge for the expenses of this Contract times
the number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is the unit which is purchased in an
Investment Division where Contributions are invested and which is used in
determining the amount in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for such Valuation Period.
ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first contribution was put into the Stock
Division, the Annuity Unit Value was at $1.26 and $1.52 for contracts with
Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively.
The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit
Value for the immediately preceding Valuation Period multiplied by the Adjusted
Net Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for a Valuation Period is the Net Investment Factor for such
period reduced for each calendar day in such subsequent Valuation Period by the
Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net
Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net
Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall
be 5%, except in states where the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar
month is equal to the average of the Annuity Unit Values for all Valuation
Periods ending in such month.
SECTION 1.25 TRANSACTION DATE. The term "Transaction Date" means the business
day we receive a Contribution or a written contract transaction request
providing the information we need at the Processing Office. In the case of a
transfer request initiated through the use of a touch tone telephone, as
described in Section 2.05, the Transaction Date is the business day the
telephone transaction is received.
SECTION 1.26 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
SECTION 1.27 TRUSTEE. The term "Trustee" means the person or persons named as
trustee under a Trusteed Plan and such Trustee's successors. Under this
Contract, the Trustee is the Owner.
SECTION 1.28 TRUSTEED PLAN. The term "Trusteed Plan" means a Plan under which
there is maintained a trust forming a part of the Plan.
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PART II - ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. The Employer or the Trustee, as applicable, is to
make Contributions from time to time on such dates and in such amounts as
determined by the Employer pursuant to the terms of the Plan. The Employer or
the Trustee is to specify the amount allocated to each Division. Each
contribution, received by us will, before its allocation under this Contract, be
reduced by the amount of any applicable tax charge as determined by us.
Contributions will be allocated to the Division in accordance with instructions
received on the application unless later changed.
Pursuant to the terms of the Plan, we will accept rollover contributions and
transfers made on your behalf from a plan qualified under 401(a) of the Code or
from a conduit individual retirement arrangement as described in Section 408 of
the Code.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to, or withdrawn or transferred from, an Investment
Division, the Annuity Account Value will be credited or charged, as the case may
be, with the number of Accumulation Units determined by dividing said amount by
the Accumulation Unit Value for the appropriate Investment Division for the
Valuation Period which includes that date. The number of units in an Investment
Division on any date is equal to (i) the sum of any
No. 92CTRB Page 7
Accumulation Units that have been allocated pursuant to Section 2.04 minus (ii)
the sum of any Accumulation Units that have been withdrawn pursuant to Sections
2.07, 2.08, 210 or 2.11 or transferred from the Investment Division pursuant to
Section 2.05. The amount in an Investment Division on any date is equal to the
product of (i) the number of Accumulation Units in the Investment Division on
that date and (ii) the Accumulation Unit Value for the Investment Division for
the Valuation Period which includes that date.
Participation in the Separate Account under this Contract terminates on the
earliest of (i) Election and Commencement of Annuity Benefits pursuant to
Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of
this Contract pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets which support
the guarantees of this Contract and other contracts.
The amount in the Guaranteed Interest Division at any time is equal to the sum
of all amounts that have been allocated to the Guaranteed Interest Division
pursuant to Section 2.04 or Section 2.10 plus the amount of any interest accrued
but not allocated, less the sum of all amounts that have been withdrawn from the
Guaranteed Interest Division pursuant to Section 2.07, 2.08, 2.10 or 2.11 or
transferred from the Guaranteed Interest Division pursuant to Section 2.05.
Interest is allocated to the Guaranteed Interest Division on a Transaction Date
pursuant to Section 2.04.
We will credit the amount in the Guaranteed Interest Division with interest at
effective annual rates that we determine. For each Class of Contracts we
determine a yearly guaranteed interest rate that will remain in effect
throughout the next year. We guarantee that this yearly guaranteed interest rate
will never be less than 3%.
Participation in the Guaranteed Interest Division under this Contract terminates
on the earliest of (i) Election and Commencement of Annuity Benefits pursuant to
Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of
this Contract pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction of any applicable tax charge) to one or more
Divisions, as specified to us in writing. Allocation percentages must be in
whole numbers and the sum must equal 100. The allocation is made as of the
Transaction Date on which we have received both such Contribution and such
direction. Contributions made to an Investment Division purchase Accumulation
Units in that Investment Division, using the Accumulation Unit Value next
computed after the Transaction Date.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon termination of this Contract pursuant to Section 2.06, and (vi)
upon your death pursuant to Section 2.12.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. Upon written request or through the use
of a touch tone telephone, the Owner may transfer all or part of the amounts in
a Division to one or more of the Divisions as follows: (1) amounts in the
Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive
Stock Division may be transferred among such Divisions; and (2) amounts in the
Money Market Division may be transferred to other Divisions. Written
authorization for touch tone telephone initiated transfers is only required when
authorization for telephone transfers is requested. (Upon advance written notice
to the Owner, we reserve the right to discontinue the acceptance of transfer
requests through the use of a touch tone telephone.) All transfers will be made
on the Transaction Date and will be subject to our rules in effect at the time
of transfer. With respect to the Investment Divisions, the transfer will be made
at the Accumulation Unit Value next computed after the Transaction Date. No
transfers are permitted to the Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the
terms of the Plan, including the spousal consent rules set forth in Section
3.06, the Owner may elect by written notice to terminate this Contract. We will
determine the Cash Value of this Contract as of the Transaction Date.
If this Contract is terminated, surrendered or exchanged prior to the Retirement
Date, any applicable tax charges we have paid may be deducted. If we have
previously deducted charges for applicable taxes from Contributions pursuant to
Section 2.01, we will not again deduct charges for the same taxes on
terminations, unless a change in applicable law has occurred with respect to
this Contract.
The payment of such Cash Value may be deferred by us in accordance with the
provisions of Section 4.07.
No. 92CTRB Page 8
Subject to the terms of the Plan, we reserve the right to pay the Annuity
Account Value less any outstanding loan under this Contract and terminate this
Contract if (i) no Contributions are made on your behalf during the last three
completed Contract Years, and the Annuity Account Value is less than $500 or
(ii) a partial withdrawal is made that would result in your Annuity Account
Value falling below $500. We reserve the right to terminate this Contract if no
contributions have been made within 120 days of the Contract Date.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount in the Divisions under this Contract and the Annuity Account Value
with respect to this Contract shall be zero. We will be released from any and
all liability for payments with respect to the Contributions from which the
Annuity Account Value arose.
SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any restrictions under the terms of
the Plan, the Owner may elect, by written notice to us, to make a partial
withdrawal from the Divisions. Partial withdrawals are subject to the spousal
consent rules set forth in Section 3.06.
On the Transaction Date, we will pay the lesser of the Cash Value or the amount
of partial withdrawal requested to the Owner (or such other person designated by
the Owner to us in advance via written instructions). The amount paid plus any
withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the
amounts in the Divisions. Unless instructed otherwise, the amount withdrawn
(including any withdrawal charge) will be allocated among the Divisions in
proportion to the amounts in such Divisions.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300.
If a withdrawal made under this Section would result in an Annuity Account Value
of less than $500, we will so advise the Owner and reserve the right to pay the
Annuity Account Value less any outstanding loan, and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. There will be no partial
withdrawal charge if the amount of the partial withdrawal requested is not
greater than the Free Corridor Amount defined in Section 2.09.
However, if the amount of partial withdrawal requested is greater than the Free
Corridor Amount, we will (i) first withdraw from such Divisions an amount equal
to the excess of the amount requested over the Free Corridor Amount, and (ii)
then withdraw an amount equal to the excess of the amount requested over the
Free Corridor Amount, plus a withdrawal charge, if applicable. Such withdrawal
charge will be calculated in the following manner:
(a) Withdrawals of Contributions made on your behalf during the current and five
prior Contract Years will be subject to a charge of 6% of the amount
withdrawn (including such charge).
(b) Withdrawals of other amounts will not be subject to any withdrawal charges.
For purposes of determining withdrawal charges described in this Section,
amounts withdrawn up to the Free Corridor Amount will not be considered a
withdrawal of any Contributions. Any excess withdrawals, i.e. those pursuant to
item (ii) above, shall be considered withdrawals of Contributions in the order
received, with the older Contributions first.
With respect to partial withdrawals requested by the Owner, there will be no
partial withdrawal charge if (i) you have completed at least 5 Contract Years
and you have attained the age of 59 years and 6 months or (ii) you have attained
age 59 years and 6 months and have retired or terminated employment. Your
retirement or termination of employment must be verified by the Trustee. Such
verification should be in the form of a statement signed by the Trustee and
accompanying the request for withdrawal. The request for withdrawal must be
signed by both you and the Trustee. The partial withdrawal charge will be
imposed if this verification is not received at our Processing Office together
with the withdrawal request.
If withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to your Contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means an
amount equal to the excess, if any, of (i) 10% of the Annuity Account Value on
the Transaction Date over (ii) cumulative prior withdrawals made pursuant to
Section 2.07 in the current Contract Year.
No. 92CTRB Page 9
SECTION 2.10 LOANS. Unless otherwise restricted by the Plan, or the Code, the
Owner may get a loan under this Contract on your behalf before the Election and
Commencement of Annuity Benefits, if an agreement between the Owner and us
relating to such loan ("Trustee Agreement") has been executed and is in effect
on the "Loan Effective Date", as defined below. Plan loans are subject to the
spousal consent rules set forth in Section 3.06. Future restrictions in the Code
may require revision or withdrawal of the loan provisions as provided below. The
Annuity Account Value (including the loan reserve account as described below)
will be the sole security for the loan.
If your loan agreement and application form ("Loan Agreement") is properly
completed and signed by you, approved by the Owner, accepted by us and received
at the Processing Office by the 15th of the month, the loan is effective on the
first day of the following month. If your Loan Agreement is properly completed
and signed by you, approved by the Owner, accepted by us and received at the
Processing Office after the 15th of the month, the loan is effective on the
first day of the second month following.
The Owner may establish a reasonable interest rate for the loan provided that
such rate is not (1) less than an effective annual rate of 6% or (2) greater
than the maximum rate permitted by applicable laws.
Beginning the first day of the third month following the effective date of the
loan and quarterly on the first day of the month thereafter, loan repayments
must be made to us. Loan requests shall be amortized in substantially level
payments over the term of the loan. If the effective annual rate of the loan is
6%, such repayments will be equal to the sum of (a) and (b) where
(a) is the loan interest, calculated at an effective annual rate of 6%, and
(b) is an amortized portion of the loan principal.
If the effective annual rate of the loan is greater than 6%, such payments will
be equal to the sum of (a), (b) and (c) where
(a) is the loan interest, calculated at an effective annual rate of 6%,
(b) is an amortized portion of the loan principal, and
(c) is the loan interest, calculated at the effective annual rate determined by
the Owner less the loan interest calculated at an effective annual rate of
6% ("Excess Interest").
Any Excess Interest received by us will be allocated among the Divisions in
accordance with Section 2.04 and may be withdrawn, transferred or annuatized as
described in this Contract.
By each due date, if the amount of the loan payment is less than the amortized
loan interest and principal due calculated at an effective annual rate of 6% or
the loan repayment is not received at our Processing Office, we will deduct and
treat as a partial withdrawal from the loan reserve account an amount equal to
the amortized interest and principal payments due plus any applicable withdrawal
charges and any required income tax withholding. Specifically, an amount equal
to the principal payment will be deducted from the portion of the loan reserve
account which earns interest at an effective annual rate of 4%, and an amount
equal to the interest payment, calculated at the effective annual rate of 6%,
plus any applicable withdrawal charges and required income tax withholding will
be deducted from the portion of the loan reserve account which earns interest at
the Guaranteed Interest Rate.
Amounts deducted, if the amount of the loan repayment is less than the amount
due or the loan payment is not received at our Processing Office, may be
reportable to the IRS and other appropriate government authorities as taxable
distributions. In addition, you may be subject to a 10% penalty tax on the
taxable portion of the amounts deducted.
The amount of the loan may not be more than 50% of the Annuity Account Value. In
no event shall the loan amount exceed $50,000 less the highest outstanding
balance under this Contract during the one year period ending the day before the
effective date of the loan. The minimum loan permitted is $1,000. For this
purpose, the Annuity Account Value is taken as of the Loan Effective Date. Only
one outstanding loan is permitted at a time under this Contract. As a condition
for granting a loan, we will require you to represent that the loan amount
requested, when aggregated with loans (principal plus interest) from all
qualified plans of your Employer, does not exceed 50% of the value of your
nonforfeitable accrued benefits, and in no event exceeds $50,000 less the
highest outstanding balance of all loans from qualified plans during the one
year period ending on the day before the effective date of the loan. The
provisions of this Contract require spousal consent in order to receive a loan
if you are married.
No. 92CTRB Page 10
The loan term will be either (i) ten years, if you represent that the purpose of
the loan is to acquire, build or substantially rehabilitate a dwelling unit
which, within a reasonable period of time, is to be used as your principal
residence or (ii) five years. In any event, the loan term may not extend beyond
the earlier of
(i) the Election and Commencement of Annuity Benefits pursuant to Section
3.03,
(ii) the date we receive written notice to terminate this Contract pursuant to
Section 2.06,
(iii) the date we pay a death benefit pursuant to Section 2.12, and
(iv) any date provided for such loans by future Federal tax rules including
acceleration of the loan repayment in order that the operation of the loan
provisions do not adversely affect the tax treatment of this Contract.
Future Federal tax rules may also impose certain additional requirements to
obtain the ten year loan period described above which may apply to existing ten
year loans.
On the Loan Effective Date, we will transfer to a loan reserve account an amount
equal to the sum of (i) the loan amount, which will earn interest at the
effective annual rate of 4% during the loan term and (ii) 25% of the loan
amount, which will earn interest at the Guaranteed Interest Rate, as defined in
this Contract. With the Owner's approval you may specify from which Divisions
these amounts are to be transferred. In the absence of direction from the Owner,
or if your directions cover only part of the amount required to be transferred
to the loan reserve account, we will transfer the required (or additional
required) amounts from each Division in proportion to the amount that you have
in such Division. On the first day of the third month following the effective
date of the loan and quarterly thereafter (or first business day thereafter, if
such day is not a business day), the amount of interest earned at 4% annually
during the prior quarter will be transferred to the portion of the loan reserve
account that earns interest at the Guaranteed Interest Rate.
The loan must be repaid in part on each quarterly due date and may be repaid in
full at any time on or after the first loan anniversary and must include the
full interest due. Any payments received will first be applied to interest due,
with the balance applied towards repayment of the loan. Any partial loan
repayment will result in a transfer of the amount equal to the principal repaid
from (i) the portion of the loan reserve account that earns interest at the
effective annual rate of 4% to (ii) the Guaranteed Interest Division and may be
withdrawn, transferred or annuitized as described in this Contract.
Partial withdrawals or transfers may not be made from the loan reserve account.
Upon full repayment of the loan, any amounts remaining in the loan reserve
account will be transferred to the Guaranteed Interest Division and may be
withdrawn, transferred or annuitized as described in this Contract.
Upon termination of this Contract pursuant to Section 2.06 or 2.12 or
annuitization pursuant to Section 3.04 prior to the full repayment of the loan,
the loan reserve account shall be zero.
SECTION 2.11 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $25,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts in the Divisions.
For this purpose, any loan reserve account is included within the Guaranteed
Interest Division. The portion of the charge attributable to the Guaranteed
Interest Division and any loan reserve account will be first withdrawn from the
Guaranteed Interest Division and then, if the amount in the Guaranteed Interest
Division is not sufficient, the remaining allocation will be withdrawn from the
portion of the loan reserve account that earns interest at the Guaranteed
Interest Rate.
If the Annuity Account Value is less than $25,000 on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03
or (b) the date of termination of this Contract pursuant to Section 2.06 or
2.12, we will prorate the Annual Administrative Charge applicable to the
completed portion of the current Contract Year and withdraw such amount in lieu
of the Annual Administrative Charge described in this Section for the applicable
part of that Contract Year.
If the Annuity Account Value is $25,000 or greater at the end of a Contract
Year, the Annual Administrative charge is zero.
SECTION 2.12 DEATH BENEFIT. If we ascertain that you have died while you have
amounts in the Divisions, we will, upon receipt of due proof of your death, and
subject to the terms of the Plan including the spousal survivor benefit rules
set forth in Section 3.06, pay to the beneficiary designated to receive such
payment under Section 4.04 of this Contract, the death benefit payable.
If the beneficiary under this Contract is the Trustee, the Trustee may, subject
to the terms of the Plan, change the beneficiary within 31 days after we receive
due proof of your death. The change shall be made in the same manner and subject
to the same provisions as apply to a change of beneficiary during your lifetime.
No. 92CTRB Page 11
If the Trustee changes the beneficiary of this Contract after your death
according to the terms of the Plan, the Trustee may elect an Annuity Benefit on
any annuity form offered by us or one of our affiliated or subsidiary life
insurance companies, subject to our rules then in effect, for the benefit of the
beneficiary. The beneficiary may not revoke or change any election made by the
Trustee. If the Trustee does not make an election, the beneficiary may make such
election for the beneficiary's own benefit. Any election of an Annuity Benefit
must meet the minimum distribution requirements as described in Section 3.05.
If the beneficiary under this Contract is not the Trustee, and you are married
at the time of your death, we will pay the death benefit under this Contract to
your spouse in the form of a Life Annuity, unless your spouse makes an election
for a single sum payment or for an Annuity Benefit on any other annuity form
offered by us, subject to our rules then in effect. Any election of an Annuity
Benefit must meet the minimum distribution requirements as described in Section
3.05.
The amount of the death benefit is equal to the greater of (i) the Annuity
Account Value less any outstanding loan and (ii) the minimum death benefit. Such
minimum death benefit is the sum of all Contributions made pursuant to Section
2.01 (before reduction for any applicable tax charge) less any outstanding loan
and less any withdrawals made pursuant to Section 2.07. Any such withdrawal will
reduce the minimum death benefit (as adjusted by any previous such withdrawal)
by an amount which is in the same proportion as the amount being withdrawn is to
the Annuity Account Value.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value shall be zero. We will be released from any and all
liability from which the Annuity Account Value arose.
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PART III - ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under the terms of this Contract with respect to a payee is the amount provided
pursuant to Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division of the Separate Account.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of Net
Investment Return referred to in Section 1.24 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to
provide for any applicable tax charge. These charges include a daily charge for
financial accounting, death benefits, mortality risk, expenses and expense risk,
plus the investment advisory fee charges and direct operating expense charges of
the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under the terms of this Contract with respect to a payee is the
monthly amount provided with respect to a payee pursuant to the fifth paragraph
of Section 3.04. The amount of the fourth and each subsequent payment under a
Variable Annuity Benefit will be equal to the number of Annuity Units with
respect to such benefit, multiplied by the Average Annuity Unit Value for the
second calendar month immediately preceding the due date of the payment. The
number of Annuity Units with respect to a benefit is the number determined by
dividing the amount of the first monthly payment under such benefit by the
Annuity Unit Value for the Valuation Period which includes the due date of the
first monthly payment. (As described in Section 3.05, we will notify the payee
how each Variable Annuity payment is determined.)
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. Subject to the terms
of the Plan, including the spousal consent and survivor rules described in
Section 3.06, as of your Retirement Date, provided you are then living, the
Annuity Account Value less any outstanding loan shall be applied to provide the
Normal Form of Annuity Benefit, unless an election is made (i) to receive the
Cash Value of this Contract in a single sum, (ii) to apply the Annuity Account
Value, (less any outstanding loan as set forth in Section 2.10) or Cash Value,
whichever is applicable pursuant to the first paragraph of Section 3.04, to
provide an Annuity Benefit on any other form offered by us or one of our
affiliated or subsidiary life insurance companies, or (iii) to take partial
withdrawals in amounts and at times as required by the minimum distribution
rules of Section 401(a)(9) of the Code and applicable Treasury Regulations,
pursuant to Section 3.05, subject to our rules then in effect and any other
applicable requirements under the Code.
No. 92CTRB Page 12
We will provide notice and election forms to the Owner not more than six months
before your Retirement Date.
If an election is made to terminate this Contract pursuant to Section 2.06, an
election may be made to receive an Annuity Benefit in lieu of the Cash Value.
We will have the right to require pertinent information to provide an Annuity
Benefit, and will be fully protected in relying on such information and need not
inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary
life insurance companies.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If, pursuant to the first or third
paragraph of Section 3.03, an election is made to receive an Annuity Benefit in
lieu of the Cash Value, the amount applied to provide the Annuity Benefit will
be (i) the Annuity Account Value less any outstanding loan if the annuity form
elected involves life contingencies or (ii) the Cash Value if the annuity form
elected does not involve life contingencies.
The amount applied to provide an Annuity Benefit may be reduced by any
applicable tax charge on annuity considerations, as we determine. If we have
previously deducted any applicable tax charges from Contributions as provided in
Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to this Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your Contract will be governed by our
supplementary contract then in effect.
The amount to be applied to provide an Annuity Benefit will, in addition to any
tax charge reduction, be reduced by an administrative charge. The amount of such
charge will be determined from time to time in accordance with our general
practices applicable on a uniform basis to all contracts of the same type as
this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts in
the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under the terms of this
Contract, as indicated, on the Joint and Survivor Life Annuity Form (with 100%
of the amount of your payment continued to your spouse). The amount of income
provided under the Fixed Annuity Benefit payable on the Joint and Survivor Life
Annuity Form, is based on 3.5% interest and the 1983 Individual Annuity
Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males
and females at age zero. The amounts of income initially provided under the
Variable Annuity Benefit payable on the Life Annuity Form are based on a 50-50
split of males and females at age zero and an Assumed Base Rate of Net
Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.24.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us on 3.5% interest and the 1983 Individual Annuity Mortality
Table "a" adjusted to a unisex basis based on a 50-50 split of males and females
at age zero if such annuity form provides for a Fixed Annuity Benefit, and on
the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50
split of males and females at age zero and an Assumed Base Rate of Net
Investment Income Return of 5% or 3.5%, whichever applies pursuant to Section
1.24, if such annuity form provides for a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract
will be distributed or begin to be distributed, in accordance with Section
401(a)(9) of the Code and the applicable Treasury Regulations thereunder, no
later than the first day of April following the calendar year in which you
attain age 70 years and 6 months ("Required Beginning Date") or such later date
as specified in such Section or regulations. Your entire interest may be
distributed, as you elect, over (a) your life, or the lives of you and your
designated beneficiary, or (b) a period certain not extending beyond your life
expectancy, or the joint and last survivor expectancy of you and your designated
beneficiary. Distributions must be made in periodic payments at intervals of no
longer than one year. In addition, payments must be either nonincreasing or they
may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the
Proposed Treasury Regulations, or any successor Regulation thereto.
All distributions made hereunder shall be made in accordance with the
requirements of Section 40(a)(9) of the Code, including the incidental death
benefit requirements of Section 401(a)(9)(G) of the Code, and applicable
Treasury Regulations, including the minimum distribution incidental benefit
requirement of Section 1.401(a)(9)-2 of the. Proposed Treasury Regulations, or
any successor Regulation thereto.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.05, while any distribution shall be subject to such requirements of
the Code and regulations, any distribution shall also be subject to the terms of
this Contract. That is, the forms of distribution shall be those which are made
available by us at the time of your election.
No. 92CTRB Page 13
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9.
Unless you otherwise elect prior to the time distributions are required to
begin, those life expectancies shall be recalculated annually. Such election
shall be irrevocable and shall apply to all subsequent years. The life
expectancy of a non-spouse beneficiary may not be recalculated. Instead, life
expectancy will be calculated using the attained age of such beneficiary during
the calendar year in which you attain age 70 years and 6 months, and payments
for subsequent years shall be calculated based on such life expectancy reduced
by one for each calendar year which has elapsed since the calendar year life
expectancy was first calculated.
If you die after distribution of your interest described in this Contract has
begun, the remaining portion of such interest will continue to be distributed at
least as rapidly as under the method of distribution being used prior to your
death.
If you die before distribution of your interest begins, distribution of your
entire interest shall be completed no later than December 31 of the calendar
year containing the fifth anniversary of your death, except to the extent that
an election is made to receive death benefit distributions in accordance with
(1) or (2) below:
(1) If your interest is payable to a designated beneficiary, then your entire
interest may be distributed over the life of, or over a period certain not
greater than the life expectancy of, the designated beneficiary. Such
distributions must commence on or before December 31 of the calendar year
immediately following the calendar year of your death.
(2) If the designated beneficiary is your surviving spouse, the date
distributions that are required to begin in accordance with (1) above shall
not be earlier than the later of (A) December 31 of the calendar year
immediately following the calendar year of your death or (B) December 31 of
the calendar year in which you would have attained age 70 years and 6
months.
For purposes of determining the "period certain" referred to in the
immediately preceding paragraph, life expectancy is computed by use of the
expected return multiples in Tables V and VI of Treasury Regulation Section
1.72-9. For purposes of distributions beginning after your death, unless
otherwise elected by the surviving spouse by the time distributions are
required to begin, life expectancies shall be recalculated annually. Such
election shall be irrevocable by the surviving spouse and shall apply to all
subsequent years. In the case of any other designated beneficiary, life
expectancies shall be calculated using the attained age of such beneficiary
during the calendar year in which distributions are required to begin
pursuant to this Section, and payments for any subsequent calendar year
shall be calculated based on such life expectancy reduced by one for each
calendar year which has elapsed since the calendar year life expectancy was
first calculated.
Distributions under this Section are considered to have begun if distributions
are made because you have reached your Required Beginning Date or if prior to
the Required Beginning Date distributions irrevocably commence to you over a
period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1
of the Proposed Treasury Regulations or any successor Regulation thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under the terms of this Contract was based on information
that is subsequently found to be incorrect, benefits will not be invalidated,
but an adjustment on the basis of the correct information will be made in the
amount of the benefit payments, or any amount used to provide the benefit, or
any combination thereof. Overpayments by us will be charged against and
underpayments will be added to any payments thereafter falling due under the
terms of this Contract with respect to a payee, affecting as many such payments
as are necessary to correct the overpayment or underpayment. Our liability with
respect to a payee is limited to the correct information and the actual amounts
used to provide the benefits then in force with respect to the payee under this
Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under the terms of this Contract is physically or mentally
incompetent to receive such payment or is a minor, (ii) another person or an
institution is then maintaining or has custody of such payee, and (iii) no
guardian, committee, or other representative of the estate of such payee has
been appointed, we may, unless the Plan provides to the contrary, make the
payments (in the case of a minor, at a rate not exceeding %200 a month) to such
other person or institution, and will thereupon be fully discharged from all
liability with respect thereto.
If a variable annuity form made available by us provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one of two persons, a payee for payments
thereunder may elect, without the concurrence of any other person, to receive
the commuted value of any remaining payments, provided no person upon whose life
the income depends is surviving.
No. 92CTRB Page 14
Upon an election, pursuant to Section 3.03, of an annuity form providing
payments for a period certain, such Owner may designate (in accordance with the
terms of the Plan and with the right to change such designation in accordance
with the terms of the Plan) a payee to receive any payments that may become due
after the death of the person or persons upon whose life or lives the income may
depend.
The payee may designate (with the right to change such designation and without
the concurrence of any other person unless the Plan provides to the contrary) a
person or persons to receive any payments or installments payable after such
payee's death, if the absence of such a designation would result in a single sum
payment to such payee's estate in accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments, The commuted value of any such remaining payments will be
determined on the basis of compound interest at the rate utilized in the
actuarial rate basis applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
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TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT
AND SURVIVOR LIFE ANNUITY FORM
100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE
(Minimum Monthly Income per $1,000 of Annuity Account Value)
--------------------------------------------------------------------------------------------------------------------------------
Age 60 61 62 63 64 65 66 67 68 69 70
--------------------------------------------------------------------------------------------------------------------------------
60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88
61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96
62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03
63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11
64 4.89 4.94 5.00 5.05 5.10 5.14 5.19
65 5.00 5.06 5.11 5.17 5.22 5.27
66 5.12 5.18 5.24 5.29 5.35
67 5.24 5.31 5.37 5.43
68 5.37 5.44 5.51
69 5.52 5.59
70 5.67
--------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE
ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1,000 of Annuity Account Value)
--------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT
IF ASSUMED BASE RATE OF NET
INVESTMENT RETURN IS
Age 3.5% 5%
--------------------------------------------------------------------------------
60 5.27 6.16
61 5.39 6.28
62 5.52 6.41
63 5.66 6.55
64 5.81 6.70
65 5.97 6.86
66 6.15 7.03
67 6.33 7.21
68 6.53 7.41
69 6.74 7.62
70 6.97 7.85
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We will, with respect to each payment under a Variable Annuity Benefit, notify
the payee of the number of Annuity Units and the Average Annuity Unit Value used
in determining the amount of each variable payment. Such notice will be mailed
with each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary as
described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
No. 92CTRB Page 15
SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If you are married,
your interest in this Contract shall be paid in the Normal Form joint and
survivor annuity, and if you are unmarried, your interest shall be paid in the
Normal Form life annuity, unless you elect otherwise as described in this
Section. If you are married and die before payment of your interest has
commenced, your interest shall be paid to your surviving spouse in the form of a
life annuity, unless at the time of your death there was a contrary election
made pursuant to this Section. The foregoing notwithstanding, your surviving
spouse may elect, before payment is to commence, to have payment made in any
form permitted under the terms of this Contract.
You may elect, at any time within the 90 consecutive day period before the first
day of the first period for which your interest is paid as an annuity or in any
other form, not to have your interest paid in the Normal Form in which case it
shall be paid in any other form elected under the terms of this Contract. If
such interest is to be paid to your spouse upon your death, you may elect,
during the period beginning on the first day of the plan year of the Plan in
which you attain age 35 (or, if you separate from service prior to that plan
year, beginning on the date of separation) and ending with your death, for a
beneficiary other than your spouse to receive payment of the value of your
interest. In addition, if you will not yet attain age 35 by the end of any
current plan year, you may make a special qualified election to designate a
beneficiary other than your spouse to receive payment of the value of your
interest. Such special qualified election shall be effective for the period
beginning on the date of such election and ending on the first day of the plan
year in which you will attain age 35. Amounts payable in accordance with this
Section will be automatically reinstated as of the first day of the plan year in
which you attain age 35 unless a new election designating a beneficiary other
than the spouse is made in accordance with the requirements of this Section.
Any election described in the foregoing paragraph must be consented to by your
spouse in writing before a notary public or a representative of the Plan, unless
you can prove that there is no spouse or that the spouse cannot be located.
Also, if you have become legally separated from your spouse or have been
abandoned (within the meaning of local law) and have a court order to such
effect, spousal consent is not required unless a qualified domestic relations
order provides otherwise. Your election must designate a specific beneficiary
(including any class of beneficiaries or any contingent beneficiaries) that may
not be changed without further consent of the spouse, unless the spouse's
consent expressly permits designation by you without further consent of the
spouse. The spouse's consent under this Section shall acknowledge the effect of
the election. In addition, the spouse's consent (or the establishment that the
consent of the spouse may not be obtained) shall only be valid with respect to
such spouse. Your waiver of the Normal Form joint and survivor annuity shall not
be effective unless the election designates a form of benefit payment which may
not be changed without spousal consent (or the spouse expressly permits
designations by you without any further spousal consent). A consent that permits
designations by you without any requirement of further consent by such spouse
must acknowledge that the spouse has the right to limit consent to a specific
beneficiary, and a specific form of benefit where applicable, and that the
spouse voluntarily elects to relinquish either or both of such rights. If you
make an election under this Section you may revoke that election, without
spousal consent, at any time before the first day of the first period for which
an amount is paid as an annuity or in any other form.
The provision requiring spousal consent in this Section shall also apply with
regard to your election to terminate this Contract or make partial withdrawals
pursuant to Sections 2.06 and 2.07 and with respect to a beneficiary designation
set forth in Section 4.04. Spousal consent, as described in this Section, is
also required in the 90 day period before a Plan loan is granted to you pursuant
to Section 2.10.
If the Annuity Account Value applied to provide the spousal benefits on the date
payment is to commence is in the aggregate less than $3,500, we may choose to
make payment in a single sum rather than in the form of a Qualified Joint and
Survivor Annuity or Life Annuity as described herein. Upon any payment made
pursuant to this Section, we will be released from any and all liability for
payment with respect to the Contributions made for you.
--------------------------------------------------------------------------------
PART IV - General PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the
parties and the terms of this Contract alone will govern with respect to our
rights and obligations. A copy of the application is incorporated in and made
part of this Contract.
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by our authorized officer. The terms of this
Contract may be changed by amendment or replacement upon agreement between the
Owner and us without the consent of any other person, provided the change does
not reduce any annuity benefit.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of
this Contract without the consent of any other person in order to comply with
applicable laws and regulations. Such right shall include, but not be limited
to, the right to conform this Contract to reflect changes in the Code,
applicable Treasury Regulations or in regulations or published rulings of the
Internal Revenue Service so that this Contract will continue to be an Annuity
under a qualified plan.
No. 92CTRB Page 16
SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY. No interest of yours or of a
beneficiary under this Contract may be transferred to any person other than us
upon the surrender of this Contract. Except as permitted under Section
401(a)(13) of the Code, no right or interest of you or any other payee or
beneficiary in this Contract shall be (a) assignable; (b) subject to any lien;
or (c) liable for, or subject to, any obligation or liability of any person. The
preceding sentence shall not apply to an assignment, transfer or attachment
pursuant to a qualified domestic relations order, as defined in Section 414(p)
of the Code.
SECTION 4.04 BENEFICIARY. The Owner, as of the Contract Date, is to provide us
with an initial designation of the beneficiary entitled to receive any death
benefit payable with respect to you pursuant to Section 2.12. Subject to the
Plan and spousal consent and survivor rules of Section 3.06, you may change such
designation from time to time during your lifetime and while this Contract is in
force. If the beneficiary is the Trustee, the Trustee will have the right within
31 days of the day we receive due proof of your death and pursuant to the
provisions of the Plan, to change the beneficiary entitled to receive your death
benefits.
If the Trustee is not the beneficiary, the beneficiary will be your spouse
unless he or she has given duly witnessed written consent to the designation of
another beneficiary as described in Section 3.06, or you establish prior to your
death that he or she cannot be located. Such spousal consent must be on file
with the Trustee while this Contract is owned by the Trustee. If the Trustee is
not the Owner, such spousal consent must be presented to us with the change of
beneficiary request or with proof of your death and election of an Xxxxxxx
Xxxxxxx.
SECTION 4.05 DISQUALIFICATION. In the event that the Plan fails to qualify as a
Plan under Section 401(a) of the Code and applicable Treasury Regulations, we
reserve the right, upon receiving notice of such fact, to transfer the Annuity
Account Value under this Contract to another annuity contract issued by us on
your life, or one of our affiliated subsidiary life insurance corporations, or
to terminate this Contract and pay to the Owner the Annuity Account Value less
deduction for applicable taxes, solely at our option.
In the event that this Contract fails to qualify as an Annuity under a qualified
Plan as described in Section 1.02, we shall have the right, upon receiving
notice of such fact, to terminate this Contract and pay at the direction of the
Owner the Annuity Account Value less any outstanding loan and less a deduction
for the appropriate part attributable to the Owner of any Federal income tax
payable which would not have been payable if you had an Annuity.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the, Employer, we
reserve the right at our sole discretion to limit Contributions under this
Contract.
SECTION 4.07 DEFERMENT. Applications of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of your Annuity Account Value
(less any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities Exchange
Commission, by order, permits us to defer payments in order to protect persons
with interests in the Investment Divisions. We can defer payment of any portion
of your Annuity Account Value in the Guaranteed Interest Division for up to six
months while you are living.
SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year, we will furnish
you with a notice showing the following:
(1) the amount in the Guaranteed Interest Division,
(2) the total number of Accumulation Units in the Stock Division, Balanced
Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Value,
(4) the amount in the Stock Division, Balanced Division, Aggressive Stock
Division and Money Market Division,
(5) the amount in the loan reserve account,
(6) the Cash Value, and
(7) the amount of death benefit.
No. 92CTRB Page 17
We will also furnish annual calendar year reports concerning the status of the
annuity and any other reports required by the Code or applicable Treasury
Regulations.
After your Retirement Date, we will notify you of the number of Annuity Units
and the Average Annuity Unit Value used in determining the amount of each
Variable Annuity Benefit payment, if any.
SECTION 4.09 TRUSTEE'S RESPONSIBILITY. The Trustee shall hold this Contract on
your behalf and your beneficiaries as an asset of the trust, unless this
Contract is distributed to you pursuant to the terms of the Plan. The Trustee
shall be responsible for transferring all payment made under this Contract to
the Annuitant and the Annuitant's beneficiaries in accordance with the terms of
the Plan and the applicable provisions of the Code. We shall make no payment
hereunder without written instructions from the Trustee, and we shall be fully
discharged of any liability therefor to the extent such payments are made to and
at the direction of the Trustee.
SECTION 4.10 AGE. If your age has been misstated, any benefits will be those
which would have been purchased at the correct age. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
No. 92CTRB Page 18
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APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P.O. Box 2996,
New York, New York 10116-2996
QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR:
EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY
-------------------------------------------------------------------------------
1. TYPE OF PURCHASE (Complete One Plan Only)
a. | | TSA Public School (GV-PS-I)
b. | | TSA 501(c)(3) Organization (GV-501-I)
c. | | TSA University (GV-PS-U-I)
d. | | IRA Individual (including IRA to IRA transfers)
(XX-XXX 4971)
e. | | IRA Unit Billed (including IRA to IRA transfers) (XX-XXX 4971)
f. | | IRA QUALIFIED PLAN ROLLOVER--(QP IRA)
(Distribution from a Qualified Plan)
(XX-XXX 4971-71)
g. | | EDC (Public Employee Deferred Compensation (GV-EDC 4991)
h. |X| EDC (Tax Exempt Organization)(GV-EDC 4991-SU-080)
i. | | SEP (Simplified Employee Pension)(GV-SEP 4981)
j. | | SARSEP (Salary Reduction SEP) ____________
k. | | CORPORATE TRUSTEED (GV-CORP 4941-41)
l. | | XXXXX/HR-10 TRUSTEE (GV HR-10 4911-11)
(trustee owned)
m. | | Xxxxx/HR-10 (GV-HR-10 4911)
(not trustee owned) (issued to existing units only)
-------------------------------------------------------------------------------
DO NOT COMPLETE THIS SECTION IF BOX 1.d OR 1.f CHECKED ABOVE
2. EMPLOYER/PLAN NAME
|A|B|C| | C|O|M|P|A|N|Y| | | | | | | | | | | | | | | | | | | | | | | | | | |
3. | | EXISTING UNIT NO. | | | | | | | - | | |X| NEW UNIT |0|0|0|1|2|3|-|4|5|6|
(FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP,
OR TRUSTEED PLANS. FORM 983-135B IS REQUIRED.)
-------------------------------------------------------------------------------
4. PROPOSED ANNUITANT Print name to appear on Contract.
|J|o|h|n| | | | | | | | | | | | | | | | | | |O|E | | | | | | |
First Middle Initial Last
a. |x| Mr. | | Mrs. | | Miss | | Ms. | | Other _______
b. Date of Birth: Year 1954 Month JANUARY Day 27
----- -------- ----
c. Age at Nearest Birthday: 38 d. |x| Male | | Female
------
e. Annuitant's Mailing Address: f. State of Residence: N.J.
----
No., St. |1|7| |E|L|M| |S|T|R|E|E|T| | | | | | | | | | | | |
City |A|N|Y|T|O|W|N| | | | | | | | | | | | | | | | | |
State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1|
g. Telephone Number (000) 000-0000 |x| Home | | Work
h. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9|
i. Are you associated with or employed by a member of National Association
of Securities Dealers, Inc. (NASD)? | | Yes |x| No
5. OWNER (Print Name) - If Trusteed or EDC Plan Print Name of Owner; for all
other Markets Print Name of Annuitant.
XXXX XXX
------------------------------------------------------------
a. Title
----------------------------------------------------
6. RETIREMENT AGE 65
--------------------------------------------
7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death
Benefit upon Xxxxxxxxx's death before Retirement Date.) BENEFICIARY MUST BE
THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.)
XXXX XXX - WIFE
-----------------------------------------------------------
-----------------------------------------------------------
-----------------------------------------------------------
8. CONTRIBUTION ALLOCATION
Guaranteed Interest Division 20%
--
Stock Division 20%
--
Money Market Division 20%
--
Balanced Division 20%
--
Aggressive Stock Division 20%
--
(PERCENTAGES IN WHOLE NUMBERS) Total 100%
9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F)
a. Reminder Notice (Billing) Required | | Yes |x| No
IF YES, complete b-c-d-e
b. REMINDER DATE Required for Individual IRA or
otherwise must agree with existing unit or attached
983-135B. MONTH _________ DAY _________
c. REMINDER FREQUENCY
| | Annual | |Semi-Annual
| | Quarterly | |Monthly
Available for TSA, EDC, SARSEP AND CORPORATE
TRUSTEED AND UNIT BILLED IRA ONLY:
| | Semi-Monthly | | Bi-Weekly
d. REMINDER AMOUNT $______________________
e. BILLING MONTHS TO BE EXCLUDED - TSA ONLY
----------------------------------------------------------
----------------------------------------------------------
----------------------------------------------------------
10. EXPECTED FIRST CONTRACT YEAR
CONTRIBUTION. $ 1000
-----------
If an advanced billing and/or contract date are requested, complete #9b and
#12.
--------------------------------------------------------------------------------
(FOR PROCESSING OFFICE USE)
Unit Name ____________________________ Reminder Date__________________________
Cert. or App# ________________________ Amendment Required_____________________
EDC Emp. Add._________________________ Emp. Fed. ID # ________________________
Frequency ____________________________ Contract Date _________________________
Receipt Date Batch # Inquiry # Processor
--------------------------------------------------------------------------------
180-1000
10. Did you receive the Separate Account Prospectus? |x|Yes | |No
Date shown on Prospectus January 1, 1992
-----------------------------
Date of any supplement to Prospectus
--------------------
11. Items (a) through (f) are to be answered by the annuitant. We are required
by the NASD to ask these questions.
(a) Name of Employer: ABC COMPANY
----------------------------------
(b) Address of Employer:
00 XXXX XXXXXX
------------------------------------------------------
ANYTOWN, NJ
------------------------------------------------------
(c) Occupation SALES
-------------------------------------------
(d) Assuming the contract applied for will be issued, will any existing
insurance or annuity be replaced or changed (or has it been)?
| | Yes |x| No
(e) Estimated Family Annual Income $100,000
-----------------------
(f) Estimated Net Worth $250,000
-----------------------
(g) Investment Objective: | | Income |x| Income & Growth
| | Aggressive Growth | | Growth | | Safety Of Principal
12. SPECIAL INSTRUCTIONS
--------------------------------------------------------------
--------------------------------------------------------------
--------------------------------------------------------------
--------------------------------------------------------------
--------------------------------------------------------------
13. AMOUNT PAID WITH THIS FORM: $ 1000
---------
(If a check is submitted with this request, no advanced Contract Date is
permitted.) BACKDATING IS NOT PERMITTED.
NOTE: Xxxxxx paid will be credited upon receipt at Equitable's Processing
Office, subject to return if the contract is not issued. The Contract Date
will be the date of receipt by Equitable of this application, properly
signed and completed, and Contribution at Equitable's Processing Office.
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
AGREEMENT
All information and statements furnished in this application are true and
complete to the best of my knowledge and belief. I understand and acknowledge
that no Agent has the authority to make or modify any contract on Equitable's
behalf, or to waive or alter any of Equitable's rights and regulations.
IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO
THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT
PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT.
UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S)
OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND
COMPLETE.
--------------------------------------------------------------------------------
LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR
ANNUITY APPLICATION WITH INFORMATION YOU KNOW IS FALSE
OR TO LEAVE OUT MATERIAL FACTS
--------------------------------------------------------------------------------
X_________________________________ Date __________ City ___________ State_______
Signature of Annuitant
X_________________________________ Date __________ City ___________ State_______
Signature of Authorized Individual (REQUIRED FOR EDC AND
TRUSTEED) OR OWNER
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
AGENT'S SECTION
Will any existing Insurance or annuity be replaced or changed (or has it been),
assuming the Contract will be issued? | | Yes | | No | |
| | I (we) certify that a prospectus for the Contract has been given to the
proposed Annuitant and that no written sales materials other than those approved
by The Equitable have been used.
EQUI-VEST issues must adequately reflect the commission interest of all Agents
on previous contracts.
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Print Agent's Name(s) Initial of Last Agent Agent Agency District Agent's
(Service Agent first) Name Number % Code Manager Code Signature
------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
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------------------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------
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FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS ______ Date ______ District EQS ________ Date ________
------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------
(For ASU Use)
ASU Code and App. No ________________________________
ASU Rec'd ___________________________________________
ASU Rec'd ___________________________________________
Date to Proc. Off ________________________Campaign | |
Agent(s) shown above is Equity Qualified and is licensed in the state where the
request is signed. Above Agent information verified by XXX (Registered Rep)
--------------------------------------------------------------------------------
Application reviewed by _________________________________
--------------------------------------------------------------------------------
180-1000
Owner: ABC STATE DEFERRED COMPENSATION PROGRAM
Annuitant: XXXX XXX
Contract Number: 00 000 000
Issue Date: FEB 28, 1992
Contract Date: FEB 28, 1992
Retirement Date: JAN 1, 2020
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York,
New York 10116
AGREES
o TO ALLOCATE the Contributions made to this Contract after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division of the Separate Account (referred
to in this Contract as the "Investment Divisions") or to the Guaranteed
Interest Division, in accordance with Sections 2.02, 2.03 and 2.04 as
directed by you, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide the
Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant
is then living, and
o TO PROVIDE you with the other rights and benefits of this Contract.
This is the entire Contract. These agreements are subject to the provisions of
this Contract. In this Contract, "we", "our" and "us" mean The Equitable Life
Assurance Society of the United States. "You" and "your" mean the Employer at
the time a right is exercised by the Employer.
TEN DAYS TO EXAMINE CONTRACT - You may cancel this Contract by returning it to
us within ten days after receipt of it. Upon such cancellation, we will refund
any Contribution made to us on the Annuitant's behalf under this Contract.
/s/ Xxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxxxx
Vice President and Secretary Chairman of the Board
and Chief Executive Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
FOR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE
MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL
ACCOUNTING, DEATH BENEFITS, MORTALITY RISKS, EXPENSES AND EXPENSE RISK, PLUS THE
INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE
TRUST.
No. 92 EDCA
This Contract is issued in consideration of the payment to us of the
Contributions made under the terms of this Contract.
The provisions on the following pages are part of this Contract.
-------------------------------------------------------------------------------
TABLE OF CONTENTS
Definitions Page
Section 1.01 - Annuitant................................4
1.02 - Annuity..................................4
1.03 - Annuity Account Value....................4
1.04 - Annuity Benefit..........................4
1.05 - Cash Value...............................4
1.06 - Class of Contracts.......................5
1.07 - Code.....................................5
1.08 - Contract.................................5
1.09 - Contract Date............................5
1.10 - Contract Year............................5
1.11 - Contribution.............................5
1.12 - Divisions................................5
1.13 - Eligible Annuity Certain.................5
1.14 - Employer.................................5
1.15 - Guaranteed Interest Rate.................5
1.16 - Joint and Survivor Life
Annuity Form.............................5
1.17 - Life Annuity Form........................5
1.18 - Normal Form..............................5
1.19 - Period Certain Annuity...................5
1.20 - Plan.....................................5
1.21 - Processing Office........................6
1.22 - Retirement Date..........................6
1.23 - Separate Account.........................6
1.24 - Separate Account Definitions.............7
1.25 - Substituted Beneficiary..................7
1.26 - Transaction Date.........................7
1.27 - Trust....................................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions............................8
2.02 - Separate Account Investment
Divisions................................8
2.03 - Guaranteed Interest Division.............8
2.04 - Allocation to Divisions..................8
2.05 - Transfers Among Divisions................9
2.06 - Termination of this Contract.............9
2.07 - Partial Withdrawals......................9
2.08 - Charges for Partial
Withdrawals..............................9
2.09 - Free Corridor Amount....................10
2.10 - Annual Administrative
Charge..................................10
2.11 - Death Benefit...........................10
ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit...................10
3.02 - Variable Annuity Benefit................11
3.03 - Election and Commencement of
Annuity Benefits........................11
3.04 - Amount of Xxxxxxx Xxxxxxxx..............11
3.05 - Payment of Xxxxxxx Xxxxxxxx.............12
GENERAL PROVISIONS
Section 4.01 - Contract................................14
4.02 - Statutory Compliance....................14
4.03 - Nonforfeitability, Nontransfer-
ability and Assignments.................14
4.04 - Beneficiary.............................15
4.05 - Disqualification of
Plan or Contract........................15
4.06 - Future Contributions....................15
4.07 - Deferment...............................15
4.08 - Annual Notice...........................15
4.09 - Age.....................................15
4.10 - Ownership Right of Employer.............15
No. 92 EDCA Page 2
OWNER: ABC STATE DEFERRED COMPENSATION PROGRAM
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 000
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28, 1992
RETIREMENT DATE: JAN 1, 2020
INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992
MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992
3.00% AFTER DEC 31, 1992
BENEFICIARY: XXXX XXX
FORM NUMBER: 92 EDCA
---------------------------------------------------------------------------------------------------------------
TABLE OF GUARANTEED VALUES
ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION
NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY
SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65*
------------------------ ---------- ------------------
1 976 6.62
2 1,946 16.20
3 2,944 26.67
4 3,998 38.83
5 5,064 46.70
6 6,220 56.28
7 7,362 65.58
8 8,538 74.61
9 9,841 83.38
10 11,204 91.89
11 12,628 100.16
12 14,117 108.18
13 15,673 115.97
14 17,143 123.53
15 18,658 131.18
16 20,217 138.63
17 21,824 145.90
18 23,478 152.80
19 25,213 159.69
20 26,999 166.03
24 (Age 62) 34,697 189.57
27 (Age 65) 41,098 205.49
THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000
CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT
DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE
(SEE SECTION 2.10) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ANNUITY ACCOUNT
VALUE (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND
EARNINGS ARE ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION.
YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON
THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS.
THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE
WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY
BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A
SETTLEMENT WITHIN 5 YEARS OF THE CONTRACT DATE WILL BE SUBJECT TO A CHARGE (SEE
SECTION 3.04).
*ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO
SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT.
No. 92 EDCA Page 2
PART I - DEFINITIONS
SECTION 1.01 ANNUITANT. The term "Annuitant" means an individual who
participates in a Plan, or, if the Plan permits, a beneficiary under the Plan,
as shown on Page 3 of this Contract, and on whose behalf this Contract is
purchased and is maintained.
SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in
accordance with the terms of the Plan.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts that you have in the Guaranteed Interest Division and the
Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by us pursuant to Section 3.04 of this Contract. Various sections of this
Contract (Sections 1.16, 1.17, 1.18, 1.19, 3.01, and 3.02) refer to monthly
payments to be made under an Annuity Benefit. You may elect to have the Annuity
Benefit paid at other intervals, such as quarterly, semi-annually, or annually,
instead of monthly. You may elect this at the time you elect the Annuity Benefit
form as described in Section 3.03; in that event, all references in this
Contract to monthly payments will be deemed to mean payments at the frequency
you elect, subject to our rules at the time of election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value
less any applicable withdrawal charge determined as follows:
The withdrawal charge equals the lesser of (a) or (b) where:
(a) equals
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the excess of (i) the sum of the Annuity Account Value over (ii) the
Free Corridor Amount defined in Section 2.09.
(b) is the excess, if any, of (i) 8% of the total Contributions made on the
Annuitant's behalf during the current Contract Year and the nine preceding
Contract Years over (ii) the cumulative total of any prior partial
withdrawal charges made pursuant to Section 2.08.
However, notwithstanding the above, if the Annuitant is age 60 or older on the
Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of
the excess of the Annuity Account Value over the Free Corridor Amount.
A withdrawal charge will not apply, which means the Cash Value will equal the
Annuity Account Value upon any of the following occurrences:
(i) the later of the completion of at least five Contract Years and the
Annuitant's attainment of age 59 years and 6 months, or
(ii) the completion of at least twelve Contract Years, or
(iii) a request is made for a refund of a Contribution in excess of the amount
that may be contributed under Section 457 of the Code within one month of
the date on which the Contribution is made, or
(iv) the Annuitant's attainment of age 55, his completion of at least five
Contract Years and the receipt by us of a properly completed settlement
election form providing for the application of the Annuity Account Value
to purchase an Eligible Annuity Certain, defined in Section 1.13, or
(v) the Annuitant's completion of at least three Contract Years and the
receipt by us of a properly completed settlement election form providing
for the application of the Annuity Account Value to purchase a Period
Certain Annuity, defined in Section 1.19, where the certain period of
such annuity is at least ten years, or
(vi) the receipt by us of a properly completed settlement election form
providing for the application of the Annuity Account Value to purchase a
life annuity distribution, pursuant to the terms of this Contract, or
(vii) the Annuitant dies and a death benefit is payable to the beneficiary.
No. 92 EDCA Page 4
The above statements notwithstanding, we reserve the right to modify or waive
any early withdrawal charges in order to comply with any applicable state or
local legal or regulatory requirements. Any such modification or waiver will
apply equally to all Annuitants under a Plan subject to such a state or local
legal or regulatory requirement.
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same calendar year.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as
amended, or any corresponding provisions of prior or subsequent United States
revenue laws.
SECTION 1.08 CONTRACT. The term "Contract" means this Contract.
SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both the application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us
pursuant to the terms of the Plan to this Contract. We are under no obligation
to accept any Contribution less than $20.00.
SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following divisions described in this
Contract:
(i) the Guaranteed Interest Division, and
(ii) the Investment Divisions of the Separate Account.
SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
a Period Certain Annuity issued by us which extends beyond the Annuitant's
attainment of age 59 years and 6 months and does not permit any prepayment of
the unpaid principal (that is, no withdrawal or single sum payment) prior to
your attainment of age 59 years and 6 months.
SECTION 1.14 EMPLOYER. The term "Employer" means one of the following types of
entity which is eligible to adopt, has adopted, and maintains a Plan: (i) a
State, a political subdivision of a State, or an agency or instrumentality of a
State or political subdivision of a State, or (ii) any other organization exempt
from tax under the Code which has adopted and maintains a Plan for a select
group of management or highly compensated employees within the meaning of the
Employee Retirement Income Security Act of 1974, as amended. The Employer is the
Owner of and beneficiary under this Contract.
SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrued on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of
this Contract. Section 2.03 describes the determination of the rate to apply
thereafter.
SECTION 1.16 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected by you. The payments commence on the date as of which the Joint and
Survivor Life Annuity Form is purchased and terminate with the last payment due
before the death of the survivor.
SECTION 1.17 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us providing monthly payments during the lifetime of the person upon
whose Life such payments depend. The payments commence on the date as of which
the Life Annuity Form is purchased and terminate with the last payment due
before the death of such person.
SECTION 1.18 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means (i) if the Annuitant has a living spouse at the Retirement
Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity
Form with such spouse as the contingent annuitant (with 100% of the monthly
payment amount continued to the spouse), and (ii) if the Annuitant does not have
a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the
Life Annuity Form.
SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us which does not permit any
prepayment of the unpaid principal (that is, you cannot elect to receive part of
the payment as a single sum payment with the remainder paid in monthly annuity
payments).
SECTION 1.20 PLAN. The term "Plan" refers to an "Eligible Deferred Compensation
Plan" meeting the requirements of Section 457(b) of the Code and applicable
Treasury Regulations which is established and maintained by an Employer for the
benefit of individuals performing services for the Employer and their
beneficiaries.
No. 92 EDCA Page 5
SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P.O. Box 2996, GPO, New York, New York 10116, or such
other location as we shall designate by advance written notice to the Employer
or the Plan's Trustee, as applicable.
SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which
the Annuitant attains the retirement age as shown on Page 3 of this Contract.
Before the Retirement Date the Employer may elect to change the Retirement Date
to another Retirement Date, which may be any date after the filing of the
election (other than the 29th, 30th, or 31st day of any month). No Retirement
Date shall be earlier than the Retirement Date provided under the Plan nor shall
it be later than the date the Annuitant attains age 70 years and 6 months. Any
election for such change must be made in writing by you and shall not take
effect until received by us at the Processing Office.
SECTION 1.23 SEPARATE ACCOUNT. The term "Separate Account" means Separate
Account A which is organized as a unit investment trust, a type of investment
company. We established the Separate Account and it is maintained in accordance
with the laws of New York State. Realized and unrealized gains and losses from
the assets of the Separate Account are credited to or charged against it without
regard to our other income, gains or losses. Assets are put in the Separate
Account to support this Contract and other variable annuity contracts and
certificates. Assets may be put in the Separate Account for other purposes, but
not to support contracts or policies other than variable annuities or variable
life insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust where each class (or series) represents a separate portfolio in
such Trust. We reserve the right to change the designated trust or investment
company or to add designated trusts or investment companies. The Investment
Divisions available are the Stock Division, the Money Market Division, the
Balanced Division and the Aggressive Stock Division. The Guaranteed Interest
Division is not part of the Separate Account, but rather is an asset of our
General Account.
We will value the assets of each Investment Division on each business day. A
business day is any day on which we are open, the New York Stock Exchange is
open for trading and there is a sufficient degree of trading in the portfolio
securities in which an Investment Division is invested to materially affect the
Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments we are
permitted by law to make.
We reserve the right to:
(i) cause the registration or deregistration of the Separate Account under
the Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any
other form;
(v) add Investment Divisions (or sub-divisions of Investment Divisions) to,
or remove Investment Divisions (or sub-divisions of Investment Divisions)
from the Separate Account (the term "Investment Division" in this
Contract shall then refer to any other Investment Division in which the
assets, of a class of contracts to which this Contract belongs, were
placed);
(vi) combine any two or more Investment Divisions (or sub-divisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
class of contracts to which this Contract belongs.
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, you will be notified of such exercise, as
required by law.
No. 92 EDCA Page 6
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for applicable tax
charges) at a rate not to exceed 1.49% per year for each of the Stock, Money
Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock
Division, for financial accounting, death benefits, mortality risk, expenses and
expense risk. The charge shall be made in accordance with Subsection (c) of the
Net Investment Factor provision in Section 1.24. The relative proportion of
these charges may be modified. This daily charge, plus the investment advisory
fee charges and direct operating expense charges of the Trust, shall not exceed
a total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract.
SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any preceding consecutive
non-business days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c) where
(a) is the value of the Investment Division's shares of the Corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment
Division for the Valuation Period. For this purpose, we use the share
value reported to us by the Trust.
(b) is the value of the Investment Division's shares of the Corresponding
portfolio of the Trust at the end of the preceding Valuation Period
(after taking into account any amounts allocated or withdrawn for that
Valuation Period).
(c) is the daily Separate Amount charge for the expenses of this Contract
times, the number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an
Investment Division where Contributions made on the Annuitant's behalf are
invested and which is used in determining the amount in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for that Investment Division for such Valuation Period.
ANNUITY UNIT: The "Annuity Unit" is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: An "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first Contribution was put into the Stock
Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed
Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The
Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value
for the immediately preceding Valuation Period multiplied by the Adjusted Net
Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for a Valuation Period is the Net Investment Factor for such
period reduced for each calendar day in such subsequent Valuation Period by the
Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net
Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net
Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall
be 5%, except in states where the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar
month is equal to the average of the Annuity Unit Values for all Valuation
Periods ending in such month.
SECTION 1.25 SUBSTITUTED BENEFICIARY. The term "Substituted Beneficiary" refers
to the beneficiary designated under the Plan by the Annuitant to receive death
benefits payable under the Plan, where the Employer has elected, pursuant to
Section 4.04 to designate such person to receive the death benefit payable under
Section 2.11.
SECTION 1.26 TRANSACTION DATE. The term "Transaction Date" means the business
day we receive a Contribution or a written contract transaction request
providing the information we need at the Processing Office. In the case of a
transfer request initiated through the use of a touch tone telephone, as
described in Section 2.05, the Transaction Date is the business day the
telephone transaction is received.
SECTION 1.27 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
No. 92 EDCA Page 7
PART II - ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. You are to make Contributions form time to time on
such dates and in such amounts as you determine pursuant to the terms of the
Plan. Contributions will be allocated to the Divisions in accordance with the
instructions received on the application, unless later changed.
Each Contribution received by us on the Annuitant's behalf will, before its
allocation under this Contract, be reduced by the amount of any applicable tax
charge, as determined by us.
If the Plan permits, we will accept transfers made from another eligible
deferred compensation plan meeting the requirements of Section 457 of the Code
or other funds invested under the Employer's Plan.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to, or withdrawn or transferred from, an Investment
Division, the Annuity Account Value will be credited or charged, as the case may
be, with the number of Accumulation Units determined by dividing said amount by
the Accumulation Unit Value for the appropriate Investment Division for the
Valuation Period which includes that date. The number of units in an Investment
Division on any date is equal to (i) the sum of any Accumulation Units that have
been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation
Units that have been withdrawn pursuant to Sections 2.07 or 2.08 or transferred
from the Investment Division pursuant to Section 2.05. The amount in an
Investment Division on any date is equal to the product of (i) the number of
Accumulation Units in the Investment Division on that date and (ii) the
Accumulation Unit Value for the Investment Division for the Valuation Period
which includes that date.
Participation in the Separate Account under this Contract terminates on the
earliest of (i) Election and Commencement of Annuity Benefits pursuant to
Section 3.03, (ii) receipt of due proof of the Annuitant's death or (iii)
Termination of this Contract pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets which support
the guarantees of this Contract and other contracts.
The amount in the Guaranteed Interest Division at any time is equal to the sum
of all amounts that have been allocated to the Guaranteed Interest Division
pursuant to Section 2.04 plus the amount of any interest accrued but not
allocated, less the sum of all amounts that have been withdrawn from the
Guaranteed Interest Division pursuant to Sections 2.07, 2.08 or 2.10 or
transferred from the Guaranteed Interest Division pursuant to Section 2.05.
Interest is allocated to the Guaranteed Interest Division on a Transaction Date
pursuant to Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division under the terms of this
Contract terminates on the earliest of (i) Election and Commencement of Annuity
Benefits pursuant to Section 3.03, (ii) receipt of due proof of Xxxxxxxxx's
death or (iii) Termination of this Contract pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction for any applicable tax charge) to one or more
Divisions, at your sole direction as specified to us. Allocation percentages
must be in whole numbers and the sum must equal 100. The allocation is made as
of the Transaction Date on which we have received both such Contribution and
such direction. Contributions made to an Investment Division purchase
Accumulation Units in that Investment Division, using the Accumulation Unit
Value next computed after the Transaction Date. If your Plan permits, and you
provide us with advance written instructions to do so, we will accept allocation
instructions directly from the Annuitant.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application on amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon termination of this Contract pursuant to Section 2.06 and (vi)
upon the Annuitant's death pursuant to Section 2.11.
No. 92 EDCA Page 8
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through
the use of a touch tone telephone, transfer all of part of the amount you have
in a Division to one or more of the Divisions as follows: (1) amounts in the
Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive
Stock Division may be transferred among such Divisions; and (2) amounts in the
Money Market Division may be transferred to other Divisions. Written
authorization for touch tone telephone initiated transfers is only required when
authorization for telephone transfers is requested. Upon advance written notice
to you, we reserve the right to discontinue the acceptance of transfer requests
through the use of a touch tone telephone. If the Plan permits and you provide
us with advance written instructions to do so, we will accept transfer
instructions directly from the Annuitant. All transfers will be effective on the
Transaction Date and will be subject to our rules in effect at the time of
transfer. With respect to the Investment Divisions, the transfer will be made at
the Accumulation Unit Value next computed after the Transaction Date. No
transfers are permitted to the Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the
terms of the Plan, you may elect by written notice to terminate this Contract.
We will determine the Cash Value of this Contract as of the Transaction Date.
If this Contract is terminated, surrendered or exchanged prior to the
Annuitant's Retirement Date, any applicable tax charges we have paid may be
deducted. If we previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on terminations, unless a change in applicable law has occurred with
respect to this Contract.
Cash Value payments may be deferred by us in accordance with the provisions of
Section 4.07.
Subject to the terms of the Plan, we reserve the right to pay the Annuity
Account Value under this Contract and terminate this Contract if (i) you make no
Contributions during the last three completed Contract Years, or (ii) you make a
partial withdrawal that would result in the Annuitant's Annuity Account Value
falling below $500. We also reserve the right to terminate this Contract if no
Contributions have been made within 120 days from the Contract Date shown on
Page 3 of this Contract.
We will pay the Cash Value or Annuity Account Value, as applicable, directly to
you unless you give us written notice at the time of termination that you
request us to make payment to the Annuitant or another person, and that such
payment is permissible under the Plan.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount in the Divisions under this Contract and the Annuity Account Value
with respect to this Contract shall be zero. We will be released from any and
all liability for payments with respect to the Contributions from which the
Annuity Account Value arose.
SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any restrictions under the terms of
the Plan, you may elect by written notice to us to make a partial withdrawal
from the Divisions.
On the Transaction Date, we will pay the lesser of the Cash Value or the amount
of partial withdrawal requested to you. The amount paid plus any withdrawal
charge applicable pursuant to Section 2.08 will be withdrawn from the amounts
you have in the Divisions. Unless instructed otherwise, the amount withdrawn
(including any withdrawal charge) will be allocated among the Divisions in
proportion to the amounts that you have in such Divisions.
We will pay the Cash Value or Annuity Account Value, as applicable, directly to
you unless you give us written notice at the time of the withdrawal that you
request us to make payment to the Annuitant or another person, and that such
payment is permissible under the Plan.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal less than $300. If a
withdrawal under this Section would result in an Annuity Account Value of less
than $500, we will so advise you and reserve the right to pay the Annuity
Account Value to you, and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS.
NO WITHDRAWAL CHARGE FOR PARTIAL WITHDRAWALS: There will be no charge for a
partial withdrawal if (a) the amount of partial withdrawal requested is not
greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash
Value is equal to the Annuity Account Value, pursuant to Section 1.05.
WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than
the Free Corridor Amount, we will (i) first withdraw from the Divisions an
amount equal to the Free Corridor Amount in proportion to the amount you have in
them, and (ii) then withdraw an amount equal to the excess of the amount
requested over the Free Corridor Amount, plus a partial withdrawal charge. Such
partial withdrawal charge will be equal to the lesser of (a) or (b) where:
No. 92 EDCA Page 9
(a) is an amount equal to
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the amount withdrawn in excess of the Free Corridor Amount (including
such charge) pursuant to (ii) of the preceding sentence.
(b) is the excess, if any, of (i) 8% of the total Contributions made on the
Annuitant's behalf during the current Contract Year and the nine preceding
Contract Years over (ii) the cumulative total of any prior partial
withdrawal charges made pursuant to this Section.
If withdrawals are made from this Contract prior to the Annuitant's Retirement
Date, any applicable tax charges we have paid with respect to this Contract may
be deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to this Contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if the
Annuitant has completed three Contract Years or attained age 59 years and 6
months an amount equal to the excess, if any, of (i) 10% of the sum of the
Annuity Account Value on the Transaction Date over (ii) cumulative prior
withdrawals made pursuant to Section 2.07 in the current Contract Year. If the
Annuitant has not completed three Contract Years or attained age 59 years and 6
months, the Free Corridor Amount is zero.
SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $25,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts you have in the
Divisions.
If the Annuity Account Value is $25,000 or greater at the end of a Contract
Year, the Annual Administrative Charge is zero.
If the Annuity Account Value is less than $25,000 on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03
or (b) the date of termination of this Contract pursuant to Sections 2.06 or
2.11, we will prorate the Annual Administrative Charge applicable to the
completed portion of the current Contract Year and withdraw such amount in lieu
of the Annual Administrative Charge described in this Section for the applicable
part of that Contract Year.
SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of the Annuitant's death,
we will pay to you as beneficiary in a single sum the amount of the death
benefit. You may change the beneficiary or the payment method of the death
benefit as permitted by the Plan, pursuant to Section 4.04. The amount of the
death benefit is equal to the greater of (i) the Annuity Account Value and (ii)
the minimum death benefit. Such minimum death benefit is the sum of all
Contributions made by you pursuant to Section 2.01 (before reduction for any
applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any
such withdrawal will reduce the minimum death benefit (as adjusted by any
previous such withdrawal) by an amount which is in the same proportion as the
amount that was withdrawn is to the Annuity Account Value. If, in accordance
with the provisions in Section 2.01, the cash value of another annuity contract
issued by us or one of our affiliated or subsidiary life insurance companies,
which provides for a death benefit before retirement equal to the greater of the
contract cash value or an alternate amount based on premiums paid or
contributions made under the annuity contract, is transferred to this Contract,
such cash value or alternative amount as of the date of transfer will be
included in the "sum of all Contributions" in lieu of the amount of cash value
transferred for purposes of the death benefit under this Contract.
We will pay the death benefit to the beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.04. Also in accordance with the last paragraph of Section 4.04, if no such
election is in effect at your death, we will pay the death benefit to the
beneficiary in a single sum, unless the beneficiary elects, before we pay the
death benefit, to apply the death benefit to an Annuity Benefit.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value under this Contract shall be zero. We will be released
from any and all liability for payments with respect to the Contributions from
which the Annuity Account Value arose.
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PART III - ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
No. 92 EDCA Page 10
The amount of each monthly payment under any Fixed Annuity Benefit provided
under the terms of this Contract with respect to a payee is the amount provided
with respect to the payee pursuant to Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division of the Separate Account.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of net
investment return referred to in Section 1.24 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to
provide for tax charges. These charges include a daily charge for financial
accounting, death benefits, mortality risk, expenses and expense risk, plus the
investment advisory fee charges and direct operating expense charges of the
Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under the terms of this Contract with respect to a payee is the
monthly amount provided with respect to the payee pursuant to the fourth
paragraph of section 3.04. The amount of the fourth and each subsequent payment
under a Variable Annuity Benefit will be equal to the number of Annuity Units
with respect to such benefit, multiplied by the Average Annuity Unit Value for
the second calendar month immediately preceding the due date of the payment. The
number of Annuity Units with respect to a benefit is the number determined by
dividing the amount of the first monthly payment under such benefit by the
Annuity Unit Value for the Valuation Period which includes the due date of the
first monthly payment. (As described in Section 3.05, we will notify the payee
how each Variable Annuity payment is determined.)
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of the
Annuitant's Retirement Date, provided the Annuitant is then living, the Annuity
Account Value shall be applied to provide the Normal Form of Annuity Benefit,
unless you elect, subject to the terms of the Plan and the provisions of the
Code, (i) to have the Cash Value paid in a single sum, (ii) to apply the Annuity
Account Value or Cash Value, whichever is applicable pursuant to the first
paragraph of Section 3.04, to provide an Annuity Benefit on any other form
offered by us or one of our affiliated or subsidiary life insurance companies,
as elected by you or (iii) to take partial withdrawals in amounts and at times
as required by the distribution rules of Section 457(d) and 401(a)(9) of the
Code and applicable Treasury Regulations, pursuant to Section 3.05, and subject
to our rules then in effect.
Notice and election forms will be provided to you not more than six months prior
to the Retirement Date. (On your prior written request we will also provide
notice and election forms directly to the Annuitant.)
If you elect prior to the Annuitant's Retirement Date to terminate this Contract
pursuant to Section 2.06, you may elect to have an Annuity Benefit paid in lieu
of the Cash Value.
If your Plan permits and you provide us written instructions to do so in advance
of payment, we will make payment of the Cash Value, Annuity Benefits or partial
withdrawals directly to the Annuitant, Substituted Beneficiary or other payee
designated by you.
We will have the right to require you to furnish pertinent information to
provide an Annuity Benefit, and will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary
life insurance companies.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect pursuant to the first or
third paragraph of Section 3.03 to have paid an Annuity Benefit in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be (i) the
Annuity Account Value if the annuity form elected involves life contingencies,
or (ii) the Cash Value if the annuity form elected does not involve life
contingencies.
The amount applied to provide an Annuity Benefit may be reduced by a charge for
any applicable taxes on annuity considerations, as we determine. If we have
previously deducted charges for applicable taxes from Contributions as provided
in Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to this Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, this Contract will be governed by our
supplementary contract then in effect.
No. 92 EDCA Page 11
If an amount is applied to an Annuity Benefit, the amount to be applied will, in
addition to any tax charge reduction, be reduced by an administrative charge.
The amount of such charge will be determined from time to time in accordance
with our general practices applicable on a uniform basis to all contracts of the
same type as this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts
you have in the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under the terms of this
Contract, as indicated, on either the Life Annuity Form or the Joint and
Survivor Life Annuity Form (with 100% of the amount of your payment continued to
your spouse). The amount of income provided under the Fixed Annuity Benefit
payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, is
based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a"
adjusted to a unisex basis based on a 50-50 split of males and females. The
amounts of income initially provided under the Variable Annuity Benefit payable
on the Life Annuity Form and Joint Survivor Life Annuity Form are based on a
50-50 split of males and females at age zero and an Assumed Base Rate of Net
Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.23.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us on 3.5% interest and the 1983 Individual Annuity Mortality
Table "a" adjusted to a unisex basis based on a 50-50 split of males and females
at age zero if such annuity form provides for a Fixed Annuity Benefit, and on
the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50
split of males and females at age zero and an Assumed Base Rate of Net
Investment Income Return of 5% or 3.5%, whichever applies pursuant to Section
1.23, if such annuity form provides for a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Pursuant to Sections 457(d) and
401(a)(9) of the Code, and subject to the terms of the Plan, the entire interest
of the Annuitant will be distributed or begin to be distributed, no later than
the first day of April following the calendar year in which the Annuitant
attains 70 years and 6 months ("Required Beginning Date"). The entire interest
may be distributed, as elected pursuant to the Plan and this Contract, over (a)
the life of the Annuitant, or the lives of the Annuitant and a designated
beneficiary, or (b) a period certain not extending beyond the Annuitant's life
expectancy, or the joint and last survivor life expectancy of the Annuitant and
a designated beneficiary. Distributions must be made in periodic payments at
intervals of no longer than one year. In addition, payments must be either
nonincreasing or they may increase only as provided in Q&A F-3 of Section
1.401(a)(9)-1 of the Proposed Treasury Regulations, or any successor Regulation
thereto. All distributions made hereunder shall be made in accordance with the
requirements of Section 401(a)(9) of the Code, including the incidental death
benefit requirements of Section 401(a)(9)(G) of the Code, and applicable
Treasury Regulations, including the minimum distribution incidental benefit
requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or
any successor Regulation thereto.
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9.
Unless otherwise elected prior to the time distributions are required to begin,
those life expectancies shall be recalculated annually. Such election shall be
irrevocable and shall apply to all subsequent years. The life expectancy of a
non-spouse beneficiary may not be recalculated. Instead, life expectancy will be
calculated using the attained age of such beneficiary during the calendar year
in which the Annuitant attains age 70 years and 6 months, and payments for
subsequent years shall be calculated based on such life expectancy reduced by
one for each calendar year which has elapsed since the calendar year life
expectancy was first calculated.
If the Annuitant dies after distribution of the interest described in the first
paragraph of this Section has begun, the remaining portion of such interest will
continue to be distributed at least as rapidly as under the method of
distribution being used prior to the Annuitant's death.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.05, while any distribution shall be subject to such requirements of
the Code and regulations, and distribution shall also be subject to the terms of
this Contract. That is, the forms of distribution shall be those which are made
available by us at the time of your election.
If the Annuitant dies before distribution of the interest described in the first
paragraph of this Section begins, distribution of the entire interest shall be
completed no later than December 31 of the calendar year containing the fifth
anniversary of the Annuitant's death, except to the extent that an election is
made to receive death benefit distributions in accordance with (1) or (2) below:
(1) If the Annuitant's interest is payable to a designated beneficiary, then
the entire interest may be distributed over a period certain not greater
than the life expectancy of the designated beneficiary. Such distributions
must commence on or before December 31 of the calendar year immediately
following the calendar year of the Annuitant's death. If the designated
beneficiary is not the Annuitant's surviving spouse, a period certain
Annuity Benefit cannot exceed 15 years, (even if life expectancy is greater
than 15 years).
(2) If the designated beneficiary is he Annuitant's surviving spouse, the date
distributions that are required to begin in accordance with (1) above shall
not be earlier than the later of (A) December 31 of the calendar year
immediately following the calendar year of the Annuitant's death or (B)
December 31 of the calendar year in which the Annuitant would have attained
age 70 years and 6 months.
No. 92 EDCA Page 12
For purposes of determining the "period certain" referred to in the immediately
preceding paragraph, life expectancy is computed by use of the expected return
multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes
of distributions beginning after the Annuitant's death,, unless otherwise
elected by the surviving spouse by the time distributions are required to begin,
life expectancies shall be recalculated annually. Such election shall be
irrevocable by the surviving spouse and shall apply to all subsequent years. In
the case of any other designated beneficiary, life expectancies shall be
calculated using the attained age of such beneficiary during the calendar year
in which distributions are required to begin pursuant to this Section, and
payments for any subsequent calendar year shall be calculated based on such life
expectancy reduced by one for each calendar year which has elapsed since the
calendar year life expectancy was first calculated.
Distributions under this Section are considered to have begun if distributions
are made because the Required Beginning Date was reached, or, if prior to the
Required Beginning Date, distributions irrevocably commence to an individual
over a period permitted an in an annuity form acceptable under Section
1.401(a)(9) of the Proposed Treasury Regulations or any successor Regulation
thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under the terms of this Contract was based on information
that is subsequently found to be incorrect, the benefit will not be invalidated,
but an adjustment on the basis of the correct information will be made in the
amount of the benefit payments, or any amount used to provide the benefit, or
any combination thereof. Overpayments by us will be charged against, and
underpayments will be added to, any payments thereafter falling due under this
Contract with respect to the payee, affecting as many such payments as are
necessary to correct the overpayment or underpayment. Our liability, with
respect to the payee, is limited to the correct information and the actual
amounts used to provide the benefits then in force with respect to the payee
under this Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under this Contract is physically or mentally incompetent to receive
such payment or is a minor, (ii) another person or an institution is then
maintaining or has custody of such payee, and (iii) no guardian, committee, or
other representative of the estate of such payee has been appointed, we may make
the payments (in the case of a minor, at a rate not exceeding $200 a month) to
such other person or institution, and will thereupon be fully discharged from
all liability with respect thereto.
If a variable annuity form made available by us provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one of two persons, a payee for payments
thereunder may elect, without the concurrence of any other person, to receive
the commuted value of any remaining payments, provided no person upon whose life
the income depends is surviving.
Pursuant to Section 3.03, upon the election of an annuity form providing payment
for a period certain, you (or the Annuitant, if you have advised us in writing
that it is permitted under the terms of the Plan) may designate (with the right
to change such designation) a payee to receive any payments that may become due
after the death of the person or persons upon whose life or lives the income may
depend.
Subject to the terms of the Plan, the payee may designate (with the right to
change such designation and without the concurrence of any other person) a
person or persons to receive any payments or installments payable after such
payee's death, if the absence of such a designation would result in a single sum
payment to such payee's estate in accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments.
The commuted value of any such remaining payments will be determined on the
basis of compound interest at the rate utilized in the actuarial rate basis
applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
period due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
No. 92 EDCA Page 13
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TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT
AND SURVIVOR LIFE ANNUITY FORM
100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE
(Minimum Monthly Income per $1,000 of Annuity Account Value)
----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ----------
Age 60 61 62 63 64 65 66 67 68 69 70
----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ----------
60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88
61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96
62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03
63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11
64 4.89 4.94 5.00 5.05 5.10 5.14 5.19
65 5.00 5.06 5.11 5.17 5.22 5.27
66 5.12 5.18 5.24 5.29 5.35
67 5.24 5.31 5.37 5.43
68 5.37 5.44 5.51
69 5.52 5.59
70 5.67
----------- ---------- --------- ---------- ---------- --------- ---------- ---------- ---------- --------- ---------- ----------
ANNUITY BENEFIT PAYABLE
ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1,000 of Annuity Account Value)
VARIABLE ANNUITY BENEFIT
IF ASSUMED BASE RATE OF NET
INVESTMENT RETURN IS
Age 3.5% 5%
------------- ------------------------ ----------------------
60 5.27 6.16
61 5.39 6.28
62 5.52 6.41
63 5.66 6.55
64 5.81 6.70
65 5.97 6.86
66 6.15 7.03
67 6.33 7.21
68 6.53 7.41
69 6.74 7.62
70 6.97 7.85
We will, with respect to each payment of a Variable Annuity Benefit, notify the
payee of the number of Annuity Units and the Average Annuity Unit Value used in
determining the amount of each variable payment. Such notice will be mailed with
each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary as
described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
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PART IV - GENERAL PROVISIONS
SECTION 4.01 CONTRACT. The Contract constitutes the entire Contract between the
parties and the terms of this Contract alone will govern with respect to our
rights and obligations. A copy of the application is incorporated in and made
part of this Contract.
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by our authorized officer. The terms of this
Contract may be changed by amendment or replacement upon agreement between the
Owner and us without the consent of any other person.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the term of
this Contract without the consent of any other person in order to comply with
applicable laws and regulations. Such right shall include, but not be limited
to, the right to conform this Contract to reflect changes in the Code,
applicable Treasury Regulations or in regulations or published rulings of the
Internal Revenue Service so that this Contract will continue to be an Annuity
utilized to fund a plan qualifying under Section 457 of the Code.
SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY AND ASSIGNMENTS. The entire
interest under this Contract is nonforfeitable except by surrender to us.
Any interest under the terms of this Contract may not be sold, assigned,
discounted, or pledged as collateral for a loan or as security for the
performance of an obligation or for any other purpose to any person other than
us.
No amount payable under the terms of this Contract may be assigned or commuted,
unless specifically provided for under the terms of this Contract, or encumbered
by the payee, and, to the extent permitted by law, no such amount will in any
way be subject to any claim against such payee.
No. 92 EDCA Page 14
SECTION 4.04 BENEFICIARY. You, as beneficiary, are entitled to receive any death
benefit payable under this Contract pursuant to Section 2.11. Upon the
Annuitant's death you may, by written request to our Processing Office, at any
time up to and including provision of due proof of such death, change the
beneficiary designation for the Section 2.11 death benefit from you to the
Substitute Beneficiary.
Subject to the terms of the Plan, the Substitute Beneficiary may elect to
receive the death benefit payable under Section 2.11 in the form of an Annuity
Benefit rather than as a single sum. Any such election must meet the minimum
distribution rules of Sections 457(d) and 401(a)(9) of the Code and applicable
Treasury Regulations, as described in Section 3.05.
SECTION 4.05 DISQUALIFICATION OF PLAN OR CONTRACT. In the event that the Plan
fails to qualify as an Eligible Deferred Compensation Plan under Section 457 of
the Code and applicable Treasury Regulations, we reserve the right, upon
receiving notice of such fact, to transfer the Annuity Account Value under this
Contract to another annuity contract issued by us or one of our affiliated or
subsidiary life insurance companies on the life of the Annuitant, or to
terminate this Contract and pay to the Annuity Account Value less a deduction
for applicable taxes, solely at our option.
In the event that this Contract fails to qualify as an Xxxxxxx as described in
Section 1.02, we will have the right, upon receiving notice of such fact, to
terminate this Contract and pay to you the Annuity Account Value less a
deduction for the appropriate part attributable to you of any income tax payable
by you which would not have been payable if you had an Annuity.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you, we reserve the
right to limit Contributions under this Contract if required by law.
SECTION 4.07 DEFERMENT. Applications of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of the Annuity Account Value (less
any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities and
Exchange Commission, by order, permits us to defer payments in order to protect
persons with interests in the Investment Divisions. We can defer payment of any
portion of the Annuity Account Value in the Guaranteed Interest Division for up
to six months while the Annuitant is living.
SECTION 4.08. ANNUAL NOTICE. At the end of each Contract Year, we will furnish
you with a notice showing the following:
(1) the amount in the Guaranteed Interest Division,
(2) the total number of Accumulation Units in the Stock Division, Balanced
Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Value,
(4) the amount you have in the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division,
(5) the Cash Value, and
(6) the amount of death benefit payable with respect to the Annuitant.
We will also furnish annual calendar year reports concerning the status of the
annuity and any other reports required by the Code or applicable Treasury
Regulations.
After your Retirement Date, we will notify the Employer of the number of Annuity
Units and the Average Annuity Unit Value used in determining the amount of each
Variable Annuity Benefit payment, if any.
SECTION 4.09 AGE. If the Annuitant's age has been misstated, any benefits will
be those which would have been purchased at the correct age. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
SECTION 4.10 OWNERSHIP RIGHT OF EMPLOYER. Notwithstanding any other provision of
the terms of this Contract, until amounts under this Contract are distributed or
made available to the Annuitant or the Annuitant's beneficiary in accordance
with the terms of this Contract and the terms of the Plan, this Contract remains
solely the property of the Employer subject only to claims of the Employer's
general creditors. This Section shall be construed and administered in
accordance with Section 457(b)(6) of the Code and the regulations thereunder.
No. 92 EDCA Page 15
APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P.O. Box 2996, New York,
New York 10116-2996
QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR:
EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY
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TYPE OF PURCHASE (Complete One Plan Only)
A. |_| TSA PUBLIC SCHOOL (GV-PS-I)
B. |_| TSA 501(c)(3) ORGANIZATION (GV-501-I)
C. |_| TSA University (GV-PS-U-I)
D. |_| IRA Individual (including IRA to IRA transfers) (XX-XXX 4971)
E. |_| IRA Unit Billed (including IRA to IRA transfers) (XX-XXX 4971)
F. |_| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified
Plan) (XX-XXX 4971-71)
G. |X| EDC (Public Employee Deferred Compensation) (GV-EDC 4991)
H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-808)
I. |_| SEP (Simplified Employee Pension) (GV-SEP 4981)
J. |_| SARSEP (Salary Reduction SEP) _________________________________________
K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41)
L. |_| XXXXX/HR-10 TRUSTEE (GV HR-10 4911-11)
(trustee owned)
M. |_| XXXXX/HR-10 (GV-HR-10 4911)
(not trustee owned) (issued to existing units only)
--------------------------------------------------------------------------------
DO NOT COMPLETE THIS SECTION IF BOX 1.D OR 1.F CHECKED ABOVE
2. EMPLOYER/PLAN NAME
|A|B|C|_|S|T|A|T|E|_|D|E|F|E|R|R|E|D|_|C|O|M|P|E|N|S|A|T|I|O|N|_|P|R|O|G|R|A|M|
3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_|
|_| NEW UNIT |_|_|_|_|_|_|-|_|_|_|
(FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS,
FORM 983-135B IS REQUIRED.)
--------------------------------------------------------------------------------
4. PROPOSED ANNUITANT Print name to appear on Contract.
|J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_|
First Middle Initial Last
A. |X| Mr. |_| Mrs. |_| Ms. |_| Other ____
B. Date of Birth: Year 1954 Month JANUARY Day 27
---- ------- --
C. Age at Nearest Birthday: 38 D. |X| Male |_| Female
----
X. Xxxxxxxxx's Mailing Address: F. State of Residence: N.J.
--------
No. St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_|
City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1|
G. Telephone Number (101) 222 - 3456 |X| Home |_| Work
H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9|
I. Are you associated with or employed by a member of National
Association of Securities Dealers, Inc. (NASD)? |_| Yes |X| No
5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner; for all
other Markets Print Name of Annuitant.
XXXX XXX
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a. Title _________________________________________
6. RETIREMENT AGE __65_______________________________
7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death
Benefit upon Xxxxxxxxx's death before Retirement Date.) (BENEFICIARY MUST
BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS).
ABC STATE DEFERRED COMPENSATION PROGRAM - EMPLOYER
---------------------------------------------------------------------------
---------------------------------------------------------------------------
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8. CONTRIBUTION ALLOCATION
Guaranteed Interest Division ____%
Stock Division ____%
Money Market Division ____%
Balanced Division ____%
Aggressive Stock Division ____%
(PERCENTAGES IN WHOLE NUMBERS) Total 100%
9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F)
A. Reminder Notice (Billing) Required |_| Yes |_| No
IF YES, COMPLETE B-C-D-E
B. REMINDER DATE Required for Individual IRA or otherwise must agree with
existing unit or attached 983-135B. MONTH _________ DAY __________
C. REMINDER FREQUENCY
|_| Annual |_| Semi-Annual
|_| Quarterly |_| Monthly
Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED
IRA ONLY:
|_| Semi-Monthly |_| Bi-Weekly
D. REMINDER AMOUNT $_____________________________________________________
E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY
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10. EXPECTED FIRST CONTRACT YEAR
Contribution. $1000
-------------------------------------------------------------
If an advanced billing and/or contract date are requested, complete #9b and
#12.
--------------------------------------------------------------------------------
(FOR PROCESSING OFFICE USE)
Unit Name ____________________________ Reminder Date ________________________
Cert. or App# ________________________ Amendment Required____________________
EDC Emp. Add. ________________________ Emp. Fed. ID# ________________________
Frequency ____________________________ Contract Date ________________________
Receipt Date Batch # Inquiry # Processor
--------------------------------------------------------------------------------
180-1000B
--------------------------------------------------------------------------------
10. Did you receive the Separate Account Prospectus? |X| Yes |_| No
Date shown on Prospectus January 1, 1992
Date of any supplement to Prospectus ______________________________________
11. Items (a) through (f) are to be answered by the annuitant. We are
required by the NASD to ask these questions.
(a) Name of Employer: ABC Company
-----------------------------------------------------
(b) Address of Employer:
00 Xxxx Xxxxxx
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Anytown, NJ
---------------------------------------------------------------------------
(c) Occupation Sales
-------------------------------------------------------------
(d) Assuming the contract applied for will be issued, will any existing
insurance or annuity be replaced or changed (or has it been)?
|_| Yes |x| No
(e) Estimated Family Annual Income $100,000
(f) Estimated Net Worth $250,000
(g) Investment Objective: |_| Income |X| Income & Growth
|_| Aggressive Growth |_| Growth |_| Safety of Principal
12. SPECIAL INSTRUCTIONS
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13. AMOUNT PAID WITH THIS FORM: $1000
-----------------------------------------------
(If a check is submitted with this request, no advanced Contract Date is
permitted.) BACKDATING IS NOT PERMITTED.
NOTE: Xxxxxx paid will be credited upon receipt at Equitable's Processing
Office, subject to return if the contract is not issued. The Contract Date will
be the date of receipt by Equitable of this application, properly signed and
completed, and Contribution at Equitable's Processing Office.
================================================================================
AGREEMENT
All information and statements furnished in this application are true and
complete to the best of my knowledge and belief. I understand and acknowledge
that no Agent has the authority to make or modify any contract on Equitable's
behalf, or to waive or alter any of Equitable's rights and regulations.
IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO
THE INVESTMENT FUNDS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT
PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT.
UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S)
OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND
COMPLETE.
--------------------------------------------------------------------------------
LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY
APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS.
--------------------------------------------------------------------------------
x__________________________________ Date_______ City __________ State __________
Signature of Annuitant
x__________________________________ Date_______ City __________ State __________
Signature of Authorized Individual
(REQUIRED FOR EDC AND TRUSTEED) OR Owner
================================================================================
AGENT'S SECTION
Will any existing insurance or annuity be replaced or changed (or has it been),
assuming the Contract will be issued? |_| Yes |_| No
|_| I (we) certify that a prospectus for the Contract has been given to the
proposed Annuitant and that no written sales materials other than those approved
by The Equitable have been used.
EQUI-VEST issues must adequately reflect the commission interest of all Agents
on previous contracts.
--------------------------------------------------------------------------------
Print Agent's Name(s) Initial of Agent Agent Agency District Agent's
(Service Agent first) Last Name Number % Code Manager Code Signature
--------------------------------------------------------------------------------
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For Agency Compliance File: Initials of Agency EQS_ Date_ District EQS_ Date_
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(FOR ASU USE)
ASU Code and App. No. __________________________________________________________
ASU Rec'd. _____________________________________________________________________
Date to Proc. Off. ________________________________________________ Campaign |_|
Agent(s) shown above is Equity Qualified and is licensed in the state where the
request is signed. Above Agent information verified by XXX (Registered Rep)
--------------------------------------------------------------------------------
Application reviewed by ________________________________________________________
--------------------------------------------------------------------------------
180-1000B
[THE EQUITABLE LOGO]
Owner:
Annuitant:
Contract Number:
Issue Date:
Contract Date:
Retirement Date:
--------------------------------------------------------------------------------
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P O Box 2996,
New York, New York 10116-2996
AGREES
o TO ALLOCATE the Contributions made to this Contract after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division of the Separate Account (referred
to in this Contract as the "Investment Divisions") or to the Guaranteed
Interest Division, in accordance with Sections 2.02, 2.03 and 2.04, as
directed by you, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide the
Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant
is then living, and
o TO PROVIDE you with the other rights and benefits of this Contract.
This is the entire Contract. In this Contract, "we", "our" and "us" mean The
Equitable Life Assurance Society of the United States. "You" and "your" mean the
Employer at the time a right is exercised by the Employer.
TEN DAYS TO EXAMINE CONTRACT -- You may cancel this Contract by returning it to
us within ten days after receipt of it. Upon such cancellation, we will refund
any Contribution made to us on the Annuitant's behalf under this Contract, plus
or minus any investment gain or loss experienced in the Investment Divisions of
the Separate Account from the date such Contribution was allocated to such
Investment Division to the date we receive the returned Contract.
/s/Xxxxxxx Xxxxxxx /s/Xxxxxx X. Xxxxxx
Xxxxxxx Xxxxxxx Xxxxxx X. Xxxxxx
Vice President, Secretary & President and
Associate General Counsel Chief Executive Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE
MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL
ACCOUNTING, DEATH BENEFITS, MORTALITY RISKS, EXPENSES AND EXPENSE RISK, PLUS THE
INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE
TRUST.
No. 92 EDCB
This Contract is issued in consideration of the payment to us of the
Contributions made under the terms of this Contract.
The provisions on the following pages are part of this Contract.
--------------------------------------------------------------------------------
TABLE OF CONTENTS
DEFINITIONS Page
Section 1.01 - Annuitant ................................................4
1.02 - Annuity ..................................................4
1.03 - Annuity Account Value ....................................4
1.04 - Annuity Benefit ..........................................4
1.05 - Cash Value ...............................................4
1.06 - Class of Contracts........................................5
1.07 - Code .....................................................5
1.08 - Contract..................................................5
1.09 - Contract Date ............................................5
1.10 - Contract Year ............................................5
1.11 - Contribution .............................................5
1.12 - Divisions.................................................5
1.13 - Eligible Annuity Certain..................................5
1.14 - Employer..................................................5
1.15 - Guaranteed Interest Rate..................................5
1.16 - Joint and Survivor Life Annuity Form......................5
1.17 - Life Annuity Form.........................................5
1.18 - Normal Form...............................................5
1.19 - Period Certain Annuity ...................................5
1.20 - Plan......................................................5
1.21 - Processing Office.........................................6
1.22 - Retirement Date ..........................................6
1.23 - Separate Account .........................................6
1.24 - Separate Account Definitions..............................7
1.25 - Substituted Beneficiary ..................................7
1.26 - Transaction Date .........................................7
1.27 - Trust ....................................................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions ............................................8
2.02 - Separate Account Investment Divisions.....................8
2.03 - Guaranteed Interest Division .............................8
2.04 - Allocation to Divisions ..................................8
2.05 - Transfers Among Divisions ................................9
2.06 - Termination of this Contract .............................9
2.07 - Partial Withdrawals ......................................9
2.08 - Charges for Partial Withdrawals ..........................9
2.09 - Free Corridor Amount ....................................10
2.10 - Annual Administrative Charge ............................10
2.11 - Death Benefit............................................10
ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit ...................................10
3.02 - Variable Annuity Benefit.................................11
3.03 - Election and Commencement of Annuity Benefits............11
3.04 - Amount of Annuity Benefits...............................11
3.05 - Payment of Annuity Benefits .............................12
GENERAL PROVISIONS
Section 4.01 - Contract.................................................14
4.02 - Statutory Compliance ....................................14
4.03 - Nonforfeitability, Nontransferability and Assignments....14
4.04 - Beneficiary .............................................15
4.05 - Disqualification of Plan or Contract.....................15
4.06 - Future Contributions ....................................15
4.07 - Deferment ...............................................15
4.08 - Annual Notice............................................15
4.09 - Age......................................................15
4.10 - Ownership Right of Employer..............................15
No. 92 EDCB Page 2
PART I -- DEFINITIONS
SECTION 1.01 ANNUITANT. The term "Annuitant" means an individual who
participates in a Plan or, if the Plan permits, a beneficiary under the Plan, as
shown on Page 3 of this Contract, and on whose behalf this Contract is purchased
and is maintained.
SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in
accordance with the terms of the Plan.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts that you have in the Guaranteed Interest Division and the
Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by us pursuant to Section 3.04 of this Contract. Various sections of this
Contract (Sections 1.16, 1.17, 1.18, 1.19, 3.01, and 3.02) refer to monthly
payments to be made under an Annuity Benefit. You may elect to have the Annuity
Benefit paid at other intervals, such as quarterly, semi-annually, or annually,
instead of monthly. You may elect this at the time you elect the Annuity Benefit
form as described in Section 3.03; in that event, all references in this
Contract to monthly payments will be deemed to mean payments at the frequency
you elect, subject to our rules at the time of election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value
less any applicable withdrawal charge determined as follows:
The withdrawal charge equals the lesser of (a) or (b) where:
(a) equals
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the excess of (i) the sum of the Annuity Account Value over (ii) the
Free Corridor Amount defined in Section 2.09.
(b) is the excess, if any, of (i) 8% of the total Contributions made on the
Annuitant's behalf during the current Contract Year and the nine preceding
Contract Years over (ii) the cumulative total of any prior partial
withdrawal charges made pursuant to Section 2.08.
However, notwithstanding the above, if the Annuitant is age 60 or older on the
Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of
the excess of the Annuity Account Value over the Free Corridor Amount.
A withdrawal charge will not apply, which means the Cash Value will equal the
Annuity Account Value upon any of the following occurrences:
(i) the later of the completion of at least five Contract Years and the
Annuitant's attainment of age 59 years and 6 months, or
(ii) the completion of at least twelve Contract Years, or
(iii) a request is made for a refund of a Contribution in excess of the amount
that may be contributed under Section 457 of the Code within one month
of the date on which the Contribution is made, or
(iv) the Annuitant's attainment of age 55, his completion of at least five
Contract Years and the receipt by us of a properly completed settlement
election form providing for the application of the Annuity Account Value
to purchase an Eligible Annuity Certain, defined in Section 1.13, or
(v) the Annuitant's completion of at least three Contract Years and the
receipt by us of a properly completed settlement election form providing
for the application of the Annuity Account Value to purchase a Period
Certain Annuity, defined in Section 1.19, where the certain period of
such annuity is at least ten years, or
(vi) the receipt by us of a properly completed settlement election form
providing for the application of the Annuity Account Value to purchase a
life annuity distribution, pursuant to the terms of this Contract, or
(vii) the Annuitant dies and a death benefit is payable to the beneficiary.
No. 92 EDCB Page 4
The above statements notwithstanding, we reserve the right to modify or waive
any early withdrawal charges in order to comply with any applicable state or
local legal or regulatory requirements. Any such modification or waiver will
apply equally to all Annuitants under a Plan subject to such a state or local
legal or regulatory requirement.
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same calendar year.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as
amended, or any corresponding provisions of prior or subsequent United States
revenue laws.
SECTION 1.08 CONTRACT. The term "Contract" means this Contract.
SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both the application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us
pursuant to the terms of the Plan to this Contract. We are under no obligation
to accept any Contribution less than $20.00.
SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following divisions described in this
Contract:
(i) the Guaranteed Interest Division, and
(ii) the Investment Divisions of the Separate Account.
SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
a Period Certain Annuity issued by us which extends beyond the Annuitant's
attainment of age 59 years and 6 months and does not permit any prepayment of
the unpaid principal (that is, no withdrawal or single sum payment) prior to
your attainment of age 59 years and 6 months.
SECTION 1.14 EMPLOYER. The term "Employer" means one of the following types of
entity which is eligible to adopt, has adopted, and maintains a Plan: (i) a
State, a political subdivision of a State, or an agency or instrumentality of a
State or political subdivision of a State, or (ii) any other organization exempt
from tax under the Code which has adopted and maintains a Plan for a select
group of management or highly compensated employees within the meaning of the
Employee Retirement Income Security Act of 1974, as amended. The Employer is the
Owner of and beneficiary under this Contract.
SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrued on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of
this Contract. Section 2.03 describes the determination of the rate to apply
thereafter.
SECTION 1.16 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected by you. The payments commence on the date as of which the Joint and
Survivor Life Annuity Form is purchased and terminate with the last payment due
before the death of the survivor.
SECTION 1.17 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us providing monthly payments during the lifetime of the person upon
whose life such payments depend. The payments commence on the date as of which
the Life Annuity Form is purchased and terminate with the last payment due
before the death of such person.
SECTION 1.18 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means (i) if the Annuitant has a living spouse at the Retirement
Date, the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity
Form with such spouse as the contingent annuitant (with 100% of the monthly
payment amount continued to the spouse), and (ii) if the Annuitant does not have
a living spouse at the Retirement Date, the Fixed Annuity Benefit payable on the
Life Annuity Form.
SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us which does not permit any
prepayment of the unpaid principal (that is, you cannot elect to receive part of
the payments as a single sum payment with the remainder paid in monthly annuity
payments).
SECTION 1.20 PLAN. The term "Plan" refers to an "Eligible Deferred Compensation
Plan" meeting the requirements of Section 457(b) of the Code and applicable
Treasury Regulations which is established and maintained by an Employer for the
benefit of individuals performing services for the Employer and their
beneficiaries.
No. 92 EDCB Page 5
SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such
other location as we shall designate by advance written notice to the Employer
or the Plan's Trustee, as applicable.
SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which
the Annuitant attains the retirement age as shown on Page 3 of this Contract.
Before the Retirement Date the Employer may elect to change the Retirement Date
to another Retirement Date, which may be any date after the filing of the
election (other than the 29th, 30th, or 31st day of any month). No Retirement
Date shall be earlier than the Retirement Date provided under the Plan nor shall
it be later than the date the Annuitant attains age 70 years and 6 months. Any
election for such change must be made in writing by you and shall not take
effect until received by us at the Processing Office.
SECTION 1.23 SEPARATE ACCOUNT. The term "Separate Account" means Separate
Account A which is organized as a unit investment trust, a type of investment
company. We established the Separate Account and it is maintained in accordance
with the laws of New York State; Realized and unrealized gains and losses from
the assets of the Separate Account are credited to or charged against it without
regard to our other income, gains or losses. Assets are put in the Separate
Account to support this Contract and other variable annuity contracts and
certificates. Assets may be put in the Separate Account for other purposes, but
not to support contracts or policies other than variable annuities or variable
life insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust where each class (or series) represents a separate portfolio in
such Trust. We reserve the right to change the designated trust or investment
company or to add designated trusts or investment companies. The Investment
Divisions available are the Stock Division, the Money Market Division, the
Balanced Division and the Aggressive Stock Division. The Guaranteed Interest
Division is not part of the Separate Account, but rather is an asset of our
General Account.
We will value the assets of each Investment Division on each business day. A
business day is any day on which we are open, the New York Stock Exchange is
open for trading and there is a sufficient degree of trading in the portfolio
securities in which an Investment Division is invested to materially affect the
Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments we are
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under
the Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any
other form;
(v) add Investment Divisions (or sub-divisions of Investment Divisions) to,
or remove Investment Divisions (or sub-divisions of Investment
Divisions) from the Separate Account (the term "investment Division" in
this Contract shall then refer to any other Investment Division in which
the assets, of a class of contracts to which this Contract belongs, were
placed);
(vi) combine any two or more Investment Divisions (or sub-divisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
class of contracts to which this Contract belongs.
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, you will be notified of such exercise, as
required by law.
No. 92 EDCB Page 6
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for applicable tax
charges) at a rate not to exceed 1.49% per year for each of the Stock, Money
Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock
Division, for financial accounting, death benefits, mortality risk, expenses and
expense risk. The charge shall be made in accordance with Subsection (c) of the
Net Investment Factor provision in Section 1.24. The relative proportion of
these charges may be modified. This daily charge, plus the investment advisory
fee charges and direct operating expense charges of the Trust, shall not exceed
a total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract.
SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any preceding consecutive
non-business days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment
Division for the Valuation Period. For this purpose, we use the share
value reported to us by the Trust.
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period
(after taking into account any amounts allocated or withdrawn for that
Valuation Period).
(c) is the daily Separate Account charge for the expenses of this Contract,
times the number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an
Investment Division where Contributions made on the Annuitant's behalf are
invested and which is used in determining the amount in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for that Investment Division for such Valuation Period.
ANNUITY UNIT: The "Annuity Unit" is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: An "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first Contribution was put into the Stock
Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed
Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The
Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value
for the immediately preceding Valuation Period multiplied by the Adjusted Net
Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for a Valuation Period is the Net Investment Factor for such
period reduced for each calendar day in such subsequent Valuation Period by the
Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net
Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net
Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall
be 5%, except in states where the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar
month is equal to the average of the Annuity Unit Values for all Valuation'
Periods ending in such month.
SECTION 1.25 SUBSTITUTED BENEFICIARY. The term "Substituted Beneficiary" refers
to the beneficiary designated under the Plan by the Annuitant to receive death
benefits payable under the Plan, where the Employer has elected, pursuant to
Section 4.04 to designate such person to receive the death benefit payable under
Section 2.11.
SECTION 1.26 TRANSACTION DATE. The term "Transaction Date" means the business
day we receive a Contribution or a written contract transaction request
providing the information we need at the Processing Office. In the case of a
transfer request initiated through the use of a touch tone telephone, as
described in Section 2.05, the Transaction Date is the business day the
telephone transaction is received.
SECTION 1.27 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
No. 92 EDCB Page 7
--------------------------------------------------------------------------------
PART II -- ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. You are to make Contributions from time to time on
such dates and in such amounts as you determine pursuant to the terms of the
Plan; Contributions will be allocated to the Divisions in accordance with the
instructions received on the application, unless later changed.
Each Contribution received by us on the Annuitant's behalf will, before its
allocation under this Contract, be reduced by the amount of any applicable tax
charge, as determined by us.
If the Plan permits, we will accept transfers made from another eligible
deferred compensation plans meeting the requirements of Section 457 of the Code
or other funds invested under the Employer's Plan.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to, or withdrawn or transferred from, an Investment
Division, the Annuity Account Value will be credited or charged, as the case may
be, with the number of Accumulation Units determined by dividing said amount by
the Accumulation Unit Value for the appropriate Investment Division for the
Valuation Period which includes that date. The number of units in an Investment
Division on any date is equal to (i) the sum of any Accumulation Units that have
been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation
Units that have been withdrawn pursuant to Sections 2.07 or 2.08 or transferred
from the Investment Division pursuant to Section 2.05. The amount in an
Investment Division on any date is equal to the product of (i) the number of
Accumulation Units in the Investment Division on that date and (ii) the
Accumulation Unit Value for the Investment Division for the Valuation Period
which includes that date.
Participation in the Separate Account under this Contract terminates on the
earliest of (i) Election and Commencement of Annuity Benefits pursuant to
Section 3.03, (ii) receipt of due proof of the Annuitant's death or (iii)
Termination of this Contract pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets which support
the guarantees of this Contract and other contracts.
The amount in the Guaranteed Interest Division at any time is equal to the sum
of all amounts that have been allocated to the Guaranteed Interest Division
pursuant to Section 2.04 plus the amount of any interest accrued but not
allocated, less the sum of all amounts that have been withdrawn from the
Guaranteed Interest Division pursuant to Sections 2.07, 2.08 or 2.10 or
transferred from the Guaranteed Interest Division pursuant to Section 2.05.
Interest is allocated to the Guaranteed Interest Division on a Transaction Date
pursuant to Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division under the terms of this
Contract terminates on the earliest of (i) Election and Commencement of Annuity
Benefits pursuant to Section 3.03, (ii) receipt of due proof of the Annuitant's
death or (iii) Termination of this Contract pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction for any applicable tax charge) to one or more
Divisions, at your sole direction as specified to us. Allocation percentages
must be in whole numbers and the sum must equal 100. The allocation is made as
of the Transaction Date on which we have received both such Contribution and
such direction. Contributions made to an Investment Division purchase
Accumulation Units in that Investment Division, using the Accumulation Unit
Value next computed after the Transaction Date. If your Plan permits, and you
provide us with advance written instructions to do so, we will accept allocation
instructions directly from the Annuitant.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon Termination of this Contract pursuant to Section 2.06 and (vi)
upon the Annuitant's death pursuant to Section 2.11.
No. 92 EDCB Page 8
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through
the use of a touch tone telephone, transfer all or part of the amount you have
in a Division to one or more of the Divisions as follows: (1) amounts in the
Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive
Stock Division may be transferred among such Divisions; and (2) amounts in the
Money Market Division may be transferred to other Divisions. Written
authorization for touch tone telephone initiated transfers is only required when
authorization for telephone transfers is requested. Upon advance written notice
to you, we reserve the right to discontinue the acceptance of transfer requests
through the use of a touch tone telephone. If the Plan permits and you provide
us with advance written instructions to do so, we will accept transfer
instructions directly from the Annuitant. All transfers will be effective on the
Transaction Date and will be subject to our rules in effect at the time of
transfer. With respect to the Investment Divisions, the transfer will be made at
the Accumulation Unit Value next computed after the Transaction Date. No
transfers are permitted to the Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the
terms of the Plan, you may elect by written notice to terminate this Contract.
We will determine the Cash Value of this Contract as of the Transaction Date.
If this Contract is terminated, surrendered or exchanged prior to the
Annuitant's Retirement Date, any applicable tax charges we have paid may be
deducted. If we previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on terminations, unless a change in applicable law has occurred with
respect to this Contract.
Cash Value payments may be deferred by us in accordance with the provisions of
Section 4.07.
Subject to the terms of the Plan, we reserve the right to pay the Annuity
Account Value under this Contract and terminate this Contract if (i) you make no
Contributions during the last three completed Contract Years, or (ii) you make a
partial withdrawal that would result in the Annuitant's Annuity Account Value
falling below $500. We also reserve the right to terminate this Contract if no
Contributions have been made within 120 days from the Contract Date shown on
Page 3 of this Contract.
We will pay the Cash Value or Annuity Account Value, as applicable, directly to
you unless you give us written notice at the time of termination that you
request us to make payment to the Annuitant or another person, and that such
payment is permissible under the Plan.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount in the Divisions under this Contract and the Annuity Account Value
with respect to this Contract shall be zero. We will be released from any and
all liability for payments with respect to the Contributions from which the
Annuity Account Value arose.
SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any restrictions under the terms of
the Plan, you may elect by written notice to us to make a partial withdrawal
from the Divisions.
On the Transaction Date, we will pay the lesser of the Cash Value or the amount
of partial withdrawal requested to you. The amount paid plus any withdrawal
charge applicable pursuant to Section 2.08 will be withdrawn from the amounts
you have in the Divisions. Unless instructed otherwise, the amount withdrawn
(including any withdrawal charge) will be allocated among the Divisions in
proportion to the amounts that you have in such Divisions.
We will pay the Cash Value or Annuity Account Value, as applicable, directly to
you unless you give us written notice at the time of the withdrawal that you
request us to make payment to the Annuitant or another person, and that such
payment is permissible under the Plan.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300.
If a withdrawal made under this Section would result in an Annuity Account Value
of less than $500, we will so advise you and reserve the right to pay the
Annuity Account Value to you, and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS.
NO WITHDRAWAL CHARGE FOR PARTIAL WITHDRAWALS: There will be no charge for a
partial withdrawal if (a) the amount of partial withdrawal requested is not
greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash
Value is equal to the Annuity Account Value, pursuant to Section 1.05.
WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than
the Free Corridor Amount, we will (i) first withdraw from the Divisions an
amount equal to the Free Corridor Amount in proportion to the amount you have in
them, and (ii) then withdraw an amount equal to the excess of the amount
requested over the Free Corridor Amount, plus a partial withdrawal charge. Such
partial withdrawal charge will be equal to the lesser of (a) or (b) where:
No. 92 EDCB Page 9
(a) is an amount equal to
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the amount withdrawn in excess of the Free Corridor Amount (including
such charge) pursuant to (ii) of the preceding sentence.
(b) is the excess, if any, of (i) 8% of the total Contributions made on the
Annuitant's behalf during the current Contract Year and the nine preceding
Contract Years over (ii) the cumulative total of any prior partial
withdrawal charges made pursuant to this Section.
If withdrawals are made from this Contract prior to the Annuitant's Retirement
Date, any applicable tax charges we have paid with respect to this Contract may
be deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to this Contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if the
Annuitant has completed three Contract Years or attained age 59 years and 6
months an amount equal to the excess, if any, of (i) 10% of the sum of the
Annuity Account Value on the Transaction Date over (ii) cumulative prior
withdrawals made pursuant to Section 2.07 in the current Contract Year. If the
Annuitant has not completed three Contract Years or attained age 59 years and 6
months, the Free Corridor Amount is zero.
SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $25,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts you have in the
Divisions.
If the Annuity Account Value is $25,000 or greater at the end of a Contract
Year, the Annual Administrative Charge is zero.
If the Annuity Account Value is less than $25,000 on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03
or (b) the date of termination of this Contract pursuant to Sections 2.06 or
2.11, we will prorate the Annual Administrative Charge applicable to the
completed portion of the current Contract Year and withdraw such amount in lieu
of the Annual Administrative Charge described in this Section for the applicable
part of that Contract Year.
SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of the Annuitant's death,
we will pay to you as beneficiary in a single sum the amount of the death
benefit. You may change the beneficiary or the payment method of the death
benefit as permitted by the Plan, pursuant to Section 4.04. The amount of the
death benefit is equal to the greater of (i) the Annuity Account Value and (ii)
the minimum death benefit. Such minimum death benefit is the sum of all
Contributions made by you pursuant to Section 2.01 (before reduction for any
applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any
such withdrawal will reduce the minimum death benefit (as adjusted by any
previous such withdrawal) by an amount which is in the same proportion as the
amount that was withdrawn is to the Annuity Account Value. If, in accordance
with the provisions of Section 2.01, the cash value of another annuity contract
issued by us or one of our affiliated or subsidiary life insurance companies,
which provides for a death benefit before retirement equal to the greater of the
contract cash value or an alternate amount based on premiums paid or
contributions made under the annuity contract, is transferred to this Contract,
such cash value or alternative amount as of the date of transfer will be
included in the "sum of all Contributions" in lieu of the amount of cash value
transferred for purposes of the death benefit under this Contract.
We will pay the death benefit to the beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.04. Also in accordance with the last paragraph of Section 4.04, if no such
election is in effect at your death, we will pay the death benefit to the
beneficiary in a single sum, unless the beneficiary elects, before we pay the
death benefit, to apply the death benefit to an Annuity Benefit.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value under this Contract shall be zero. We will be released
from any and all liability for payments with respect to the Contributions from
which the Annuity Account Value arose.
--------------------------------------------------------------------------------
PART III - ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
No. 92 EDCB Page 10
The amount of each monthly payment under any Fixed Annuity Benefit provided
under the terms of this Contract with respect to a payee is the amount provided
with respect to the payee pursuant to Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division of the Separate Account.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of net
investment return referred to in Section 1.24 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to
provide for tax charges. These charges include a daily charge for financial
accounting, death benefits, mortality risk, expenses and expense risk, plus the
investment advisory fee charges and direct operating expense charges of the
Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under the terms of this Contract with respect to a payee is the
monthly amount provided with respect to the payee pursuant to the fifth
paragraph of Section 3.04. The amount of the fourth and each subsequent payment
under a Variable Annuity Benefit will be equal to the number of Annuity Units
with respect to such benefit, multiplied by the Average Annuity Unit Value for
the second calendar month immediately preceding the due date of the payment. The
number of Annuity Units with respect to a benefit is the number determined by
dividing the amount of the first monthly payment under such benefit by the
Annuity Unit Value for the Valuation Period which includes the due date of the
first monthly payment. (As described in Section 3.05, we will notify the payee
how each Variable Annuity payment is determined.)
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of the
Annuitant's Retirement Date, provided the Annuitant is then living, the Annuity
Account Value shall be applied to provide the Normal Form of Annuity Benefit,
unless you elect, subject to the terms of the Plan and the provisions of the
Code, (i) to have the Cash Value paid in a single sum, (ii) to apply the Annuity
Account Value or Cash Value, whichever is applicable pursuant to the first
paragraph of Section 3.04, to provide an Annuity Benefit on any other form
offered by us or one of our affiliated or subsidiary life insurance companies,
as elected by you or (iii) to take partial withdrawals in amounts and at times
as required by the distribution rules of Section 457(d) and 401(a)(9) of the
Code and applicable Treasury Regulations, pursuant to Section 3.05, and subject
to our rules then in effect.
Notice and election forms will be provided to you not more than six months prior
to the Retirement Date. (On your prior written request we will also provide
notice and election forms directly to the Annuitant).
If you elect prior to the Annuitant's Retirement Date to terminate this Contract
pursuant to Section 2.06, you may elect to have an Annuity Benefit paid in lieu
of the Cash Value.
If your Plan permits and you provide us written instructions to do so in advance
of payment, we will make payment of the Cash Value, Annuity Benefits or partial
withdrawals directly to the Annuitant, Substituted Beneficiary or other payee
designated by you.
We will have the right to require you to furnish pertinent information to
provide an Annuity Benefit, and will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary
life insurance companies.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect pursuant to the first or
third paragraph of Section 3.03 to have paid an Annuity Benefit in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be (i) the
Annuity Account Value if the annuity form elected involves life contingencies,
or (ii) the Cash Value if the annuity form elected does not involve life
contingencies.
The amount applied to provide an Annuity Benefit may be reduced by a charge for
any applicable taxes on annuity considerations, as we determine. If we have
previously deducted charges for applicable taxes from Contributions as provided
in Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to this Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, this Contract will be governed by our
supplementary contract then in effect.
No. 92 EDCB Page 11
If an amount is applied to provide an Annuity Benefit, the amount to be applied
will, in addition to any tax charge reduction, be reduced by an administrative
charge. The amount of such charge will be determined from time to time in
accordance with our general practices applicable on a uniform basis to all
contracts of the same type as this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts
you have in the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under the terms of this
Contract, as indicated, on either the Life Annuity Form or the Joint and
Survivor Life Annuity Form (with 100% of the amount of your payment continued to
your spouse). The amount of income provided under the Fixed Annuity Benefit
payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, is
based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a"
adjusted to a unisex basis based on a 50-50 split of males and females. The
amounts of income initially provided under the Variable Annuity Benefit payable
on the Life Annuity Form and Joint and Survivor Life Annuity Form are based on a
50-50 split of males and females at age zero and an Assumed Base Rate of Net
Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.23.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us on 3.5% interest and the 1983 Individual Annuity Mortality
Table "a" adjusted to a unisex basis based on a 50-50 split of males and females
at age zero if such annuity form provides for a Fixed Annuity Benefit, and on
the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50
split of males and females at age zero and an Assumed Base Rate of Net
Investment Income Return of 5% or 3.5%, whichever applies pursuant to Section
1.23, if such annuity form provides for a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Pursuant to Sections 457(d) and
401(a)(9) of the Code, and subject to the terms of the Plan, the entire interest
of the Annuitant will be distributed or begin to be distributed, no later than
the first day of April following the calendar year in which the Annuitant
attains 70 years and 6 months ("Required Beginning Date"). The entire interest
may be distributed, as elected pursuant to the Plan and this Contract, over (a)
the life of the Annuitant, or the lives of the Annuitant and a designated
beneficiary, or (b) a period certain not extending beyond the Annuitant's life
expectancy, or the joint and last survivor life expectancy of the Annuitant and
a designated beneficiary. Distributions must be made in periodic payments at
intervals of no longer than one year. In addition, payments must be either
nonincreasing or they may increase only as provided in Q & A F-3 of Section
1.401(a)(9)-1 of the Proposed Treasury Regulations, or any successor Regulation
thereto. All distributions made hereunder shall be made in accordance with the
requirements of Section 401(a)(9) of the Code, including the incidental death
benefit requirements of Section 401(a)(9)(G) of the Code, and applicable
Treasury Regulations, including the minimum distribution incidental benefit
requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or
any successor Regulation thereto.
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9.
Unless otherwise elected prior to the time distributions are required to begin,
those life expectancies shall be recalculated annually. Such election shall be
irrevocable and shall apply to all subsequent years. The life expectancy of a
non-spouse beneficiary may not be recalculated. Instead, life expectancy will be
calculated using the attained age of such beneficiary during the calendar year
in which the Annuitant attains age 70 years and 6 months, and payments for
subsequent years shall be calculated based on such life expectancy reduced by
one for each calendar year which has elapsed since the calendar year life
expectancy was first calculated.
If the Annuitant dies after distribution of the interest described in the first
paragraph of this Section has begun, the remaining portion of such interest will
continue to be distributed at least as rapidly as under the method of
distribution being used prior to the Annuitant's death.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.05, while any distribution shall be subject to such requirements of
the Code and regulations, any distribution shall also be subject to the terms of
this Contract. That is, the forms of distribution shall be those which are made
available by us at the time of your election.
If the Annuitant dies before distribution of the interest described in the first
paragraph of this Section begins, distribution of the entire interest shall be
completed no later than December 31 of the calendar year containing the fifth
anniversary of the Annuitant's death, except to the extent that an election is
made to receive death benefit distributions in accordance with (1) or (2) below:
(1) If the Annuitant's interest is payable to a designated beneficiary, then
the entire interest may be distributed over a period certain not greater
than the life expectancy of the designated beneficiary. Such
distributions must commence on or before December 31 of the calendar
year immediately following the calendar year of the Annuitant's death.
If the designated beneficiary is not the Annuitant's surviving spouse,
a period certain Annuity Benefit cannot exceed 15 years, (even if life
expectancy is greater than 15 years).
(2) If the designated beneficiary is the Annuitant's surviving spouse, the
date distributions that are required to begin in accordance with (1)
above shall not be earlier than the later of (A) December 31 of the
calendar year immediately following the calendar year of the Annuitant's
death or (B) December 31 of the calendar year in which the Annuitant
would have attained age 70 years and 6 months.
No. 92 EDCB Page 12
For purposes of determining the "period certain" referred to in the immediately
preceding paragraph, life expectancy is computed by use of the expected return
multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes
of distributions beginning after the Annuitant's death, unless otherwise elected
by the surviving spouse by the time distributions are required to begin, life
expectancies shall be recalculated annually. Such election shall be irrevocable
by the surviving spouse and shall apply to all subsequent years. In the case of
any other designated beneficiary, life expectancies shall be calculated using
the attained age of such beneficiary during the calendar year in which
distributions are required to begin pursuant to this Section, and payments for
any subsequent calendar year shall be calculated based on such life expectancy
reduced by one for each calendar year which has elapsed since the calendar year
life expectancy was first calculated.
Distributions under this Section are considered to have begun if distributions
are made because the Required Beginning Date was reached, or, if prior to the
Required Beginning Date, distributions irrevocably commence to an individual
over a period permitted and in an annuity form acceptable under Section
1.401(a)(9) of the Proposed Treasury Regulations or any successor Regulation
thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under the terms of this Contract was based on information
that is subsequently found to be incorrect, the benefit will not be invalidated,
but an adjustment on the basis of the correct information will be made in the
amount of the benefit payments, or any amount used to provide the benefit, or
any combination thereof. Overpayments by us will be charged against, and
underpayments will be added to, any payments thereafter falling due under this
Contract with respect to the payee, affecting as many such payments as are
necessary to correct the overpayment or underpayment. Our liability, with
respect to a payee, is limited to the correct information and the actual amounts
used to provide the benefits then in force with respect to the payee under this
Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under this Contract is physically or mentally incompetent to receive
such payment or is a minor, (ii) another person or an institution is then
maintaining or has custody of such payee, and (iii) no guardian, committee, or
other representative of the estate of such payee has been appointed, we may make
the payments (in the case of a minor, at a rate not exceeding $200 a month) to
such other person or institution, and will thereupon be fully discharged from
all liability with respect thereto.
If a variable annuity form made available by us provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one of two persons, a payee for payments
thereunder may elect, without the concurrence of any other person, to receive
the commuted value of any remaining payments, provided no person upon whose life
the income depends is surviving.
Pursuant to Section 3.03, upon the election of an annuity form providing
payments for a period certain, you (or the Annuitant, if you have advised us in
writing that it is permitted under the terms of the Plan) may designate (with
the right to change such designation) a payee to receive any payments that may
become due after the death of the person or persons upon whose life or lives the
income may depend.
Subject to the terms of the Plan, the payee may designate (with the right to
change such designation and without the concurrence of any other person) a
person or persons to receive any payments or installments payable after such
payee's death, if the absence of such a designation would result in a single sum
payment to such payee's estate in accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments.
The commuted value of any such remaining payments will be determined on the
basis of compound interest at the rate utilized in the actuarial rate basis
applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
No. 92 EDCB Page 13
TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE
JOINT AND SURVIVOR LIFE ANNUITY FORM
100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE
(Minimum Monthly Income per $1,000 of Annuity Account Value)
------------------------------------------------------------------------------------------------------------------------------------
Age 60 61 62 63 64 65 66 67 68 69 70
------------------------------------------------------------------------------------------------------------------------------------
60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88
61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96
62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03
63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11
64 4.89 4.94 5.00 5.05 5.10 5.14 5.19
65 5.00 5.06 5.11 5.17 5.22 5.27
66 5.12 5.18 5.24 5.29 5.35
67 5.24 5.31 5.37 5.43
68 5.37 5.44 5.51
69 5.52 5.59
70 5.67
------------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE
ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1,000 of Annuity Account Value)
--------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT
IF ASSUMED BASE RATE OF NET
INVESTMENT RETURN IS
Age 3.5% 5%
--------------------------------------------------------------------------------
60 5.27 6.16
61 5.39 6.28
62 5.52 6.41
63 5.66 6.55
64 5.81 6.70
65 5.97 6.86
66 6.15 7.03
67 6.33 7.21
68 6.53 7.41
69 6.74 7.62
70 6.97 7.85
--------------------------------------------------------------------------------
We will, with respect to each payment of a Variable Annuity Benefit, notify the
payee of the number of Annuity Units and the Average Annuity Unit Value used in
determining the amount of each variable payment. Such notice will be mailed with
each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary,
as described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
--------------------------------------------------------------------------------
PART IV - GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the
parties and the terms of this Contract alone will govern with respect to our
rights and obligations. A copy of the application is incorporated in and made
part of this Contract.
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by our authorized officer. The terms of this
Contract may be changed by amendment or replacement upon agreement between the
Owner and us without the consent of any other person.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of
this Contract without the consent of any other person in order to comply with
applicable laws and regulations. Such right shall include, but not be limited
to, the right to conform this Contract to reflect changes in the Code,
applicable Treasury Regulations, or in regulations or published rulings of the
Internal Revenue Service so that this Contract will continue to be an Annuity
utilized to fund a plan qualifying under Section 457 of the Code.
SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY AND ASSIGNMENTS. The entire
interest under this Contract is nonforfeitable except by surrender to us.
Any interest under the terms of this Contract may not be sold, assigned,
discounted, or pledged as collateral for a loan or as security for the
performance of an obligation or for any other purpose to any person other than
us.
No amount payable under the terms of this Contract may be assigned or commuted,
unless specifically provided for under the terms of this Contract, or encumbered
by the payee, and, to the extent permitted by law, no such amount will in any
way be subject to any claim against such payee.
No. 92 EDCB Page 14
SECTION 4.04 BENEFICIARY. You, as beneficiary, are entitled to receive any death
benefit payable under this Contract pursuant to Section 2.11. Upon the
Annuitant's death you may, by written request to our Processing Office, at any
time up to and including provision of due proof of such death, change the
beneficiary designation for the Section 2.11 death benefit from you to the
Substitute Beneficiary.
Subject to the terms of the Plan, the Substitute Beneficiary may elect to
receive the death benefit payable under Section 2.11 in the form of an Annuity
Benefit rather than as a single sum. Any such election must meet the minimum
distribution rules of Sections 457(d) and 401(a)(9) of the Code and applicable
Treasury Regulations, as described in Section 3.05.
SECTION 4.05 DISQUALIFICATION OF PLAN OR CONTRACT. In the event that the Plan
fails to qualify as an Eligible Deferred Compensation Plan under Section 457 of
the Code and applicable Treasury Regulations, we reserve the right, upon
receiving notice of such fact, to transfer the Annuity Account Value under this
Contract to another annuity contract issued by us or one of our affiliated or
subsidiary life insurance companies on the life of the Annuitant, or to
terminate this Contract and pay to you the Annuity Account Value less a
deduction for applicable taxes, solely at our option.
In the event that this Contract fails to qualify as an Xxxxxxx as described in
Section 1.02, we will have the right, upon receiving notice of such fact, to
terminate this Contract and pay to you the Annuity Account Value less a
deduction for the appropriate part attributable to you of any income tax payable
by you which would not have been payable if you had an Annuity.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you, we reserve the
right to limit Contributions under this Contract if required by law.
SECTION 4.07 DEFERMENT. Applications of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of the Annuity Account Value (less
any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities and
Exchange Commission, by order, permits us to defer payments in order to protect
persons with interests in the Investment Divisions. We can defer payment of any
portion of the Annuity Account Value in the Guaranteed Interest Division for up
to six months while the Annuitant is living.
SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year, we will furnish
you with a notice showing the following:
(1) the amount in the Guaranteed Interest Division,
(2) the total number of Accumulation Units in the Stock Division, Balanced
Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Value,
(4) the amount you have in the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division,
(5) the Cash Value, and
(6) the amount of death benefit payable with respect to the Annuitant.
We will also furnish annual calendar year reports concerning the status of the
annuity and any other reports required by the Code or applicable Treasury
Regulations.
After the Retirement Date, we will notify the Employer of the number of Annuity
Units and the Average Annuity Unit Value used in determining the amount of each
Variable Annuity Benefit payment, if any.
SECTION 4.09 AGE. If the Annuitant's age has been misstated, any benefits will
be those which would have been purchased at the correct age. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
SECTION 4.10 OWNERSHIP RIGHT OF EMPLOYER. Notwithstanding any other provision of
the terms of this Contract, until amounts under this Contract are distributed or
made available to the Annuitant or the Annuitant's beneficiary in accordance
with the terms of this Contract and the terms of the Plan, this Contract remains
solely the property of the Employer subject only to claims of the Employer's
general creditors. This Section shall be construed and administered in
accordance with Section 457(b)(6) of the Code and the regulations thereunder.
No. 92 EDCB Page 15
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 92HR1A
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28, 1992
RETIREMENT DATE: JAN 1, 2020
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York,
New York 10116
AGREES
o TO ALLOCATE the Contributions made to this Contract, after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division of the Separate Account (referred to
in this Contract as the "Investment Divisions") or to the Guaranteed Interest
Division, in accordance with Sections 2.02, 2.03 and 2.04, as directed by
you, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide you with
an Annuity Benefit or a Cash Value benefit if you are then living, and
o TO PROVIDE you with the other rights and benefits of this Contract.
This is the entire Contract. In this Contract, "we", "our" and "us" mean The
Equitable Life Assurance Society of the United States. "You" and "your" mean the
Annuitant (Owner) at the time a right is exercised by the Annuitant (Owner).
TEN DAYS TO EXAMINE CONTRACT -- You may cancel this contract by returning it to
us within ten days after receipt of it. Upon such cancellation, we will refund
any Contribution made to us on your behalf under this Contract
SPECIMEN SPECIMEN
/s/Xxxxx X. Xxxxxx /s/Xxxxxxx X. Xxxxxxxx
Chairman of the Board
Vice President and Secretary and Chief Executive Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT FACTOR REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE
MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL
ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSE AND EXPENSE RISK, PLUS THE
INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE
TRUST.
No. 92HR1A
This Contract is issued in consideration of the payment to us of the
Contributions made under the terms of this Contract.
The provisions on the following pages are parts of this Contract.
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TABLE OF CONTENTS
DEFINITIONS Page
Section 1.01 - Annuitant..........................................4
1.02 - Annuity............................................4
1.03 - Annuity Account Value..............................4
1.04 - Annuity Benefit....................................4
1.05 - Cash Value.........................................4
1.06 - Class of Contracts.................................5
1.07 - Code...............................................5
1.08 - Contract...........................................5
1.09 - Contract Date......................................5
1.10 - Contract Year......................................5
1.11 - Contribution.......................................5
1.12 - Divisions..........................................5
1.13 - Xxxxxxxx Xxxxxxx Xxxxxxx...........................5
1.14 - Employer...........................................5
1.15 - Guaranteed Interest Rate...........................5
1.16 - Joint and Survivor Life Annuity Form...............5
1.17 - Life Annuity Form..................................5
1.18 - Normal Form........................................5
1.19 - Period Certain Annuity.............................5
1.20 - Plan...............................................5
1.21 - Processing Office..................................6
1.22 - Retirement Date....................................6
1.23 - Separate Account...................................6
1.24 - Separate Account Definitions.......................7
1.25 - Transaction Date...................................7
1.26 - Trust..............................................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions......................................8
2.02 - Separate Account Investment Divisions..............8
2.03 - Guaranteed Interest Division.......................8
2.04 - Allocation to Divisions............................8
2.05 - Transfers Among Divisions..........................8
2.06 - Termination of this Contract.......................9
2.07 - Partial Withdrawals................................9
2.08 - Charges for Partial Withdrawals....................9
2.09 - Free Corridor Amount..............................10
2.10 - Annual Administrative Charge......................10
2.11 - Death Benefit.....................................10
ANNUITY BENEFITS
Section 3.01 - Xxxxx Xxxxxxx Xxxxxxx.............................11
3.02 - Variable Annuity Benefit..........................11
3.03 - Election and Commencement of Xxxxxxx Xxxxxxxx.....11
3.04 - Amount of Xxxxxxx Xxxxxxxx........................11
3.05 - Payment of Annuity Benefits.......................12
3.06 - Special Annuity and Spousal Consent Provisions....14
GENERAL PROVISIONS
Section 4.01 - Contract..........................................15
4.02 - Statutory Compliance..............................15
4.03 - Assignments and Nontransferability................15
4.04 - Beneficiary.......................................15
4.05 - Disqualification..................................16
4.06 - Future Contributions..............................16
4.07 - Deferment.........................................16
4.08 - Annual Notice.....................................16
4.09 - Age...............................................16
No. 92HR1A Page 2
OWNER: XXXX XXX
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 000
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28, 1992
RETIREMENT DATE: JAN 1, 2020
INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992
MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992
3.00% AFTER DEC 31, 1992
BENEFICIARY: XXXX XXX
FORM NUMBER: 92HR1A
--------------------------------------------------------------------------------
TABLE OF GUARANTEED VALUES
ISSUE AGE 38 MALE $1,000 ANNUAL CONTRIBUTION
NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY
SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65
----------------------- ---------- -----------------
1 977 6.63
2 1,946 16.20
3 2,944 26.67
4 3,998 36.84
5 5,064 46.70
6 6,220 56.28
7 7,362 65.59
8 8,538 74.62
9 9,841 83.38
10 11,204 91.90
11 12,629 100.16
12 14,118 108.18
13 15,673 115.97
14 17,144 123.54
15 18,658 131.18
16 20,218 138.64
17 21,824 145.90
18 23,479 152.80
19 25,213 159.70
20 27,000 166.03
24 (Age 62) 34,697 189.57
27 (Age 65) 41,098 205.49
THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000
CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT
DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE
(SEE SECTION 2.10) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ANNUITY ACCOUNT
VALUE (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND
EARNINGS ARE ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION.
YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON
THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS.
THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE
WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY
BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A
SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04).
*ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO
SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT.
No. 92HR1A Page 3
--------------------------------------------------------------------------------
PART I -- DEFINITIONS
SECTION 1.01 ANNUITANT. The term "Annuitant" means the Owner of this Contract,
as shown on Page 3 of this Contract, and on whose behalf this Contract is
purchased and is maintained and who exercises all rights under the terms of this
Contract.
SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in
accordance with the terms of the Plan.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts that you have in the Guaranteed Interest Division and the
Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by us pursuant to Section 3.04 of this Contract.
Various sections of this Contract (Sections 1.16, 1.17, 1.18, 3.01 and 3.02)
refer to monthly payments to be made under an Annuity Benefit. You may wish to
have your Annuity Benefit paid at other intervals, such as quarterly,
semi-annually, or annually, instead of monthly. You may elect this at the time
you elect the Annuity Benefit form as described in Section 3.03; in that event,
all references in this Contract to monthly payments will be deemed to mean
payments at the frequency you elect, subject to our rules at the time of
election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value
less an applicable withdrawal charge determined as follows:
The withdrawal charge equals the lesser of (a) or (b) where:
(a) equals
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the excess of (i) the Annuity Account Value over (ii) the Free
Corridor Amount defined in Section 2.09; and
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the Current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior partial withdrawal
charges made pursuant to Section 2.08.
However, notwithstanding the above, if you are age 60 years or older on the
Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of
the excess of the Annuity Account Value over the Free Corridor Amount.
However, a withdrawal charge will not apply, which means the Cash Value will
equal the Annuity Account Value, upon any of the following occurrences:
(i) your attainment of age 59 years and 6 months and your completion of at
least five Contract Years, or
(ii) your completion of at least twelve Contract Years, or
(iii) your attainment of age 55 years, your completion of at least five
Contract Years and the receipt by us of a properly completed settlement
election form providing for the application of the Annuity Account Value
to purchase an Eligible Annuity Certain, defined in Section 1.13, or
(iv) your completion of at least three Contract Years and the receipt by us
of a properly completed settlement election form providing for the
application of the Annuity Account Value to purchase a Period Certain
Annuity, defined in Section 1.19, where the certain period of such
annuity is at least ten years, or
(v) the receipt by us of a properly completed settlement election form
providing for the application of the Annuity Account Value to purchase a
life annuity distribution option, pursuant to the terms of this
Contract, or
(vi) you die and the withdrawal is made by the beneficiary.
No. 92HR1A Page 4
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same calendar year.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as
amended, or any corresponding provisions of prior or subsequent United States
revenue laws.
SECTION 1.08 CONTRACT. The term "Contract" means this Contract.
SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us both the application for this Contract, properly signed and completed, and
a Contribution.
SECTION 1.10 CONTRACT YEAR. The term Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us
for you with respect to an Annuity purchased for you under Plan. We are under no
obligation to accept any Contribution less than $20.00.
SECTION 1.12 DIVISIONS. The term "Division" or "Divisions" mean, singly or
severally as the case may be, the following divisions described in this
Contract:
(i) the Guaranteed Interest Division, and
(ii) the Investment Divisions of the Separate Account.
SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
an annuity not involving life contingencies issued by us which extends beyond
your attainment of age 59 years and 6 months and does not permit any prepayment
of the unpaid principal (that is, no withdrawal or single sum payment) prior
to your attainment of age 59 years and 6 months.
SECTION 1.14 EMPLOYER. The term "Employer" means the sole proprietor or the
partnership adopting the Plan, or any successor unincorporated trade or business
that assumes in writing the obligations of the Plan.
SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrues on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of
this Contract. Section 2.03 describes determination of the rate to apply
thereafter.
SECTION 1.16 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected by you. The payments commence on the date as of which the Joint and
Survivor Life Annuity Form is purchased and terminate with the last payment due
before the death of the survivor.
SECTION 1.17 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us providing monthly payments during the lifetime of the person upon
whose life such payments depend. The payments commence on the date as of which
the Life Annuity Form is purchased and terminate with the last payment due
before the death of such person.
SECTION 1.18 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means (i) if you have a living spouse at the Retirement Date, the
Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with
such spouse as the contingent annuitant (with 100% of the monthly payment amount
continued to your spouse), and (ii) if you do not have a living spouse at the
Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form.
SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us which does not permit any
prepayment of the unpaid principal (that is, you cannot elect to receive part of
your payments as a single sum payment with the remainder paid in monthly annuity
payments).
SECTION 1.20 PLAN. The term "Plan" means the Standardized Non-Trusteed Defined
Contribution Plan for Unincorporated Employers, a prototype plan for
self-employed individuals and their employees which is sponsored by us.
No. 92HR1A Page 5
SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116, or
such other location as we shall designate by advance written notice to the
Employer or the trustee, as applicable, and to you.
SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which
you attain the retirement age as sown on Page 3 of this Contract. Before the
Retirement Date you may elect to change the Retirement Date to another
Retirement Date, which may be any date after the filing of the election (other
than the 29th, 30th or 31st day of any month). No Retirement Date shall be
earlier than the date you attain age 59 years and 6 months nor shall it be later
than the date you attain age 70 years and 6 months. Any election for such change
must be made in writing by you and shall not take effect until received by us at
our Processing Office.
SECTION 1.23 SEPARATE ACCOUNT. The term "Separate Account" means our Separate
Account A which is organized as a unit investment trust, a type of investment
company. We have established the Separate Account and it is maintained in
accordance with the laws of New York State. Realized and unrealized gains and
losses from the assets of the Separate Account are credited or charged against
it without regard to our other income, gains or losses. Assets are put in the
Separate Account to support this Contract and other variable annuity contracts
and certificates. Assets may be put in the Separate Account for other purposes,
but not to support contracts or policies other than variable annuities and
variable life insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust where each class (or series) represents a separate portfolio in
such Trust. We reserve the right to change the designated trust or investment
company or to add designated trusts or investment companies. The Investment
Divisions available are the Stock Division, the Money Market Division, the
Balanced Division and the Aggressive Stock Division. The Guaranteed Interest
Division is not part of the Separate Account but rather is an asset of our
General Account.
We will value the assets of each Investment Division on each business day. A
business day is any day on which we are open, the New York Stock Exchange is
open for trading and there is a sufficient degree of trading in the portfolio
securities in which an Investment Division is invested to materially affect the
Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments we are
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under
the Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any
other form;
(v) add Investment Divisions (or sub-divisions of Investment Divisions) to,
or remove Investment Divisions (or sub-divisions of Investment
Divisions) from the Separate Account (the term "Investment Division" in
this Contract shall then refer to any other Investment Division in which
the assets, of a Class of Contracts to which this Contract belongs, were
placed);
(vi) combine any two or more Investment Divisions (or sub-divisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
Class of Contracts to which this Contract belongs.
No. 92HR1A Page 6
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, you will be notified of such exercise, as
required by law.
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for applicable tax
charges) at a rate not to exceed 1.49% per year for each of the Stock, Money
Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock
Division, for financial accounting, death benefits, mortality risk, expenses and
expense risk. The charge shall be made in accordance with Subsection (c) of the
Net Investment Factor provision in Section 1.24. The relative proportion of
these charges may be modified. This daily charge, plus the investment advisory
fee charges and direct operating expense charges of the Trust, shall not exceed
a total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract.
SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any preceding consecutive
non-business days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period giving effect
to any amounts allocated to or withdrawn from the Investment Division
for the Valuation Period. For this purpose, we use the share value
reported to us by the Trust.
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period
(after any amounts allocated or withdrawn for that Valuation Period).
(c) is the daily Separate Account charge for the expenses of this Contract,
times the number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an
Investment Division where your Contributions are invested and which is used in
determining the amount you have in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for that Investment Division for such Valuation Period.
ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first contribution was put into the Stock
Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed
Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The
Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value
for the immediately preceding Valuation Period multiplied by the Adjusted Net
Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for a Valuation Period is the Net Investment Factor for such
period reduced for each calendar day in such subsequent Valuation Period by the
Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net
Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net
Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall
be 5%, except in states where the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar
month is equal to the average of the Annuity Unit Values for all Valuation
Periods ending in such month.
SECTION 1.25 TRANSACTION DATE. The term "Transaction Date" means the business
day we receive a Contribution or a written contract transaction request
providing the information we need at the Processing Office. In the case of a
transfer request initiated through the use of a touch tone telephone as
described in Section 2.05, the term Transaction Date means the business day the
telephone transaction is received.
SECTION 1.26 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
No. 92HR1A Page 7
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PART II -- ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. The Employer is to make Contributions from time to
time on such dates and in such amounts as determined by the Employer pursuant to
the terms of the Plan or Agreement. Contributions will be allocated to the
Divisions in accordance with the instructions received on the application,
unless later changed.
Each Contribution received by us with respect to you will, before its allocation
under this Contract, be reduced by the amount of any applicable tax charge, as
determined by us.
Pursuant to the terms of the Plan, we will accept rollover contributions and
transfers made on your behalf from a plan qualified under Section 401(a) of the
Code or from a conduit individual retirement arrangement as described in Section
408 of the Code.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to, or withdrawn or transferred from, an Investment
Division, the Annuity Account Value will be credited or charged, as the case may
be, with the number of Accumulation Units determined by dividing said amount by
the Accumulation Unit Value for the appropriate Investment Division for the
Valuation Period which includes that date. The number of units in an Investment
Division on any date is equal to (i) the sum of any Accumulation Units that have
been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation
Units that have been withdrawn pursuant to Section 2.07 or 2.10 or transferred
from the Investment Division pursuant to Section 2.05. The amount in an
Investment Division on any date is equal to the product of (i) the number of
Accumulation Units in the Investment Division on that date, and (ii) the
Accumulation Unit Value for the Investment Division for the Valuation Period
which includes that date.
Participation in the Separate Account under the terms of this Contract
terminates on the earliest of (i) Election and the Commencement of Annuity
Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or
(iii) Termination of this Contract pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets, which support
the guarantees of this Contract and other contracts.
The amount in the Guaranteed Interest Division at any time is equal to the sum
of all amounts that have been allocated to the Guaranteed Interest Division
pursuant to Section 2.04 plus the amount of any interest accrued but not
allocated, less the sum of all amounts that have been withdrawn from the
Guaranteed Interest Division pursuant to Section 2.07, 2.10 or 2.11 or
transferred from the Guaranteed Interest Division, pursuant to Section 2.05.
Interest is allocated to the Guaranteed Interest Division on a Transaction Date
pursuant to Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division under the terms of this
Contract terminates on the earliest (i) Election and Commencement of Annuity
Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or
(iii) Termination of this Contract pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction of any applicable tax charge) to one or more
Divisions, at your sole direction as specified to us. Allocation percentages
must be in whole numbers and the sum must equal 100. The allocation is made as
of the Transaction Date on which we have received both such Contribution and
such direction. Contributions made to an Investment Division purchase
Accumulation Units in that Investment Division, using the Accumulation Unit
Value next computed after the Transaction Date
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon Termination of this Contract pursuant to Section 2.06, and (vi)
upon your death pursuant to Section 2.11.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through
the use of a touch tone telephone, transfer all or part of the amount you have
in a Division to one or more of the Divisions as follows: (1) amounts in the
Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive
Stock Division may be transferred among such Divisions; (2) amounts in the Money
Market Division may be
No. 92HR1A Page 8
transferred to other Divisions. Written authorization for touch tone telephone
initiated transfers is only required when authorization for telephone transfers
is requested. (Upon advance written notice to you, we reserve the right to
discontinue the acceptance of transfer requests through the use of a touch tone
telephone.) All transfers will be effective on the Transaction Date and will be
subject to our rules in effect at the time of transfer. With respect to the
Investment Divisions, the transfer will be made at the Accumulation Unit Value
next computed after the Transaction Date. No transfers are permitted to the
Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the
terms of the Plan, including the spousal consent rules set forth in Section
3.06, you may elect, by written notice, to terminate this Contract. We will
determine the Cash Value under this Contract as of the Transaction Date.
If this Contract is terminated, surrendered or exchanged prior to your
Retirement Date, any applicable tax charges we have paid may be deducted. If we
have previously deducted charges for applicable taxes from Contributions
pursuant to Section 2.01, we will not again deduct charges for the same taxes on
terminations, unless a change in a applicable law has occurred with respect to
your Contract.
The payment of such Cash Value may be deferred by us in accordance with the
provisions of Section 4.07. If no tax has been previously deducted or if such a
tax is due at termination, we will deduct the amount due.
Subject to the terms of the Plan, we reserve the right to pay the Annuity
Account Value under this Contract and terminate this Contract if (i) no
Contributions are made on your behalf during the last three completed Contract
Years, and the Annuity Account Value is less than $500 or (ii) a partial
withdrawal is made that would result in your Annuity Account Value falling below
$500. We also reserve the right to terminate this Contract if no Contributions
have been made within 120 days from the Contract Date shown on Page 3 of this
Contract.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount in the Divisions and the Annuity Account Value shall be zero. We will
be released from any and all liability for payments with respect to the
Contributions from which the Annuity Account Value arose.
SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under
the terms of the Plan, you may elect, by written notice to us, to make a partial
withdrawal from the Divisions. Partial withdrawals are subject to spousal
consent rules set forth in Section 3.06.
On the Transaction Date, we will pay the lesser of the Cash Value or the amount
of partial withdrawal requested to the person entitled to receive such payment
as designated in writing by you. The amount paid plus any withdrawal charge
applicable pursuant to Section 2.08 will be drawn from the amounts you have in
the Divisions. Unless instructed otherwise, the amount withdrawn (including any
withdrawal charge) will be allocated among the Divisions in proportion to the
amounts that you have in such Divisions.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300.
If a withdrawal made under this Section would result in an Annuity Account Value
of less than $500, we will so advise you and reserve the right to pay the
Annuity Account Value to you, and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS.
NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the
amount of partial withdrawal requested is not greater than the Free Corridor
Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity
Account Value pursuant to Section 1.05.
WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than
the Free Corridor Amount, we will (i) first withdraw from the Divisions an
amount equal to the Free Corridor Amount in proportion to the amount you have in
them, and (ii) then withdraw an amount equal to the excess of the amount
requested over the Free Corridor Amount, plus a partial withdrawal charge. Such
partial withdrawal charge will be equal to the lesser of (a) or (b) where:
(a) is an amount equal to
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
No. 92HR1A Page 9
of the amount withdrawn in excess of the Free Corridor Amount (including
such charge) pursuant to (ii) of the preceding sentence.
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior partial withdrawal
charges made pursuant to this Section.
If withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to your Contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if you
have completed three Contract Years or attained age 59 years and 6 months, an
amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account
Value on the Transaction Date over (ii) cumulative prior withdrawals made
pursuant to Section 2.07 in the current Contract Year. If you have not completed
three Contract Years or attained age 59 years and 6 months, the Free Corridor
Amount is zero.
SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $10,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts that you have in
the Divisions.
If the Annuity Account Value is less than $10,000 on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03
or (b) the date of termination of this Contract pursuant to Section 2.06 or
2.11, we will prorate the Annual Administrative Charge applicable to the
completed portion of the Current Contract Year and withdraw such amount in lieu
of the full Annual Administrative Charge described in this Section for the
applicable part of that Contract Year.
If the Annuity Account Value is $10,000 or greater at the end of a Contract
Year, the Annual Administrative Charge is zero.
SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of your death we will pay
(subject to the terms of the Plan, in the spousal survivor benefit rules set
forth in Section 3.06) to the beneficiary designated to receive such payment,
pursuant to Section 4.04 of this Contract, the amount of death benefit payable.
The amount of the death benefit is equal to the greater of (i) the Annuity
Account Value and (ii) your minimum death benefit. Such minimum death benefit is
the sum of all Contributions made pursuant to Section 2.01 (before reduction for
any applicable tax charge) less any withdrawals made pursuant to Section 2.07.
Any such withdrawal will reduce your minimum death benefit (as adjusted by any
previous withdrawal) by an amount which is in the same proportion as the amount
that was withdrawn is to the Annuity Account Value. If, in accordance with the
provisions of Section 2.01, the cash value of another annuity contract issued by
us or one of our affiliated or subsidiary life insurance companies, which
provides for a death benefit before retirement equal to the greater of the
contract cash value or an alternate amount based on premiums paid or
contributions made under the annuity contract, is transferred to this Contract,
such cash value or alternative amount as of the date of transfer will be
included in the "sum of all Contributions" in lieu of the amount of cash value
transferred for purposes of the death benefit under this Contract.
We will pay the death benefit to the beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.04. Also in accordance with the last paragraph of Section 4.04, if no such
election is in effect at your death, we will pay the death benefit to the
beneficiary in a single sum, unless the beneficiary elects, before we pay the
death benefit, to apply the death benefit to an Annuity Benefit, subject to the
minimum distribution requirement of the Code as described in Section 3.06 and
our rules then in effect.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value shall be zero. We will be released from any and all
liability for payments with respect to the Contributions from which the Annuity
Account Value arose.
No. 92HR1A Page 10
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PART III -- ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under the terms of this Contract with respect to a payee is the amount provided
pursuant to Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division of the Separate Account.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of Net
Investment Return referred to in Section 1.24 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to
provide for any applicable tax charge. These charges include a daily charge for
financial accounts, death benefits, mortality risk, expenses and expense risk,
plus the investment advisory fee charges and direct operating expense charges of
the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under the terms of this Contract with respect to a payee is the
monthly amount provided pursuant to the fourth paragraph of Section 3.04. The
amount of the fourth and each subsequent payment under a Variable Annuity
Benefit will be equal to the number of Annuity Units with respect to such
benefit, multiplied by the Average Annuity Unit Value for the second calendar
month immediately preceding the due date of the payment. The number of Annuity
Units with respect to a benefit is the number determined by dividing the amount
of the first monthly payment by the Annuity Unit Value for the Valuation Period
which includes the due date of the first monthly payment. (As described in
Section 3.05, we will notify the payee how each Variable Annuity Payment is
determined.)
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your
Retirement Date, provided you are then living, the Annuity Account Value shall
be applied to provide the Normal Form of Annuity Benefit, unless you elect (i)
to receive the Cash Value in a single sum or (ii) to apply the Annuity Account
Value or Cash Value, whichever is applicable pursuant to the first paragraph of
Section 3.04, to provide an Annuity Benefit on any other annuity form offered by
us, or one of our affiliated or subsidiary life insurance companies, as elected
by you, or (iii) to take partial withdrawals pursuant to Section 2.07 in the
amounts and at times as required by the minimum distribution rules of Section
401(a)(9) of the Code and applicable Treasury Regulations, pursuant to Sections
2.07 and 3.05, subject to our rules then in effect and any other applicable
requirements under the Code.
We will provide notice and election forms to you not more than six months before
your Retirement Date.
If you elect to terminate this Contract, pursuant to Section 2.06, an election
may be made to receive an Annuity Benefit in lieu of the Cash Value.
We will have the right to require you to furnish pertinent information to
provide an Annuity Benefit, and will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary
life insurance companies. An election to receive Annuity Benefits in accordance
with this Section is subject to the spousal consent and spousal survivor rules
set forth in Section 3.06 of this Contract.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or
third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be (i) the
Annuity Account Value if the annuity form elected involves life contingencies or
(ii) the Cash Value if the payments under the annuity form elected does not
involve life contingencies.
The amount applied to provide an Annuity Benefit may be reduced by any
applicable tax charge on annuity considerations, as we determine. If we have
previously deducted any applicable tax charges from Contributions as provided in
Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to your Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your Contract will be governed by our
supplementary contract then in effect.
No. 92HR1A Page 11
The amount to be applied to provide an Annuity Benefit will, in addition to any
tax charge reduction, be reduced by an administrative charge. The amount of such
charge will be determined from time to time in accordance with our general
practices applicable on a uniform basis to all contracts of the same type as
this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts
you have in the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under the terms of this
Contract, as indicated, on either the Life Annuity Form or the Joint and
Survivor Life Annuity Form (with 100% of the amount of your payment continued to
your spouse). The amounts of income provided under the Fixed Annuity Benefit
payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are
based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a"
adjusted to a unisex basis based on a 50-50 split of males and females. The
amounts of income initially provided under the Variable Annuity Benefit payable
on the Life Annuity Form are based on a 50-50 split of males and females and an
Assumed Base Rate of Net Investment Return of 3.5% or 5%, whichever applies
pursuant to Section 1.24.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us on 3.5% interest and the 1983 Individual Annuity Mortality
Table "a" adjusted to a unisex basis based on a 50-50 split of males and females
if such annuity from provides for a Fixed Annuity Benefit, and on the projected
1983 Basic Table "a" adjusted to a unisex basis based on a 50-50 split of males
and females and an Assumed Base Rate of Net Investment Income Return of 5% or
3.5%, whichever applies pursuant to Section 1.24, if such annuity form provides
for a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract
will be distributed or begin to be distributed in accordance with Section
401(a)(9) of the Code and the applicable Treasury Regulations thereunder, no
later than the first day of April following the calendar year in which you
attain age 70 years and 6 months ("Required Beginning Date") or such later date
as specified in such section or regulations. Your entire interest may be
distributed, as you elect over (a) the life, or the lives of you and or your
designated beneficiary, or (b) a period certain not extending beyond your life
expectancy, or the joint and last survivor expectancy of you and your designated
beneficiary. Distributions must be made in periodic payments at intervals of no
longer than one year. In addition, payments must be either nonincreasing or they
may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the
proposed Treasury Regulations, or any successor Regulation thereto.
All distributions made hereunder shall be made in accordance with the
requirements of Section 401(a)(9) of the Code, including the incidental death
benefit requirements of Section 401(a)(9)(G) of the Code, and applicable
Treasury Regulations, including the minimum distribution incidental benefit
requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or
any successor Regulation thereto.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.05, while any distribution shall be subject to such requirements of
the Code and regulations, any distribution shall also be subject to the terms of
this Contract. That is, the forms of distribution shall be those which are made
available by us at the time of your election.
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9.
Unless you otherwise elect prior to the time distributions are required to
begin, those life expectancies shall be recalculated annually. Such election
shall be irrevocable and shall apply to all subsequent years. The life
expectancy of a non-spouse beneficiary may not be recalculated. Instead, life
expectancy will be calculated using the attained age of such beneficiary during
the calendar year in which you attain age 70 years and 6 months, and payments
for subsequent years shall be calculated based on such life expectancy reduced
by one for each calendar year which has elapsed since the calendar year life
expectancy was first calculated.
If you die after distribution of your interest in this Contract has begun, the
remaining portion of such interest will continue to be distributed at least as
rapidly as under the method of distribution being used prior to your death.
If you die before distribution of your interest in this Contract begins,
distribution of your entire interest shall be completed no later than December
31 of the calendar year containing the fifth anniversary of your death, except
to the extent that an election is made to receive death benefit distributions in
accordance with (1) or (2) below:
(1) If your interest is payable to a designated beneficiary, then your entire
interest may be distributed over the life of, or over a period certain not
greater than the life expectancy of, the designated beneficiary. Such
distributions must commence on or before December 31 of the calendar year
immediately following the calendar year of your death.
No. 92HR1A Page 12
(2) If the designated beneficiary is your surviving spouse, the date
distributions that are required to begin in accordance with (1) above shall
not be earlier than the later of (A) December 31 of the calendar year
immediately following the calendar year of your death or (B) December 31 of
the calendar year in which you would have attained age 70 years and 6
months.
For purposes of determining the "period certain" referred to in the
immediately preceding paragraph, life expectancy is computed by use of the
expected return multiples in Tables V and VI of Treasury Regulation Section
1.72-9. For purposes of distributions beginning after your death, unless
otherwise elected by the surviving spouse by the time distributions are
required to begin, life expectancies shall be recalculated annually. Such
election shall be irrevocable by the surviving spouse and shall apply to
all subsequent years. In the case of any other designated beneficiary, life
expectancies shall be calculated using the attained age of such beneficiary
during the calendar year in which distributions are required to begin
pursuant to this Section, and payments for any subsequent calendar year
shall be calculated based on such life expectancy reduced by one for each
calendar year which has elapsed since the calendar year life expectancy was
first calculated.
Distributions under this Section are considered to have begun if distributions
are made because you have reached your Required Beginning Date or if prior to
the Required Beginning Date distributions irrevocably commence to you over a
period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1
of the Proposed Treasury Regulations or any successor Regulation thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under the terms of this Contract was based on information
that is subsequently found to be incorrect, your benefit will not be
invalidated, but an adjustment on the basis of the correct information will be
made in the amount of the benefit payments, or any amount used to provide the
benefit, or any combination thereof. Overpayments by us will be charged against
and underpayments will be added to any payment thereafter falling due under the
terms of this Contract with respect to the payee, affecting as many such
payments as are necessary to correct the overpayment or underpayment. Our
liability, with respect to a payee, is limited to the correct information and
the actual amounts used to provide the benefits then in force with respect to
the payee under this Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under the terms of this Contract is physically or mentally
incompetent to receive such payment or is a minor, (ii) another person or an
institution is then maintaining or has custody of such payee, and (iii) no
guardian, committee or other representative of the estate of such payee has been
appointed, we may make the payments (in the case of a minor, at a rate not
exceeding $200 a month) to such other person or institution, and will thereupon
be fully discharged from all liability with respect thereto.
If a variable annuity form made available by us provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one or two persons, a payee for payments
thereunder may elect, without the concurrence of any other person, to receive
the commuted value of any remaining payments, provided no person upon whose life
the income depends is surviving.
Pursuant to Section 3.03, upon your election of an annuity form providing
payments for a period certain, you may designate (with the right to change such
designation) a payee to receive any payments that may become due after the death
of the person or persons upon whose life or lives the income may depend.
The payee may designate (with the right to change such designation and without
the concurrence of any other person) a person or persons to receive any payments
or installments payable after such payee's death, if the absence of such a
designation would result in a single sum payment to such payee's estate in
accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments.
The commuted value of any such remaining payments will be determined on the
basis of compound interest at the rate utilized in the actuarial rate basis
applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
No. 92HR1A Page 13
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
--------------------------------------------------------------------------------
TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM
100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE
(Minimum Monthly Income per $1,000 of Annuity Account Value)
---------------------------------------------------------------------------------------------------------------------------------
Age 60 61 62 63 64 65 66 67 68 69 70
---------------------------------------------------------------------------------------------------------------------------------
60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88
61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96
62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03
63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11
64 4.89 4.94 5.00 5.05 5.10 5.14 5.19
65 5.00 5.06 5.11 5.17 5.22 5.27
66 5.12 5.18 5.24 5.29 5.35
67 5.24 5.31 5.37 5.43
68 5.37 5.44 5.51
69 5.52 5.59
70 5.67
---------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1,000 of Annuity Account Value)
------------------------------------------------------------
VARIABLE ANNUITY BENEFIT
PAYABLE ON THE LIFE ANNUITY FORM
IF ASSUMED BASE RATE OF NET
INVESTMENT RETURN IS
Age 3.5% 5.0%
------------------------------------------------------------
60 5.27 6.16
61 5.39 6.28
62 5.52 6.41
63 5.66 6.55
64 5.81 6.70
65 5.97 6.86
66 6.15 7.03
67 6.33 7.21
68 6.53 7.41
69 6.74 7.62
70 6.97 7.85
-----------------------------------------------------------
We will, with respect to each payment under a Variable Annuity Benefit, notify
the payee of the number of Annuity Units and the Average Unit Value used in
determining the amount of each variable payment. Such notice will be mailed with
each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary,
as described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If you are married,
your interest in this Contract shall be paid in the Normal Form joint and
survivor annuity, and if you are unmarried, your interest shall be paid in the
Normal Form life annuity, unless you elect otherwise as described in this
Section. If you are married and die before payment of your interest has
commenced, your interest shall be paid to your surviving spouse in the form of a
life annuity, unless at the time of your death there was a contrary election
made pursuant to this Section. The foregoing notwithstanding, your surviving
spouse may elect, before payment is to commence, to have payment made in any
form permitted under the terms of this Contract.
You may elect, at any time within the 90 consecutive day period before the first
day of the first period for which your interest is paid as an annuity or in any
other form, not to have your interest paid in the Normal Form in which case it
shall be paid in any other form elected under the terms of this Contract. If
such interest is to be paid to your spouse upon your death, you may elect,
during the period beginning on the first day of the plan year of the Plan in
which you attain age 35 years (or if you separate from Service prior to that
plan year, beginning on the date of separation) and ending with your death, for
a beneficiary other than your spouse to receive payment of the value of your
interest. In addition, if you will not yet attain age 35 years by the end of any
current plan year, you may make a special qualified election to designate a
beneficiary other than your spouse to receive payment of the value of your
interest. Such special qualified election shall be effective for the period
beginning on the date of such election and ending on the first day of the plan
year in which you will attain age 35. Amounts payable in accordance with this
Section will be automatically reinstated as of the first day of the plan year in
which you attain age 35 unless a new election designating a beneficiary other
than the spouse is made in accordance with the requirements of this Section.
No. 92HR1A Page 14
Any election described in the foregoing paragraph must be consented to by your
spouse in writing before a notary or a representative of the Plan unless you can
prove that there is no spouse or that the spouse cannot be located. Also, if you
have become legally separated from your spouse or have been abandoned (within
the meaning of local law) and have a court order to such effect, spousal consent
is not required unless a qualified domestic relations order provides otherwise.
Your election must designate a specific beneficiary (including any class of
beneficiaries or any contingent beneficiaries) that may not be changed without
further consent of the spouse, unless the spouse's consent expressly permits
designation by you without further consent of the spouse. The spouse's consent
under this Section shall acknowledge the effect of the election. In addition,
the spouse's consent (or the establishment that the consent of the spouse may
not be obtained) shall only be valid with respect to such spouse. Your waiver of
the Normal Form joint and survivor annuity shall not be effective unless the
election designates a form of benefit payment which may not be changed without
spousal consent (or the spouse expressly permits designations by you without any
further spousal consent). A consent that permits designations by you without any
requirement of further consent by such spouse must acknowledge that the spouse
has the right to limit consent to a specific beneficiary, and a specific form of
benefit where applicable, and that the spouse voluntarily elects to relinquish
either or both of such rights. If you make an election under this Section, you
may revoke that election, without spousal consent, at any time before the first
day of the first period for which an amount is paid as an annuity or in any
other form.
The provision requiring spousal consent in this Section shall also apply with
regard to your election to terminate this Contract or make partial withdrawals
pursuant to Sections 2.06 and 2.07, with respect to death benefits under Section
2.11 with respect to the Election and Commencement of Annuity Benefits pursuant
to Section 3.03, and with respect to a beneficiary designation set forth in
Section 4.04.
If the Annuity Account Value applied to provide the spousal benefits on the date
payment is to commence is in the aggregate less than $3,500, we may choose to
make payment in a single sum rather than in the form of a Qualified Joint and
Survivor Life Annuity or Life Annuity as described herein. Upon any payment made
pursuant to this Section, we will be released from any and all liability for
payment with respect to the Contributions made for you.
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PART IV -- GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the
parties and the terms of this Contract alone will govern with respect to our
rights and obligations. A copy of the application is incorporated in and made
part of this Contract.
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by our authorized officer. The terms of this
Contract may be changed by amendment or replacement upon agreement between you
and us without the consent of any other person.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of
this Contract without the consent of any other person in order to comply with
applicable laws and regulations. Such right shall include, but not be limited
to, the right to conform the terms of this Contract to reflect changes in the
Code, applicable Treasury Regulations, or regulations or published rulings of
the Internal Revenue Service so this Contract will continue to be an Annuity
used to fund a plan qualified under Section 401(a) of the Code.
SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY. No interest of yours or of a
beneficiary under this Contract may be transferred to any person other than us
upon the surrender of this Contract. Except as permitted under Section
401(a)(13) of the Code, no right or interest of you or any other payee or
beneficiary in this Contract shall be (a) assignable; (b) subject to any lien;
or (c) liable for, or subject to, any obligation or liability of any person. The
preceding sentence shall not apply to an assignment, transfer or attachment
pursuant to a qualified domestic relations order, as defined in Section 414(p)
of the Code.
SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an
initial designation of the beneficiary entitled to receive any death benefit
payable pursuant to Section 2.11. Subject to the spousal consent and survivor
rules of Section 3.06, you may change such designation from time to time during
your lifetime and while this Contract is in force. Any such designation or
change will be made by written notice in a form satisfactory to us. A change
will, upon receipt at the Processing Office, take effect as of the time the
written notice was signed, whether or not you are living on the date of receipt,
but without further liability as to any payment or other settlement made by us
before receipt of such change.
Unless otherwise specified in the designation, if you have designated two or
more persons as beneficiary, the beneficiary will be the designated person or
persons who survive you, and if more than one survive they will share equally.
No. 92HR1A Page 15
Any part of a death benefit payable pursuant to Section 2.11 for which there is
no designated beneficiary living at your death will be payable in a single sum
to your children who survive you, in equal shares, or should none survive, then
to your estate.
If you elect in writing, any amount that would otherwise be payable to a
beneficiary in a single sum may be applied to provide an Annuity Benefit, on the
form of annuity previously elected by you, with respect to the beneficiary,
subject to our rules then in effect. If at your death there is no election in
effect to apply the single sum death benefit to provide an Annuity Benefit, the
beneficiary may make such an election. Any such election must meet the minimum
distribution requirements under the Code, as described in Section 3.05. The
foregoing notwithstanding, any designation of beneficiary is subject to the
Spousal Consent rules set forth in Section 3.06.
SECTION 4.05 DISQUALIFICATION. In the event that this Contract fails to qualify
as an Xxxxxxx as described in Section 1.02, we will have the right, upon
receiving notice of such fact before the Retirement Date, to terminate this
Contract and pay to you the Annuity Account Value less a deduction for the
appropriate part attributable to you of any Federal income tax payable which
would not have been payable if you had an Annuity.
In the event that the Plan fails to qualify as a Plan under Section 401(a) of
the Code and applicable Treasury Regulations, we reserve the right, upon
receiving notice of such fact, to transfer the Annuity Account Value under this
Contract to another annuity contract issued by us, an affiliate or subsidiary,
on your life, or to terminate this Contract and pay to you the Annuity Account
Value less deduction for applicable taxes, solely at our option.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Employer, we
reserve the right at our sole discretion to limit contributions to this
Contract.
SECTION 4.07 DEFERMENT. Applications of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of your Annuity Account Value
(less any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities Exchange
Commission, by order, permits us to defer payments in order to protect persons
with interests in the Investment Divisions. We can defer payments of any portion
of your Annuity Account Value in the Guaranteed Interest Division for up to six
months while you are living.
SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year, we will furnish
you with a notice showing the following:
(1) the amount you have in the Guaranteed Interest Division,
(2) the total number of Accumulation Units you have in the Stock Division,
Balanced Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Values,
(4) the amount you have in the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division,
(5) the Cash Value, and
(6) the amount of your death benefit.
We will also furnish annual calendar year reports concerning the status of the
annuity and any other reports required by the Code or applicable Treasury
Regulations.
After the Retirement Date, we will notify you of the number of Annuity Units and
the Average Annuity Unit Value used in determining the amount of each Variable
Annuity Benefit payment, if any.
SECTION 4.09 AGE. If your age has been misstated, any benefits will be those
which would have been purchased at the correct age. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
No. 92HR1A Page 16
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APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
PROCESSING OFFICE: INDIVIDUAL ANNUITY CENTER, P.O. BOX 2996,
NEW YORK, NEW YORK 10116-2996
QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR:
EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY
--------------------------------------------------------------------------------
TYPE OF PURCHASE (Complete One Plan Only)
A. |_| TSA PUBLIC SCHOOL (GV-PS-I)
B. |_| TSA 501(C)(3) ORGANIZATION (GV-501-I)
C. |_| TSA University (GV-PS-U-I)
D. |_| IRA Individual (Including IRA to IRA transfers) (XX-XXX 4971)
E. |_| IRA Unit Billed (Including IRA to IRA transfers) (XX-XXX 4971)
F. |_| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified
Plan) (XX-XXX 4971-71)
G. |_| EDC (Public Employee Deferred Compensation) (GV-EDC 4991)
H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-080)
I. |_| SEP (Simplified Employee Pension) (GV-SEP 4981)
J. |_| SARSEP (Salary Reduction SEP) _________________________________________
K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41)
L. |_| XXXXX/HR-10 TRUSTEE (GV HR-10 4911-11)
(trustee owned)
M. |X| XXXXX/HR-10 (GV-HR-10 4911)
(not trustee owned) (issued to existing units only)
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DO NOT COMPLETE THIS SECTION IF 1.D OR 1.F CHECKED ABOVE
2. EMPLOYER/PLAN NAME
|A|B|C|_|C|O|M|P|A|N|Y|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_|
|x| NEW UNIT |0|0|0|1|2|3|-|4|5|6|
(FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM
983-135B IS REQUIRED)
--------------------------------------------------------------------------------
4. PROPOSED ANNUITANT Print name to appear on Contract.
|J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_|
FIRST MIDDLE INITIAL LAST
A. |X| MR. |_| MRS. |_| MS. |_| OTHER ____
B. Date of Birth: Year 1954 Month JANUARY Day 27
---- ------- --
C. Age at Nearest Birthday: 38 D. |X| Male |_| Female
----
X. Xxxxxxxxx's Mailing Address: F. State of Residence: N.J.
----
No., St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_|
City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1|
G. Telephone Number (101) 222 - 3456 |X| Home |_| Work
H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9|
I. Are you associated with or employed by a member of National
Association of Securities Dealers, Inc.(NASD)? |_| Yes |X| No
5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner, for all
other Markets Print Name of Annuitant.
XXXX XXX
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a. Title ____________________________________________________________________
6. RETIREMENT AGE 65
---------------------------------------------------------------
7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death
Benefit upon Xxxxxxxxx's death before Retirement Date.) (BENEFICIARY MUST
BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.)
XXXX XXX - WIFE
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
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8. CONTRIBUTION ALLOCATION
Guaranteed Interest Division 20%
-----
Stock Division 20%
-----
Money Market Division 20%
-----
Balanced Division 20%
-----
Aggressive Stock Division 20%
-----
(PERCENTAGES IN WHOLE NUMBERS) Total 100%
9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F)
A. Reminder Notice (Billing) Required |_| Yes |X| No
IF YES, COMPLETE B-C-D-E
B. REMINDER DATE Required for Individual IRA or otherwise must agree
with existing unit or attached 983-135B. MONTH _________ DAY __________
C. REMINDER FREQUENCY
|_| Annual |_| Semi-Annual
|_| Quarterly |_| Monthly
Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA
ONLY:
|_| Semi-Monthly |_| Bi-Weekly
D. REMINDER AMOUNT $_________________________________
E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
10.EXPECTED FIRST CONTRACT YEAR
Contribution. $1000
----------------------------------------------------------------
IF AN ADVANCED BILLING AND/OR CONTRACT DATE ARE REQUESTED, COMPLETE #9B
AND #12.
--------------------------------------------------------------------------------
(FOR PROCESSING OFFICE USE)
Unit Name ___________________________ Reminder Date ___________________________
Cert. or App# _______________________ Amendment Required_______________________
EDC Emp. Add. _______________________ Emp. Fed. ID# ___________________________
Frequency ___________________________ Contract Date ___________________________
--------------------------------------------------------------------------------
Receipt Date Batch # Inquiry # Processor
--------------------------------------------------------------------------------
180-1000
--------------------------------------------------------------------------------
10. Did you receive the Separate Account Prospectus? |X| Yes |_| No
Date shown on Prospectus January 1, 1992
----------------------------------------------------
Date of any supplement to Prospectus _______________________________________
11. Items (a) through (f) are to be answered by the annuitant. We are
required by the NASD to ask these questions.
(a) Name of Employer: ABC Company
------------------------------------------------------
(b) Address of Employer:
10 Main Street
---------------------------------------------------------------------------
Anytown, NJ
---------------------------------------------------------------------------
(c) Occupation Sales
-------------------------------------------------------------
(d) Assuming the contract applied for will be issued, will any existing
insurance or annuity be replaced or changed (or has it been)?
| | Yes |X| No
(e) Estimated Family Annual Income $100,000
----------------------------------------
(f) Estimated Net Worth $250,000
-----------------------------------------------------
(g) Investment Objective: |_| Income |X| Income & Growth
|_| Aggressive Growth |_| Growth |_| Safety of Principal
12. SPECIAL INSTRUCTIONS
----------------------------------------------------------------------------
----------------------------------------------------------------------------
----------------------------------------------------------------------------
----------------------------------------------------------------------------
----------------------------------------------------------------------------
13. Amount paid with this form: $1000
(If a check is submitted with this request, no advanced Contract Date is
permitted.) BACKDATING IS NOT PERMITTED.
NOTE: Xxxxxx paid will be credited upon receipt at Equitable's Processing
Office, subject to return if the certificate is not issued. The Contract Date
will be the date of receipt by Equitable of this application, properly signed
and completed, and Contribution at Equitable's Processing Office.
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
AGREEMENT
All information and statements furnished in this application are true and
complete to the best of my knowledge and belief. I understand and acknowledge
that no Agent has the authority to make or modify any contract on Equitable's
behalf, or to waive or alter any of Equitable's rights and regulations.
IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO
THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT
PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT.
UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S)
OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND
COMPLETE.
--------------------------------------------------------------------------------
LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY
APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS.
--------------------------------------------------------------------------------
X__________________________________ Date_______ City __________ State __________
Signature of Annuitant
X__________________________________ Date_______ City __________ State __________
Signature of Authorized Individual (REQUIRED FOR EDC AND
TRUSTEED) OR OWNER
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
AGENT'S SECTION
Will any existing insurance or annuity be replaced or changed (or has it been),
assuming the Contract will be issued? | | Yes | | No
|_| I (we) certify that a prospectus for the Contract has been given to the
proposed Annuitant and that no written sales materials other than those approved
by Equitable have been used.
EQUI-VEST issues must adequately reflect the commission interest of all Agents
on previous contracts.
--------------------------------------------------------------------------------
Print Agent's Name(s) Initial of Agent Agent Agency District Agent's
(Service Agent first) Last Name Number % Code Manager Code Signature
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
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FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS___ Date ___ District EQS ___
Date ____
--------------------------------------------------------------------------------
(FOR ASU USE)
ASU Code and App. No. __________________________________________________________
ASU Rec'd. _____________________________________________________________________
Date to Proc. Off. ________________________________________________ Campaign |_|
Agent(s) shown above is Equity Qualified and is licensed in the state where the
request is signed. Above Agent information verified by XXX (Registered Rep)
--------------------------------------------------------------------------------
Application reviewed by ________________________________________________________
--------------------------------------------------------------------------------
180-1000
Owner: [THE EQUITABLE LOGO]
Annuitant:
Contract Number:
Issue Date:
Contract Date:
Retirement Date:
--------------------------------------------------------------------------------
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P O Box 2996, New York,
New York 10116-2996
AGREES
o TO ALLOCATE the Contributions made to this Contract, after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division of the Separate Account (referred
to in this Contract as the "Investment Divisions") or to the Guaranteed
Interest Division, in accordance with Sections 2.02, 2.03 and 2.04, as
directed by you, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide you
with an Annuity Benefit or a Cash Value benefit if you are then living, and
o TO PROVIDE you with the other rights and benefits of this Contract.
This is the entire Contract. In this Contract, "we", "our" and "us" mean The
Equitable Life Assurance Society of the United States. "You" and "your" mean the
Annuitant (Owner) at the time a tight is exercised by the Annuitant (Owner).
TEN DAYS TO EXAMINE CONTRACT -- You may cancel this Contract by returning it to
us within ten days after receipt of it. Upon such cancellation, we will refund
any Contribution made to us on your behalf under this Contract, plus or minus
any investment gain or loss experienced in the Investment Divisions of the
Separate Account from the date such Contribution is allocated to such Investment
Division to the date we receive the returned Contract.
/s/ Xxxxxxx Xxxxxxx /s/ Xxxxxx X. Xxxxxx
Xxxxxxx Xxxxxxx, Vice President, Secretary & Xxxxxx X. Xxxxxx
Associate General Counsel President and Chief Executive
Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT FACTOR REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE
MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL
ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE
INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE
TRUST.
NO. 92HR1B
This Contract is issued in consideration of the payment to us of the
Contributions made under the terms of this Contract.
The provisions on the following pages are part of this Contract.
--------------------------------------------------------------------------------
TABLE OF CONTENTS
DEFINITIONS Page
Section 1.01 - Annuitant..........................................4
1.02 - Annuity............................................4
1.03 - Annuity Account Value..............................4
1.04 - Annuity Benefit....................................4
1.05 - Cash Value.........................................4
1.06 - Class of Contracts.................................5
1.07 - Code...............................................5
1.08 - Contract...........................................5
1.10 - Contract Year......................................5
1.11 - Contribution.......................................5
1.12 - Divisions..........................................5
1.13 - Eligible Annuity Certain...........................5
1.14 - Employer...........................................5
1.15 - Guaranteed Interest Rate...........................5
1.16 - Joint and Survivor Life
Annuity Form.......................................5
1.17 - Life Annuity Form..................................5
1.18 - Normal Form........................................5
1.19 - Period Certain Annuity ............................5
1.20 - Plan...............................................5
1.21 - Processing Office..................................6
1.22 - Retirement Date....................................6
1.23 - Separate Account...................................6
1.24 - Separate Account
Definitions........................................7
1.25 - Transaction Date ..................................7
1.26 - Trust .............................................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions......................................8
2.02 - Separate Account
Investment Divisions...............................8
2.03 - Guaranteed Interest ...............................8
Division...........................................8
2.04 - Allocation to Divisions............................8
2.05 - Transfers Among Divisions..........................8
2.06 - Termination of this Contract.......................9
2.07 - Partial Withdrawals................................9
2.08 - Charges for Partial
Withdrawals........................................9
2.09 - Free Corridor Amount..............................10
2.10 - Annual Administrative Charge .....................10
2.11 - Death Benefit.....................................10
ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit ............................11
3.02 - Variable Annuity Benefit..........................11
3.03 - Election and Commencement
of Annuity Benefits...............................11
3.04 - Amount of Annuity Benefits........................11
3.05 - Payment of Annuity Benefits ......................12
3.06 - Special Annuity and Spousal
Consent Provisions................................14
GENERAL PROVISIONS
Section 4.01 - Contract..........................................15
4.02 - Statutory Compliance..............................15
4.03 - Assignments and
Nontransferability................................15
4.04 - Beneficiary ......................................15
4.05 - Disqualification..................................16
4.06 - Future Contributions .............................16
4.07 - Deferment ........................................16
4.08 - Annual Notice.....................................16
4.09 - Age...............................................16
NO. 92HR1B Page 2
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PART I -- DEFINITIONS
SECTION 1.01 ANNUITANT. The term "Annuitant" means the Owner of this Contract,
as shown on Page 3 of this Contract, and on whose behalf this Contract is
purchased and is maintained and who exercises all rights under the terms of this
Contract.
SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in
accordance with the terms of the Plan.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts that you have in the Guaranteed Interest Division and the
Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by us pursuant to Section 3.04 of this Contract.
Various sections of this Contract (Sections 1.16, 1.17, 1.18, 3.01 and 3.02)
refer to monthly payments to be made under an Annuity Benefit. You may wish to
have your Annuity Benefit paid at other intervals, such as quarterly,
semi-annually, or annually, instead of monthly. You may elect this at the time
you elect the Annuity Benefit form as described in Section 3.03; in that event,
all references in this Contract to monthly payments will be deemed to mean
payments at the frequency you elect, subject to our rules at the time of
election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value
less an applicable withdrawal charge determined as follows:
The withdrawal charge equals the lesser of (a) or (b) where:
(a) equals
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
O% thereafter
of the excess of (i) the Annuity Account Value over (ii) the Free Corridor
Amount defined in Section 2.09; and
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the Current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior partial withdrawal
charges made pursuant to Section 2.08.
However, notwithstanding the above, if you are age 60 years or older on the
Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of
the excess of the Annuity Account Value over the Free Corridor Amount.
However, a withdrawal charge will not apply, which means the Cash Value will
equal the Annuity Account Value, upon any of the following occurrences:
(i) your attainment of age 59 years and 6 months and your completion of at
least five Contract Years, or
(ii) your completion of at least twelve Contract Years, or
(iii) your attainment of age 55 years, your completion of at least five Contract
Years and the receipt by us of a properly completed settlement election
form providing for the application of the Annuity Account Value to
purchase an Eligible Annuity Certain, defined in Section 1.13, or
(iv) your completion of at least three Contract Years and the receipt by us of
a properly completed settlement election form providing for the
application of the Annuity Account Value to purchase a Period Certain
Annuity, defined in Section 1.19, where the certain period of such annuity
is at least ten years, or
(v) the receipt by us of a properly completed settlement election form
providing for the application of the Annuity Account Value to purchase a
life annuity distribution option, pursuant to the terms of this Contract,
or
(vi) you die and the withdrawal is made by the beneficiary.
NO. 92HR1B Page 4
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same calendar year.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as
amended, or any corresponding provisions of prior or subsequent United States
revenue laws.
SECTION 1.O8 CONTRACT. The term "Contract" means this Contract.
SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both the application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us
for you with respect to an Annuity purchased for you under the Plan. We are
under no obligation to accept any Contribution less than $20.00.
SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following divisions described in this
Contract:
(i) the Guaranteed Interest Division, and
(ii) the Investment Divisions of the Separate Account.
SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
an annuity not involving life contingencies issued by us which extends beyond
your attainment of age 59 years and 6 months and does not permit any prepayment
of the unpaid principal (that is, no withdrawal or single sum payment) prior to
your attainment of age 59 years and 6 months.
SECTION 1.14 EMPLOYER. The term "Employer" means the sole proprietor or the
partnership adopting the Plan, or any successor unincorporated trade or business
that assumes in writing the obligations of the Plan.
SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed interest Rate" means
the effective annual rate at which interest accrues on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of
this Contract. Section 2.03 describes determination of the rate to apply
thereafter.
SECTION 1.16 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected by you. The payments commence on the date as of which the Joint and
Survivor Life Annuity Form is purchased and terminate with the last payment due
before the death of the survivor.
SECTION 1.17 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us providing monthly payments during the lifetime of the person upon
whose life such payments depend. The payments commence on the date as of which
the Life Annuity Form is purchased and terminate with the last payment due
before the death of such person.
SECTION 1.18 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means (i) if you have a living spouse at the Retirement Date, the
Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with
such spouse as the contingent annuitant (with 100% of the monthly payment amount
continued to your spouse), and (ii) if you do not have a living spouse at the
Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form.
SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us which does not permit any
prepayment of the unpaid principal (that is, you cannot elect to receive part of
your payments as a single sum payment with the remainder paid in monthly annuity
payments).
SECTION 1.20 PLAN. The term "Plan" means the Standardized Non-Trusteed Defined
Contribution Plan for Unincorporated Employers, a prototype plan for
self-employed individuals and their employees which is sponsored by us.
No. 92HR1B Page 5
SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such
other location as we shall designate by advance written notice to the Employer
or the trustee, as applicable, and to you.
SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which
you attain the retirement age as shown on Page 3 of this Contract. Before the
Retirement Date you may elect to change the Retirement Date to another
Retirement Date, which may be any date after the filing of the election (other
than the 29th, 30th or 31st day of any month). No Retirement Date shall be
earlier than the date you attain age 59 years and 6 months nor shall it be later
than the date you attain age 70 years and 6 months. Any election for such change
must be made in writing by you and shall not take effect until received by us at
our Processing Office.
SECTION 1.23 SEPARATE ACCOUNT. The term "Separate Account" means our Separate
Account A which is organized as a unit investment trust, a type of investment
company. We have established the Separate Account and it is maintained in
accordance with the laws of New York State. Realized and unrealized gains and
losses from the assets of the Separate Account are credited or charged against
it without regard to our other income, gains or losses. Assets are put in the
Separate Account to support this Contract and other variable annuity contracts
and certificates. Assets may be put in the Separate Account for other purposes,
but not to support contracts or policies other than variable annuities and
variable life insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust where each class (or series) represents a separate portfolio in
such Trust. We reserve the right to change the designated trust or investment
company or to add designated trusts or investment companies. The Investment
Divisions available are the Stock Division, the Money Market Division, the
Balanced Division and the Aggressive Stock Division. The Guaranteed Interest
Division is not part of the Separate Account but rather is an asset of our
General Account.
We will value the assets of each Investment Division on each business day. A
business day is any day on which we are open, the New York Stock Exchange is
open for trading and there is a sufficient degree of trading in the portfolio
securities in which an Investment Division is invested to materially affect the
Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments we are
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under the
Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any other
form;
(v) add Investment Divisions (or sub-divisions of Investment Divisions) to,
or remove Investment Divisions (or sub-divisions of Investment Divisions)
from the Separate Account (the term "Investment Division" in this Contract
shall then refer to any other Investment Division in which the assets, of
a Class of Contracts to which this Contract belongs, were placed);
(vi) combine any two or more` Investment Divisions (or sub-divisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
Class of Contracts to which this Contract belongs.
NO. 92HR1B Page 6
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, you will be notified of such exercise, as
required by law.
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for applicable tax
charges) at a rate not to exceed 1.49% per year for each of the Stock, Money
Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock
Division, for financial accounting, death benefits, mortality risk, expenses and
expense risk. The charge shall be made in accordance with Subsection (c) of the
Net Investment Factor provision in Section 1.24. The relative proportion of
these charges may be modified. This daily charge, plus the investment advisory
fee charges and direct operating expense charges of the Trust, shall not exceed
a total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract.
SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any preceding consecutive
non-business days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment
Division for the Valuation Period. For this purpose, we use the share
value reported to us by the Trust.
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period (after
any amounts allocated or withdrawn for that Valuation Period).
(c) is the daily Separate Account charge for the expenses of this Contract,
times the number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an
Investment Division where your Contributions are invested and which is used in
determining the amount you have in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for that Investment Division for such Valuation Period.
ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first contribution was put into the Stock
Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed
Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The
Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value
for the immediately preceding Valuation Period multiplied by the Adjusted Net
Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for a Valuation Period is the Net Investment Factor for such
period reduced for each calendar day in such subsequent Valuation Period by the
Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net
Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net
Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall
be 5%, except in states where the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar
month is equal to the average of the Annuity Unit Values for all Valuation
Periods ending in such month.
SECTION 1.25 TRANSACTION DATE. The term "Transaction Date" means the business
day we receive a Contribution or a written contract transaction request
providing the information we need at the Processing Office. In the case of a
transfer request initiated through the use of a touch tone telephone as
described in Section 2.05, the term Transaction Date means the business day the
telephone transaction is received.
SECTION 1.26 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
NO. 92HR1B Page 7
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PART II -- ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. The Employer is to make Contributions from time to
time on such dates and in such amounts as determined by the Employer pursuant to
the terms of the Plan or Agreement. Contributions will be allocated to the
Divisions in accordance with the instructions received on the application,
unless later changed.
Each Contribution received by us with respect to you will, before its allocation
under this Contract, be reduced by the amount of any applicable tax charge, as
determined by us.
Pursuant to the terms of the Plan, we will accept rollover contributions and
transfers made on your behalf from a plan qualified under Section 401(a) of the
Code or from a conduit individual retirement arrangement as described in Section
408 of the Code.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to, or withdrawn or transferred from, an Investment
Division, the Annuity Account Value will be credited or charged, as the case may
be, with the number of Accumulation Units determined by dividing said amount by
the Accumulation Unit Value for the appropriate Investment Division for the
Valuation Period which includes that date. The number of units in an Investment
Division on any date is equal to (i) the sum of any Accumulation Units that have
been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation
Units that have been withdrawn pursuant to Section 2.07 or 2.10 or transferred
from the Investment Division pursuant to Section 2.05. The amount in an
Investment Division on any date is equal to the product of (i) the number of
Accumulation Units in the Investment Division on that date, and (ii) the
Accumulation Unit Value for the Investment Division for the Valuation Period
which includes that date.
Participation in the Separate Account under the terms of this Contract
terminates on the earliest of (i) Election and Commencement of Annuity Benefits
pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii)
Termination of this Contract pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets, which support
the guarantees of this Contract and other contracts.
The amount in the Guaranteed Interest Division at any time is equal to the sum
of all amounts that have been allocated to the Guaranteed Interest Division
pursuant to Section 2.04 plus the amount of any interest accrued but not
allocated, less the sum of all amounts that have been withdrawn from the
Guaranteed Interest Division pursuant to Section 2.07, 2.10 or 2.11 or
transferred from the Guaranteed Interest Division, pursuant to Section 2.05.
Interest is allocated to the Guaranteed Interest Division on a Transaction Date
pursuant to Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division under the terms of this
Contract terminates on the earliest of (i) Election and Commencement of Annuity
Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or
(iii) Termination of this Contract pursuant to. Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction of any applicable tax charge) to one or more
Divisions, at your sole direction as specified to us. Allocation percentages
must be in whole numbers and the sum must equal 100. The allocation is made as
of the Transaction Date on which we have received both such Contribution and
such direction. Contributions made to an Investment Division purchase
Accumulation Units in that Investment Division, using the Accumulation Unit
Value next computed after the Transaction Date.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon Termination of this Contract pursuant to Section 2.06, and (vi)
upon your death pursuant to Section 2.11.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through
the use of a touch tone telephone, transfer all or part of the amount you have
in a Division to one or more of the Divisions as follows: (1) amounts in the
Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive
Stock Division may be transferred among such Divisions; (2) amounts in the Money
Market Division may be transferred to other Divisions. Written authorization for
touch tone telephone initiated transfers is only required when authorization for
telephone transfers is requested. (Upon advance written notice to you, we
reserve the right to discontinue the acceptance of transfer requests through the
use of a touch tone telephone.) All transfers will be effective on the
Transaction Date and will be subject to our rules in effect at the time of
transfer. With respect to the Investment Divisions, the transfer will be made at
the Accumulation Unit Value next computed after the Transaction Date. No
transfers are permitted to the Money Market Division from the other Divisions.
NO. 92HR1B Page 8
SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the
terms of the Plan, including the spousal consent rules set forth in Section
3.06, you may elect, by written notice, to terminate this Contract. We will
determine the Cash Value under this Contract as of the Transaction Date.
If this Contract is terminated, surrendered or exchanged prior to your
Retirement Date, any applicable tax charges we have paid may be deducted. If we
have previously deducted charges for applicable taxes from Contributions
pursuant to Section 2.01, we will not again deduct charges for the same taxes on
terminations, unless a change in applicable law has occurred with respect to
your Contract.
The payment of such Cash Value may be deferred by us in accordance with the
provisions of Section 4.07. If no tax has been previously deducted or if such a
tax is due at termination, we will deduct the amount due.
Subject to the terms of the Plan, we reserve the right to pay the Annuity
Account Value under this Contract and terminate this Contract if (i) no
Contributions are made on your behalf during the last three completed Contract
Years, and the Annuity Account Value is less than $500 or (ii) a partial
withdrawal is made that would result in your Annuity Account Value falling below
$500. We also reserve the right to terminate this Contract if no Contributions
have been made within 120 days from the Contract Date shown on Page 3 of this
Contract.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount in the Divisions and the Annuity Account Value shall be zero. We will
be released from any and all liability for payments with respect to the
Contributions from which the Annuity Account Value arose.
SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under
the terms of the Plan, you may elect, by written notice to us, to make a partial
withdrawal from the Divisions. Partial withdrawals are subject to spousal
consent rules set forth in Section 3.06.
On the Transaction Date, we will pay the lesser of the Cash Value or the amount
of partial withdrawal requested to the person entitled to receive such
payment as designated in writing by you. The amount paid plus any withdrawal
charge applicable pursuant to Section 2.08 will be withdrawn from the amounts
you have in the Divisions. Unless instructed otherwise, the amount withdrawn
(including any withdrawal charge) will be allocated among the Divisions in
proportion to the amounts that you have in such Divisions.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300.
If a withdrawal made under this Section would result in an Annuity Account Value
of less than $500, we will so advise you and reserve the right to pay the
Annuity Account Value to you, and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS.
NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the
amount of partial withdrawal requested is not greater than the Free Corridor
Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity
Account Value pursuant to Section 1.05.
WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than
the Free Corridor Amount, we will (i) first withdraw from the Divisions an
amount equal to the Free Corridor Amount in proportion to the amount you have in
them, and (ii) then withdraw an amount equal to the excess of the amount
requested over the Free Corridor Amount, plus a partial withdrawal charge. Such
partial withdrawal charge will be equal to the lesser of (a) or (b) where:
(a) is an amount equal to
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
NO. 92HR1B Page 9
of the amount withdrawn in excess of the Free Corridor Amount (including
such charge) pursuant to (ii) of the preceding sentence.
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior partial withdrawal
charges made pursuant to this Section.
If withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to your Contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if you
have completed three Contract Years or attained age 59 years and 6 months, an
amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account
Value on the Transaction Date over (ii) cumulative prior withdrawals made
pursuant to Section 2.07 in the current Contract Year. If you have not completed
three Contract Years or attained age 59 years and 6 months, the Free Corridor
Amount is zero.
SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $10,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts that you have in
the Divisions.
If the Annuity Account Value is less than $10,000 on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03
or (b) the date of termination of this Contract pursuant to Section 2.06 or
2.11, we will prorate the Annual Administrative Charge applicable to the
completed portion of the Current Contract Year and withdraw such amount in lieu
of the full Annual Administrative Charge described in this Section for the
applicable part of that Contract Year.
If the Annuity Account Value is $10,000 or greater at the end of a Contract
Year, the Annual Administrative Charge is zero.
SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of your death we will pay
(subject to the terms of the Plan, in the spousal survivor benefit rules set
forth in Section 3.06) to the beneficiary designated to receive such payment,
pursuant to Section 4.04 of this Contract, the amount of death benefit payable.
The amount of the death benefit is equal to the greater of (i) the Annuity
Account Value and (ii) your minimum death benefit. Such minimum death benefit is
the sum of all Contributions made pursuant to Section 2.01 (before reduction for
any applicable tax charge) less any withdrawals made pursuant to Section 2.07.
Any such withdrawal will reduce your minimum death benefit (as adjusted by any
previous withdrawal) by an amount which is in the same proportion as the amount
that was withdrawn is to the Annuity Account Value. If, in accordance with the
provisions of Section 2.01, the cash value of another annuity contract issued by
us or one of our affiliated or subsidiary life insurance companies, which
provides for a death benefit before retirement equal to the greater of the
contract cash value or an alternate amount based on premiums paid or
contributions made under the annuity contract, is transferred to this Contract,
such cash value or alternative amount as of the date of transfer will be
included in the "sum of all Contributions" in lieu of the amount of cash value
transferred for purposes of the death benefit under this Contract.
We will pay the death benefit to the beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.04. Also in accordance with the last paragraph of Section 4.04, if no such
election is in effect at your death, we will pay the death benefit to the
beneficiary in a single sum, unless the beneficiary elects, before we pay the
death benefit, to apply the death benefit to an Annuity Benefit, subject to the
minimum distribution requirement of the Code as described in Section 3.06 and
our rules then in effect.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value shall be zero. We will be released from any and all
liability for payments with respect to the Contributions from which the Annuity
Account Value arose.
NO. 92HR1B Page 10
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PART III -- ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under the terms of this Contract with respect to a payee is the amount provided
pursuant to Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division of the Separate Account.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of Net
Investment Return referred to in Section 1.24 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to
provide for any applicable tax charge. These charges include a daily charge for
financial accounts, death benefits, mortality risk, expenses and expense risk,
plus the investment advisory fee charges and direct operating expense charges of
the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under the terms of this Contract with respect to a payee is the
monthly amount provided pursuant to the fifth paragraph of Section 3.04. The
amount of the fourth and each subsequent payment under a Variable Annuity
Benefit will be equal to the number of Annuity Units with respect to such
benefit, multiplied by the Average Annuity Unit Value for the second calendar
month immediately preceding the due date of the payment. The number of Annuity
Units with respect to a benefit is the number determined by dividing the amount
of the first monthly payment by the Annuity Unit Value for the Valuation Period
which includes the due date of the first monthly payment. (As described in
Section 3.05, we will notify the payee how each Variable Annuity Payment is
determined.)
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your
Retirement Date, provided you are then living, the Annuity Account Value shall
be applied to provide the Normal Form of Annuity Benefit, unless you elect (i)
to receive the Cash Value in a single sum or (ii) to apply the Annuity Account
Value or Cash Value, whichever is applicable pursuant to the first paragraph of
Section 3.04, to provide an Annuity Benefit on any other annuity form offered by
us, or one of our affiliated or subsidiary life insurance companies, as elected
by you, or (iii) to take partial withdrawals pursuant to Section 2.07 in the
amounts and at times as required by the minimum distribution rules of Section
401(a)(9) of the Code and applicable Treasury Regulations, pursuant to Sections
2.07 and 3.05, subject to our rules then in effect and any other applicable
requirements under the Code.
We will provide notice and election forms to you not more than six months before
your Retirement Date.
If you elect to terminate this Contract, pursuant to Section 2.06, an election
may be made to receive an Annuity Benefit in lieu of the Cash Value.
We will have the right to require you to furnish pertinent information to
provide an Annuity Benefit, and will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary
life insurance companies. An election to receive Annuity Benefits in accordance
with this Section is subject to the spousal consent and spousal survivor rules
set forth in Section 3.06 of this Contract.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or
third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be (i) the
Annuity Account Value if the annuity form elected involves life contingencies or
(ii) the Cash Value if the payments under the annuity form elected does not
involve life contingencies.
The amount applied to provide an Annuity Benefit may be reduced by any
applicable tax charge on annuity considerations, as we determine. If we have
previously deducted any applicable tax charges from Contributions as provided in
Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to your Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your Contract will be governed by our
supplementary contract then in effect.
NO. 92HR1B Page 11
The amount to be applied to provide an Annuity Benefit will, in addition to any
tax charge reduction, be reduced by an administrative charge. The amount of such
charge will be determined from time to time in accordance with our general
practices applicable on a uniform basis to all contracts of the same type as
this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts
you have in the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under the terms of this
Contract, as indicated, on either the Life Annuity Form or the Joint and
Survivor Life Annuity Form (with 100% of the amount of your payment continued
to your spouse). The amounts of income provided under the Fixed Annuity Benefit
payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are
based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a"
adjusted to a unisex basis based on a 50-50 split of males and females. The
amounts of income initially provided under the Variable Annuity Benefit payable
on the Life Annuity Form are based on a 50-50 split of males and females and an
Assumed Base Rate of Net Investment Return of 3.5% or 5%,whichever applies
pursuant to Section 1.24.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us on 3.5% interest and the 1983 Individual Annuity Mortality
Table "a" adjusted to a unisex basis based on a 50-50 split of males and females
if such annuity form provides for a Fixed Annuity Benefit, and on the projected
1983 Basic Table "a" adjusted to a unisex basis based on a 50-50 split of males
and females and an Assumed Base Rate of Net Investment Income Return of 5% or
3.5%, whichever applies pursuant to Section 1.24, if such annuity form provides
for a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract
will be distributed or begin to be distributed in accordance with Section
401(a)(9) of the Code and the applicable Treasury Regulations thereunder, no
later than the first day of April following the calendar year in which you
attain age 70 years and 6 months ("Required Beginning Date") or such later date
as specified in such section or regulations. Your entire interest may be
distributed, as you elect over (a) the life, or the lives of you and or your
designated beneficiary, or (b) a period certain not extending beyond your life
expectancy, or the joint and last survivor expectancy of you and your designated
beneficiary. Distributions must be made in periodic payments at intervals of no
longer than one year. In addition, payments must be either non-increasing or
they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the
proposed Treasury Regulations, or any successor Regulation thereto.
All distributions made hereunder shall be made in accordance with the
requirements of Section 401(a)(9) of the Code, including the incidental death
benefit requirements of Section 401(a)(9)(G)of the Code, and applicable Treasury
Regulations, including the minimum distribution incidental benefit requirement
of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or any successor
Regulation thereto.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.05, while any distribution shall be subject to such requirements of
the Code and regulations, any distribution shall also be subject to the terms of
this Contract. That is, the forms of distribution shall be those which are made
available by us at the time of your election.
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9.
Unless you otherwise elect prior to the time distributions are required to
begin, those life expectancies shall be recalculated annually. Such election
shall be irrevocable and shall apply to all subsequent years. The life
expectancy of a non-spouse beneficiary may not be recalculated. Instead, life
expectancy will be calculated using the attained age of such beneficiary during
the calendar year in which you attain age 70 years and 6 months, and payments
for subsequent years shall be calculated based on such life expectancy reduced
by one for each calendar year which has elapsed since the calendar year life
expectancy was first calculated.
If you die after distribution of your interest in this Contract has begun, the
remaining portion of such interest will continue to be distributed at least as
rapidly as under the method of distribution being used prior to your death.
If you die before distribution of your interest in this Contract begins,
distribution of your entire interest shall be completed no later than December
31 of the calendar year containing the fifth anniversary of your death, except
to the extent that an election is made to receive death benefit distributions in
accordance with (1) or (2) below:
(1) If your interest is payable to a designated beneficiary, then your entire
interest may be distributed over the life of, or over a period certain not
greater than the life expectancy of, the designated beneficiary. Such
distributions must commence on or before December 31 of the calendar year
immediately following the calendar year of your death.
NO. 92HR1B Page 12
(2) If the designated beneficiary is your surviving spouse, the date
distributions that are required to begin in accordance with (1) above shall
not be earlier than the later of (A) December 31 of the calendar year
immediately following the calendar year of your death or (B) December 31 of
the calendar year in which you would have attained age 70 years and 6
months.
For purposes of determining the "period certain" referred to in the
immediately preceding paragraph, life expectancy is computed by use of the
expected return multiples in Tables V and VI of Treasury Regulation Section
1.72-9. For purposes of distributions beginning after your death, unless
otherwise elected by the surviving spouse by the time distributions are
required to begin, life expectancies shall be recalculated annually. Such
election shall be irrevocable by the surviving spouse and shall apply to all
subsequent years. In the case of any other designated beneficiary, life
expectancies shall be calculated using the attained age of such beneficiary
during the calendar year in which distributions are required to begin
pursuant to this Section, and payments for any subsequent calendar year
shall be calculated based on such life expectancy reduced by one for each
calendar year which has elapsed since the calendar year life expectancy was
first calculated.
Distributions under this Section are considered to have begun if distributions
are made because you have reached your Required Beginning Date or if prior to
the Required Beginning Date distributions irrevocably commence to you over a
period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1
of the Proposed Treasury Regulations or any successor Regulation thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under the terms of this Contract was based on information
that is subsequently found to be incorrect, your benefit will not be
invalidated, but an adjustment on the basis of the correct information will be
made in the amount of the benefit payments, or any amount used to provide the
benefit, or any combination thereof. Overpayments by us will be charged against
and underpayments will be added to any payment thereafter falling due under the
terms of this Contract with respect to the payee, affecting as many such
payments as are necessary to correct the overpayment or underpayment. Our
liability, with respect to a payee, is limited to the correct information and
the actual amounts used to provide the benefits then in force with respect to
the payee under this Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under the terms of this Contract is physically or mentally
incompetent to receive such payment or is a minor, (ii)) another person or an
institution is then maintaining or has custody of such payee, and (iii) no
guardian, committee or other representative of the estate of such payee has been
appointed, we may make the payments (in the case of a minor, at a rate not
exceeding $200 a month) to such other person or institution, and will thereupon
be fully discharged from all liability with respect hereto.
If a variable annuity form made available by us provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one or two persons, a payee for payments
thereunder may elect, without the concurrence of any other person, to receive
the commuted value of any remaining payments, provided no person upon whose life
the income depends is surviving.
Pursuant to Section 3.03, upon your election of an annuity form providing
payments for a period certain, you may designate (with the right to change such
designation) a payee to receive any payments that may become due after the death
of the person or persons upon whose life or lives the income may depend.
The payee may designate (with the right to change such designation and without
the concurrence of any other person) a person or persons to receive any payments
or installments payable` after such payee's death, if the absence of such a
designation would result in a single sum payment to such payee's estate in
accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments.
The commuted value of any such remaining payments will be determined on the
basis of compound interest at the rate utilized in the actuarial rate basis
applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
NO. 92HR1B Page 13
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
--------------------------------------------------------------------------------
TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR
LIFE ANNUITY FORM
100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE
(Minimum Monthly Income per $1,000 OF Annuity Account Value)
--------------------------------------------------------------------------------------------
Age 60 61 62 63 64 65 66 67 68 69 70
--------------------------------------------------------------------------------------------
60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88
61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96
62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03
63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11
64 4.89 4.94 5.00 5.05 5.10 5.14 5.19
65 5.00 5.06 5.11 5.17 5.22 5.27
66 5.12 5.18 5.24 5.29 5.35
67 5.24 5.31 5.37 5.43
68 5.37 5.44 5.51
69 5.52 5.59
70 5.67
--------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE
ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1,000 of Annuity Account Value)
--------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON
THE LIFE ANNUITY FORM IF ASSUMED
BASE RATE OF NET INVESTMENT RETURN IS
Age 3.5% 5.0%
--------------------------------------------------------------------------------
60 5.27 6.16
61 5.39 6.28
62 5.52 6.41
63 5.66 6.55
64 5.81 6.70
65 5.97 6.86
66 6.15 7.03
67 6.33 7.21
68 6.53 7.41
69 6.74 7.62
70 6.97 7.85
--------------------------------------------------------------------------------
We will, with respect to each payment under a Variable Annuity Benefit, notify
the payee of the number of Annuity Units and the Average Annuity Unit Value used
in determining the amount of each variable payment. Such notice will be mailed
with each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary,
as described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If you are married,
your interest in this Contract shall be paid in the Normal Form joint and
survivor annuity, and if you are unmarried, your interest shall be paid in the
Normal Form life annuity, unless you elect otherwise as described in this
Section. If you are married and die before payment of your interest has
commenced, your interest shall be paid to your surviving spouse in the form of a
life annuity, unless at the time of your death there was a contrary election
made pursuant to this Section. The foregoing notwithstanding, your surviving
spouse may elect, before payment is to commence, to have payment made in any
form permitted under the terms of this Contract.
You may elect, at any time within the 90 consecutive day period before the first
day of the first period for which your interest is paid as an annuity or in any
other form, not to have your interest paid in the Normal Form in which case it
shall be paid in any other form elected under the terms of this Contract. If
such interest is to be paid to your spouse upon your death, you may elect,
during the period beginning on the first day of the plan year of the Plan in
which you attain age 35 years (or if you separate from Service prior to that
plan year, beginning on the date of separation) and ending with your death, for
a beneficiary other than your spouse to receive payment of the value of your
interest. In addition, if you will not yet attain age 35 years by the end of any
current plan year, you may make a special qualified election to designate a
beneficiary other than your spouse to receive payment of the value of your
interest. Such special qualified election shall be effective for the period
beginning on the date of such election and ending on the first day of the plan
year in which you will attain age 35. Amounts payable in accordance with this
Section will be automatically reinstated as of the first day of the plan year in
which you attain age 35 unless a new election designating a beneficiary other
than the spouse is made in accordance with the requirements of this Section.
NO. 92HR1B Page 14
Any election described in the foregoing paragraph must be consented to by your
spouse in writing before a notary or a representative of the Plan unless you can
prove that there is no spouse or that the spouse cannot be located. Also, if you
have become legally separated from your spouse or have been abandoned (within
the meaning of local law) and have a court order to such effect, spousal consent
is not required unless a qualified domestic relations order provides otherwise.
Your election must designate a specific beneficiary (including any class of
beneficiaries or any contingent beneficiaries) that may not be changed without
further consent of the spouse, unless the spouse's consent expressly permits
designation by you without further consent of the spouse. The spouse's consent
under this Section shall acknowledge the effect of the election. In addition,
the spouse's consent (or the establishment that the consent of the spouse may
not be obtained) shall only be valid with respect to such spouse. Your waiver of
the Normal Form joint and survivor annuity shall not be effective unless the
election designates a form of benefit payment which may not be changed without
spousal consent (or the spouse expressly permits designations by you without any
further spousal consent). A consent that permits designations by you without any
requirement of further consent by such spouse must acknowledge that the spouse
has the right to limit consent to a specific beneficiary, and a specific form of
benefit where applicable, and that the spouse voluntarily elects to relinquish
either or both of such rights. If you make an election under this Section, you
may revoke that election, without spousal consent, at any time before the first
day of the first period for which an amount is paid as an annuity or in any
other form.
The provision requiring spousal consent in this Section shall also apply with
regard to your election to terminate this Contract or make partial withdrawals
pursuant to Sections 2.06 and 2.07, with respect to death benefits under Section
2.11 with respect to the Election and Commencement of Annuity Benefits pursuant
to Section 3.03, and with respect to a beneficiary designation set forth in
Section 4.04.
If the Annuity Account Value applied to provide the spousal benefits on the date
payment is to commence is in the aggregate less than $3,500, we may choose to
make payment in a single sum rather than in the form of a Qualified Joint and
Survivor Life Annuity or Life Annuity as described herein. Upon any payment made
pursuant to this Section, we will be released from any and all liability for
payment with respect to the Contributions made for you.
--------------------------------------------------------------------------------
PART IV -- GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the
parties and the terms of this Contract alone will govern with respect to our
rights and obligations. A copy of the application is incorporated in and made
part of this Contract.
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by our authorized officer. The terms of this
Contract may be changed by amendment or replacement upon agreement between you
and us without the consent of any other person.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of
this Contract without the consent of any other person in order to comply with
applicable laws and regulations. Such right shall include, but not be limited
to, the right to conform the terms of this Contract to reflect changes in the
Code, applicable Treasury Regulations, or regulations or published rulings of
the Internal Revenue Service so this Contract will continue to be an Annuity
used to fund a plan qualified under Section 401(a) of the Code.
SECTION 4.03 ASSIGNMENTS AND NON-TRANSFERABILITY. No interest of yours or of a
beneficiary under this Contract may be transferred to any person other than us
upon the surrender of this Contract. Except as permitted under Section
401(a)(13) of the Code, no right or interest of you or any other payee or
beneficiary in this Contract shall be (a) assignable; (b) subject to any lien;
or (c) liable for, or subject to, any obligation or liability of any person. The
preceding sentence shall not apply to an assignment, transfer or attachment
pursuant to a qualified domestic relations order, as defined in Section 414(p)
of the Code.
SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an
initial designation of the beneficiary entitled to receive any death benefit
payable pursuant to Section 2.11. Subject to the spousal consent and survivor
rules of Section 3.06, you may change such designation from time to time during
your lifetime and while this Contract is in force. Any such designation or
change will be made by written notice in a form satisfactory to us. A change
will, upon receipt at the Processing Office, take effect as of the time the
written notice was signed, whether or not you are living on the date of receipt,
but without further liability as to any payment or other settlement made by us
before receipt of such change.
Unless otherwise specified in the designation, if you have designated two or
more persons as beneficiary, the beneficiary will be the designated person or
persons who survive you, and if more than one survive they will share equally.
NO. 92HR1B Page 15
Any part of a death benefit payable pursuant to Section 2.11 for which there is
no designated beneficiary living at your death will be payable in a single sum
to your children who survive you, in equal shares, or should none survive, then
to your estate.
If you elect in writing, any amount that would otherwise be payable to a
beneficiary in a single sum may be applied to provide an Annuity Benefit, on the
form of annuity previously elected by you, with respect to the beneficiary,
subject to our rules then in effect. If at your death there is no election in
effect to apply the single sum death benefit to provide an Annuity Benefit, the
beneficiary may make such an election. Any such election must meet the minimum
distribution requirements under the Code, as described in Section 3.05. The
foregoing notwithstanding, any designation of beneficiary is subject to the
Spousal Consent rules set forth in Section 3.06.
SECTION 4.05 DISQUALIFICATION. In the event that this Contract fails to qualify
as an Xxxxxxx as described in Section 1.02, we will have the right, upon
receiving notice of such fact before the Retirement Date, to terminate this
Contract and pay to you the Annuity Account Value less a deduction for the
appropriate part attributable to you of any Federal income tax payable which
would not have been payable if you had an Annuity.
In the event that the Plan fails to qualify as a Plan under Section 401(a) of
the Code and applicable Treasury Regulations, we reserve the right, upon
receiving notice of such fact, to transfer the Annuity Account Value under this
Contract to another annuity contract issued by us, an affiliate or subsidiary,
on your life, or to terminate this Contract and pay to you the Annuity Account
Value less deduction for applicable taxes, solely at our option.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Employer, we
reserve the right at our sole discretion to limit contributions to this
Contract.
SECTION 4.07 DEFERMENT. Applications of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of your Annuity Account Value
(less any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities Exchange
Commission, by order, permits us to defer payments in order to protect persons
with interests in the Investment Divisions. We can defer payments of any portion
of your Annuity Account Value in the Guaranteed Interest Division for up to six
months while you are living.
SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year, we will furnish
you with a notice showing the following:
(1) the amount you have in the Guaranteed Interest Division,
(2) the total number of Accumulation Units you have in the Stock Division,
Balanced Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Values,
(4) the amount you have in the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division,
(5) the Cash Value, and
(6) the amount of your death benefit.
We will also furnish annual calendar year reports concerning the status of the
annuity and any other reports required by the Code or applicable Treasury
Regulations.
After the Retirement Date, we will notify you of the number of Annuity Units and
the Average Annuity Unit Value used in determining the amount of each Variable
Annuity Benefit payment, if any.
SECTION 4.09 AGE. If your age has been misstated, any benefits will be those
which would have been purchased at the correct age. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
NO. 92HR1B Page 16
OWNER: XXXX XXX
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 000
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28,1992
RETIREMENT DATE: JAN 1, 2020
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York,
New York 10116
AGREES
o TO ALLOCATE the Contributions made to this Contract, after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division (referred to in this Contract as the
"Investment Divisions") or to the Guaranteed Interest Division, in accordance
with Sections 2,02, 2.03 and 2.04 as directed by you, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide the
Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is
then living, and
o TO PROVIDE the Annuitant with the other rights and benefits of this Contract.
This is the entire Contract. In this Contract "we", "our", and "us" mean The
Equitable Life Assurance Society of the United States ("Equitable"). "You" and
"your" mean the Annuitant at the time a right is exercised by the Annuitant.
TEN DAYS TO EXAMINE CONTRACT--You may cancel this Contract by returning it to us
within ten days after receipt of it. Upon such cancellation, we will refund any
Contribution made to us under this Contract.
/s/ Xxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxxxx
Vice President and Secretary Chairman of the Board and
Chief Executive Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.22 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE
MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL
ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE
INVESTMENT ADVISORY FEE CHARGE AND DIRECT OPERATING EXPENSE CHARGES OF THE
TRUST.
No. 92 IRAA
The Contract is issued in consideration of the payment to us of the
Contributions made under the terms of the Contract.
The provisions on the following pages are part of this Contract. A copy of the
application is incorporated in and made part of this Contract.
--------------------------------------------------------------------------------
TABLE OF CONTENTS
DEFINITIONS Page
Section 1.01 - Annuitant..........................................4
1.02 - Annuity............................................4
1.03 - Annuity Account Value..............................4
1.04 - Annuity Benefit....................................4
1.05 - Cash Value.........................................4
1.06 - Class of Contracts.................................4
1.07 - Code...............................................4
1.08 - Contract...........................................4
1.09 - Contract Date......................................4
1.10 - Contract Year......................................4
1.11 - Contribution.......................................4
1.12 - Divisions..........................................5
1.13 - Xxxxxxxx Xxxxxxx Xxxxxxx...........................5
1.14 - Guaranteed Interest Rate...........................5
1.15 - Joint and Survivor Life
Annuity Form....................................5
1.16 - Life Annuity Form..................................5
1.17 - Normal Form........................................5
1.18 - Period Certain Annuity.............................5
1.19 - Processing Office..................................5
1.20 - Retirement Date....................................5
1.21 - Separate Account...................................5
1.22 - Separate Account Definitions.......................6
1.23 - Transaction Date...................................7
1.24 - Trust..............................................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contribution.......................................7
2.02 - Separate Account Investment
Divisions.......................................7
2.03 - Guaranteed Interest Division.......................7
2.04 - Allocation to Divisions............................7
2.05 - Transfers Among Divisions..........................8
2.06 - Termination of this Contract.......................8
2.07 - Partial Withdrawals................................8
2.08 - Charges for Partial Withdrawals....................8
2.09 - Free Corridor Amount...............................8
2.10 - Annual Administrative Charge.......................9
2.11 - Death Benefit......................................9
ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit..............................9
3.02 - Variable Annuity Benefit...........................9
3.03 - Election and Commencement
of Annuity Benefits............................10
3.04 - Amount of Annuity Benefits........................10
3.05 - Payment of Annuity Benefits.......................10
GENERAL PROVISIONS
Section 4.01 - Contract..........................................12
4.02 - Statutory Compliance..............................13
4.03 - Nonforfeitability,
Nontransferability, and
Assignments....................................13
4.04 - Beneficiary.......................................13
4.05 - Disqualification..................................13
4.06 - Future Contributions..............................13
4.07 - Deferment.........................................13
4.08 - Annual Notice.....................................13
4.09 - Age and Sex.......................................13
No. 92 IRAA Page 2
OWNER: XXXX XXX
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 000
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28,1992
RETIREMENT DATE: JAN 1, 2020
INITIAL GUARANTEED INTEREST RATE: 7.50% to MAR 31, 1992
MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992
3.00% AFTER DEC 31, 1992
BENEFICIARY: XXXX XXX
FORM NUMBER: 92IRAA
--------------------------------------------------------------------------------
TABLE OF GUARANTEED VALUES
ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION
NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY
SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65
------------------------ ---------- -----------------
1 983 6.61
2 1,958 16.17
3 2,963 26.62
4 3,998 36.76
5 5,064 46.61
6 6,220 56.96
7 7,362 67.37
8 8,538 77.25
9 9,870 86.97
10 11,263 95.47
11 12,719 103.72
12 14,242 111.73
13 15,832 119.50
14 17,337 127.05
15 18,887 134.38
16 20,484 141.49
17 22,129 148.40
18 23,822 155.10
19 25,567 161.61
20 27,364 167.94
24 (Age 62) 35,108 191.43
27 (Age 65) 41,547 207.32
THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000
CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT
DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE
(SEE SECTION 2.10) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ACCOUNT VALUE (SEE
SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND EARNINGS ARE
ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION.
YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON
THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS.
THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE
WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY
BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A
SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04).
*ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO
SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT.
No. 92 IRAA Page 3
--------------------------------------------------------------------------------
PART I--DEFINITIONS
SECTION 1.01 ANNUITANT. The term "Annuitant" means the person who owns this
Contract as shown on page 3 and who exercises all rights under the terms of this
Contract.
SECTION 1.02 ANNUITY. The Term "Annuity" means an individual retirement annuity
contract meeting the requirements of Section 408(b) of the Code.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts that you have in the Guaranteed Interest Division and the
Investment Divisions of the Separate Account, pursuant to Sections 2.02 and
2.03.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by Equitable pursuant to Section 3.04 of this Contract. Various sections of this
Contract (Sections 1.15, 1.16, 3.01, and 3.02) refer to monthly payments to be
made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at
other intervals, such as quarterly, semi-annually, or annually, instead of
monthly. You may elect this at the time you elect the Annuity Benefit form
described in Section 3.03; in that event, all references in this Contract to
monthly payments will be deemed to mean payments at the frequency you elect,
subject to our rules at the time of election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value
less any applicable withdrawal charge determined as follows:
The withdrawal charge equals the lesser of (a) or (b) where
(a) equals
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the excess of (i) the Annuity Account Value over (ii) the Free Corridor
Amount defined in Section 2.09; and
(b) is the excess, if any, of (i) 8% of the total Contributions made during
the Current Contract Year and the nine preceding Contract Years over (ii)
the cumulative total of any prior charges for partial withdrawals made
pursuant to Section 2.08.
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
A withdrawal charge will not apply, which means the Cash Value will equal the
Annuity Account Value upon any of the following occurrences:
(i) your attainment of age 59 and 6 months and your completion of at least
five Contract Years, or
(ii) a request is made for a refund of a contribution in excess of amounts
allowed to be contributed under Section 408 of the Code within one month
of the date on which the contribution is made, or
(iii) you die and a distribution is made to the beneficiary, or
(iv) your attainment of age 55, your completion of at least five Contract Years
and you use the amount withdrawn to purchase from us an Eligible Annuity
Certain, or
(v) your completion of at least three Contract Years and you use the amount
withdrawn to purchase from us a Period Certain Annuity of at least 10
years, or
(vi) your Annuity Account Value is applied to the election of a Life Annuity
Form or Joint and Survivor Life Annuity Form distribution option, or
(vii) your completion of at least twelve Contract Years.
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same calendar year.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as
amended, or any corresponding provisions of prior or subsequent United States
revenue laws.
SECTION 1.08 CONTRACT. The term "Contract" means this Contract, which is
intended to qualify as an individual retirement annuity contract under Section
408(b) of the Code. This Contract is established for the exclusive benefit of
you or your beneficiaries.
SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both an application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made in cash
or by check to us with respect to this Contract. We are under no obligation to
ac-
No. 92 IRAA Page 4
cept any Contribution less than $20.00
Except in the case of a rollover contribution (as permitted by Sections
402(a)(5), 402(a)(6), 402(a)(7), 403(a)(4), 402(b)(8), or 408(d)(3) of the
Code), no Contributions will be accepted unless they are in cash, and the total
of such Contributions shall not exceed $2,000 for any taxable year. In addition,
amounts directly transferred to this Contract, from an individual retirement
account, or annuity contract meeting the requirements of Section 408 of the Code
are also not subject to the $2,000 limit on contributions.
SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following Divisions described in this
Contract:
(a) the Guaranteed Interest Division, and
(b) the Investment Division of the Separate Account.
SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
an annuity not involving life contingencies issued by us, which extends beyond
your attainment of age 59 and 6 months and does not permit any prepayment of the
unpaid principal (that is no withdrawal or single sum payment) prior to your
attainment of age 59 and 6 months.
SECTION 1.14 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrues on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on page 3 of
this Contract. Section 2.03 describes the determination of the rate to apply
thereafter.
SECTION 1.15 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected by you. The payments commence on the date as of which the Joint and
Survivor Life Annuity Form is purchased and terminate with the last payment due
before the death of the survivor.
SECTION 1.16 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us providing monthly payments during the lifetime of the person upon
whose life such payments depend. The payments commence on the date as of which
the Life Annuity Form is purchased and terminate with the last payment due
before the death of such person.
SECTION 1.17 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means, (i) if you have a living spouse at your Retirement Date,
the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form
with your spoons as the contingent annuitant (with 100% of the monthly payment
amount continued to your spouse), and (ii) if you do not have a living spouse at
the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form.
SECTION 1.18 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us which does not permit any
prepayment of the unpaid principal (that is, you cannot elect to receive part of
your payments as a single sum payment with the remainder paid in monthly annuity
payments).
SECTION 1.19 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116, or
such other location as we shall designate by advance written notice to you.
SECTION 1.20 RETIREMENT DATE. The term "Retirement Date" means the date on which
you attain your retirement age as shown on page 3 of this Contract. Before the
Retirement Date you may elect to change the Retirement Date to another
Retirement Date, which may be any date after the filing of the election (other
than the 29th, 30th, or 31st day of any month). No Retirement Date shall be
earlier than the date you attain age 59 and 6 months nor shall be later than the
first day of April following the calendar year in which you attain age 70 and 6
months. Any election for such change must be made in writing by you and shall
not take effect until received by us at our Processing Office.
SECTION 1.21 SEPARATE ACCOUNT. The term "Separate Account" means our Separate
Account A, which is organized as a unit investment trust (a type of investment
company). We established the Separate Account and it is maintained in accordance
with the laws of New York State. Realized and unrealized gains and losses from
the assets of the Separate Account are credited to or charged against it without
regard to our other income, gains or losses. Assets are put in the Separate
Account to support this Contract and other variable annuity contracts. Assets
may be put in the Separate Account for other purposes, but not to support
contracts or policies other than variable annuities and variable life insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these Contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust where each class (or series) represents a separate portfolio in
the Trust. We reserve the right to change the designated Trust or to add
designated trusts or investment companies. The Investment Divisions available
are the Stock Division, the Money Market Division, the Balanced Division and the
Aggressive Stock Division. The Guaranteed Interest Division is not part
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of the Separate Account, but rather is an asset of our General Account.
We will value the assets of each Investment Division on each business day. A
business day is any day on which Equitable is open, the New York Stock Exchange
is open for trading and there is a sufficient degree of trading in the portfolio
securities in which an Investment Division is invested to materially affect the
Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments it is
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under the
Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such a committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any other
form;
(v) add Investment Divisions (or subdivisions of Investment Divisions) to, or
remove Investment Divisions (or subdivisions of Investment Divisions) from
the Separate Account (the term "Investment Division" in this Contract
shall then refer to any other Investment Division in which the assets of a
Class of Contracts to which this Contract belongs, were placed);
(vi) combine any two or more Investment Divisions (or subdivisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
Class of Contracts to which this Contract belongs.
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, you will be notified of such exercise, as
required by law.
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for any applicable
tax charges) at a rate not to exceed 1.49% per year for each of the Stock, Money
Market and Balanced Divisions, and 1.34% per year, for the Aggressive Stock
Division, for financing accounting, death benefits, mortality risk, expenses and
expense risks. The charge shall be made in accordance with Subsection (c) of the
Net Investment Factor provision in Section 1.22. The relative proportion of
these charges may be modified. The daily charge, plus the investment advisory
fee charges and direct operating expense charges of the Trust shall not exceed a
total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract. The maximum rate may not be altered
without your approval.
SECTION 1.22 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any preceding consecutive
non-business days.
NET INVESTMENT FACTOR: For the Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment
Division for the Valuation Period. For this purpose, we use the share
value reported to us by the Trust.
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period (after
taking into account any amounts allocated or withdrawn for that Valuation
Period).
(c) is the daily asset charge for the expenses of this Contract, times the
number of calendar days in the Valuation Period.
ACCUMULATION UNIT: an "Accumulation Unit" is a unit which is purchased in an
Investment Division where your Contributions are invested and which is used in
determining the amount you have in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for such Valuation Period.
ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first Contribution was put into the Stock
Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed
Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The
Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value
for the immediately preceding Valuation Period multiplied by the Adjusted Net
Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for
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a Valuation Period is the Net Investment Factor for such period reduced for each
calendar day in such subsequent Valuation Period by the Net Investment Factor
times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5% and
(ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%. The
Assumed Base Rate of Net Investment Return shall be 5%, except in states where
the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar
month is equal to the average of the Annuity Unit Values for all Valuation
Periods ending in such month.
SECTION 1.23 TRANSACTION DATE. The term "Transaction Date" means the business
day we receive a Contribution or a written contract transaction request
providing the information we need at the Processing Office. In the case of a
transfer request initiated through the use of a touch tone telephone as
described in Section 2.05, the term "Transaction Date" means the business day
the telephone transaction is received.
SECTION 1.24 Trust. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
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PART II--ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. Contributions under this Contract are not fixed and
may be made at any time and in any amount subject to the limits described in
Section 1.11 of this Contract. (If you make a Contribution which qualifies as a
qualified plan rollover within the meaning of Section 402(a)(5) or 403(b)(8) of
the Code, and such amount will be commingled with other Contributions under this
Contract, such rollover contributions may not be rolled over to a qualified plan
at a future date, unless otherwise provided by the Code).
Each Contribution received by us will, before its allocation under this
Contract, be reduced by the amount of any applicable tax charge, as determined
by us.
Contributions will be allocated to the Division in accordance with the
instructions received on your application, unless later changed.
Except in the case of a rollover Contribution (as permitted by 402(a)(5),
402(a)(6), 402(a)(7), 403(a)(4), 403(b)(8), or 408(d)(3) of the Code), no
Contributions will be accepted unless they are in cash, and the total of such
Contributions shall not exceed $2,000 for any taxable year. Amounts transferred
to this Contract from an individual retirement account or annuity contract
meeting the requirements of Section 408 of the Code are not subject to the
$2,000 limit on contributions.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to or withdrawn or transferred from an Investment
Division, you will be credited or charged, as the case may be, with the number
of Accumulation Units determined by dividing said amount by the Accumulation
Unit Value for the appropriate Investment Division for the Valuation Period
which includes that date. The number of units you have in an Investment Division
on any date is equal to (i) the sum of any Accumulation Units that have been
allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units
have been withdrawn pursuant to Sections 2.07 or 2.08 or transferred from the
Investment Division pursuant to Section 2.05. The amount in an Investment
Division on any date is equal to the product of (i) the number of Accumulation
Units in the Investment Division on the date and (ii) the Accumulation Unit
Value for the Investment Division for the Valuation Period which includes that
date.
Participation in the Separate Account under this Contract terminates on the
earliest of (i) your election and commencement of Annuity Benefits pursuant to
Section 3.03, (ii) receipt of due proof of your death, or (iii) Termination of
this Contract, pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets, which support
the guarantees of this Contract and other contracts.
The amount in the Guaranteed Interest Division at any time is equal to the sum
of all amounts that have been allocated to the Guaranteed Interest Division
pursuant to Section 2.04 plus the amount of any interest accrued but not
allocated, less the sum of all amounts that have been withdrawn from the
Guaranteed Interest Division pursuant to Section 2.07, 2.08, or 2.10 or
transferred from the Guaranteed Interest Division, pursuant to Section 2.05.
Interest is allocated to the Guaranteed Interest Division on a Transaction Date,
pursuant to Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts, we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division under this Contract terminates
on the earliest of (i) your election and commencement of annuity benefits
pursuant to Section 3.03, (ii) receipt of due proof of your death, and (iii)
Termination of this Contract, pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction of any applicable tax charge) to one or more
Divisions, at your sole direction as specified to us. Allocation percentages
must be in whole numbers and the sum must equal 100. The allocation is made as
of the Transaction
No. 92 IRAA Page 7
Date on which we have received both such Contribution and such direction.
Contributions made to an Investment Division purchase Accumulation Units in that
Investment Division, using the Accumulation Unit Value next computed after the
Transaction Date.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon Termination of this Contract pursuant to Section 2.06, and (vi)
upon your death pursuant to Section 2.11.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request, or
through the use of a touch tone telephone, transfer all or part of the amount
you have in a Division to one or more of the Divisions as follows: (1) amounts
in the Guaranteed Interest Division, Stock Division, Balanced Division and
Aggressive Stock Division may be transferred among such Divisions; (2) amounts
in the Money Market Division may be transferred to other Divisions. Written
authorization for touch tone telephone initiated transfers is only required when
authorization for telephone transfer is requested. Upon advance written notice
to you, we reserve the right to discontinue the acceptance of transfer requests
through the use of a touch tone telephone. All transfers will be effective on
the Transaction Date and will be subject to our rules in effect at the time of
transfer. With respect to the Investment Division; the transfer will be made at
the Accumulation Unit Value next computed after the Transaction Date. No
transfers are permitted to the Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. You may elect by written notice to
terminate this Contract. We will determine the Cash Value as of the Transaction
Date we receive your written election.
If this Contract is terminated, surrendered or exchanged prior to your
Retirement Date, any applicable tax charges we have paid may be deducted. If we
have previously deducted charges for applicable taxes from Contributions
pursuant to Section 2.01, we will not again deduct charges for the same taxes on
terminations, unless a change in applicable law has occurred with respect to
your Contract.
The payment of such Cash Value may be deferred by us in accordance with the
provisions of Section 4.07.
We reserve the right to pay the Annuity Account Value under the Contract and
terminate this Contract. This right may be exercised if (i) no Contributions are
made on your behalf during the last three completed Contract Years and the
Annuity Account Value is less than $500, or (ii) a partial withdrawal that would
result in your Annuity Account Value falling below $500. We also reserve the
right to terminate this Contract if no Contributions have been made within 120
months of the Contract Date shown on page 3 of this Contract.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount you have in the Divisions and the Annuity Account Value shall be
zero. We will be released from any and all liability for payments with respect
to the Contributions from which the Annuity Account Value arose.
SECTION 2.07 PARTIAL WITHDRAWALS. You may elect, by written notice to us, to
make a partial withdrawal from the Divisions.
On the Transaction Date, we will pay the lesser of the Cash Value or the amount
of partial withdrawal requested to the person entitled to such payment as
designated in writing by you. The amount paid plus any withdrawal charge
applicable pursuant to Section 2.08 will be withdrawn from the amounts you have
in the Divisions. Unless we are instructed otherwise, the amount withdrawn
(including any withdrawal charge) will be allocated among the Divisions in
proportion to the amounts that you have in such Divisions.
Upon any partial withdrawal payment, we will be released from and any all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300.
If a withdrawal made under this Section would result in an Annuity Account Value
of less than $500, we will so advise you and reserve the right to pay the
Annuity Account Value to you, and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS.
NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the
amount of partial withdrawal requested is not greater than the Free Corridor
Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity
Account Value, pursuant to Section 1.05.
WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than
the Free Corridor Amount, we will (i) first withdraw from the Divisions an
amount equal to the Free Corridor Amount, in proportion to the amount you have
in them, and (ii) then withdraw an amount equal to the excess of the amount
requested over the Free Corridor Amount, plus a partial withdrawal charge. Such
partial withdrawal charge will be equal to the lesser of (a) or (b) where:
(a) is an amount equal to
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the amount withdrawn in excess of the Free Corridor
No. 92 IRAA Page 8
Amount (including such charge) pursuant to (ii) of the preceding sentence.
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior partial withdrawal
charges made pursuant to this Section.
However, notwithstanding the above, if your are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
If withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to your contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means, if you
have completed three Contract Years or attained age 59 and 6 months, an amount
equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value
on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to
Section 2.07 in the current Contract year. If you have not completed three
Contract years or attained age 59 and 6 months, the Free Corridor Amount is
zero.
SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $10,000, we will
withdrawn from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value, including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts that you have in
the Divisions.
If the Annuity Account Value is less than $10,000, on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03,
or (b) the date of Termination of this Contract pursuant to Section 2.06 or
2.11, we will prorate the Annual Administrative Charge applicable to the
completed portion of the Current Contract Year and withdraw such amount in lieu
of the Annual Administrative Charge applicable to the completed portion of the
Current Contract Year and withdraw such amount in lieu of the full Annual
Administrative Charge described in this Section for the applicable part of that
Contract Year.
If the Annuity Account Value is $10,000 or greater at the end of a Contract
Year, the Annual Administrative Charge is zero.
SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of your death , we will
pay to the beneficiary designated by you to receive such payment, pursuant to
Section 4.04 of this contract, the amount of death benefit payable. The amount
of the death benefit is equal to the greater of (i) the Annuity Account Value
and (ii) the minimum death benefit. Such minimum death benefit is the sum of all
Contributions made pursuant to Section 2.01 (before reduction for any applicable
tax charge) less any withdrawals made pursuant to Section 2.07. Any such
withdrawal will reduce the minimum death benefit (as adjusted by any previous
such withdrawal) by an amount which is in the same proportion as the amount that
was withdrawn is to the Annuity Account Value. If, in accordance with the
provisions of Section 3.02, the Cash Value of another annuity contract issued by
us, or one of our affiliated or subsidiary life insurance companies, which
provides for a death benefit before retirement equal to the greater of the
contract Cash Value or an alternate amount based on premiums paid or
Contributions made under the annuity contract is transferred to this Contract,
such Cash Value or alternative amount as of the date of transfer will be
included in the "sum of all Contributions" in lieu of the amount of Cash Value
transferred for purposes of the death benefit under this Contract.
We will pay the death benefit to your beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.04. Also, in accordance with the last paragraph of Section 4.04, if no such
election is in effect at your death, we will pay the death benefit to your
beneficiary in a single sum, unless the beneficiary elects, before we pay the
death benefit, to apply the death benefit to an Annuity Benefit.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value will be zero. We will be released from any and all
liability for payments with respect to the Contributions from which the Annuity
Account Value arose.
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PART III--ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The Amount of each monthly payment under any Fixed Annuity Benefit provided
under this Contract with respect to a payee is the amount provided pursuant to
Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed based rate of net
investment return referred to in Section 1.22 is 5% or 3.5%, respectively. The
daily rate of investment return is
No. 92 IRAA Page 9
before deduction of charges, as described in Section 1.21, not to exceed the
maximum rate of 1.75% after any deductions to provide for any applicable tax
charge. These charges include a daily charge for financial accounting, death
benefits, mortality risk, expenses and expense risk, plus the investment
advisory fee charges and direct operating expense charges of the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under this Contract with respect to a payee is the monthly
amount provided with respect to a payee pursuant to the fourth paragraph of
Section 3.04. The amount of the fifth and each subsequent payment under a
Variable Annuity Benefit will be equal to the number of Annuity Units with
respect to such benefit, multiplied by the Average Annuity Unit Value for the
second calendar month immediately preceding the due date of the payment. The
number of Annuity Units with respect to a benefit is the number determined by
dividing the amount of the first monthly payment under such benefit by the
Annuity Unit Value for the Valuation Period which includes the due date of the
first monthly payment. (As described in Section 3.05, we will notify the payee
how each Variable Annuity payment is determined).
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your
Retirement Date, provided you are then living, the Annuity Account Value shall
be applied to provide the Normal Form of Annuity Benefit, unless you elect (i)
to receive the Cash Value of this Contract in a single sum or (ii) to apply the
Annuity Account Value or Cash Value, whichever is applicable pursuant to the
first paragraph of Section 3.04, to provide an Annuity Benefit on any other form
offered by us, or one of our affiliated or subsidiary life insurance companies,
as elected by you, or (iii) to take partial withdrawals in amounts and at times
as required by the Code, pursuant to Sections 2.07 and 3.05, subject to our
rules then in effect and any other applicable requirements under the Code.
We will provide notice and election forms to you not more than six months before
your Retirement Date.
If you elect to terminate this Contract, prior to the Retirement Date, pursuant
to Section 2.06, an election may be made to receive an Annuity Benefit in lieu
of the Cash Value.
We will have the right to require you to furnish pertinent information to
provide an Annuity Benefit and will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form, issued by us or one of our affiliated or subsidiary
life insurance companies.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or
third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be (i) the
Annuity Account Value if the annuity form elected involves life contingencies or
(ii) the Cash Value, if the Annuity Form elected does not involve life
contingencies.
The amount applied to provide an Annuity Benefit may be reduced by any
applicable tax charge on annuity considerations, as we determine, If we have
previously deducted any applicable tax charge from Contributions as provided in
Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to your Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below, or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your contract will be governed by our
supplementary contract then in effect.
If an amount is applied to provide an Annuity Benefit, the amount to be applied
will, in addition to any tax charge reduction, be reduced by an administrative
charge. The amount of such charge will be determined from time to time in
accordance with our general practices applicable on a uniform basis to all
contracts of the same type as this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts
you have in the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under this Contract, as
indicated, on the Joint and Survivor Life Annuity Form (with 100% of the amount
of your payment continued to your spouse). The amounts of income provided under
the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and
Survivor Life Annuity Form are based on 3.5% interest and the 1983 Individual
Annuity Table "a". The amount of income initially provided under the Variable
Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life
Annuity Form are based on the 1983 Individual Annuity Table "a" and an Assumed
Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies
pursuant to Section 1.22.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us based on 3.5% interest and the 1983 Individual Annuity Table
"a" if such annuity form provides for a Fixed Annuity Benefit, and on the same
such Table and an Assumed Base Rate of Net Investment Income Return of 3.5% or
5%, which applies pursuant to Section 1.22 if such annuity form provides for a
Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract
will be distributed or begin to be distributed, in accordance with Section
401(a)(9) of the Code and the applicable Treasury Regulations thereunder no
later than the first day of April following the calendar year in which you
attain age 70 and 6 months ("Required Beginning Date"). Your entire interest may
be distributed, as you elect, over (a) your life, or the lives of you and your
designated beneficiary, or (b) a period certain not extending beyond your life
expectancy, or the joint and last survivor expectancy of you and your designed
benefi-
No. 92 IRAA Page 10
ciary. Distributions must be made in periodic payments at intervals of no longer
than one year. In addition, payments must be either non-increasing or they may
increase only as provided in Q&A F-3 of Section 1.401(a)(9)-1 of the proposed
Treasury Regulations, or any successor Regulation thereto.
All distributions made hereunder shall be made in accordance with the
requirements of Section 401(a)(9) of the Code, including the incidental death
benefit requirements of Section 401(a)(9)(G) of the Code, and applicable
Treasury Regulations, including the minimum distribution incidental benefit
requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or
any successor Regulation thereto.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.05, while any distribution shall be subject to such requirements of
the Code and regulations, any distribution shall also be subject to the terms of
this Contract. That is, the forms of distribution shall be those which are made
available by us at the time of your election.
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9.
Unless you otherwise elect prior to the time distributions are required to
begin, those life expectancies shall be recalculated annually. Such election
shall be irrevocable and shall apply to all subsequent years. The life
expectancy of a non-spouse beneficiary may not be recalculated. Instead, life
expectancy will be calculated using the attained age of such beneficiary during
the calendar year in which you attain age 70 and 6 months, and payments for
subsequent years shall be calculated based on such life expectancy reduced by
one for each calendar year which has elapsed since the calendar year life
expectancy was first calculated.
If you die after distribution of your interest in this Contract has begun, the
remaining portion of such interest will continue to be distributed at least as
rapidly as under the method of distribution being used prior to your death.
If you die before distribution of your interest begins, distribution of your
entire interest shall be completed no later than December 31 of the calendar
year containing the fifth anniversary of your death, except to the extent that
an election is made to receive death benefit distributions in accordance with
(1) or (2) below:
(1) If your interest is payable to a designated beneficiary, then your entire
interest may be distributed over the life of, or over a period certain not
greater than the life expectancy of, the designated beneficiary. Such
distributions must commence on or before December 31 of the calendar year
immediately following the calendar year of your death.
(2) If the designated beneficiary is your surviving spouse, the date that
distributions are required to begin in accordance with (1) above shall not
be earlier than the later of (A) December 31 of the calendar year
immediately following the calendar year of your death or (B) December 31 of
the calendar year in which you would have attained age 70 and 6 months.
For purposes of determining the "period certain" referred to in the immediately
preceding paragraph, life expectancy is computed by use of the expected return
multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes
of distributions beginning after your death, unless otherwise elected by the
surviving spouse by the time distributions are required to begin, life
expectancies shall be recalculated annually. Such election shall be irrevocable
by the surviving spouse and shall apply to all subsequent years. In the case of
any other designated beneficiary, life expectancies shall be calculated using
the attained age of such beneficiary during the calendar year in which
distributions are required to begin, pursuant to this Section, and payments for
any subsequent calendar year shall be calculated based on life expectancy
reduced by one for each calendar year which has elapsed since the calendar year
life expectancy was first calculated.
Distributions under this Section are considered to have begun if distributions
are made because you have reached your Required Beginning Date or if prior to
the Required Beginning Date, distributions irrevocably commence to you over a
period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1
of the Proposed Treasury Regulations or any successor Regulation thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under this Contract was based on information that is
subsequently found to be incorrect, your benefit will not be invalidated, but an
adjustment on the basis of the correct information will be made in the amount of
the benefit payments, or any amount used to provide the benefit, or any
combination thereof. Overpayments by us will be charged against and
underpayments will be added to any payments thereafter falling due under this
Contract with respect to the payee, affecting as many such payments as are
necessary to correct the overpayment or underpayment. Our liability with respect
to a payee is limited to the correct information and the actual amounts used to
provide the benefits then in force with respect to the payee under this
Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under this Contract is physically or mentally incompetent to receive
such payment or is a minor, (ii) another person or an institution is then
maintaining or has custody of such payee, and (iii) no guardian, committee, or
other representative of the estate of such payee has been appointed, we may make
the payments (in the case of a minor, at a rate not exceeding $200 a month) to
such other person or institution, and will thereupon be fully discharged from
all liability with respect thereto.
If a variable annuity form made available by us provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one of two persons, the payee thereunder
may elect, without the concurrence of any other person, to receive the
No. 92 IRAA Page 11
commuted value of any remaining payments, provided no person upon whose life the
income depends is surviving.
Pursuant to Section 3.03, upon your election of an annuity form providing
payments for a period certain, you may designate (with the right to change such
designation) a payee or payees to receive any payments that may become due after
the death of the person or persons upon whose life or lives the income may
depend.
The payee may designate (with the right to change such designation and without
the concurrence of any other person) a person or persons to receive any payments
or installments payable after such payee's death, if the absence of such a
designation would result in a single sum payment to such payee's estate in
accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments. The commuted value of any such remaining payments will be
determined on the basis of compound interest at the rate utilized in the
actuarial rate basis applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
We will, with respect to each payment under a Variable Annuity Benefit, notify
the payee of the number of Annuity Units and the Average Annuity Unit Value used
in determining the amount of each variable payment. Such notice will be mailed
with each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary,
as described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
TABLES OF
GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT
AND SURVIVOR LIFE ANNUITY FORM
100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE
(Minimum Monthly Income per $1,000 of Annuity Account Value)
----------------------------------------------------------------------------------------------------------------------------------
Age 60 61 62 63 64 65 66 67 68 69 70
----------------------------------------------------------------------------------------------------------------------------------
60 4.51 4.56 4.61 4.66 4.71 4.76 4.81 4.85 4.90 4.94 4.99
61 4.59 4.65 4.70 4.75 4.81 4.86 4.91 4.96 5.01 5.06
62 4.69 4.74 4.80 4.85 4.91 4.97 5.02 5.07 5.13
63 4.78 4.84 4.90 4.96 5.02 5.08 5.14 5.20
64 4.88 4.95 5.01 5.08 5.14 5.20 5.27
65 4.99 5.06 5.13 5.20 5.27 5.34
66 5.11 5.18 5.26 5.33 5.41
67 5.24 5.31 5.39 5.47
68 5.37 5.45 5.54
69 5.51 5.60
70 5.67
----------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1000 of Annuity Value)
-------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON
THE LIFE ANNUITY FORM IF ASSUMED BASE
RATE OF NET INVESTMENT RETURN IS:
3.5% 5.0%
AGE MALES FEMALES MALES FEMALES
-------------------------------------------------------------------------------------------------
60 5.57 5.00 6.46 5.89
61 5.71 5.11 6.60 6.00
62 5.86 5.23 6.75 6.11
63 6.03 5.36 6.92 6.24
64 6.20 5.49 7.09 6.37
65 6.39 5.64 7.28 6.51
66 6.58 5.79 7.47 6.66
67 6.80 5.96 7.69 6.83
68 7.02 6.13 7.92 7.00
69 7.27 6.32 8.16 7.19
70 7.53 6.53 8.42 7.40
-------------------------------------------------------------------------------------------------
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PART IV - GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire agreement between
the parties and the provisions of this Contract alone govern with respect to our
rights and obligations. A copy of the application is incorporated in and made
part of this Contract.
This Contract may not be modified nor may any of our rights or requirements be
waived, except in writing and by an authorized officer of Equitable. This
Contract may be changed by amendment or replacement upon agreement between you
and us without the consent of any other person.
No. 92 IRAA Page 12
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend this Contract
without the consent of any other person in order to comply with applicable laws
and regulations. Such rights shall include, but not be limited to, the right to
conform this Contract to reflect changes in the Code, applicable Treasury
Regulations, or published rulings of the Internal Revenue Service so that this
Contract will continue to be an Annuity.
SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY, AND ASSIGNMENTS. Your entire
interest under the Contract is nonforfeitable. This Contract is nontransferable
except by surrender to us. Your interest under this Contract may not be sold,
assigned, discounted, or pledged as collateral for a loan or as security for the
performance of an obligation or for any other purpose to any person other than
Equitable.
No amount payable under this Contract may be assigned, commuted, or encumbered
by the payee, unless otherwise permitted as described herein, and, to the extent
permitted by law, no such amount will in any way be subject to any claim against
such payee.
SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an
initial designation of the beneficiary entitled to receive any death benefit
payable pursuant to Section 2.11. You may change such designation from time to
time during your lifetime and while this Contract is in force. Any such
designation or change will be made by written notice in a form satisfactory to
us. A change will, upon receipt at the Processing Office, take effect as of the
time the written notice was signed, whether or not you are living on the
Transaction Date, but without further liability as to any payment or other
settlement made by us before receipt of such change.
Unless otherwise specified in the designation, if you have designated two or
more persons as beneficiary, the beneficiary will be the designated person or
persons who survive you, and if more than one survive, they will share equally.
Any part of a death benefit payable pursuant to Section 2.11 for which there is
no designated beneficiary living at your death will be payable in a single sum
to your children who survive you, in equal shares, or should none survive, then
to your estate.
In you elect in writing, any amount that would otherwise be payable to a
beneficiary in a single sum may be applied to provide an Annuity Benefit, on the
form of annuity elected by you, with respect to the beneficiary, subject to our
rules then in effect. If at your death there is no election in effect to apply
the single sum death benefit to provide an Annuity Benefit, the beneficiary may
make such an election. Any such election must meet the minimum distribution
requirements under the Code, as described in Section 3.05.
SECTION 4.05 DISQUALIFICATION. In the event that this Contract fails to qualify
as an Annuity, we will have the right, upon receiving notice of such fact, prior
to the Retirement Date, to terminate this Contract and pay to you the Annuity
Account Value less a deduction for the appropriate part attributable to you of
any Federal income tax payable which would not have been payable if you had an
Annuity.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you, we reserve the
right, at our sole discretion, to limit Contributions under this Contract, as
required by law or if such Contributions are in excess of the maximum amounts as
permitted under the Code.
SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of your Annuity Account Value
(less any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities and
Exchange Commission, by order, permits us to defer payment in order to protect
persons with interests in the Investment Divisions. We can defer payment of any
portion of your Annuity Account Value in the Guaranteed Interest Division for up
to six months while you are living.
SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you
with a notice showing the following:
(1) the amount you have in the Guaranteed Interest Division,
(2) the total number of Accumulation Units you have in the Stock Division,
Balanced Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Values,
(4) the amount you have in the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division,
(5) the Annuity Account Value,
(6) the Cash Value, and
(7) the amount of death benefit payable with respect to you.
We will also furnish annual calendar year reports concerning the status of the
Annuity and any other reports required by the Code or applicable Treasury
Regulations.
After the Retirement Date, we will notify you of the number of Annuity Units and
the Average Annuity Unit Value used in determining the amount of each Variable
Annuity Benefit payment, if any.
SECTION 4.09 AGE AND SEX. If your age or sex has been misstated, any benefits
will be those which would have been purchased at the correct age or sex. Any
overpayments or underpayments made by us will be charged or credited with
interest at the rate of 6% per year, and such interest will be deducted from or
added to benefits falling due thereafter.
No. 92 IRAA Page 13
Owner: [EQUITABLE LOGO]
Annuitant:
Contract Number:
Issue Date:
Contract Date:
Retirement Date:
--------------------------------------------------------------------------------
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P O Box 2996, New York,
New York 10116-2996
AGREES
o TO ALLOCATE the Contributions made to this Contract, after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division (referred to in this Contract as the
"Investment Divisions") or to the Guaranteed Interest Division, in accordance
with Sections 2.02, 2.03 and 2.04 as directed by you, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide the
Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is
then living, and
o TO PROVIDE the Annuitant with the other rights and benefits of this Contract.
This is the entire Contract. In this Contract "we", "our", and "us" mean The
Equitable Life Assurance Society of the United States ("Equitable"). "You" and
"your" mean the Annuitant at the time a right is exercised by the Annuitant.
TEN DAYS TO EXAMINE CONTRACT - You may cancel this Contract by returning it to
us within ten days after receipt of it. Upon such cancellation, we will refund
any Contribution made to us under this Contract, plus or minus any investment
gain or loss experienced in the Investment Divisions of the Separate Account
from the date such Contribution is allocated to such Investment Division to the
date we receive the returned Contract.
/s/Xxxxx X. Xxxxxx /s/Xxxxxx X. Xxxxxx
Xxxxx X. Xxxxxx Xxxxxx X. Xxxxxx
Vice President and Secretary Chairman of the Board and Chief Executive Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.22 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE
MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL
ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE
INVESTMENT ADVISORY FEE CHARGE AND DIRECT OPERATING EXPENSE CHARGES OF THE
TRUST.
No. 92 IRAB
The Contract is issued in consideration of the payment to us of the
Contributions made under the terms of the Contract.
The provisions on the following pages are part of this Contract. A copy of the
application is incorporated in and made part of this Contract.
--------------------------------------------------------------------------------
TABLE OF CONTENTS
DEFINITIONS Page
Section 1.01 - Annuitant...................................................4
1.02 - Annuity.....................................................4
1.03 - Annuity Account Value.......................................4
1.04 - Annuity Benefit.............................................4
1.05 - Cash Value..................................................4
1.06 - Class of Contracts..........................................4
1.07 - Code........................................................4
1.08 - Contract....................................................4
1.09 - Contract Date...............................................4
1.10 - Contract Year...............................................4
1.11 - Contribution................................................4
1.12 - Divisions...................................................5
1.13 - Eligible Annuity Certain....................................5
1.14 - Guaranteed Interest Rate....................................5
1.15 - Joint and Survivor Life
Annuity Form................................................5
1.16 - Life Annuity Form...........................................5
1.17 - Normal Form.................................................5
1.18 - Period Certain Annuity......................................5
1.19 - Processing Office...........................................5
1.20 - Retirement Date.............................................5
1.21 - Separate Account............................................5
1.22 - Separate Account
Definitions.................................................6
1.23 - Transaction Date............................................7
1.24 - Trust.......................................................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions...............................................7
2.02 - Separate Account
Investment Divisions........................................7
2.03 - Guaranteed Interest Division................................7
2.04 - Allocation to Divisions.....................................7
2.05 - Transfers Among Divisions...................................8
2.06 - Termination of this Contract................................8
2.07 - Partial Withdrawals.........................................8
2.08 - Charges for Partial Withdrawals.............................8
2.09 - Free Corridor Amount........................................9
2.10 - Annual Administrative Charge................................9
2.11 - Death Benefit...............................................9
ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit.......................................9
3.02 - Variable Annuity Benefit....................................9
3.03 - Election and Commencement
of Annuity Benefits........................................10
3.04 - Amount of Annuity Benefits.................................10
3.05 - Payment of Annuity Benefits................................10
GENERAL PROVISIONS
Section 4.01 - Contract...................................................12
4.02 - Statutory Compliance.......................................13
4.03 - Nonforfeitability,
Nontransferability, and Assignments........................13
4.04 - Beneficiary................................................13
4.05 - Disqualification...........................................13
4.06 - Future Contributions.......................................13
4.07 - Deferment..................................................13
4.08 - Annual Notice..............................................13
4.09 - Age and Sex................................................13
No. 92 IRAB Page 2
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PART I - DEFINITIONS
SECTION 1.01 ANNUITANT. The term "Annuitant" means the person who owns this
Contract as shown on page 3 and who exercises all rights under the terms of this
Contract.
SECTION 1.02 ANNUITY. The term "Annuity" means an individual retirement annuity
contract meeting the requirements of Section 408(b) of the Code.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts that you have in the Guaranteed Interest Division and the
Investment Divisions of the Separate Account, pursuant to Sections 2.02 and
2.03.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by Equitable pursuant to Section 3.04 of this Contract. Various sections of this
Contract (Sections 1.15, 1.16, 3.01, and 3.02) refer to monthly payments to be
made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at
other intervals, such as quarterly, semiannually, or annually, instead of
monthly. You may elect this at the time you elect the Annuity Benefit form
described in Section 3.03; in that event, all references in this Contract to
monthly payments will be deemed to mean payments at the frequency you elect,
subject to our rules at the time of election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value
less any applicable withdrawal charge determined as follows:
The withdrawal charge equals the lesser of (a) or (b) where
(a) equals
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the excess of (i) the Annuity Account Value over (ii) the Free Corridor
Amount defined in Section 2.09; and
(b) is the excess, if any, of (i) 8% of the total Contributions made during the
Current Contract Year and the nine preceding Contract Years over (ii) the
cumulative total of any prior charges for partial withdrawals made pursuant
to Section 2.08.
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
A withdrawal charge will not apply, which means the Cash Value will equal the
Annuity Account Value upon any of the following occurrences:
(i) your attainment of age 59 and 6 months and your completion of at least
five Contract Years, or
(ii) a request is made for a refund of a contribution in excess of amounts
allowed to be contributed under Section 408 of the Code within one month
of the date on which the contribution is made, or
(iii) you die and a distribution is made to the beneficiary, or
(iv) your attainment of age 55, your completion of at least five Contract Years
and you use the amount withdrawn to purchase from us an Eligible Annuity
Certain, or
(v) your completion of at least three Contract Years and you use the amount
withdrawn to purchase from us a Period Certain Annuity of at least 10
years, or
(vi) your Annuity Account Value is applied to the election of a Life Annuity
Form or Joint and Survivor Life Annuity Form distribution option, or
(vii) your completion of at least twelve Contract Years.
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same calendar year.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as
amended, or any corresponding provisions of prior or subsequent United States
revenue laws.
SECTION 1.08 CONTRACT. The term "Contract" means this Contract, which is
Intended to qualify as an individual retirement annuity contract under Section
408(b) of the Code. This Contract is established for the exclusive benefit of
you or your beneficiaries.
SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both an application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made in cash
or by check to us with respect to this Contract. We are under no obligation to
accept any Contribution less than $20.00.
No. 92 IRAB Page 4
Except in the case of a rollover contribution (as permitted by Sections
402(a)(5), 402(a)(6), 402(a)(7), 403(a)(4), 402(b)(8), or 408(d)(3) of the
Code), no Contributions will be accepted unless they are in cash, and the total
of such Contributions shall not exceed $2,000 for any taxable year. In addition,
amounts directly transferred to this Contract, from an individual retirement
account, or annuity contract meeting the requirements of Section 408 of the Code
are also not subject to the $2,000 limit on contributions.
SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following Divisions described in this
Contract:
(a) the Guaranteed Interest Division, and
(b) the Investment Divisions of the Separate Account.
SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
an annuity not involving life contingencies issued by us, which extends beyond
your attainment of age 59 and 6 months and does not permit any prepayment of the
unpaid principal (that is no withdrawal or single sum payment) prior to your
attainment of age 59 and 6 months.
SECTION 1.14 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrues on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on page 3 of
this Contract. Section 2.03 describes the determination of the rate to apply
thereafter.
SECTION 1.15 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected by you. The payments commence on the date as of which the Joint and
Survivor Life Annuity Form is purchased and terminate with the last payment due
before the death of the survivor.
SECTION 1.16 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us providing monthly payments during the lifetime of the person upon
whose life such payments depend. The payments commence on the date as of which
the Life Annuity Form is purchased and terminate with the last payment due
before the death of such person.
SECTION 1.17 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means, (i) if you have a living spouse at your Retirement Date,
the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form
with your spouse as the contingent annuitant (with 100% of the monthly payment
amount continued to your spouse), and (ii) if you do not have a living spouse at
the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form.
SECTION 1.18 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us which does not permit any
prepayment of the unpaid principal (that is, you cannot elect to receive part of
your payments as a single sum payment with the remainder paid in monthly annuity
payments).
SECTION 1.19 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such
other location as we shall designate by advance written notice to you.
SECTION 1.20 RETIREMENT DATE. The term "Retirement Date" means the date on which
you attain your retirement age as shown on page 3 of this Contract. Before the
Retirement Date you may elect to change the Retirement Date to another
Retirement Date, which may be any date after the filing of the election (other
than the 29th, 30th, or 31st day of any month). No Retirement Date shall be
earlier than the date you attain age 59 and 6 months nor shall be later than the
first day of April following the calendar year in which you attain age 70 and
6 months. Any election for such change must be made in writing by you and shall
not take effect until received by us at our Processing Office.
SECTION 1.21 SEPARATE ACCOUNT. The term "Separate Account" means our Separate
Account A, which is organized as a unit investment trust (a type of investment
company). We established the Separate Account and it is maintained in accordance
with the laws of New York State. Realized and unrealized gains and losses from
the assets of the Separate Account are credited to or charged against it without
regard to our other income, gains or losses. Assets are put in the Separate
Account to support this Contract and other variable annuity contracts. Assets
may be put in the Separate Account for other purposes, but not to support
contracts or policies other than variable annuities and variable life insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these Contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust where each class (or series) represents a separate portfolio in
the Trust. We reserve the right to change the designated Trust or to add
designated trusts or investment companies. The Investment Divisions available
are the Stock Division, the Money Market Division, the Balanced Division and the
Aggressive Stock Division. The Guaranteed Interest Division is not part of the
Separate Account, but rather is an asset of our General Account.
No. 92 IRAB Page 5
We will value the assets of each Investment Division on each business day. A
business day is any day on which Equitable is open, the New York Stock Exchange
is open for trading and there is a sufficient degree of trading in the portfolio
securities in which an Investment Division is invested to materially affect the
Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments it is
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under the
Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such a committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any other
form;
(v) add Investment Divisions (or subdivisions of Investment Divisions) to, or
remove Investment Divisions (or subdivisions of Investment Divisions) from
the Separate Account (the term "Investment Division" in this Contract
shall then refer to any other Investment Division in which the assets of a
Class of Contracts to which this Contract belongs, were placed);
(vi) combine any two or more Investment Divisions (or subdivisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
Class of Contracts to which this Contract belongs.
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, you will be notified of such exercise, as
required by law.
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for any applicable
tax charges) at a rate not to exceed 1.49% per year for each of the Stock, Money
Market and Balanced Divisions, and 1.34% per year, for the Aggressive Stock
Division, for financial accounting, death benefits, mortality risk, expenses and
expense risks. The charge shall be made in accordance with Subsection (c) of the
Net Investment Factor provision in Section 1.22. The relative proportion of
these charges may be modified. The daily charge, plus the investment advisory
fee charges and direct operating expense charges of the Trust shall not exceed a
total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract. The maximum rate may not be altered
without your approval.
SECTION 1.22 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any preceding consecutive
non-business days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment Division
for the Valuation Period. For this purpose, we use the share value reported
to us by the Trust.
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period (after
taking into account any amounts allocated or withdrawn for that Valuation
Period).
(c) is the daily asset charge for the expenses of this Contract, times the
number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an
Investment Division where your Contributions are invested and which is used in
determining the amount you have in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for such Valuation Period.
ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first Contribution was put into the Stock
Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed
Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The
Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value
for the immediately preceding Valuation Period multiplied by the Adjusted Net
Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for a Valuation Period is the Net Investment Factor for such
period reduced for each calendar day in such subsequent Valuation Period by the
Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net
Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net
Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall
be 5%, except in states where the rate is not permitted by law.
No. 92 IRAB Page 6
AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar
month is equal to the average of the Annuity Unit Values for all Valuation
Periods ending in such month.
SECTION 1.23 TRANSACTION DATE. The term "Transaction Date" means the business
day we receive a Contribution or a written contract transaction request
providing the information we need at the Processing Office. In the case of a
transfer request initiated through the use of a touch tone telephone as
described in Section 2.05, the term "Transaction Date" means the business day
the telephone transaction is received.
SECTION 1.24 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
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PART II - ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. Contributions under this Contract are not fixed and
may be made at any time and in any amount subject to the limits described in
Section 1.11 of this Contract. (If you make a Contribution which qualifies as a
qualified plan rollover within the meaning of Section 402(a)(5) or 403(b)(8) of
the Code, and such amount will be commingled with other Contributions under this
Contract, such rollover contributions may not be rolled over to a qualified plan
at a future date, unless otherwise provided by the Code).
Each Contribution received by us will, before its allocation under this
Contract, be reduced by the amount of any applicable tax charge, as determined
by us.
Contributions will be allocated to the Division in accordance with the
instructions received on your application, unless later changed.
Except in the case of a rollover Contribution (as permitted by 402(a)(5),
402(a)(6), 402(a)(7), 403(a)(4), 403(b)(8), or 408(d)(3) of the Code), no
Contributions will be accepted unless they are in cash, and the total of such
Contributions shall not exceed $2,000 for any taxable year. Amounts transferred
to this Contract from an individual retirement account or annuity contract
meeting the requirements of Section 408 of the Code are not subject to the
$2,000 limit on contributions.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to or withdrawn or transferred from an Investment
Division, you will be credited or charged, as the case may be, with the number
of Accumulation Units determined by dividing said amount by the Accumulation
Unit Value for the appropriate Investment Division for the Valuation Period
which includes that date. The number of units you have in an Investment Division
on any date is equal to (i) the sum of any Accumulation Units that have been
allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units
that have been withdrawn pursuant to Sections 2.07 or 2.08 or transferred from
the Investment Division pursuant to Section 2.05. The amount in an Investment
Division on any date is equal to the product of (i) the number of Accumulation
Units in the Investment Division on that date and (ii) the Accumulation Unit
Value for the Investment Division for the Valuation Period which includes that
date.
Participation in the Separate Account under this Contract terminates on the
earliest of (i) your election and commencement of Annuity Benefits pursuant to
Section 3.03, (ii) receipt of due proof of your death, or (iii) Termination of
this Contract, pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets, which support
the guarantees of this Contract and other contracts.
The amount in the Guaranteed Interest Division at any time is equal to the sum
of all amounts that have been allocated to the Guaranteed Interest Division
pursuant to Section 2.04 plus the amount of any interest accrued but not
allocated, less the sum of all amounts that have been withdrawn from the
Guaranteed Interest Division pursuant to Section 2.07, 2.08, or 2.10 or
transferred from the Guaranteed Interest Division, pursuant to Section 2.05.
Interest is allocated to the Guaranteed Interest Division on a Transaction Date,
pursuant to Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts, we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division under this Contract terminates
on the earliest of (i) your election and commencement of annuity benefits
pursuant to Section 3.03, (ii) receipt of due proof of your death, and (iii)
Termination of this Contract, pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction of any applicable tax charge) to one or more
Divisions, at your sole direction as specified to us. Allocation percentages
must be in whole numbers and the sum must equal 100. The allocation is made as
of the Transaction Date on which we have received both such Contribution and
such direction. Contributions made to an Investment Division purchase
Accumulation Units in that Investment Division, using the Accumulation Unit
Value next computed after the Transaction Date.
No. 92 IRAB Page 7
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon Termination of this Contract pursuant to Section 2.06, and (vi)
upon your death pursuant to Section 2.11.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request, or
through the use of a touch tone telephone, transfer all or part of the amount
you have in a Division to one or more of the Divisions as follows: (1) amounts
in the Guaranteed Interest Division, Stock Division, Balanced Division and
Aggressive Stock Division may be transferred among such Divisions; (2) amounts
in the Money Market Division may be transferred to other Divisions. Written
authorization for touch tone telephone initiated transfers is only required when
authorization for telephone transfers is requested. Upon advance written notice
to you, we reserve the right to discontinue the acceptance of transfer requests
through the use of a touch tone telephone. All transfers will be effective on
the Transaction Date and will be subject to our rules in effect at the time of
transfer. With respect to the Investment Division, the transfer will be made at
the Accumulation Unit Value next computed after the Transaction Date. No
transfers are permitted to the Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. You may elect by written notice to
terminate this Contract. We will determine the Cash Value as of the Transaction
Date we receive your written election.
If this Contract is terminated, surrendered or exchanged prior to your
Retirement Date, any applicable tax charges we have paid may be deducted. If we
have previously deducted charges for applicable taxes from Contributions
pursuant to Section 2.01, we will not again deduct charges for the same taxes on
terminations, unless a change in applicable law has occurred with respect to
your Contract.
The payment of such Cash Value may be deferred by us in accordance with the
provisions of Section 4.07.
We reserve the right to pay the Annuity Account Value under the Contract and
terminate this Contract. This right may be exercised if (i) no Contributions are
made on your behalf during the last three completed Contract Years and the
Annuity Account Value is less than $500, or (ii) a partial withdrawal that would
result in your Annuity Account Value falling below $500. We also reserve the
right to terminate this Contract if no Contributions have been made within 120
days of the Contract Date shown on page 3 of this Contract.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount you have in the Divisions and the Annuity Account Value shall be
zero. We will be released from any and all liability for payments with respect
to the Contributions from which the Annuity Account Value arose.
SECTION 2.07 PARTIAL WITHDRAWALS. You may elect, by written notice to us, to
make a partial withdrawal from the Divisions.
On the Transaction Date, we will pay the lesser of the Cash Value or the amount
of partial withdrawal requested to the person entitled to such payment as
designated in writing by you. The amount paid plus any withdrawal charge
applicable pursuant to Section 2.08 will be withdrawn from the amounts you have
in the Divisions. Unless we are instructed otherwise, the amount withdrawn
(including any withdrawal charge) will be allocated among the Divisions in
proportion to the amounts that you have in such Divisions.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300.
If a withdrawal made under this Section would result in an Annuity Account Value
of less than $500, we will so advise you and reserve the right to pay the
Annuity Account Value to you, and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS.
NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the
amount of partial withdrawal requested is not greater than the Free Corridor
Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity
Account Value, pursuant to Section 1.05.
WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than
the Free Corridor Amount, we will (i) first withdraw from the Divisions an
amount equal to the Free Corridor Amount, in proportion to the amount you have
in them, and (ii) then withdraw an amount equal to the excess of the amount
requested over the Free Corridor Amount, plus a partial withdrawal charge. Such
partial withdrawal charge will be equal to the lesser of (a) or (b) where:
(a) is an amount equal to
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the amount withdrawn in excess of the Free Corridor Amount (including
such charge) pursuant to (ii) of the preceding sentence.
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior partial withdrawal charges
made pursuant to this Section.
No. 92 IRAB Page 8
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
If withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to your contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means, if you
have completed three Contract Years or attained age 59 and 6 months, an amount
equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value
on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to
Section 2.07 in the current Contract Year. If you have not completed three
Contract Years or attained age 59 and 6 months, the Free Corridor Amount is
zero.
SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $10,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value, including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts that you have in
the Divisions.
If the Annuity Account Value is less than $10,000, on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03,
or (b) the date of Termination of this Contract pursuant to Section 2.06 or
2.11, we will prorate the Annual Administrative Charge applicable to the
completed portion of the Current Contract Year and withdraw such amount in lieu
of the full Annual Administrative Charge described in this Section for the
applicable part of that Contract Year.
If the Annuity Account Value is $10,000 or greater at the end of a Contract
Year, the Annual Administrative Charge is zero.
SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of your death, we will pay
to the beneficiary designated by you to receive such payment, pursuant to
Section 4.04 of this Contract, the amount of death benefit payable. The amount
of the death benefit is equal to the greater of (i) the Annuity Account Value
and (ii) the minimum death benefit. Such minimum death benefit is the sum of all
Contributions made pursuant to Section 2.01 (before reduction for any applicable
tax charge) less any withdrawals made pursuant to Section 2.07. Any such
withdrawal will reduce the minimum death benefit (as adjusted by any previous
such withdrawal) by an amount which is in the same proportion as the amount that
was withdrawn is to the Annuity Account Value. If, in accordance with the
provisions of Section 2.01, the Cash Value of another annuity contract issued by
us, or one of our affiliated or subsidiary life insurance companies, which
provides for a death benefit before retirement equal to the greater of the
contract Cash Value or an alternate amount based on premiums paid or
Contributions made under the annuity contract is transferred to this Contract,
such Cash Value or alternative amount as of the date of transfer will be
included in the "sum of all Contributions" in lieu of the amount of Cash Value
transferred for purposes of the death benefit under this Contract.
We will pay the death benefit to your beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.04. Also, in accordance with the last paragraph of Section 4.04, if no such
election is in effect at your death, we will pay the death benefit to your
beneficiary in a single sum, unless the beneficiary elects, before we pay the
death benefit, to apply the death benefit to an Annuity Benefit.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value will be zero. We will be released from any and all
liability for payments with respect to the Contributions from which the Annuity
Account Value arose.
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PART III - ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under this Contract with respect to a payee is the amount provided pursuant to
Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of net
investment return referred to in Section 1.22 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.21, not to exceed the maximum rate of 1.75% after
No. 92 IRAB Page 9
any deductions to provide for any applicable tax charge. These charges include a
daily charge for financial accounting, death benefits, mortality risk, expenses
and expense risk, plus the investment advisory fee charges and direct operating
expense charges of the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under this Contract with respect to a payee is the monthly
amount provided with respect to a payee pursuant to the fifth paragraph of
Section 3.04. The amount of the fourth and each subsequent payment under a
Variable Annuity Benefit will be equal to the number of Annuity Units with
respect to such benefit, multiplied by the Average Annuity Unit Value for the
second calendar month immediately preceding the due date of the payment. The
number of Annuity Units with respect to a benefit is the number determined by
dividing the amount of the first monthly payment under such benefit by the
Annuity Unit Value for the Valuation Period which includes the due date of the
first monthly payment. (As described in Section 3.05, we will notify the payee
how each Variable Annuity payment is determined).
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your
Retirement Date, provided you are then living, the Annuity Account Value shall
be applied to provide the Normal Form of Annuity Benefit, unless you elect (i)
to receive the Cash Value of this Contract in a single sum or (ii) to apply the
Annuity Account Value or Cash Value, whichever is applicable pursuant to the
first paragraph of Section 3.04, to provide an Annuity Benefit on any other form
offered by us, or one of our affiliated or subsidiary life insurance companies,
as elected by you, or (iii) to take partial withdrawals in amounts and at times
as required by the Code, pursuant to Sections 2.07 and 3.05, subject to our
rules then in effect and any other applicable requirements under the Code.
We will provide notice and election forms to you not more than six months before
your Retirement Date.
If you elect to terminate this Contract, prior to the Retirement Date, pursuant
to Section 2.06, an election may be made to receive an Annuity Benefit in lieu
of the Cash Value.
We will have the right to require you to furnish pertinent information to
provide an Annuity Benefit and will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form, issued by us or one of our affiliated or subsidiary
life insurance companies.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or
third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be (i) the
Annuity Account Value if the annuity form elected involves life contingencies or
(ii) the Cash Value, if the Annuity Form elected does not involve life
contingencies.
The amount applied to provide an Annuity Benefit may be reduced by any
applicable tax charge on annuity considerations, as we determine. If we have
previously deducted any applicable tax charge from Contributions as provided in
Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to your Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below, or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your contract will be governed by our
supplementary contract then in effect.
If an amount is applied to provide an Annuity Benefit, the amount to be applied
will, in addition to any tax charge reduction, be reduced by an administrative
charge. The amount of such charge will be determined from time to time in
accordance with our general practices applicable or a uniform basis to all
contracts of the same type as this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts
you have in the Divisions and the Annuity Account Value shall be zero. The
Tables of Guaranteed Annuity Payments set forth the minimum amount of monthly
income that $1,000 of Annuity Value will provide under this Contract, as
indicated, on the Joint and Survivor Life Annuity Form (with 100% of the amount
of your payment continued to your spouse). The amounts of income provided under
the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and
Survivor Life Annuity Form are based on 3.5% interest and the 1983 Individual
Annuity Table "a". The amount of income initially provided under the Variable
Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life
Annuity Form are based on the 1983 Individual Annuity Table "a" and an Assumed
Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies
pursuant to Section 1.22.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us based on 3.5% interest and the 1983 Individual Annuity Table
"a" if such annuity form provides for a Fixed Annuity Benefit, and on the same
such Table and an Assumed Base Rate of Net Investment Income Return of 3.5% or
5%, whichever applies pursuant to Section 1.22 if such annuity form provides for
a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract
will be distributed or begin to be distributed, in accordance with Section
401(a)(9) of the Code and the applicable Treasury Regulations thereunder no
later than the first day of April following the calendar year in which you
attain age 70 and 6 months ("Required Beginning Date"). Your entire interest may
be distributed, as you elect, over (a) your life, or the lives of you and your
designated beneficiary, or (b) a period certain not extending beyond your life
expectancy, or the joint and last survivor expectancy of you and your designated
beneficiary. Distributions must be made in periodic payments at intervals of no
longer than one year. In
No. 92 IRAB Page 10
addition, payments must be either non-increasing or they may increase only as
provided in Q & A F-3 of Section 1.401(a)(9)-1 of the proposed Treasury
Regulations, or any successor Regulation thereto.
All distributions made hereunder shall be made in accordance with the
requirements of Section 401(a)(9) of the Code, including the incidental death
benefit requirements of Section 401(a)(9)(G) of the Code, and applicable
Treasury Regulations, including the minimum distribution incidental benefit
requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or
any successor Regulation thereto.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.05, while any distribution shall be subject to such requirements of
the Code and regulations, any distribution shall also be subject to the terms of
this Contract. That is, the forms of distribution shall be those which are made
available by us at the time of your election.
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9.
Unless you otherwise elect prior to the time distributions are required to
begin, those life expectancies shall be recalculated annually. Such election
shall be irrevocable and shall apply to all subsequent years. The life
expectancy of a non-spouse beneficiary may not be recalculated. Instead, life
expectancy will be calculated using the attained age of such beneficiary during
the calendar year in which you attain age 70 and 6 months, and payments for
subsequent years shall be calculated based on such life expectancy reduced by
one for each calendar year which has elapsed since the calendar year life
expectancy was first calculated.
If you die after distribution of your interest in this Contract has begun, the
remaining portion of such interest will continue to be distributed at least as
rapidly as under the method of distribution being used prior to your death.
If you die before distribution of your interest begins, distribution of your
entire interest shall be completed no later than December 31 of the calendar
year containing the fifth anniversary of your death, except to the extent that
an election is made to receive death benefit distributions in accordance with
(1) or (2) below:
(1) If your interest is payable to a designated beneficiary, then your entire
interest may be distributed over the life of, or over a period certain not
greater than the life expectancy of, the designated beneficiary. Such
distributions must commence on or before December 31 of the calendar year
immediately following the calendar year of your death.
(2) If the designated beneficiary is your surviving spouse, the date that
distributions are required to begin in accordance with (1) above shall not
be earlier than the later of (A) December 31 of the calendar year
immediately following the calendar year of your death or (B) December 31 of
the calendar year in which you would have attained age 70 and 6 months.
For purposes of determining the "period certain" referred to in the immediately
preceding paragraph, life expectancy is computed by use of the expected return
multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes
of distributions beginning after your death, unless otherwise elected by the
surviving spouse by the time distributions are required to begin, life
expectancies shall be recalculated annually. Such election shall be irrevocable
by the surviving spouse and shall apply to all subsequent years. In the case of
any other designated beneficiary, life expectancies shall be calculated using
the attained age of such beneficiary during the calendar year in which
distributions are required to begin, pursuant to this Section, and payments for
any subsequent calendar year shall be calculated based on life expectancy
reduced by one for each calendar year which has elapsed since the calendar year
life expectancy was first calculated.
Distributions under this Section are considered to have begun if distributions
are made because you have reached your Required Beginning Date or if prior to
the Required Beginning Date, distributions irrevocably commence to you over a
period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1
of the Proposed Treasury Regulations or any successor Regulation thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under this Contract was based on information that is
subsequently found to be incorrect, your benefit will not be invalidated, but an
adjustment on the basis of the correct information will be made in the amount of
the benefit payments, or any amount used to provide the benefit, or any
combination thereof. Overpayments by us will be charged against and
underpayments will be added to any payments thereafter falling due under this
Contract with respect to the payee, affecting as many such payments as are
necessary to correct the overpayment or underpayment. Our liability with respect
to a payee is limited to the correct information and the actual amounts used to
provide the benefits then in force with respect to the payee under this
Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under this Contract is physically or mentally incompetent to receive
such payment or is a minor, (ii) another person or an institution is then
maintaining or has custody of such payee, and (iii) no guardian, committee, or
other representative of the estate of such payee has been appointed, we may make
the payments (in the case of a minor, at a rate not exceeding $200 a month) to
such other person or institution, and will thereupon be fully discharged from
a11 liability with respect thereto.
If a variable annuity form made available by us provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one of two persons, the payee thereunder
may elect, without the concurrence of any other person, to receive the commuted
value of any remaining payments, provided no person upon whose life the income
depends is surviving.
No. 92 IRAB Page 11
Pursuant to Section 3.03, upon your election of an annuity form providing
payments for a period certain, you may designate (with the right to change such
designation) a payee or payees to receive any payments that may become due after
the death of the person or persons upon whose life or lives the income may
depend.
The payee may designate (with the right to change such designation and without
the concurrence of any other person) a person or persons to receive any payments
or installments payable after such payee's death, if the absence of such a
designation would result in a single sum payment to such payee's estate in
accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments. The commuted value of any such remaining payments will be
determined on the basis of compound interest at the rate utilized in the
actuarial rate basis applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
We will, with respect to each payment under a Variable Annuity Benefit, notify
the payee of the number of Annuity Units and the Average Annuity Unit Value used
in determining the amount of each variable payment. Such notice will be mailed
with each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary,
as described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT
AND SURVIVOR LIFE ANNUITY FORM
100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE
(Minimum Monthly Income per $1,000 of Annuity Account Value)
---------------------------------------------------------------------------------------------------------------------------------
Age 60 61 62 63 64 65 66 67 68 69 70
---------------------------------------------------------------------------------------------------------------------------------
60 4.51 4.56 4.61 4.66 4.71 4.76 4.81 4.85 4.90 4.94 4.99
61 4.59 4.65 4.70 4.75 4.81 4.86 4.91 4.96 5.01 5.06
62 4.69 4.74 4.80 4.85 4.91 4.97 5.02 5.07 5.13
63 4.78 4.84 4.90 4.96 5.02 5.08 5.14 5.20
64 4.88 4.95 5.01 5.08 5.14 5.20 5.27
65 4.99 5.06 5.13 5.20 5.27 5.34
66 5.11 5.18 5.26 5.33 5.41
67 5.24 5.31 5.39 5.47
68 5.37 5.45 5.54
69 5.51 5.60
70 5.67
---------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE
ANNUITY FORM
(Minimum Monthly Income per $1,000 of Annuity Value)
--------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON
THE LIFE ANNUITY FORM IF ASSUMED BASE
RATE OF NET INVESTMENT RETURN IS:
3.5% 5.0%
Age Males Females Males Females
--------------------------------------------------------------------------------
60 5.57 5.00 6.46 5.89
61 5.71 5.11 6.60 6.00
62 5.86 5.23 6.75 6.11
63 6.03 5.36 6.92 6.24
64 6.20 5.49 7.09 6.37
65 6.39 5.64 7.28 6.51
66 6.58 5.79 7.47 6.66
67 6.80 5.96 7.69 6.83
68 7.02 6.13 7.92 7.00
69 7.27 6.32 8.16 7.19
70 7.53 6.53 8.42 7.40
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
PART IV - GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire agreement between
the parties and the provisions of this Contract alone govern with respect to our
rights and obligations. A copy of the application is incorporated in and made
part of this Contract.
This Contract may not be modified nor may any of our rights or requirements be
waived, except in writing and by an authorized officer of Equitable. This
Contract may be changed by amendment or replacement upon agreement between you
and us without the consent of any other person.
No. 92 IRAB Page 12
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend this Contract
without the consent of any other person in order to comply with applicable laws
and regulations. Such rights shall include, but not be limited to, the right to
conform this Contract to reflect changes in the Code, applicable Treasury
Regulations, or published rulings of the Internal Revenue Service so that this
Contract will continue to be an Annuity.
SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY, AND ASSIGNMENTS. Your entire
interest under the Contract is nonforfeitable. This Contract is nontransferable
except by surrender to us. Your interest under this Contract may not be sold,
assigned, discounted, or pledged as collateral for a loan or as security for the
performance of an obligation or for any other purpose to any person other than
Equitable.
No amount payable under this Contract may be assigned, commuted, or encumbered
by the payee, unless otherwise permitted as described herein, and, to the extent
permitted by law, no such amount will in any way be subject to any claim against
such payee.
SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an
initial designation of the beneficiary entitled to receive any death benefit
payable pursuant to Section 2.11. You may change such designation from time to
time during your lifetime and while this Contract is in force. Any such
designation or change will be made by written notice in a form satisfactory to
us. A change will, upon receipt at the Processing Office, take effect as of the
time the written notice was signed, whether or not you are living on the
Transaction Date, but without further liability as to any payment or other
settlement made by us before receipt of such change.
Unless otherwise specified in the designation, if you have designated two or
more persons as beneficiary, the beneficiary will be the designated person or
persons who survive you, and if more than one survive, they will share equally.
Any part of a death benefit payable pursuant to Section 2.11 for which there is
no designated beneficiary living at your death will be payable in a single sum
to your children who survive you, in equal shares, or should none survive, then
to your estate.
If you elect in writing, any amount that would otherwise be payable to a
beneficiary in a single sum may be applied to provide an Annuity Benefit, on the
form of annuity elected by you, with respect to the beneficiary, subject to our
rules then in effect. If at your death there is no election in effect to apply
the single sum death benefit to provide an Annuity Benefit, the beneficiary may
make such an election. Any such election must meet the minimum distribution
requirements under the Code, as described in Section 3.05.
SECTION 4.05 DISQUALIFICATION. In the event that this Contract fails to qualify
as an Annuity, we will have the right, upon receiving notice of such fact, prior
to the Retirement Date, to terminate this Contract and pay to you the Annuity
Account Value less a deduction for the appropriate part attributable to you of
any Federal income tax payable which would not have been payable if you had an
Annuity.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you, we reserve the
right, at our sole discretion, to limit Contributions under this Contract, as
required by law or if such Contributions are in excess of the maximum amounts as
permitted under the Code.
SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of your Annuity Account Value
(less any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities and
Exchange Commission, by order, permits us to defer payment in order to protect
persons with interests in the Investment Divisions. We can defer payment of any
portion of your Annuity Account Value in the Guaranteed Interest Division for up
to six months while you are living.
SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you
with a notice showing the following:
(1) the amount you have in the Guaranteed Interest Division,
(2) the total number of Accumulation Units you have in the Stock Division,
Balanced Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Values,
(4) the amount you have in the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division,
(5) the Annuity Account Value,
(6) the Cash Value, and
(7) the amount of death benefit payable with respect to you.
We will also furnish annual calendar year reports concerning the status of the
Annuity and any other reports required by the Code or applicable Treasury
Regulations.
After the Retirement Date, we will notify you of the number of Annuity Units and
the Average Annuity Unit Value used in determining the amount of each Variable
Annuity Benefit payment, if any.
SECTION 4.09 AGE AND SEX. If your age or sex has been misstated, any benefits
will be those which would have been purchased at the correct age or sex. Any
overpayments or underpayments made by us will be charged or credited with
interest at the rate of 6% per year, and such interest will be deducted from or
added to benefits falling due thereafter.
No. 92 IRAB Page 13
Owner: [EQUITABLE LOGO]
Annuitant:
Contract Number:
Issue Date:
Contract Date:
Retirement Date:
--------------------------------------------------------------------------------
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P O Box 2996,
New York, New York 10116-2996
AGREES
o TO ALLOCATE the Contributions made to this Contract after deduction of
any applicable tax charge, to the Stock Division, Balanced Division,
Aggressive Stock Division, Money Market Division of the Separate Account
(referred to in this Contract as the Investment Divisions of the Separate
Account) or to the Guaranteed Interest Division, in accordance with
Sections 2.02, 2.03 and 2.04 or in part to any one, as directed by you.
o TO APPLY the Annuity Account Value at the Retirement Date to provide an
Annuity Benefit or a Cash Value benefit if the Annuitant is then living,
and
o TO PROVIDE you with the other rights and benefits of this Contract.
This is the entire Contract. In this Contract, "we", "our" and "us" mean The
Equitable Life Assurance Society of the United States. "You" and "your" mean the
Owner, at the time a right is exercised by the Owner.
TEN DAYS TO EXAMINE CONTRACT - You may cancel this Contract by returning it to
us within ten days after receipt of it. Upon such cancellation, we will refund
any Contribution made to us under this Contract.
/s/Xxxxx X. Xxxxxx /s/Xxxxxx X. Xxxxxx
Xxxxx X. Xxxxxx Xxxxxx X. Xxxxxx
Vice President and Secretary Chairman of the Board
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.23 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE
MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL
ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE
INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE
TRUST.
No. 92NQCA
This Contract is issued in consideration of the payment to us of the
Contributions made under the terms of this Contract.
The provisions on the following pages are part of this Contract.
--------------------------------------------------------------------------------
TABLE OF CONTENTS
PART I - DEFINITIONS Page
Section 1.01 - Annuitant....................................................4
1.02 - Annuity Account Value........................................4
1.03 - Annuity Benefit..............................................4
1.04 - Cash Value...................................................4
1.05 - Class of Contracts...........................................4
1.06 - Code.........................................................4
1.07 - Contract.....................................................4
1.08 - Contract Date................................................4
1.09 - Contract Year................................................4
1.10 - Contribution.................................................4
1.11 - Deposit Option Benefits......................................4
1.12 - Divisions....................................................4
1.13 - Free Corridor Amount.........................................4
1.14 - Guaranteed Interest Rate.....................................5
1.15 - Joint and Survivor Life Annuity Form.........................5
1.16 - Life Annuity Form............................................5
1.17 - Normal Form..................................................5
1.18 - Owner........................................................5
1.19 - Period Certain Annuity.......................................5
1.20 - Processing Office............................................5
1.21 - Retirement Date..............................................5
1.22 - Separate Account.............................................5
1.23 - Separate Account Definitions.................................6
1.24 - Transaction Date.............................................7
1.25 - Trust........................................................7
PART II - ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions................................................7
2.02 - Separate Account Investment Divisions........................7
2.03 - Guaranteed Interest Division.................................8
2.04 - Allocation to Divisions......................................8
2.05 - Transfers Among Divisions....................................8
2.06 - Termination of this Contract.................................8
2.07 - Partial Withdrawals..........................................9
2.08 - Charges for Partial Withdrawals..............................9
2.09 - Annual Administrative Charge................................10
2.10 - Death Benefit...............................................10
2.11 - Owner Death Benefit Distribution Rules.....................10
2.12 - Contribution Limit..........................................11
PART III - ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit.......................................11
3.02 - Variable Annuity Benefit....................................11
3.03 - Election and Commencement of Annuity Benefits...............11
3.04 - Amount of Annuity Benefits..................................12
3.05 - Payment of Annuity Benefits.................................12
PART IV - GENERAL PROVISIONS
Section 4.01 - Contract....................................................14
4.02 - Statutory Compliance........................................14
4.03 - Beneficiary.................................................14
4.04 - Future Contributions........................................14
4.05 - Deferment...................................................14
4.06 - Annual Notice...............................................14
4.07 - Assignments.................................................15
4.08 - Age and Sex.................................................15
No. 92NQCA Page 2
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PART I - DEFINITIONS
SECTION 1.01 ANNUITANT. The term "Annuitant" means the individual shown on page
3 of this Contract.
SECTION 1.02 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts in the Guaranteed Interest Division and the Investment
Divisions of the Separate Account pursuant to Sections 2.02 and 2.03.
SECTION 1.03 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by us pursuant to Section 3.04 of this Contract. Various Sections of this
Contract (Sections 1.15, 1.16, 3.01 and 3.02) refer to monthly payments to be
made under an Annuity Benefit. An election may be to have your Annuity Benefit
paid at other intervals, such as quarterly, semi-annually, or annually, instead
of monthly. This election may be made at the time the Annuity Benefit form as
described in Section 3.03 is elected: in that event, all references in this
Contract to monthly payments will be deemed to mean payments at the frequency
you elected, subject to our rule at the time of election.
SECTION 1.04 CASH VALUE. The term "Cash Value" means an amount equal to the
greater of (i) or (ii) below:
(i) the Annuity Account Value less 6% of the Contributions made during the
current and five prior Contract Years, which had not been previously
withdrawn pursuant to Sections 2.07 and 2.08.
(ii) the sum of (a) the Free Corridor Amount as defined in Section 1.13 and
(b) 94% of the Annuity Account Value less the Free Corridor Amount.
However, if the Annuitant was age 59 or older on the Contract Date and it is
Contract Year 5, item (ii) (b) above will be 95% of the Annuity Account Value
less the Free Corridor Amount. If it is Contract Year 6, item (ii) (b) above
will be 96% of the Annuity Account Value less the Free Corridor Amount.
SECTION 1.05 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
contracts with a Contract Date in the same calendar year.
SECTION 1.06 CODE. The term "Code" means the Internal Revenue Code of 1986, as
now or hereafter amended, or any corresponding provisions of prior or subsequent
United States revenue laws.
SECTION 1.07 CONTRACT. The term "Contract" means this Contract.
SECTION 1.08 CONTRACT DATE. The term "Contract Date" means the Date of receipt
by us of both the application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.09 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereof,
unless otherwise agreed to in writing by us.
SECTION 1.10 CONTRIBUTION. The term "Contribution" means a payment made to us
for the Annuitant with respect to an Annuity purchased under this Contract. We
are under no obligation to accept an Initial Contribution of less than $1,000.00
or, for Payroll Deductions and any Subsequent Contributions, a Contribution of
less than $50.00.
SECTION 1.11 DEPOSIT OPTION BENEFIT. The term "Deposit Option Benefit" means a
benefit derived from amounts on deposit for a period approved by us, subject to
our rules then in effect and any other applicable requirements under the Code.
Interest payments will be made at the end of each one, three, six or twelve
month interval, as elected by you, and provided that the amount of each payment
made at the end of the designated interval is at least $20. We reserve the right
to change the payment frequency for payments of less than $20.
SECTION 1.12 DIVISION. The term "Division" or "Divisions" mean, singly or
severally as the case may be, the following divisions described in this
Contract:
(i) the Guaranteed Interest Division, and
(ii) the Investment Divisions of the Separate Account.
SECTION 1.13 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means an
amount equal to the excess, if any, of (i) 10% of the Annuity Account Value on
the Transaction Date over (ii) cumulative prior withdrawals made pursuant to
Section 2.07 or 2.08 in the current Contract Year.
No. 92NQCA Page 4
SECTION 1.14 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrues on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of
this Contract. Section 2.03 describes the determination of the rate to apply
thereafter.
SECTION 1.15 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected. The payments commence on the date as of which the Joint and Survivor
Life Annuity Form is purchased and terminate with the last payment due before
the death of the survivor.
SECTION 1.16 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us providing monthly payments during the lifetime of the person upon
whose life such payments depend. The payments commence on the date as of which
the Life Annuity Form is purchased and terminate with the last payment due
before the death of such person.
SECTION 1.17 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means the Fixed Annuity Benefit payable on the Life Annuity Form,
as defined in Sections 3.01 and 1.16, with 10 years of payments guaranteed (10
years certain period). In addition, if the Annuitant dies before the certain
period has ended, payments will continue to the beneficiary designated to
receive such payments for the balance of the certain period.
SECTION 1.18 OWNER. The Owner of this Contract is the person shown as "Owner" on
page 3 unless otherwise stated in the application, or later changed.
Notwithstanding any provisions in this Contract to the contrary, only the Owner
can exercise the rights under this Contract.
While the Annuitant is living, the Owner of this Contract may change the Owner
by written notice satisfactory to us. The change will take effect on the date
the Owner signs the notice, except it will not apply to any payment we make or
other actions we take before we receive the notice.
SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us which does not permit any
prepayment of the unpaid principal (that is, you cannot elect to receive part of
your payments as a single sum payment with the remainder paid in monthly annuity
payments).
SECTION 1.20 PROCESSING OFFICE. The term "Processing Office" means Equitable
Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such
other location as we shall designate upon advance written notice to you.
SECTION 1.21 RETIREMENT DATE. The term "Retirement Date" means the date on which
the Annuitant attains the retirement age shown on Page 3 of this Contract.
Before the Retirement Date the Annuitant may elect to change the Retirement Date
to another Retirement Date, which may be any date after the filing of the
election (other than the 29th, 30th or 31st day of any month). Any election for
such change must be made in writing by you and shall not take effect until
received by us at our Processing Office.
SECTION 1.22 SEPARATE ACCOUNT. The term "Separate Account" means Separate
Account A which is organized as a unit investment trust, a type of investment
company. We established the Separate Account and it is maintained in accordance
with the laws of New York State. Realized and unrealized gains and losses from
the assets of the Separate Account are credited to or charged against it without
regard to our other income, gains or losses. Assets are put in the Separate
Account to support this Contract and other variable annuity contracts and
certificates. Assets may be put in the Separate Account for other purposes, but
not to support contracts or policies other than variable annuities and variable
life insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions" Each Investment Division
may invest its assets in a separate class (or series) of shares of a designated
Trust where each class (or series) represents a separate portfolio in the Trust
or investment company. We reserve the right to change the Trust or to add a
Trust. The Investment Divisions are the Stock Division, the Money Market
Division, the Balanced Division and the Aggressive Stock Division. The
Guaranteed Interest Division is not a part of the Separate Account A but rather
is an asset of our General Account.
No. 92NQCA Page 5
We will value the assets of each Investment Division on each business day. A
business day is any day on which we are open, the New York Stock Exchange is
open for trading and there is a sufficient degree of trading in the portfolio
securities in which an Investment Division is invested to materially affect the
Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments we are
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under
the Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any
other form;
(v) add Investment Divisions (or sub-divisions of Investment Divisions) to,
or remove Investment Divisions (or sub-divisions of Investment Divisions)
from the Separate Account (the term "Investment Division" in this
Contract shall then refer to any other Investment Division in which the
assets, of a Class of Contracts to which this Contract belongs, were
placed);
(vi) combine any two or more Investment Divisions (or sub-divisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
Class of Contracts to which this Contract belongs.
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, you will be notified of such exercise, as
required by law.
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for taxes) at a rate
not to exceed 1.49% per year for each of the Stock, Money Market and Balanced
Divisions, and 1.34% per year for the Aggressive Stock Division, for financial
accounting, death benefits, mortality risk, expenses and expense risk. The
charge shall be made in accordance with (c) of the Net Investment Factor
provision in Section 1.23. The relative proportion of these charges may be
modified. This daily charge, plus the investment advisory fee charges and direct
operating expense charges of the Trust, shall not in the aggregate exceed a
total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract.
SECTION 1.23 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Is each business day together with any consecutive preceding
non-business days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment
Division for the Valuation Period. For this purpose, we use the share
value reported to us by the Trust.
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period
(after any amounts allocated to or withdrawn for that Valuation Period).
(c) is the daily Separate Account charge for the expenses of
this Contract, times the number of calendar days in the
Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in the
Investment Division where Contributions are invested and are used in determining
the amount in an Investment Division.
No. 92NQCA Page 6
ACCUMULATION UNIT VALUE: The "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for that Investment Division for such Valuation Period.
ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first contribution was put into the Stock
Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed
Base rates of 5% and 3.5% a year, respectively. The Annuity Unit Value for any
subsequent Valuation Period is the Annuity Unit Value for the immediately
preceding Valuation Period multiplied by the Adjusted Net Investment Factor for
such subsequent Valuation Period. The Adjusted Net Investment Factor for a
Valuation Period is the Net Investment Factor for such period reduced for each
calendar day in such subsequent Valuation Period by the Net Investment Factor
times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%,
and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%.
The Assumed Base Rate of Net Investment Return shall be 5%, except in states
where the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: With respect to this Contract, the Average Annuity
Unit Value for a calendar month is equal to the average of the Annuity Unit
Values for all Valuation Periods ending in such month.
SECTION 1.24 TRANSACTION DATE. The Transaction Date is the business day we
receive a Contribution or a written contract transaction request providing the
information we need at the Processing Office. In the case of a transfer request
initiated through the use of a touch tone telephone as described in Section
2.05, the Transaction Date is the business day the telephone transaction is
received.
SECTION 1.25 TRUST. The term "Trust" means the designated trust or investment
company in which assets of the Separate Account are invested.
--------------------------------------------------------------------------------
PART II - ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. Contributions made by you can be classified, as
described under subsections A and B below, as specified on the application for
this Contract. If Contributions are made under more than one classification,
separate Contracts will be issued for each classification.
A. Post-August 13, 1982 Classification
All Contributions of new funds as well as any Contributions resulting from a
transfer to this Contract from a deferred annuity contract, other than those
described in subsection B below will be treated as within this classification.
B. Pre-August 14, 1982 Classification
Xxxxxxx transferred to this Contract through a tax free exchange of a deferred
annuity contract, where such transferred amount represents amounts invested in
or credited to investments in annuity contracts prior to August 14, 1982 will be
treated as within this classification.
Each Contribution received by us will, before its allocation under this
Contract, be reduced by the amount of any applicable tax charge, as determined
by us. Contributions will be allocated to the Division in accordance with
instructions received in your application, unless later changed.
If the Annuitant was age 57 or younger on the Contract Date, no additional
Contributions are permitted under the Contract after completion of the Contract
Year in which the Annuitant attains age 59. If the Annuitant was age 58 or older
on the Contract Date, no additional Contributions are permitted under the
Contract after the first anniversary of the Contract Date.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to or withdrawn or transferred from an Investment
Division, the Annuity Account Value will be credited or charged, as the case may
be, with the number of Accumulation Units determined by dividing said amount by
No. 92NQCA Page 7
the Accumulation Unit Value for the appropriate Investment Division for the
Valuation Period which includes that date. The number of units in an Investment
Division on any date is equal to (i) the sum of any Accumulation Units that have
been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation
Units that have been withdrawn pursuant to Sections 2.07 or 2.09 or transferred
from the Investment Division pursuant to Section 2.05. The amount in an
Investment Division on any date is equal to the product of (i) the number of
Accumulation Units in the Investment Division on that date and (ii) the
Accumulation Unit Value for the Investment Division for the Valuation Period
which includes that date.
Participation in the Separate Account under this Contract terminates on the
earliest of (i) the election and commencement of Annuity Benefits pursuant to
Section 3.03, (ii) receipt of due proof of the Annuitant's death, or (iii)
termination of this Contract pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets, which support
the guarantees of this Contract and other contracts.
The amount in the Guaranteed Interest Division at any time is equal to the sum
of all amounts that have been allocated to the Guaranteed Interest Division
pursuant to Section 2.04 plus the amount of any interest accrued but not
allocated, less the sum of all amounts that have been withdrawn from the
Guaranteed Interest Division pursuant to Section 2.07 or 2.09 or transferred
from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is
allocated to the Guaranteed Interest Division on a Transaction Date pursuant to
Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division terminates on the earliest of
(i) the Retirement Date, (ii) receipt of due proof of the Annuitant's death, or
(iii) termination of this Contract pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01, is allocated (after deduction of any applicable tax charge) to one or more
Divisions, at your sole direction. Allocation percentages must be in whole
numbers and the sum must equal 100%. The allocation is made as of the
Transaction Date on which we have received both such Contribution and such
direction. Contributions made to an investment Division purchase Accumulation
Units in that Investment Division, using the Accumulation Unit Value next
computed after the Transaction Date.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) at the time of application of amounts in the Guaranteed Interest
Division to provide forms of benefits offered by us pursuant to Section 3.03,
(vi) upon termination of participation pursuant to Section 2.06, (vii) upon the
Annuitant's death pursuant to Section 2.10, and (viii) at the end of the period
during which payments pursuant to the provisions of Section 2.06, 2.07 and 2.10,
or any commuted payments arising from a Fixed Annuity Benefit pursuant to
Section 3.05, were deferred pursuant to Section 4.05.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request, or
through the use of a touch tone telephone, transfer all or part of the amount
you have in a Division to one or more of the Divisions as follows: (1) amounts
in the Guaranteed Interest Division, Stock Division, Balanced Division and
Aggressive Stock Division may be transferred among such Divisions; (2) amounts
in the Money Market Division may be transferred to other Divisions. Written
authorization for touch tone telephone initiated transfers is only required when
authorization for telephone transfers is requested. Upon advance written notice
to you we reserve the right to discontinue acceptance of transfer requests
through the use of touch tone telephones. All transfers will be made on the
Transaction Date and will be subject to our rules in effect at the time of
transfer. With respect to the Investment Divisions, the transfers will be made
at the Accumulation Unit Value next computed after the Transaction Date. No
transfers are permitted to the Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. On or before the Retirement Date, and
while the Annuitant is alive, you may elect by written notice to terminate this
Contract. We will determine the Cash Value under this Contract as of the
Transaction Date. Such cash value will be subject to the termination charge
described below:
If you terminate this Contract, we will pay you the greater of (i) the
Annuity Account Value after the withdrawal charge has been imposed as
described in 2.08, or (ii) the Free Corridor amount, plus 94% of your
remaining Annuity Account Value.
No. 92NQCA Page 8
For purposes of calculating the Withdrawal Charge, (1) the oldest Contribution
will be treated as the first withdrawn and the most recent Contributions will be
treated next, and (2) amounts withdrawn up to the Free Corridor Amount will not
be considered a withdrawal of any of your Contributions.
No Withdrawal Charge will be applied if the amount withdrawn is applied to the
election of a life annuity distribution option, or if the Annuitant dies and the
death benefit is withdrawn by the beneficiary specified to us.
If this Contract is terminated prior to the Retirement Date, any applicable tax
charges we have paid may be deducted. If we have previously deducted charges for
applicable taxes from Contributions pursuant to Section 2.01, we will not again
deduct charges for the same taxes on termination, unless a change in applicable
law has occurred with respect to this Contract.
The payment of such Cash Value to you may be deferred by us in accordance with
the provisions of Section 4.05. If no tax has been previously deducted or if
such a tax is due at termination, we will deduct the amount due.
Prior to the Retirement Date, we reserve the right to pay the Annuity Account
Value under this Contract and terminate this Contract if (i) no Contributions
are made during the last three completed Contract Years, and the Annuity Account
Value is less than $500, or (ii) after three Contract Years and the Annuity
Account Value is less than $500. We also reserve the right to terminate this
Contract if no Contributions have been made within 120 days of the Contract Date
shown on Page 3 of this Contract.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount in the Divisions and the Annuity Account Value shall be zero. We will
be released from any and all liability for payments with respect to the
Contributions from which the Annuity Account Value arose.
SECTION 2.07 PARTIAL WITHDRAWALS. You may elect by written notice to us to make
a partial withdrawal from the Divisions before the Retirement Date while the
Annuitant is alive.
On the Transaction Date, we will pay the lesser of the Cash Value or the amount
of partial withdrawal requested by you. The amount paid plus any withdrawal
charge applicable pursuant to Section 2.08 will be withdrawn from the amounts
you have in the Divisions. Unless instructed otherwise, the amount withdrawn
(including any withdrawal charge) will be allocated among the Divisions in
proportion to the amounts that you have in such Divisions.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.05.
We may decline to accept a request for a partial withdrawal of less than $300.
If a withdrawal made under this Section would result in an Annuity Account Value
of less than $500, we will so advise you and reserve the right to pay the
Annuity Account Value to you, and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. There will be no withdrawal charge
(i) if the amount of the partial withdrawal requested is not greater than the
Free Corridor Amount defined in Section 1.13, (ii) the amount withdrawn is
applied to the election of a life annuity distribution option, or (iii) a death
benefit is withdrawn by the beneficiary.
However, if the amount of partial withdrawal requested is greater than the Free
Corridor Amount, we will (i) first withdraw from such Divisions an amount equal
to the Free Corridor Amount, and (ii) then withdraw an amount equal to the
excess of the amount requested over the Free Corridor Amount, plus a withdrawal
charge, if applicable. Such withdrawal charge will be calculated in the
following manner:
(a) Withdrawals of Contributions made by you during the current and five
prior Contract Years will be subject to a charge of 6% of the amount
withdrawn (including such charge).
(b) Withdrawals of other amounts will not be subject to any withdrawal
charges.
We will pay you the lesser of (a) the amount requested or (b) the Cash Value.
For purposes of determining withdrawal charges described in this Section,
amounts withdrawn up to the Free Corridor Amount will not be considered a
withdrawal of any Contributions. Any excess withdrawals, i.e. those pursuant to
item (ii) in the immediate preceding paragraph, shall be considered withdrawals
of older contributions first and more recent contributions next.
No. 92NQCA Page 9
If withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to this contract.
SECTION 2.09 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year before your Retirement Date, we will withdraw from the Divisions an Annual
Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account
Value including the amount of the sum of (i) the Annuity Account Value and (ii)
any withdrawals pursuant to Section 2.07 during that Contract Year. The charge
will be allocated among the Divisions in proportion to the amounts that you have
in the Divisions.
As of the Retirement Date and before application of the Annuity Account Value or
Cash Value pursuant to Section 3.03, or upon termination of this Contract
pursuant to Section 2.06 or Sections 2.10 and 2.11 during a Contract Year, if
the Annuity Account Value is less than $10,000, we will withdraw the Annual
Administrative Charge described in this Section for the applicable part of that
Contract Year.
However, if the Annuity Account Value is $10,000 or greater at the end of the
Contract Year, the Annual Administrative Charge is zero.
SECTION 2.10 DEATH BENEFIT. If we ascertain that the Annuitant has died, upon
receipt of due proof of such death, we will pay to the beneficiary you
designated pursuant to Section 4.03 to receive such payment, the amount of death
benefit payable under this Contract.
The amount of the death benefit under this Contract is equal to the greater of
(i) the Annuity Account Value and (ii) the minimum death benefit under this
Contract. Such minimum death benefit is the sum of all contributions made
pursuant to Section 2.01 (before reduction for any applicable tax charge), less
any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce
the minimum death benefit (as adjusted by any previous such withdrawal) by an
amount which is in the same proportion as the amount that was withdrawn is to
the Annuity Account Value.
We will pay the death benefit to the beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.03. Also in accordance with the last paragraph of Section 4.03, if no such
election is in effect at the Annuitant's death, we will pay the death benefit to
the beneficiary in a single sum, unless the beneficiary elects before we pay the
death benefit (i) to apply the death benefit to an Annuity Benefit on any
annuity form offered by us; (ii) to apply the death benefit to provide any other
form of benefit payment offered by us; or (iii) to apply the death benefit to
provide any combination of forms of benefit payment offered by us. All benefit
payment elections will be subject to our rules then in effect and any other
applicable requirements under the Code.
Upon payment of the death benefit, the amount in the Divisions and the Annuity
Account Value with respect to this Contract shall be zero. We will be released
from any and all liability for payments with respect to the Contributions from
which the Annuity Account Value arose.
SECTION 2.11 OWNER DEATH DISTRIBUTION RULES. Upon the death of the Owner before
an Xxxxxxxxx's Retirement Date:
(i) if you are both the Owner and the Annuitant, we will pay the death
benefit in accordance with Sections 2.10 and 4.03.
(ii) If you are not the Annuitant, the designated beneficiary will succeed as
Owner, notwithstanding the existence of any co-owner. The entire amount
in the Divisions subject to any applicable withdrawal charges as
described in the Contract must either: a) be completely distributed by
the fifth anniversary of your death, or b) within 1 year after your death
as a life annuity or installment option, for a period of not longer than
the life expectancy of the designated beneficiary.
However, if the designated beneficiary is your spouse, the entire amount the
Annuitant has in the Divisions must then be distributed no later than 5 years
after the spouse's death.
If payments under an Annuity Benefit had commenced prior to your death, such
payments will continue to be made over a period not longer than the period
provided for under the Annuity Benefit elected.
If the Annuitant dies before the entire amount the Annuitant has in the
Divisions is distributed, we will pay the death benefit in Section 2.10.
No. 92NQCA Page 10
The designated beneficiary is the same as the beneficiary who is entitled to the
death benefit upon your death.
Where more than one Owner is named, the date of death of the Owner will be
deemed to be the date of death of the first Owner to die.
SECTION 2.12 CONTRIBUTION LIMIT. We may refuse to accept a Contribution made
with respect to an Annuitant if the total prior Contributions made exceed (or if
acceptance of such Contribution would cause the total Contributions to exceed)
the following:
(i) $500,000, if the Annuitant's current age last birthday is 75 or less.
(ii) $250,000, if the Annuitant's current age last birthday is 76-79.
We may refuse to accept any Contribution made with respect to an Annuitant if
such Xxxxxxxxx's current age last birthday is 80 or greater.
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PART III - ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under this Contract with respect to a payee is the amount provided with respect
to the payee pursuant to Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division of the Separate Account.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of net
investment return referred to in Section 1.23 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.22, not to exceed the maximum rate of 1.75% after any deductions to
provide for any applicable tax charge. These charges include a daily charge for
financial accounting, death benefits, mortality risk, expenses and expense risk,
plus the investment advisory fee charges and direct operating expense charges of
the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under this Contract with respect to a payee is the monthly
amount provided with respect to a payee pursuant to the 5th paragraph of Section
3.04. The amount of the fourth and each subsequent payment under a Variable
Annuity Benefit will be equal to the number of Annuity Units with respect to
such benefit, multiplied by the Average Annuity Unit Value for the second
calendar month immediately preceding the due date of the payment. The number of
Annuity Units with respect to a benefit is the number determined by dividing the
amount of the first monthly payment by the Annuity Unit Value for the Valuation
Period which includes the due date of the first monthly payment. (As described
in Section 3.05, we will notify the payee how each variable Annuity Payment is
determined).
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of the
Annuitant's Retirement Date, provided the Annuitant is then living, the Annuity
Account Value shall be applied to provide the Normal Form of Annuity Benefit,
unless you elect, (i) to receive the Cash Value of the Contract in a single sum,
(ii) to apply the Annuity Account Value or Cash Value, whichever is applicable
pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit
on any other form offered by us or one of our affiliated or subsidiary life
insurance companies, as elected by you, or (iii) to apply the Cash Value to
provide any other form of benefit payment offered by us, subject to our rules
then in effect.
We will provide notice and election forms to you not more than six months before
the Retirement Date.
If you elect to terminate this Contract pursuant to Section 2.06 before the
Retirement Date, an election may be made to receive any form of benefit payment
offered by us, subject to our rules then in effect and any other applicable
requirements under the Code.
No. 92NQCA Page 11
We will have the right to require you to furnish pertinent information to
provide an Annuity Benefit, and will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary
life insurance companies.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect pursuant to the first or
third paragraph of Section 3.03 to have an Annuity Benefit paid in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be (i) the
Annuity Account Value if the annuity form elected involves life contingencies or
(ii) the Cash Value if the annuity form elected does not involve life
contingencies.
The amount applied to provide an Annuity Benefit may be reduced by a charge for
any applicable taxes on annuity considerations, as we determine. If we have
previously deducted charges for applicable taxes from contributions as provided
in Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to this Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your Contract will be governed by our
supplementary contract then in effect.
The amount to be applied to provide an Annuity Benefit will in addition to any
tax charge reduction, be reduced by an administrative charge. The amount of such
charge will be determined from time to time in accordance with our general
practices applicable on a uniform basis to all contracts of the same type as
this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts
you have in the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under the terms of this
Contract, as indicated on the Life Annuity Form with Ten Years Certain. The
amount of income provided under the Fixed Annuity Benefit payable on the Life
Annuity Form with Ten Years Certain is based on 3.5% interest and the 1983
Individual Annuity Table "a". The amounts of income initially provided under the
Variable Annuity Benefit payable on the Life Annuity Form with Ten Years Certain
is based on the 1983 Individual Annuity Table "a" and on an Assumed Base Rate of
Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.22.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us based on 3.5% interest and the 1983 Individual Annuity Table
"a" if such annuity form provides for a Fixed Annuity Benefit and on the same
such Table and an Assumed Base Rate of Net Investment Income Return of 3.5% or
5%, whichever applies, pursuant to Section 1.22, if such annuity form provides
for a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Evidence of each payee's survival must
be furnished to us either by personal endorsement of the check drawn for payment
or by other means satisfactory to us.
If a benefit payable under this Contract was based on information that is
subsequently found to be incorrect, such benefit will not be invalidated, but an
adjustment on the basis of the correct information will be made in the amount of
the benefit payments, or any amount used to provide the benefit, or any
combination thereof. Overpayments by us will be charged against and
underpayments will be added to any payments thereafter falling due under the
terms of this Contract with respect to the payee affecting as many such payments
as are necessary to correct the overpayment or underpayment. Our liability with
respect to a payee is limited to the correct information and the actual amounts
used to provide the benefits then in force with respect to the payee under the
terms of this Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under the terms of this Contract is physically or mentally
incompetent to receive such payment or is a minor, (ii) another person or an
institution is then maintaining or has custody of such payee, and (iii) no
guardian, committee, or other representative of the estate of such payee has
been appointed, we may make the payments (in the case of a minor, at a rate not
exceeding $200 a month) to such other person or institution, and will thereupon
be fully discharged from all liability with respect thereto.
Upon your election pursuant to Section 3.03 of an annuity form providing
payments for a period certain, you may designate (with the right to change such
designation) a payee to receive any payments that may become due after the death
of the person or persons upon, whose life or lives the income may depend.
No. 92NQCA Page 12
The payee may designate (with the right to change such designation and without
the concurrence of any other person) a person or persons to receive any payments
or installments payable after such payee's death, if the absence of such a
designation would result in a single sum payment to such payee's estate in
accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments.
The commuted value of any such remaining payments will be determined on the
basis of compound interest at the rate utilized in the actuarial rate basis
originally used to determine such payments.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
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TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE
LIFE ANNUITY FORM WITH TEN YEARS CERTAIN
(Minimum Monthly Income per $1,000 of Annuity Account Value)
------------------------------------------------------------------------------------------------------
Monthly Income Monthly Income
Age Males Females Age Males Females
------------------------------------------------------------------------------------------------------
60 5.42 4.93 73 7.40 6.76
61 5.54 5.04 74 7.57 6.95
62 5.67 5.14 75 7.75 7.15
63 5.80 5.25 76 7.92 7.34
64 5.94 5.37 77 8.09 7.54
65 6.08 5.50 78 8.26 7.74
66 6.23 5.63 79 8.42 7.94
67 6.38 5.77 80 8.57 8.14
68 6.54 5.92 81 8.71 8.32
69 6.71 6.07 82 8.85 8.50
70 6.88 6.23 83 8.98 8.67
71 7.05 6.40 84 9.09 8.83
72 7.22 6.58 85 9.20 8.97
------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE
ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1,000 of Annuity Account Value)
----------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE
LIFE ANNUITY FORM WITH TEN YEARS CERTAIN
IF ASSUMED BASE RATE OF RETURN IS:
3.5% 5.0%
---- ----
Age Males Females Males Females
----------------------------------------------------------------------------------------------------------
60 5.42 4.93 6.28 5.80
61 5.54 5.04 6.40 5.90
62 5.67 5.14 6.52 6.00
63 5.80 5.25 6.64 6.11
64 5.94 5.37 6.78 6.22
65 6.08 5.50 6.92 6.34
66 6.23 5.63 7.06 6.47
67 6.38 5.77 7.21 6.60
68 6.54 5.92 7.36 6.74
69 6.71 6.07 7.52 6.89
70 6.88 6.23 7.68 7.05
----------------------------------------------------------------------------------------------------------
We will with respect to each payment under a Variable Annuity Benefit, notify
the payee of the number of Annuity Units and the Average Annuity Unit Value used
in determining the amount of each variable payment. Such notice will be mailed
with each payment.
Any election, change, revocation or designation shall be made, and will take
effect, in the same manner as a change of beneficiary as described in Section
4.03.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.05.
No. 92NQCA Page 13
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PART V - GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the
parties and the provisions of this Contract alone will govern with respect to
our rights and obligations. A copy of the application is incorporated in and
made part of this Contract.
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by our authorized officer. The terms of this
Contract may be changed by amendment or replacement upon agreement between you
and us without the consent of any other person who has a contingent or
additional interest in this Contract.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend this Contract
without the consent of any other person in order to comply with applicable laws
and regulations. Such right shall include, but not be limited to, the right to
conform this Contract and any certificate to reflect changes in the Code,
applicable Treasury Regulations, or published rulings of the Internal Revenue
Service so this Contract will continue to be an "annuity" as described in
Section 72 of the Code.
SECTION 4.03 BENEFICIARY. As of the Contract Date, you are to provide us with an
initial designation of the beneficiary entitled to receive any death benefit
payable pursuant to Section 2.10 unless otherwise specified in the application
the person designated as beneficiary on the death of the Annuitant under Section
2.10 will also be the designated beneficiary who succeeds as "Owner" on your
death while the Annuitant is alive under Section 2.11. You may change such
designation from time to time during the Annuitant's lifetime and while the
Contract is in force. Any such designation or change will be made by written
notice in a form satisfactory to us. A change will, upon receipt at the
Processing Office, take effect as of the date the written notice was signed,
whether or not you are living on the date of receipt, but without further
liability as to any payment or other settlement made by us before receipt of
such change.
Unless otherwise specified in the application, if you have named two or more
persons as beneficiary, the beneficiary will be the named person or persons who
survive you, and if more than one survive they will share equally.
Any part of a death benefit payable pursuant to Section 2.10 for which there is
no named beneficiary living at your death will be payable in a single sum to
your children, who survive you, in equal shares, or should none survive, then to
your estate.
If you so elect in writing, any amount that would otherwise be payable to a
beneficiary in a single sum may be applied to provide an Annuity Benefit, on the
form of annuity elected by you, with respect to the beneficiary, subject to our
rules then in effect. If at your death there is no election in effect to apply
the single sum death benefit to provide an Annuity Benefit, the beneficiary may
make such an election.
SECTION 4.04 FUTURE CONTRIBUTIONS. We reserve the right at our sole discretion
to limit Contributions under this Contract.
SECTION 4.05 DEFERMENT. Application of proceeds to a variable annuity, payment
of a death benefit when Section 2.10 or any payment required under Section 2.11
and payment of any portion of your Annuity Account Value (less any applicable
withdrawal charge) will be made within seven days after the Transaction Date.
Payments or applications of proceeds from the Investment Divisions can be
deferred for any period during which (1) the New York Stock Exchange has been
closed or trading on it is restricted, (2) sales of securities or determination
of the fair value of an Investment Division's assets is not reasonably
practicable because of an emergency, or (3) the Security and Exchange
Commission, by order, permits us to defer payment in order to protect persons
with interests in the Investment Divisions. We can defer payment of any portion
of your Annuity Account Value in the Guaranteed Interest Division for up to six
months while you are living.
SECTION 4.06 ANNUAL NOTICE. At the end of each Contract Year up to and including
the Retirement Date, we will furnish you with a notice showing the following:
(1) the amount in the Guaranteed Interest Division,
(2) the total number of Accumulation Units in the Stock Division, Balanced
Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Value,
No. 92NQCA Page 14
(4) the amount in the Stock Division, Balanced Division, Aggressive Stock
Division and Money Market Division.
(5) the Cash Value, and
(6) the amount of the death benefit.
We will also furnish annual calendar year reports concerning the status of the
annuity and any other reports required by the Code or applicable Treasury
Regulations.
After the Retirement Date, we will notify you of the number of Annuity Units and
the Average Annuity Unit Value used in determining the amount of each Variable
Annuity Benefit payment, if any.
SECTION 4.07 ASSIGNMENTS. This Contract may not be assigned as collateral or
security for a loan. Otherwise, you may assign this Contract before the
Retirement Date but we will not be bound by an assignment unless it is in
writing and we have received it. Your rights and those of any other persons
referred to in this Contract will be subject to the assignment. We assume no
responsibility for the validity of any assignment.
No amounts payable under this Contract to a payee other than you may be
assigned, unless permitted herein, by that payee, nor will they be subject to
the claims of creditors or to legal process, except to the extent permitted by
law.
SECTION 4.08 AGE AND SEX. If the age or sex of any person upon whose life an
Annuity Benefit depends has been misstated, any benefits will be those which
would have been purchased at the correct age and sex. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
No. 92NQCA Page 15
Owner:
Annuitant:
Contract Number:
Issue Date:
Contract Date:
Retirement Date:
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THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P O Box 2996, New York,
New York 10116-2996
AGREES
o TO ALLOCATE the Contributions made to this Contract after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division, Money Market Division of the Separate Account (referred to
in this Contract as the Investment Divisions of the Separate Account) or to
the Guaranteed Interest Division, in accordance with Sections 2.02, 2.03
and 2.04 or in part to any one, as directed by you.
o TO APPLY the Annuity Account Value at the Retirement Date to provide an
Annuity Benefit or a Cash Value benefit if the Annuitant is then living,
and
o TO PROVIDE you with the other rights and benefits of this Contract.
This is the entire Contract. In this Contract, "we", "our" and "us" mean The
Equitable Life Assurance Society of the United States. "You" and "your" mean the
Owner, at the time a right is exercised by the Owner.
TEN DAYS TO EXAMINE CONTRACT - You may cancel this Contract by returning it to
us within ten days after receipt of it. Upon such cancellation, we will refund
any Contribution made to us under this Contract, plus or minus any investment
gain or loss experienced in the Investment Divisions of the Separate Account
from the date such Contribution is allocated to such Investment Division to the
date we receive the returned Contract.
/s/ Xxxxx X. Xxxxxx /s/ Xxxxxx X. Xxxxxx
Xxxxx X. Xxxxxx Xxxxxx X. Xxxxxx
Vice President and Secretary Chairman of the Board
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.23 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE
MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL
ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE
INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE
TRUST.
No. 92NQCB
This Contract is issued in consideration of the payment to us of the
Contributions made under the terms of this Contract.
The provisions on the following pages are part of this Contract.
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TABLE OF CONTENTS
PART I - DEFINITIONS Page
Section 1.01 - Annuitant.............................................. 4
1.02 - Annuity Account Value ................................. 4
1.03 - Xxxxxxx Xxxxxxx ....................................... 4
1.04 - Cash Value............................................. 4
1.05 - Class of Contracts..................................... 4
1.06 - Code................................................... 4
1.07 - Contract............................................... 4
1.08 - Contract Date.......................................... 4
1.09 - Contract Year.......................................... 4
1.10 - Contribution .......................................... 4
1.11 - Deposit Option Benefits ............................... 4
1.12 - Divisions.............................................. 4
1.13 - Free Corridor Amount .................................. 4
1.14 - Guaranteed Interest Rate............................... 5
1.15 - Joint and Survivor Life
Annuity Form .......................................... 5
1.16 - Life Annuity Form...................................... 5
1.17 - Normal Form............................................ 5
1.18 - Owner.................................................. 5
1.19 - Period Xxxxxxx Xxxxxxx ................................ 5
1.20 - Processing Office...................................... 5
1.21 - Retirement Date ....................................... 5
1.22 - Separate Account ...................................... 5
1.23 - Separate Account
Definitions............................................ 6
1.24 - Transaction Date ...................................... 7
1.25 - Trust ................................................. 7
PART II - ANNUITY ACCOUNT VALUE
Section 2.01- Contributions .......................................... 7
2.02 - Separate Account
Investment Divisions .................................. 7
2.03 - Guaranteed Interest Division .......................... 8
2.04 - Allocation to Divisions ............................... 8
2.05 - Transfers Among Divisions ............................. 8
2.06 - Termination of this Contract .......................... 8
2.07 - Partial Withdrawals ................................... 9
2.08 - Charges for Partial Withdrawals ....................... 9
2.09 - Annual Administrative Charge ..........................10
2.10 - Death Benefit..........................................10
2.11 - Owner Death Benefit
Distribution Rules.....................................10
2.12 - Contribution Limit.....................................11
PART III - ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit .................................11
3.02 - Variable Annuity Benefit...............................11
3.03 - Election and Commencement
of Annuity Benefits ...................................1l
3.04 - Amount of Annuity Benefits.............................12
3.05 - Payment of Annuity Benefits ...........................12
PART IV - GENERAL PROVISIONS
Section 4.01 - Contract...............................................14
4.02 - Statutory Compliance ..................................14
4.03 - Beneficiary ...........................................14
4.04 - Future Contributions ..................................14
4.05 - Deferment .............................................14
4.06 - Annual Notice..........................................14
4.07 - Assignments ...........................................15
4.08 - Age and Sex ...........................................15
No. 92NQCB Page 2
PART I - DEFINITIONS
SECTION 1.01 ANNUITANT. The term "Annuitant" means the individual shown on page
3 of this Contract.
SECTION 1.02 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts in the Guaranteed Interest Division and the Investment
Divisions of the Separate Account pursuant to Sections 2.02 and 2.03.
SECTION 1.03 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by us pursuant to Section 3.04 of this Contract. Various Sections of this
Contract (Sections 1.15, 1.16, 3.01 and 3.02) refer to monthly payments to be
made under an Annuity Benefit. An election may be to have your Annuity Benefit
paid at other intervals, such as quarterly, semi-annually, or annually, instead
of monthly. This election may be made at the time the Annuity Benefit form as
described in Section 3.03 is elected: in that event, all references in this
Contract to monthly payments will be deemed to mean payments at the frequency
you elected, subject to our rule at the time of election.
SECTION 1.04 CASH VALUE. The term "Cash Value" means an amount equal to the
greater of (i) or (ii) below:
(i) the Annuity Account Value less 6% of the Contributions made during the
current and five prior Contract Years, which had not been previously
withdrawn pursuant to Sections 2.07 and 2.08.
(ii) the sum of (a) the Free Corridor Amount as defined in Section 1.13 and (b)
94% of the Annuity Account Value less the Free Corridor Amount.
However, if the Annuitant was age 59 or older on the Contract Date and it is
Contract Year 5, item (ii) (b) above will be 95% of the Annuity Account Value
less the Free Corridor Amount. If it is Contract Year 6, item (ii) (b) above
will be 96% of the Annuity Account Value less the Free Corridor Amount.
SECTION 1.05 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
contracts with a Contract Date in the same calendar year.
SECTION 1.06 CODE. The term "Code" means the Internal Revenue Code of 1986, as
now or hereafter amended, or any corresponding provisions of prior or subsequent
United States revenue laws.
SECTION 1.07 CONTRACT. The term "Contract" means this Contract.
SECTION 1.08 CONTRACT DATE. The term "Contract Date" means the Date of receipt
by us of both the application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.09 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereof,
unless otherwise agreed to in writing by us.
SECTION 1.10 CONTRIBUTION. The term "Contribution" means a payment made to us
for the Annuitant with respect to an Annuity purchased under this Contract. We
are under no obligation to accept an Initial Contribution of less than $1,000.00
or, for Payroll Deductions and any Subsequent Contributions, a Contribution of
less than $50.00.
SECTION 1.11 DEPOSIT OPTION BENEFIT. The term "Deposit Option Benefit" means a
benefit derived from amounts on deposit for a period approved by us, subject to
our rules then in effect and any other applicable requirements under the Code.
Interest payments will be made at the end of each one, three, six or twelve
month interval, as elected by you, and provided that the amount of each payment
made at the end of the designated interval is at least $20. We reserve the right
to change the payment frequency for payments of less than $20.
SECTION 1.12 DIVISION. The term "Division" or "Divisions" mean, singly or
severally as the case may be, the following divisions described in this
Contract:
(i) the Guaranteed Interest Division, and
(ii) the Investment Divisions of the Separate Account.
SECTION 1.13 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means an
amount equal to the excess, if any, of (i) 10% of the Annuity Account Value on
the Transaction Date over (ii) cumulative prior withdrawals made pursuant to
Section 2.07 or 2.08 in the current Contract Year.
No. 92NQCB Page 4
SECTION 1.14 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrues on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of
this Contract. Section 2.03 describes the determination of the rate to apply
thereafter.
SECTION 1.15 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected. The payments commence on the date as of which the Joint and Survivor
Life Annuity Form is purchased and terminate with the last payment due before
the death of the survivor.
SECTION 1.16 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us providing monthly payments during the lifetime of the person upon
whose life such payments depend. The payments commence on the date as of which
the Life Annuity Form is purchased and terminate with the last payment due
before the death of such person.
SECTION 1.17 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means the Fixed Annuity Benefit payable on the Life Annuity Form,
as defined in Sections 3.01 and 1.16, with 10 years of payments guaranteed (10
years certain period). In addition, if the Annuitant dies before the certain
period has ended, payments will continue to the beneficiary designated to
receive such payments for the balance of the certain period.
SECTION 1.18 OWNER. The Owner of this Contract is the person shown as "Owner" on
page 3 unless otherwise stated in the application, or later changed.
Notwithstanding any provisions in this Contract to the contrary, only the Owner
can exercise the rights under this Contract.
While the Annuitant is living, the Owner of this Contract may change the Owner
by written notice satisfactory to us. The change will take effect on the date
the Owner signs the notice, except it will not apply to any payment we make or
other actions we take before we receive the notice.
SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us which does not permit any
prepayment of the unpaid principal (that is, you cannot elect to receive part of
your payments as a single sum payment with the remainder paid in monthly annuity
payments).
SECTION 1.20 PROCESSING OFFICE. The term "Processing Office" means Equitable
Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such
other location as we shall designate upon advance written notice to you.
SECTION 1.21 RETIREMENT DATE. The term "Retirement Date" means the date on which
the Annuitant attains the retirement age shown on Page 3 of this Contract.
Before the Retirement Date the Annuitant may elect to change the Retirement Date
to another Retirement Date, which may be any date after the filing of the
election (other than the 29th, 30th or 31st day of any month). Any election for
such change must be made in writing by you and shall not take effect until
received by us at our Processing Office.
SECTION 1.22 SEPARATE ACCOUNT. The term "Separate Account" means Separate
Account A which is organized as a unit investment trust, a type of investment
company. We established the Separate Account and it is maintained in accordance
with the laws of New York State. Realized and unrealized gains and losses from
the assets of the Separate Account are credited to or charged against it without
regard to our other income, gains or losses. Assets are put in the Separate
Account to support this Contract and other variable annuity contracts and
certificates. Assets may be put in the Separate Account for other purposes, but
not to support contracts or policies other than variable annuities and variable
life insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions" Each Investment Division
may invest its assets in a separate class (or series) of shares of a designated
Trust where each class (or series) represents a separate portfolio in the Trust
or investment company. We reserve the right to change the Trust or to add a
Trust. The Investment Divisions are the Stock Division, the Money Market
Division, the Balanced Division and the Aggressive Stock Division. The
Guaranteed Interest Division is not a part of the Separate Account A but rather
is an asset of our General Account.
No. 92NQCB Page 5
We will value the assets of each Investment Division on each business day. A
business day is any day on which we are open, the New York Stock Exchange is
open for trading and there is a sufficient degree of trading in the portfolio
securities in which an Investment Division is invested to materially affect the
Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments we are
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under the
Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any other
form;
(v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or
remove Investment Divisions (or sub-divisions of Investment Divisions)
from the Separate Account (the term "Investment Division" in this Contract
shall then refer to any other Investment Division in which the assets, of
a Class of Contracts to which this Contract belongs, were placed);
(vi) combine any two or more Investment Divisions (or sub-divisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
Class of Contracts to which this Contract belongs.
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, you will be notified of such exercise, as
required by law.
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for taxes) at a rate
not to exceed 1.49% per year for each of the Stock, Money Market and Balanced
Divisions, and 1.34% per year for the Aggressive Stock Division, for financial
accounting, death benefits, mortality risk, expenses and expense risk. The
charge shall be made in accordance with (c) of the Net Investment Factor
provision in Section 1.23. The relative proportion of these charges may be
modified. This daily charge, plus the investment advisory fee charges and direct
operating expense charges of the Trust, shall not in the aggregate exceed a
total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract.
SECTION 1.23 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Is each business day together with any consecutive preceding
non-business days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment
Division for the Valuation Period. For this purpose, we use the share value
reported to us by the Trust.
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period (after
any amounts allocated to or withdrawn for that Valuation Period).
(c) is the daily Separate Account charge for the expenses of this Contract,
times the number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in the
Investment Division where Contributions are invested and are used in determining
the amount in an Investment Division.
No. 92NQCB Page 6
ACCUMULATION UNIT VALUE: The "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for that Investment Division for such Valuation Period.
ANNUITY UNIT: The Annuity Unit is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first contribution was put into the Stock
Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed
Base rates of 5% and 3.5% a year, respectively. The Annuity Unit Value for any
subsequent Valuation Period is the Annuity Unit Value for the immediately
preceding Valuation Period multiplied by the Adjusted Net Investment Factor for
such subsequent Valuation Period. The Adjusted Net Investment Factor for a
Valuation Period is the Net Investment Factor for such period reduced for each
calendar day in such subsequent Valuation Period by the Net Investment Factor
times (i) .00013366, if the Assumed Base Rate of Net Investment Return is 5%,
and (ii) .00009425, if the Assumed Base Rate of Net Investment Return is 3.5%.
The Assumed Base Rate of Net Investment Return shall be 5%, except in states
where the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: With respect to this Contract, the Average Annuity
Unit Value for a calendar month is equal to the average of the Annuity Unit
Values for all Valuation Periods ending in such month.
SECTION 1.24 TRANSACTION DATE. The Transaction Date is the business day we
receive a Contribution or a written contract transaction request providing the
information we need at the Processing Office. In the case of a transfer request
initiated through the use of a touch tone telephone as described in Section
2.05, the Transaction Date is the business day the telephone transaction is
received.
SECTION 1.25 TRUST. The term "Trust" means the designated trust or investment
company in which assets of the Separate Account are invested.
--------------------------------------------------------------------------------
PART II - ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. Contributions made by you can be classified, as
described under subsections A and B below, as specified on the application for
this Contract. If Contributions are made under more than one classification,
separate Contracts will be issued for each classification.
A. Post-August 13, 1982 Classification
All Contributions of new funds as well as any Contributions resulting from a
transfer to this Contract from a deferred annuity contract, other than those
described in subsection B below will be treated as within this classification.
B. Pre-August 14, 1982 Classification
Xxxxxxx transferred to this Contract through a tax free exchange of a deferred
annuity contract, where such transferred amount represents amounts invested in
or credited to investments in annuity contracts prior to August 14, 1982 will be
treated as within this classification.
Each Contribution received by us will, before its allocation under this
Contract, be reduced by the amount of any applicable tax charge, as determined
by us. Contributions will be allocated to the Division in accordance with
instructions received in your application, unless later changed.
If the Annuitant was age 57 or younger on the Contract Date, no additional
Contributions are permitted under the Contract after completion of the Contract
Year in which the Annuitant attains age 59. If the Annuitant was age 58 or older
on the Contract Date, no additional Contributions are permitted under the
Contract after the first anniversary of the Contract Date.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to or withdrawn or transferred from an Investment
Division, the Annuity Account Value will be credited or charged, as the case may
be, with the number of Accumulation Units determined by dividing said amount by
No. 92NQCB Page 7
the Accumulation Unit Value for the appropriate Investment Division for the
Valuation Period which includes that date. The number of units in an Investment
Division on any date is equal to (i) the sum of any Accumulation Units that have
been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation
Units that have been withdrawn pursuant to Sections 2.07 or 2.09 or transferred
from the Investment Division pursuant to Section 2.05. The amount in an
Investment Division on any date is equal to the product of (i) the number of
Accumulation Units in the Investment Division on that date and (ii) the
Accumulation Unit Value for the Investment Division for the Valuation Period
which includes that date.
Participation in the Separate Account under this Contract terminates on the
earliest of (i) the election and commencement of Annuity Benefits pursuant to
Section 3.03, (ii) receipt of due proof of the Annuitant's death, or (iii)
termination of this Contract pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets, which support
the guarantees of this Contract and other contracts.
The amount in the Guaranteed Interest Division at any time is equal to the sum
of all amounts that have been allocated to the Guaranteed Interest Division
pursuant to Section 2.04 plus the amount of any interest accrued but not
allocated, less the sum of all amounts that have been withdrawn from the
Guaranteed Interest Division pursuant to Section 2.07 or 2.09 or transferred
from the Guaranteed Interest Division, pursuant to Section 2.05. Interest is
allocated to the Guaranteed Interest Division on a Transaction Date pursuant to
Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division terminates on the earliest of
(i) the Retirement Date, (ii) receipt of due proof of the Annuitant's death, or
(iii) termination of this Contract pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01, is allocated (after deduction of any applicable tax charge) to one or more
Divisions, at your sole direction. Allocation percentages must be in whole
numbers and the sum must equal 100%. The allocation is made as of the
Transaction Date on which we have received both such Contribution and such
direction. Contributions made to an Investment Division purchase Accumulation
Units in that Investment Division, using the Accumulation Unit Value next
computed after the Transaction Date.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) at the time of application of amounts in the Guaranteed Interest
Division to provide forms of benefits offered by us pursuant to Section 3.03,
(vi) upon termination of participation pursuant to Section 2.06, (vii) upon the
Annuitant's death pursuant to Section 2.10, and (viii) at the end of the period
during which payments pursuant to the provisions of Section 2.06, 2.07 and 2.10,
or any commuted payments arising from a Fixed Annuity Benefit pursuant to
Section 3.05, were deferred pursuant to Section 4.05.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request, or
through the use of a touch tone telephone, transfer all or part of the amount
you have in a Division to one or more of the Divisions as follows: (1) amounts
in the Guaranteed Interest Division, Stock Division, Balanced Division and
Aggressive Stock Division may be transferred among such Divisions; (2) amounts
in the Money Market Division may be transferred to other Divisions. Written
authorization for touch tone telephone initiated transfers is only required when
authorization for telephone transfers is requested. Upon advance written notice
to you we reserve the right to discontinue acceptance of transfer requests
through the use of touch tone telephones. All transfers will be made on the
Transaction Date and will be subject to our rules in effect at the time of
transfer. With respect to the Investment Divisions, the transfers will be made
at the Accumulation Unit Value next computed after the Transaction Date. No
transfers are permitted to the Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. On or before the Retirement Date, and
while the Annuitant is alive, you may elect by written notice to terminate this
Contract. We will determine the Cash Value under this Contract as of the
Transaction Date. Such cash value will be subject to the termination charge
described below:
If you terminate this Contract, we will pay you the greater of (i) the
Annuity Account Value after the withdrawal charge has been imposed as
described in 2.08, or (ii) the Free Corridor amount, plus 94% of your
remaining Annuity Account Value.
No. 92NQCB Page 8
For purposes of calculating the Withdrawal Charge, (1) the oldest Contribution
will be treated as the first withdrawn and the most recent Contributions will be
treated next, and (2) amounts withdrawn up to the Free Corridor Amount will not
be considered a withdrawal of any of your Contributions.
No Withdrawal Charge will be applied if the amount withdrawn is applied to the
election of a life annuity distribution option, or if the Annuitant dies and the
death benefit is withdrawn by the beneficiary specified to us.
If this Contract is terminated prior to the Retirement Date, any applicable tax
charges we have paid may be deducted. If we have previously deducted charges for
applicable taxes from Contributions pursuant to Section 2.01, we will not again
deduct charges for the same taxes on termination, unless a change in applicable
law has occurred with respect to this Contract.
The payment of such Cash Value to you may be deferred by us in accordance with
the provisions of Section 4.05. If no tax has been previously deducted or if
such a tax is due at termination, we will deduct the amount due.
Prior to the Retirement Date, we reserve the right to pay the Annuity Account
Value under this Contract and terminate this Contract if (i) no Contributions
are made during the last three completed Contract Years, and the Annuity Account
Value is less than $500, or (ii) after three Contract Years and the Annuity
Account Value is less than $500. We also reserve the right to terminate this
Contract if no Contributions have been made within 120 days of the Contract Date
shown on Page 3 of this Contract.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount in the Divisions and the Annuity Account Value shall be zero. We will
be released from any and all liability for payments with respect to the
Contributions from which the Annuity Account Value arose.
SECTION 2.07 PARTIAL WITHDRAWALS. You may elect by written notice to us to make
a partial withdrawal from the Divisions before the Retirement Date while the
Annuitant is alive.
On the Transaction Date, we will pay the lesser of the Cash Value or the amount
of partial withdrawal requested by you. The amount paid plus any withdrawal
charge applicable pursuant to Section 2.08 will be withdrawn from the amounts
you have in the Divisions. Unless instructed otherwise, the amount withdrawn
(including any withdrawal charge) will be allocated among the Divisions in
proportion to the amounts that you have in such Divisions.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.05.
We may decline to accept a request for a partial withdrawal of less than $300.
If a withdrawal made under this Section would result in an Annuity Account Value
of less than $500, we will so advise you and reserve the right to pay the
Annuity Account Value to you, and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. There will be no withdrawal charge
(i) if the amount of the partial withdrawal requested is not greater than the
Free Corridor Amount defined in Section 1.13, (ii) the amount withdrawn is
applied to the election of a life annuity distribution option, or (iii) a death
benefit is withdrawn by the beneficiary.
However, if the amount of partial withdrawal requested is greater than the Free
Corridor Amount, we will (i) first withdraw from such Divisions an amount equal
to the Free Corridor Amount, and (ii) then withdraw an amount equal to the
excess of the amount requested over the Free Corridor Amount, plus a withdrawal
charge, if applicable. Such withdrawal charge will be calculated in the
following manner:
(a) Withdrawals of Contributions made by you during the current and five prior
Contract Years will be subject to a charge of 6% of the amount withdrawn
(including such charge).
(b) Withdrawals of other amounts will not be subject to any withdrawal charges.
We will pay you the lesser of (a) the amount requested or (b) the Cash Value.
For purposes of determining withdrawal charges described in this Section,
amounts withdrawn up to the Free Corridor Amount will not be considered a
withdrawal of any Contributions. Any excess withdrawals, i.e. those pursuant to
item (ii) in the immediate preceding paragraph, shall be considered withdrawals
of older contributions first and more recent contributions next.
No. 92NQCB Page 9
If withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to this contract.
SECTION 2.09 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year before your Retirement Date, we will withdraw from the Divisions an Annual
Administrative Charge equal to the lesser of $30 or 2% of the Annuity Account
Value including the amount of the sum of (i) the Annuity Account Value and (ii)
any withdrawals pursuant to Section 2.07 during that Contract Year. The charge
will be allocated among the Divisions in proportion to the amounts that you have
in the Divisions.
As of the Retirement Date and before application of the Annuity Account Value or
Cash Value pursuant to Section 3.03, or upon termination of this Contract
pursuant to Section 2.06 or Sections 2.10 and 2.11 during a Contract Year, if
the Annuity Account Value is less than $10,000, we will withdraw the Annual
Administrative Charge described in this Section for the applicable part of that
Contract Year.
However, if the Annuity Account Value is $10,000 or greater at the end of the
Contract Year, the Annual Administrative Charge is zero.
SECTION 2.10 DEATH BENEFIT. If we ascertain that the Annuitant has died, upon
receipt of due proof of such death, we will pay to the beneficiary you
designated pursuant to Section 4.03 to receive such payment, the amount of death
benefit payable under this Contract.
The amount of the death benefit under this Contract is equal to the greater of
(i) the Annuity Account Value and (ii) the minimum death benefit under this
Contract. Such minimum death benefit is the sum of all contributions made
pursuant to Section 2.01 (before reduction for any applicable tax charge), less
any withdrawals made pursuant to Section 2.07. Any such withdrawal will reduce
the minimum death benefit (as adjusted by any previous such withdrawal) by an
amount which is in the same proportion as the amount that was withdrawn is to
the Annuity Account Value.
We will pay the death benefit to the beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.03. Also in accordance with the last paragraph of Section 4.03, if no such
election is in effect at the Annuitant's death, we will pay the death benefit to
the beneficiary in a single sum, unless the beneficiary elects before we pay the
death benefit (i) to apply the death benefit to an Annuity Benefit on any
annuity form offered by us; (ii) to apply the death benefit to provide any other
form of benefit payment offered by us; or (iii) to apply the death benefit to
provide any combination of forms of benefit payment offered by us. All benefit
payment elections will be subject to our rules then in effect and any other
applicable requirements under the Code.
Upon payment of the death benefit, the amount in the Divisions and the Annuity
Account Value with respect to this Contract shall be zero. We will be released
from any and all liability for payments with respect to the Contributions from
which the Annuity Account Value arose.
SECTION 2.11 OWNER DEATH DISTRIBUTION RULES. Upon the death of the Owner before
an Xxxxxxxxx's Retirement Date:
(i) If you are both the Owner and the Annuitant, we will pay the death benefit
in accordance with Sections 2.10 and 4.03.
(ii) If you are not the Annuitant, the designated beneficiary will succeed as
Owner, notwithstanding the existence of any co-owner. The entire amount in
the Divisions subject to any applicable withdrawal charges as described in
this Contract must either: a) be completely distributed by the fifth
anniversary of your death, or b) within 1 year after your death as a life
annuity or installment option, for a period of not longer than the life
expectancy of the designated beneficiary.
However, if the designated beneficiary is your spouse, the entire amount the
Annuitant has in the Divisions must then be distributed no later than 5 years
after the spouse's death.
If payments under an Annuity Benefit had commenced prior to your death, such
payments will continue to be made over a period not longer than the period
provided for under the Annuity Benefit elected.
If the Annuitant dies before the entire amount the Annuitant has in the
Divisions is distributed, we will pay the death benefit in Section 2.10.
No. 92NQCB Page 10
The designated beneficiary is the same as the beneficiary who is entitled to the
death benefit upon your death.
Where more than one Owner is named, the date of death of the Owner will be
deemed to be the date of death of the first Owner to die.
SECTION 2.12 CONTRIBUTION LIMIT. We may refuse to accept a Contribution made
with respect to an Annuitant if the total prior Contributions made exceed (or if
acceptance of such Contribution would cause the total Contributions to exceed)
the following:
(i) $500,000, if the Annuitant's current age last birthday is 75 or less.
(ii) $250,000, if the Annuitant's current age last birthday is 76-79.
We may refuse to accept any Contribution made with respect to an Annuitant if
such Xxxxxxxxx's current age last birthday is 80 or greater.
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PART III -- ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under this Contract with respect to a payee is the amount provided with respect
to the payee pursuant to Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division of the Separate Account.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of net
investment return referred to in Section 1.23 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.22, not to exceed the maximum rate of 1.75% after any deductions to
provide for any applicable tax charge. These charges include a daily charge for
financial accounting, death benefits, mortality risk, expenses and expense risk,
plus the investment advisory fee charges and direct operating expense charges of
the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under this Contract with respect to a payee is the monthly
amount provided with respect to a payee pursuant to the 5th paragraph of Section
3.04. The amount of the fourth and each subsequent payment under a Variable
Annuity Benefit will be equal to the number of Annuity Units with respect to
such benefit, multiplied by the Average Annuity Unit Value for the second
calendar month immediately preceding the due date of the payment. The number of
Annuity Units with respect to a benefit is the number determined by dividing the
amount of the first monthly payment by the Annuity Unit Value for the Valuation
Period which includes the due date of the first monthly payment. (As described
in Section 3.05, we will notify the payee how each variable Annuity Payment is
determined).
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of the
Annuitant's Retirement Date, provided the Annuitant is then living, the Annuity
Account Value shall be applied to provide the Normal Form of Annuity Benefit,
unless you elect, (i) to receive the Cash Value of the Contract in a single sum,
(ii) to apply the Annuity Account Value or Cash Value, whichever is applicable
pursuant to the first paragraph of Section 3.04, to provide an Annuity Benefit
on any other form offered by us or one of our affiliated or subsidiary life
insurance companies, as elected by you, or (iii) to apply the Cash Value to
provide any other form of benefit payment offered by us, subject to our rules
then in effect.
We will provide notice and election forms to you not more than six months before
the Retirement Date.
If you elect to terminate this Contract pursuant to Section 2.06 before the
Retirement Date, an election may be made to receive any form of benefit payment
offered by us, subject to our rules then in effect and any other applicable
requirements under the Code.
No. 92NQCB Page 11
We will have the right to require you to furnish pertinent information to
provide an Annuity Benefit, and will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary
life insurance companies.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS, If you elect pursuant to the first or
third paragraph of Section 3.03 to have an Annuity Benefit paid in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be (i) the
Annuity Account Value if the annuity form elected involves life contingencies or
(ii) the Cash Value if the annuity form elected does not involve life
contingencies.
The amount applied to provide an Annuity Benefit may be reduced by a charge for
any applicable taxes on annuity considerations, as we determine. If we have
previously deducted charges for applicable taxes from contributions as provided
in Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to this Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your Contract will be governed by our
supplementary contract then in effect.
The amount to be applied to provide an Annuity Benefit will in addition to any
tax charge reduction, be reduced by an administrative charge. The amount of such
charge will be determined from time to time in accordance with our general
practices applicable on a uniform basis to all contracts of the same type as
this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts
you have in the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under the terms of this
Contract, as indicated on the Life Annuity Form with Ten Years Certain. The
amount of income provided under the Fixed Annuity Benefit payable on the Life
Annuity Form with Ten Years Certain is based on 3.5% interest and the 1983
Individual Annuity Table "a". The amounts of income initially provided under the
Variable Annuity Benefit payable on the Life Annuity Form with Ten Years Certain
is based on the 1983 Individual Annuity Table "a" and on an Assumed Base Rate of
Net Investment Return of 3.5% or 5%, whichever applies pursuant to Section 1.22.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us based on 3.5% interest and the 1983 Individual Annuity Table
"a" if such annuity form provides for a Fixed Annuity Benefit and on the same
such Table and an Assumed Base Rate of Net Investment Income Return of 3.5% or
5%, whichever applies, pursuant to Section 1.22, if such annuity form provides
for a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Evidence of each payee's survival must
be furnished to us either by personal endorsement of the check drawn for payment
or by other means satisfactory to us.
If a benefit payable under this Contract was based on information that is
subsequently found to be incorrect, such benefit will not be invalidated, but an
adjustment on the basis of the correct information will be made in the amount of
the benefit payments, or any amount used to provide the benefit, or any
combination thereof. Overpayments by us will be charged against and
underpayments will be added to any payments thereafter falling due under the
terms of this Contract with respect to the payee affecting as many such payments
as are necessary to correct the overpayment or underpayment. Our liability with
respect to a payee is limited to the correct information and the actual amounts
used to provide the benefits then in force with respect to the payee under the
terms of this Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under the terms of this Contract is physically or mentally
incompetent to receive such payment or is a minor, (ii) another person or an
institution is then maintaining or has custody of such payee, and (iii) no
guardian, committee, or other representative of the estate of such payee has
been appointed, we may make the payments (in the case of a minor, at a rate not
exceeding $200 a month) to such other person or institution, and will thereupon
be fully discharged from all liability with respect thereto.
Upon your election pursuant to Section 3.03 of an annuity form providing
payments for a period certain, you may designate (with the right to change such
designation) a payee to receive any payments that may become due after the death
of the person or persons upon, whose life or lives the income may depend.
No. 92NQCB Page 12
The payee may designate (with the right to change such designation and without
the concurrence of any other person) a person or persons to receive any payments
or installments payable after such payee's death, if the absence of such a
designation would result in a single sum payment to such payee's estate in
accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments.
The commuted value of any such remaining payments will be determined on the
basis of compound interest at the rate utilized in the actuarial rate basis
originally used to determine such payments.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
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TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE
LIFE ANNUITY FORM WITH TEN YEARS CERTAIN
(Minimum Monthly Income per $1,000 of Annuity Account Value)
-------------------------------------------------------------------------------
Monthly Income Monthly Income
Age Males Females Age Males Females
---------- ------------- -------------- -------- -------------- ---------------
60 5.42 4.93 73 7.40 6.76
61 5.54 5.04 74 7.57 6.95
62 5.67 5.14 75 7.75 7.15
63 5.80 5.25 76 7.92 7.34
64 5.94 5.37 77 8.09 7.54
65 6.08 5.50 78 8.26 7.74
66 6.23 5.63 79 8.42 7.94
67 6.38 5.77 80 8.57 8.14
68 6.54 5.92 81 8.71 8.32
69 6.71 6.07 82 8.85 8.50
70 6.88 6.23 83 8.98 8.67
71 7.05 6.40 84 9.09 8.83
72 7.22 6.58 85 9.20 8.97
---------- ------------- -------------- -------- -------------- ---------------
ANNUITY BENEFIT PAYABLE
ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1,000 of Annuity Account Value)
-------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON THE
LIFE ANNUITY FORM WITH TEN YEARS CERTAIN
IF ASSUMED BASE RATE OF RETURN 1S:
3.5% 5.0%
Age Males Females Males Females
--------------- ------------ --------------- ---------------- -----------------
60 5.42 4.93 6.28 5.80
61 5.54 5.04 6.40 5.90
62 5.67 5.14 6.52 6.00
63 5.80 5.25 6.64 6.11
64 5.94 5.37 6.78 6.22
6.08 5.50 6.92 6.34
65
66 6.23 5.63 7.06 6.47
67 6.38 5.77 7.21 6.60
68 6.54 5.92 7.36 6.74
69 6.71 6.07 7.52 6.89
70 6.88 6.23 7.68 7.05
--------------- ------------ --------------- ---------------- -----------------
We will with respect to each payment under a Variable Annuity Benefit, notify
the payee of the number of Annuity Units and the Average Annuity Unit Value used
in determining the amount of each variable payment. Such notice will be mailed
with each payment.
Any election, change, revocation or designation shall be made, and will take
effect, in the same manner as a change of beneficiary as described in Section
4.03.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.05.
No. 92NQCB Page 13
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PART IV -- GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the
parties and the provisions of this Contract alone will govern with respect to
our rights and obligations. A copy of the application is incorporated in and
made part of this Contract.
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by our authorized officer. The terms of this
Contract may be changed by amendment or replacement upon agreement between you
and us without the consent of any other person who has a contingent or
additional interest in this Contract.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend this Contract
without the consent of any other person in order to comply with applicable laws
and regulations. Such right shall include, but not be limited to, the right to
conform this Contract and any certificate to reflect changes in the Code,
applicable Treasury Regulations, or published rulings of the Internal Revenue
Service so this Contract will continue to be an "annuity" as described in
Section 72 of the Code.
SECTION 4.03 BENEFICIARY. As of the Contract Date, you are to provide us with an
initial designation of the beneficiary entitled to receive any death benefit
payable pursuant to Section 2.10 unless otherwise specified in the application
the person designated as beneficiary on the death of the Annuitant under Section
2.10 will also be the designated beneficiary who succeeds as "Owner" on your
death while the Annuitant is alive under Section 2.11. You may change such
designation from time to time during the Annuitant's lifetime and while the
Contract is in force. Any such designation or change will be made by written
notice in a form satisfactory to us. A change will, upon receipt at the
Processing Office, take effect as of the date the written notice was signed,
whether or not you are living on the date of receipt, but without further
liability as to any payment or other settlement made by us before receipt of
such change.
Unless otherwise specified in the application, if you have named two or more
persons as beneficiary, the beneficiary will be the named person or persons who
survive you, and if more than one survive they will share equally.
Any part of a death benefit payable pursuant to Section 2.10 for which there is
no named beneficiary living at your death will be payable in a single sum to
your children, who survive you, in equal shares, or should none survive, then to
your estate.
If you so elect in writing, any amount that would otherwise be payable to a
beneficiary in a single sum may be applied to provide an Annuity Benefit, on the
form of annuity elected by you, with respect to the beneficiary, subject to our
rules then in effect. If at your death there is no election in effect to apply
the single sum death benefit to provide an Annuity Benefit, the beneficiary may
make such an election.
SECTION 4.04 FUTURE CONTRIBUTIONS. We reserve the right at our sole discretion
to limit Contributions under this Contract.
SECTION 4.05 DEFERMENT. Application of proceeds to a variable annuity, payment
of a death benefit when Section 2.10 or any payment required under Section 2.11
and payment of any portion of your Annuity Account Value (less any applicable
withdrawal charge) will be made within seven days after the Transaction Date.
Payments or applications of proceeds from the Investment Divisions can be
deferred for any period during which (1) the New York Stock Exchange has been
closed or trading on it is restricted, (2) sales of securities or determination
of the fair value of an Investment Division's assets is not reasonably
practicable because of an emergency, or (3) the Security and Exchange
Commission, by order, permits us to defer payment in order to protect persons
with interests in the Investment Divisions. We can defer payment of any portion
of your Annuity Account Value in the Guaranteed Interest Division for up to six
months while you are living.
SECTION 4.06 ANNUAL NOTICE. At the end of each Contract Year up to and including
the Retirement Date, we will furnish you with a notice showing the following:
(1) the amount in the Guaranteed Interest Division,
(2) the total number of Accumulation Units in the Stock Division, Balanced
Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Value,
No. 92NQCB Page 14
(4) the amount in the Stock Division, Balanced Division, Aggressive Stock
Division and Money Market Division.
(5) the Cash Value, and
(6) the amount of the death benefit.
We will also furnish annual calendar year reports concerning the status of the
annuity and any other reports required by the Code or applicable Treasury
Regulations.
After the Retirement Date, we will notify you of the number of Annuity Units and
the Average Annuity Unit Value used in determining the amount of each Variable
Annuity Benefit payment, if any.
SECTION 4.07 ASSIGNMENTS. This Contract may not be assigned as collateral or
security for a loan. Otherwise, you may assign this Contract before the
Retirement Date but we will not be bound by an assignment unless it is in
writing and we have received it. Your rights and those of any other persons
referred to in this Contract will be subject to the assignment. We assume no
responsibility for the validity of any assignment.
No amounts payable under this Contract to a payee other than you may be
assigned, unless permitted herein, by that payee, nor will they be subject to
the claims of creditors or to legal process, except to the extent permitted by
law.
SECTION 4.08 AGE AND SEX. If the age or sex of any person upon whose life an
Annuity Benefit depends has been misstated, any benefits will be those which
would have been purchased at the correct age and sex. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
No. 92NQCB Page 15
OWNER: ALL STATE DEFERRED COMPENSATION PROGRAM
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 000
ISSUE DATE: JAN 1, 1992
CONTRACT DATE: JAN 1, 1992
RETIREMENT DATE: JAN 1, 2020
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O.
New York, New York 10116
AGREES
o TO ALLOCATE the Contributions made to this Contract after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division of the Separate Account (referred to
in this Contract as the "Investment Divisions") or the Guaranteed Interest
Division, in accordance with Sections 2.02, 2.03 and 2.04, as directed by
you, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide the
Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is
then living, and
o TO PROVIDE you with the other rights and benefits of this Contract.
This is the entire Contract. In this Contract, "we", "our" and "us" mean The
Equitable Life Assurance Society of the United States. "You" and "your" mean the
Employer at the time a right is exercised by the Employer.
TEN DAYS TO EXAMINE CONTRACT -- The Employer may cancel this Contract by
returning it to us within ten days after receipt of it. Upon such cancellation,
we will refund any Contribution made to us on the Annuitant's behalf under this
Contract, plus or minus any investment gain or loss experienced in the
Investment Divisions of the Separate Account from the date such Contribution was
allocated to such Investment Division to the date we receive the returned
contract.
/s/ Xxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxxxx
Vice President and Secretary Chairman of the Board
And Chief Executive Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE ANNUITY BENEFITS PAYABLE UNDER THE CONTRACT ARE FIXED ANNUITY BENEFITS.
No. 92 PEDB
This Contract is issued in consideration of the payment to us of the
Contributions made under the terms of this Contract.
The provisions on the following pages are part of this Contract.
-------------------------------------------------------------------------------
TABLE OF CONTENTS
DEFINITIONS Page
Section 1.01 - Annuitant..........................................4
1.02 - Annuity............................................4
1.03 - Annuity Account Value..............................4
1.04 - Annuity Benefit....................................4
1.05 - Cash Value.........................................4
1.06 - Class of Contracts.................................5
1.07 - Code...............................................5
1.08 - Contract...........................................5
1.09 - Contract Date......................................5
1.10 - Contract Year......................................5
1.11 - Contribution.......................................5
1.12 - Divisions..........................................5
1.13 - Xxxxxxxx Xxxxxxx Xxxxxxx...........................5
1.14 - Employer...........................................5
1.15 - Guaranteed Interest Rate...........................5
1.16 - Normal Form........................................5
1.17 - Period Certain Annuity.............................5
1.18 - Plan...............................................5
1.19 - Processing Office..................................5
1.20 - Retirement Date....................................6
1.21 - Separate Account...................................6
1.22 - Separate Accounts Definitions......................7
1.23 - Substituted Beneficiary............................7
1.24 - Transaction Date...................................7
1.25 - Trust..............................................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions......................................7
2.02 - Separate Account Investment
Divisions.......................................8
2.03 - Guaranteed Interest Division.......................8
2.04 - Allocation to Divisions............................8
2.05 - Transfers Among Divisions..........................8
2.06 - Termination of this Contract.......................8
2.07 - Partial Withdrawals................................9
2.08 - Charges for Partial
Withdrawals........................................9
2.09 - Free Corridor Amount...............................9
2.10 - Annual Administrative Charge......................10
2.11 - Death Benefit.....................................10
ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit.............................10
3.02 - Election and Commencement of
Annuity Benefits...............................10
3.03 - Amount of Annuity Benefits........................11
3.04 - Payment of Annuity Benefits.......................11
GENERAL PROVISIONS
Section 4.01 - Contract..........................................13
4.02 - Statutory Compliance..............................13
4.03 - Nonforfeitability, Nontransferability
and Assignments...................................13
4.04 - Beneficiary.......................................14
4.05 - Disqualification..................................14
4.06 - Future Contributions..............................14
4.07 - Deferment.........................................14
4.08 - Annual Notice.....................................14
4.09 - Quarterly Notice..................................14
4.10 - Age...............................................14
4.11 - Right of Employer.................................14
No. 92 PEDB Page 2
OWNER: ABC STATE DEFERRED COMPENSATION PROGRAM
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 000
ISSUE DATE: JAN 1, 1992
CONTRACT DATE: JAN 1, 1992
RETIREMENT DATE: JAN 1, 2020
INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992
MINIMUM GUARANTEED INTEREST RATE: 6:00% TO DEC 31, 1992
3.00% AFTER DEC 31, 1992
BENEFICIARY: XXXX XXX
FORM NUMBER: 92 PEDB
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TABLE OF GUARANTEED VALUES
ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION
NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY
SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65*
------------------------ ---------- ------------------
1 976 6.62
2 1,946 16.20
3 2,944 26.67
4 3,998 36.83
5 5,064 46.70
6 6,220 56.28
7 7,362 65.58
8 8,538 74.61
9 9,841 83.38
10 11,204 91.89
11 12,628 100.16
12 14,117 108.18
13 15,673 115.97
14 17,143 123.53
15 18,658 131.18
16 20,217 138.63
17 21,824 145.90
18 23,478 152.80
19 25,213 159.69
20 26,999 166.03
24 (Age 62) 34,697 189.57
27 (Age 65) 41,098 205.49
THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000
CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT
DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE
(SEE SECTION 2.10) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ANNUITY ACCOUNT
VALUE (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND
EARNINGS ARE ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION.
YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON
THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS.
THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE
WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY
BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A
SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04).
*ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO
SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT.
No. 92 PEDB Page 3
PART I -- DEFINITIONS
SECTION 1.01 ANNUITANT. The term "Annuitant" means an individual who
participates in a Plan or, if the Plan permits, a beneficiary under the Plan, as
shown on Page 3 of this Contract and on whose behalf this Contract has been
purchased and is maintained.
SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in
accordance with the terms of the Plan.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The Term "Annuity Account Value" means the
sum of the amounts that you have in the Guaranteed Interest Division and the
Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by us pursuant to Section 3.04 of this Contract. Various sections of this
Contract (Sections 1.17 and 3.01) refer to monthly payments to be made under an
Annuity Benefit. You may elect to have the Annuity Benefit paid at other
intervals, such as quarterly, semi-annually, or annually, instead of monthly.
You may elect this at the time you elect the Annuity Benefit form as described
in Section 3.02; in that event, all references in this Contract to monthly
payments will be deemed to mean payments at the frequency you elect, subject to
our rules at the time of election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value
less any applicable withdrawal charge determined as follows:
The withdrawal charge equals the lesser of (a) or (b) where:
(a) equals
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the excess of (i) the sum of the Annuity Account Value over (ii) the
Free Corridor Amount defined in Section 2.09, and
(b) is the excess, if any, of (i) 8% of the total Contributions made on the
Annuitant's behalf during the current Contract Year and the nine preceding
Contract Years over (ii) the cumulative total of any prior partial
withdrawal charges made pursuant to Section 2.08.
The above statements notwithstanding, we reserve the right to modify or waive
any early withdrawal charges in order to comply with any applicable state or
local requirements. Any such modification or waiver will apply equally to all
Annuitants under a Plan subject to such a state or local requirement.
However, notwithstanding the above, if the Annuitant is age 60 or older on the
Contract Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of
the excess of the Annuity Account Value over the Free Corridor Amount.
A withdrawal charge will not apply, which means the Cash Value will equal the
Annuity Account Value upon any of the following occurrences:
(i) the Annuitant's completion of at least five Contract Years and the
Annuitant's attainment of age 59 years and 6 months, or
(ii) the Annuitant's completion of at least twelve Contract Years, or
(iii) a request is made for a refund of a Contribution in excess of the amount
that may be contributed under Section 457 of the Code within one month of
the date on which the Contribution is made, or
(iv) the Annuitant's completion of at least five Contract Years, the
Annuitant's attainment of age 55, and the receipt by us of a properly
completed settlement election form in order to apply the Annuity Account
Value to purchase an Eligible Annuity Certain, defined in Section 1.13, or
(v) the Annuitant's completion of at least three Contract Years and the
receipt by us of a properly completed settlement election form in order to
apply the Annuity Account Value to purchase a Period Certain Annuity,
defined in Section 1.17, where the certain period of such annuity is at
least ten years, or
(vi) the receipt by us of a properly completed settlement election form in
order to apply the Annuity Account Value to purchase a Period Certain
Annuity, defined in Section 1.16, where the certain period of such annuity
is at least 15 years, or
No. 92 PEDB Page 4
(vii) the Annuitant dies and a death benefit is payable to the beneficiary.
The above statements notwithstanding, after the completion of a period agreed
upon by the Employer and us not to exceed five Contract Years from the date as
of which an agreement is entered into between the Employer and us ("period") and
after the completion of each successive period, any assets of the plan which are
currently invested in this Contract will be transferred as soon as
administratively practicable to a successor funding agency designated by the
Employer unless, not later than 7 days before the date on which a transfer would
otherwise occur, the Employer, in accordance with the procedures specified in
Section 9003.2 of the Regulations of the Deferred Compensation Board of the
State of New York, notifies us to renew that agreement. Such funds will be
transferred in a single sum and no early withdrawal charges, surrender charges,
market value adjustments or other fees will be applied in connection with such a
transfer. We will not be responsible for the validity of any certification made
by the Employer.
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same calendar year.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as
amended, or any corresponding provisions of prior or subsequent United States
revenue laws.
SECTION 1.08 CONTRACT. The term "Contract" means this Contract.
SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both the application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.10 CONTRACT YEAR. The term "Contract Year" with respect to you means
the twelve month period beginning on (i) the Contract Date, and (ii) each
anniversary thereafter, unless otherwise agreed to in writing by us.
SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us
pursuant to the terms of the Plan to this Contract. We are under no obligation
to accept any Contribution less than $20.00.
SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following divisions described in this
Contract:
(i) the Guaranteed Interest Division, and
(ii) the Investment Divisions of the Separate Account.
SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
a Period Certain Annuity issued by us which extends beyond the Annuitant's
attainment of age 59 years and 6 months and does not permit any prepayment of
the unpaid principal (that is, no withdrawal or single sum payment) prior to
your attainment of age 59 years and 6 months.
SECTION 1.14 EMPLOYER. The term "Employer" means one of the following types of
entity which is eligible to adopt, has adopted, and maintains a Plan: (i) a
State, a political subdivision of a State, or an agency or instrumentality of a
State or political subdivision of a State, or (ii) any other organization (other
than a governmental unit) exempt from tax under the Code which has adopted and
maintains a Plan for a select group of management or highly compensated
employees within the meaning of the Employee Retirement Income Security Act of
1974, as amended. The Employer is the Owner of and beneficiary under this
Contract.
SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrued on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of
this Contract. Section 2.03 describes the determination of the rate to apply
thereafter.
SECTION 1.16 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means a Period Certain Annuity.
SECTION 1.17 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us which does not permit any
prepayment of the unpaid principal (that is, you cannot elect to receive part of
the payments as a single sum payment with the remainder paid in monthly annuity
payments). Any installment payments shall be made over a period which does not
exceed your remaining life expectancy.
SECTION 1.18 PLAN. The term "Plan" means a program constituting an "Eligible
Deferred Compensation Plan" meeting the requirements of Section 457(b) of the
Code and applicable Treasury Regulations which is established and maintained by
an Employer for the benefit of individuals performing services for the Employer
and their beneficiaries.
SECTION 1.19 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P.O. Box 2996, GPO, New York, New York 10116, or such
other location as we shall designate by at advance written notice to the
Employer or the Plan's trustee, as applicable.
No. 92 PEDB Page 5
SECTION 1.20 RETIREMENT DATE. The term "Retirement Date" means the date on which
the Annuitant attains the retirement age as shown on Page 3 of this Contract.
Before the Retirement Date the Employer may elect to change the Retirement Date
to another Retirement Date, which may be any date after the filing of the
election (other than the 29th, 30th, or 31st day of any month). No Retirement
Date shall be earlier than the Retirement Date provided under the Plan nor shall
it be later than the date the Annuitant attains age 70 years and 6 months. Any
election for such change must be made in writing by you and shall not take
effect until received by us at the Processing Office.
SECTION 1.21 SEPARATE ACCOUNT. The term "Separate Account" means Separate
Account A which is organized as a unit investment trust, a type of investment
company. We established the Separate Account and it is maintained in accordance
with the laws of New York State. Realized and unrealized gains and losses from
the assets of the Separate Account are credited to or charged against it without
regard to our other income, gains or losses. Assets are put in the Separate
Account to support this Contract and other variable annuity contracts and
certificates. Assets may be put in the Separate Account for other purposes, but
not to support contracts or policies other than variable annuities or life
variable insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust where each class (or series) represents a separate portfolio in
such Trust. We reserve the right to change the designated trust or investment
company or to add designated trusts or investment companies. The Investment
Divisions available are the Stock Division, the Money Market Division, the
Balanced Division and the Aggressive Stock Division. The Guaranteed Interest
Division is not part of the Separate Account, but rather is an asset of our
General Account.
We will value the assets of each Investment Division on each business day. A
business day is any day on which we are open, the New York Stock Exchange is
open for trading and there is a sufficient degree of trading in the portfolio
securities in which an Investment Division is invested to materially affect the
Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may relay conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments we are
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under the
Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any other
form;
(v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or
remove Investment Divisions (or sub-divisions of Investment Divisions)
from the Separate Account (the term "Investment Division" in this Contract
shall then refer to any other Investment Division in which the assets, of
a class of contracts to which this Contract belongs, were placed);
(vi) combine any two or more Investment Divisions (or sub-divisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
class of contracts to which this Contract belongs.
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, you and the Annuitant will be notified of
such exercise, as required by law.
No. 92 PEDB Page 6
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for applicable tax
charges) at a rate not to exceed 1.49% per year for each of the Stock, Money
Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock
Division, for financing accounting, death benefits, mortality risk, expenses and
expense risk. The charge shall be made i accordance with Subsection (c) of the
Net Investment Factor provision in Section 1.22. The relative proportion of
these charges may be modified. This daily charge, plus the investment advisory
fee charges and direct operating expense charges of the Trust, shall not exceed
a total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract.
SECTION 1.22 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any preceding consecutive
non-business days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment
Division for the Valuation Period. For this purpose, we use the share value
reported to us by the Trust.
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period (after
taking into account any amounts allocated or withdrawn for that Valuation
Period).
(c) is the daily Separate Account charge for the expenses of this Contract,
times the number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an
Investment Division where Contributions made on the Annuitant's behalf are
invested and which is used in determining the amount in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for that Investment Division for such Valuation Period.
SECTION 1.23 SUBSTITUTED BENEFICIARY. The term "Substituted Beneficiary" refers
to the beneficiary designated under the Plan by the Annuitant to receive death
benefits payable under the Plan, where the Employer has elected, pursuant to
Section 4.04 to designate such person to receive the death benefit payable under
Section 2.11.
SECTION 1.24 TRANSACTION DATE. The term "Transaction Date" means the business
day we received a Contribution or a written contract transaction request
providing the information we need at the Processing Office. In the case of a
transfer request initiated through the use of a touch tone telephone, as
described in Section 2.05, the Transaction Date is the business day the
telephone transaction is received.
SECTION 1.25 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
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PART II -- ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. You are to make Contributions from time to time on
such dates and in such amounts as you determine pursuant to the terms of the
Plan. Contributions will be allocated to the Divisions in accordance with the
instructions received on the applications, unless later charged.
Each Contribution received by us on the Annuitant's behalf will, before its
allocation under this Contract, be reduced by the amount of any applicable tax
charge, as determined by us.
If the Plan permits, we will accept transfers made from another eligible
deferred compensation plans meeting the requirements of Section 457 of the Code
or other funds invested under the Employer's Plan.
No. 92 PEDB Page 7
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to, or withdrawn or transferred from, an Investment
Division, the Annuity Account Value will be credited or charged, as the case may
be with the number of Accumulation Units determined by dividing said amount by
the Accumulation Unit Value for the appropriate Investment Division for the
Valuation Period which includes that date. The number of units in an Investment
Division on any date is equal to (i) the sum of any Accumulation Units that have
been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation
Units that have been withdrawn pursuant to Sections 2.07, 2.08 or 2.10 or
transferred from the Investment Division pursuant to Section 2.05. The amount in
an Investment Division on any date is equal to the product of (i) the number of
Accumulation Units in the Investment Division on that date and (ii) the
Accumulation Unit Value for the Investment Division for the Valuation Period
which includes that date.
Participation in the Separate Account under the terms of this Contract
terminates on the earliest of (i) Election and Commencement of Annuity Benefits
pursuant to Section 3.02, (ii) receipt of due proof of the Annuitant's death or
(iii) Termination of this Contract pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets which support
the guarantees of this Contract and other contracts.
The amount in the Guaranteed Interest Division at any time is equal to the sum
of all amounts that have been allocated to the Guaranteed Interest Division
pursuant to Section 2.04 or Section 2.10 plus the amount of any interest accrued
but not allocated, less the sum of all amounts that have been withdrawn from the
Guaranteed Interest Division pursuant to Sections 2.07, 2.08 or 2.10 or
transferred from the Guaranteed Interest Division pursuant to Section 2.05.
Interest is allocated to the Guaranteed Interest Division on a Transaction Date
pursuant to Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division under the terms of this
Contract terminates on the earliest of (i) Election and Commencement of Annuity
Benefits pursuant to Section 3.02, (ii) receipt of due proof of the Annuitant's
death or (iii) Termination of this Contract pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction for any applicable tax charge) to one or more
Divisions, at your sole direction as specified to us. Allocation percentages
must be in whole numbers and the sum must equal 100. The allocation is made as
of the Transaction Date on which we have received both such Contribution and
such direction. Contributions made to an Investment Division purchase
Accumulation Units in that Investment Division, using the Accumulation Unit
Value next computed after the Transaction Date. If your Plan permits, and you
provide us with advance written instructions to do so, we will accept allocation
instructions directly from the Annuitant.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.03, (v) upon termination of this Contract pursuant to Section 2.06 and (vi)
upon the Annuitant's death pursuant to Section 2.11.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through
the use of a touch tone telephone, transfer all or part of the amount you have
in a Division to one or more of the Divisions as follows: (1) amounts in the
Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive
Stock Division may be transferred among such Divisions; and (2) amounts in the
Money Market Division may be transferred to other Divisions. Written
authorization for touch tone telephone initiated transfers is only required when
authorization for telephone transfers is requested. Upon advance written notice
to you, we reserve the right to discontinue the acceptance of transfer requests
through the use of a touch tone telephone. If your Plan permits, and you provide
us with advance written instructions to do so, we will accept transfer
instructions directly from the Annuitant. All transfers will be made on the
Transaction Date and will be subject to our rules in effect at the time of
transfer. With respect to the Investment Divisions, the transfer will be made at
the Accumulation Unit Value next computed after the Transaction Date. No
transfers are permitted to the Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the
terms of the Plan, you may elect, by written notice, to terminate this Contract.
We will determine the Cash Value under this Contract as of the Transaction Date.
If this Contract is terminated, surrendered or exchanged prior to the
Annuitant's Retirement Date, any applicable tax charges we have paid may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on terminations, unless a change in applicable law has occurred with
respect to this Contract.
Cash Value payments may be deferred by us in accordance with the provisions of
Section 4.07.
No. 92 PEDB Page 8
Subject to the terms of the Plan, we reserve the right to pay the Annuity
Account Value under this Contact and terminate this Contract if (i) you make no
Contributions on the Annuitant's behalf during the last three completed Contract
Years, or (ii) you make a partial withdrawal that would result in the
Annuitant's Annuity Account Value falling below $500. We also reserve the right
to terminate this Contract if no Contributions have been made within 120 days
from the Contract Date shown on Page 3 of this Contract.
We will pay the Cash Value or Annuity Account Value, as applicable, directly to
you unless you give us written notice at the time of termination that you
request us to make payment to the Annuitant or another person, and that such
payment is permissible under the Plan.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount in the Divisions under this Contract and the Annuity Account Value
with respect to this Contract shall be zero. We will be released from any and
all liability for payments with respect to the Contributions from which the
Annuity Account Value arose.
SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any restrictions under the terms of
the Plan, you may elect by written notice to us to make a partial withdrawal
from the Divisions.
On the Transaction Date, we will pay the lesser of the Cash Value or the amount
of partial withdrawal requested to you. The amount paid plus any withdrawal
charge applicable pursuant to Section 2.08 will be withdrawn from the amounts
you have in the Divisions. Unless instructed otherwise, the amount withdrawn
(including any withdrawal charge) will be allocated among the Divisions in
proportion to the amounts that you have in such Divisions.
We will pay the Cash Value or Annuity Account Value, as applicable, directly to
you unless you give us written notice at the time of the withdrawal that you
request us to make payment to the Annuitant or another person, and that such
payment is permissible under the Plan.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300.
If a withdrawal made under this Section would result in an Annuity Account Value
of less than $500, we will so advise you and reserve the right to pay the
Annuity Account Value to you, and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS.
NO WITHDRAWAL CHARGE FOR PARTIAL WITHDRAWALS: There will be no charge for a
partial withdrawal if (a) the amount of partial withdrawal requested is not
greater than the Free Corridor Amount defined in Section 2.09 or (b) the Cash
Value is equal to the Annuity Account Value, pursuant to Section 1.05.
WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than
the Free Corridor Amount, we will (i) first withdraw from the Divisions an
amount equal to the Free Corridor Amount in proportion to the amount you have in
them, and (ii) then withdraw an amount equal to the excess of the amount
requested over the Free Corridor Amount, plus a partial withdrawal charge. Such
partial withdrawal charge will be equal to the lesser of (a) or (b) where:
(a) is an amount equal to
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the amount withdrawn in excess of the Free Corridor Amount (including
such charge) pursuant to (ii) of the preceding sentence.
(b) is the excess, if any, of (i) 8% of the total Contributions made on the
your behalf during the current Contract Year and the nine preceding
Contract Years over (ii) the cumulative total of any prior partial
withdrawal charges made pursuant to this Section
If withdrawals are made from this Contract prior to the Annuitant's Retirement
Date, any applicable tax charges we have paid with respect to this Contract may
be deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to this Contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if the
Annuitant has completed three Contract Years or attained age 59 years and 6
months an amount equal to the excess, if any, of (i) 10% of the sum of the
Annuity Account Value on the Transaction Date over (ii) cumulative prior
withdrawals made pursuant to Section 2.07 in the current Contract Year. If the
Annuitant has not completed three Contract Years or attained age 59 years and 6
months, the Free Corridor Amount is zero.
No. 92 PEDB Page 9
SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $25,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts you have in the
Divisions.
If the Annuity Account Value is $25,000 or greater at the end of a Contract
Year, the Annual Administrative Charge is zero.
If the Annuity Account Value is less than $25,000 on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.02
or (b) the date of termination of this Contract pursuant to Sections 2.06 or
2.11, we will prorate the Annual Administrative Charge applicable to the
completed portion of the current Contract Year and withdraw such amount in lieu
of the Annual Administrative Charge described in this Section for the applicable
part of that Contract Year.
SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of the Annuitant's death,
we will pay to you as beneficiary in a single sum the amount of the death
benefit. You may change the beneficiary or the payment method of the death
benefit as permitted by the Plan, pursuant to Section 4.04. The amount of the
death benefit is equal to the greater of (i) the Annuity Account Value and (ii)
the minimum death benefit. Such minimum death benefit is the sum of all
contributions made by you pursuant to Section 2.01 (before reduction for any
applicable tax charge) less any withdrawals made pursuant to Section 2.07. Any
such withdrawal will reduce the minimum death benefit (as adjusted by any
previous such withdrawal) by an amount which is in the same proportion as the
amount that was withdrawn is to the Annuity Account Value. If, in accordance
with the provisions of Section 2.01, the cash value of another annuity contract
issued by us or one of our affiliated or subsidiary life insurance companies,
which provides for a death benefit before retirement equal to the greater of the
contract cash value or an alternate amount based on premiums paid or
contributions made under the annuity contract, is transferred to this Contract,
such cash value or alternative amount as of the date of transfer will be
included in the "sum of all Contributions" in lieu of the amount of cash value
transferred for purposes of the death benefit under this Contract.
We will pay the death benefit to the beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.04. Also in accordance with the last paragraph of Section 4.04, if no such
election is in effect at your death, we will pay the death benefit to the
beneficiary in a single sum, unless the beneficiary elects, before we pay the
death benefit, to apply the death benefit to an Annuity Benefit.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value under this Contract shall be zero. We will be released
from any and all liability for payments with respect to the Contributions from
which the Annuity Account Value arose.
-------------------------------------------------------------------------------
PART III -- ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under the terms of this Contract with respect to a payee is the amount provided
with respect to the payee pursuant to Section 3.03.
SECTION 3.02 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your
Retirement Date, provided the Annuitant is then living, the Annuity Account
Value shall be applied to provide the Normal Form of Annuity Benefit, unless you
elect to receive the Cash Value in a single sum, subject to our rules then in
effect and any other applicable requirements under the Code.
Notice and election forms will be provided to you not more than six months prior
to the Retirement Date. (On your prior written request we will also provide
notice and election forms directly to the Annuitant).
If you elect prior to the Annuitant's Retirement Date to terminate this Contract
pursuant to Section 2.06, an election may be made to receive an Annuity Benefit
in lieu of the Cash Value.
If your Plan permits and you provide us written instructions to do so in advance
of payment, we will make payment of the Cash Value, Annuity Benefits or partial
withdrawals directly to the Annuitant, Substituted Beneficiary or other payee
designated by you.
We will have the right to require you to furnish pertinent facts and
determinations to provide an Annuity Benefit, and will be fully protected in
relying on such information and need not inquire as to the accuracy or
completeness thereof.
No. 92 PEDB Page 10
The applicable Annuity Benefit will be provided pursuant to Sections 3.03 and
3.04.
SECTION 3.03 AMOUNT OF ANNUITY BENEFITS. If you elect pursuant to the first or
third paragraph of Section 3.02 to have paid an Annuity Benefit in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be the Cash
Value.
The amount applied to provide an Annuity Benefit may be reduced by a charge for
any applicable taxes on annuity considerations, as we determine. If we have
previously deducted charges for applicable taxes from Contributions as provided
in Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to this Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, this Contract will be governed by our
supplementary contract then in effect.
If an amount is applied to provide an Annuity Benefit the amount to be applied
will, in addition to any tax charge reduction, be reduced by an administrative
charge. The amount of such charge will be determined from time to time in
accordance with our general practices applicable on a uniform basis to all
contracts of the same type as this Contract.
After the application of an amount to provide an Annuity Benefit the Annuity
Account Value shall be zero.
The Table of Guaranteed Annuity Payments set forth the minimum amount of monthly
income that $1,000 of Annuity Account Value will provide under this Contract, as
indicated, as a Period Certain Annuity. The amounts of income provided under the
Fixed Annuity Benefit payable on the Period Certain Annuity are based on 3.5%
interest. We may change the monthly income amounts contained in the Table of
Guaranteed Annuity Payments and the basis for determining such amounts, for new
Annuitants, by at least 90 days advance notice to the Owner and by an amendment
to this Contract.
Amounts required for periods certain not shown in the Table will be calculated
by us on 3.5% interest.
SECTION 3.04 PAYMENT OF ANNUITY BENEFITS. Pursuant to Sections 457(d) and
401(a)(9) of the Code, and subject to the terms of the Plan, the entire interest
of the Annuitant will be distributed or begin to be distributed, no later than
the first day of April following the calendar year in which the Annuitant
attains 70 years and 6 months ("Required Beginning Date"). The entire interest
may be distributed, as elected pursuant to the Plan and this Contract, over (a)
the life of the Annuitant, or the lives of the Annuitant and a designated
beneficiary, or (b) a period certain not extending beyond the Annuitant's life
expectancy, or the joint and last survivor life expectancy of the Annuitant and
a designated beneficiary. Distributions must be made in periodic payments at
intervals of no longer than one year. In addition, payments must be either
nonincreasing or they may increase only as provided in Q & A F-3 of Section
1.401(a)(9)-1 of the Proposed Treasury Regulations, or any successor Regulation
thereto.
All distributions made hereunder shall be made in accordance with the
requirements of Section 401(a)(9) of the Code, including the incidental death
benefit requirements of Section 401 (a)(9)(G) of the Code, and applicable
Treasury Regulations, including the minimum distribution incidental benefit
requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or
any successor Regulation thereto.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.04, while any distribution shall be subject to such requirements of
the Code and regulations, any distribution shall also be subject to the terms of
this Contract. That is, the forms of distribution shall be those which are made
available by us at the time of your election.
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9.
Unless otherwise elected prior to the time distributions are required to begin,
those life expectancies shall be recalculated annually. Such election shall be
irrevocable and shall apply to all subsequent years. The life expectancy of a
non-spouse beneficiary may not be recalculated. Instead, life expectancy will be
calculated using the attained age of such beneficiary during the calendar year
in which the Annuitant attains age 70 years and 6 months, and payments for
subsequent years shall be calculated based on such life expectancy reduced by
one for each calendar year which has elapsed since the calendar year life
expectancy was first calculated.
If the Annuitant dies after distribution of the interest described in the first
paragraph of this Section has begun, the remaining portion of such interest will
continue to be distributed at least as rapidly as under the method of
distribution being used prior to the Annuitant's death.
If the Annuitant dies after distribution of the interest described in the first
paragraph of this Section begins, distribution of the entire interest shall be
completed no later than December 31 of the calendar year containing the fifth
anniversary of the Annuitant's death, except to the extent that an election is
made to receive death benefit distributions in accordance with (1) or (2) below:
(1) If the Annuitant's interest is payable to a designated beneficiary, then
the entire interest may be distributed over a period certain not greater
than the life expectancy of the designated beneficiary. Such distributions
must commence on or before December 31 of the calendar year immediately
following the calendar year of the Annuitant's death. If the designated
beneficiary is not the Annuitant's surviving spouse a Period Certain
Annuity Benefit cannot exceed 15 years, (even if life expectancy is greater
than 15 years).
No. 92 PEDB Page 11
(2) If the designated beneficiary is the Annuitant's surviving spouse, the date
distributions that are required to begin in accordance with (1) above shall
not be earlier than the later of (A) December 31 of the calendar year
immediately following the calendar year of the Annuitant's death or (B)
December 31 of the calendar year in which the Annuitant would have attained
age 70 years and 6 months.
For purposes of determining the "period certain" referred to in the immediately
preceding paragraph, life expectancy is computed by use of the expected return
multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes
of distributions beginning after the Annuitant's death, unless otherwise elected
by the surviving spouse by the time distributions are required to begin, life
expectancies shall be recalculated annually. Such election shall be irrevocable
by the surviving spouse and shall apply to all subsequent years. In the case of
any other designated beneficiary, life expectancies shall be calculated using
the attained age of such beneficiary during the calendar year in which
distributions are required to begin pursuant to this Section, and payments for
any subsequent calendar year shall be calculated based on such life expectancy
reduced by one for each calendar year which has elapsed since the calendar year
life expectancy was first calculated.
Distributions under this Section are considered to have begun if distributions
are made because the Required Beginning Date was reached, or, if prior to the
Required Beginning Date, distributions irrevocably commence to an individual
over a period permitted and in an annuity form acceptable under Section
1.401(a)(9) of the Proposed Treasury Regulations or any successor Regulation
thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under this Contract was based on information that is
subsequently found to be incorrect, the benefit will not be invalidated, but an
adjustment on the basis of the correct information will be made in the amount of
the benefit payments, or any amount used to provide the benefit, or any
combination thereof. Overpayments by us will be charged against and
underpayments will be added to any payments thereafter falling due under this
Contract with respect to the payee, affecting as many such payments as are
necessary to correct the overpayment or underpayment. Our liability, with
respect to a payee, is limited to the correct information and the actual amounts
used to provide the benefits then in force with respect to the payee under this
Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under this Contract is physically or mentally incompetent to receive
such payment or is a minor, (ii) another person or an institution is then
maintaining or has custody of such payee, and (iii) no guardian, committee, or
other representative of the estate of such payee has been appointed, we may make
the payments (in the case of a minor, at a rate not exceeding $200 a month) to
such other person or institution, and will thereupon be fully discharged from
all liability with respect thereto.
Pursuant to Section 3.02, upon the election of a Period Xxxxxxx Xxxxxxx, you (or
the Annuitant, if you have advised us in writing that it is permitted under the
terms of the Plan) may designate (with the right to change such designation) a
payee to receive any payments that may become due after the death of the person
or persons upon whose life or lives the income may depend.
Subject to the terms of the Plan, the payee may designate (with the right to
change such designation and without the concurrence of any other person) a
person or persons to receive any payments or installments payable after such
payee's death, if the absence of such a designation would result in a single sum
payment to such payee's estate in accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments.
The commuted value of any such remaining payments will be determined on the
basis of compound interest at the rate utilized in the actuarial rate basis.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.02.
No. 92 PEDB Page 12
TABLE OF GUARANTEED ANNUITY PAYMENTS
FIXED ANNUITY BENEFIT PAYABLE ON THE
PERIOD CERTAIN ANNUITY
(Minimum Monthly Income per $1,000 of Annuity Account Value)
PERIOD CERTAIN PERIOD CERTAIN MONTHLY INCOME
(IN YEARS) MONTHLY INCOME (IN YEARS)
----------------------------------------------------------------------------
1 $84.65 11 $ 9.09
2 $43.06 12 $ 8.46
3 $29.19 13 $ 7.94
4 $22.27 14 $ 7.49
5 $18.12 15 $ 7.10
6 $15.35 16 $ 6.76
7 $13.38 17 $ 6.47
8 $11.90 18 $ 6.20
9 $10.75 19 $ 5.97
10 $ 9.83 20 $ 5.75
----------------------------------------------------------------------------
Any election, change, revocation, or designation shall be made, and will take
effect, on the Transaction Date, in the same manner as a change of beneficiary
as described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
-------------------------------------------------------------------------------
PART IV -- GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the
parties and the terms of this Contract alone will govern with respect to our
rights and obligations. A copy of the application is incorporated in and made
part of this Contract.
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by our authorized officer. The terms of this
Contract may be changed by amendment or replacement upon agreement between you
and us without the consent of any other person.
This Contract is subject to the rules and regulations of the Deferred
Compensation Board of the State of New York, and said rules and regulations are
made a part thereof.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of
this Contract without the consent of any other person in order to comply with
applicable laws and regulations. Such right shall include, but not be limited
to, the right to conform this Contract to reflect changes in the Code,
applicable Treasury Regulations, or in regulations or published rulings of the
Internal Revenue Service so that this Contract will continue to be an Annuity
under a qualified plan.
SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY AND ASSIGNMENTS. The entire
interest under this Contract is nonforfeitable except by surrender to us.
Any interest under the terms of this Contract may not be sold, assigned,
discounted, or pledged as collateral for a loan or as security for the
performance of an obligation or for any other purpose to any person other than
us.
No amount payable under the terms of this Contract may be assigned or commuted,
unless specifically provided for under the terms of this Contract, or encumbered
by the payee, and, to the extent permitted by law, no such amount will in any
way be subject to any claim against such payee.
No. 92 PEDB Page 13
SECTION 4.04 BENEFICIARY. You, as beneficiary, are entitled to receive any death
benefit payable under this Contract pursuant to Section 2.11. Upon the
Annuitant's death you may, by written request to our Processing Office, at any
time up to and including provision of due proof of such death, change the
beneficiary designation for the Section 2.11 death benefit from you to the
Substitute Beneficiary.
Subject to the terms of the Plan, the Substitute Beneficiary may elect to
receive the death benefit payable under Section 2.11 in the form of an Annuity
Benefit rather than as a single sum. Any such election must meet the minimum
distribution rules of Sections 457(d) and 401(a)(9) of the Code and applicable
Treasury Regulations, as described in Section 3.05.
SECTION 4.05 DISQUALIFICATION OF PLAN OR CONTRACT. In the event that the Plan
fails to qualify as an Eligible Deferred Compensation Plan under Section 457 of
the Code and applicable Treasury Regulations, we reserve the right, upon
receiving notice of such fact, to transfer the Annuity Account Value under this
Contract to another annuity contract issued by us or one of our affiliated or
subsidiary life insurance companies on the life of the Annuitant, or to
terminate this Contract and pay to you the Annuity Account Value less a
deduction for applicable taxes, solely at our option.
In the event that this Contract fails to qualify as an Xxxxxxx as described in
Section 1.02, we will have the right, upon receiving notice of such fact, to
terminate this Contract and pay to you the Annuity Account Value less a
deduction for the appropriate part attributable to you of any income tax payable
by you which would not have been payable if you had an Annuity.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you, we reserve the
right to limit Contributions under this Contract if required by law.
SECTION 4.07 DEFERMENT. Payment of death benefit and payment of any portion of
the Annuity Account Value (less any applicable withdrawal charge) will be made
within seven days after the Transaction Date. Payments from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities and
Exchange Commission, by order, permits us to defer payments in order to protect
persons with interests in the Investment Divisions. We can defer payment of any
portion of the Annuity Account Value in the Guaranteed Interest Division for up
to six months while the Annuitant is living.
SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year, we will furnish
you with a notice showing the following:
(1) the amount in the Guaranteed Interest Division,
(2) the total number of Accumulation Units in the Stock Division, Balanced
Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Value,
(4) the amount in the Stock Division, Balanced Division, Aggressive Stock
Division and Money Market Division,
(5) the Cash Value, and
(6) the amount of death benefit payable with respect to the Annuitant.
We will also furnish annual calendar year reports concerning the status of the
annuity and any other reports required by the Code or applicable Treasury
Regulations.
SECTION 4.09 QUARTERLY NOTICE. At least once during each calendar quarter up to
and including the Retirement Date, we will furnish you with a notice showing the
Annuity Account Value in the Guaranteed Interest Division, Stock Division,
Aggressive Stock Division and Money Market Division.
SECTION 4.01 AGE. If the Annuitant's age has been misstated, any benefits will
be those which would have been purchased at the correct age. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
SECTION 4.11 OWNERSHIP RIGHT TO EMPLOYER. Notwithstanding any other provision of
the terms of this Contract, until amounts under this Contract are distributed or
made available to the Annuitant or the Annuitant's beneficiary in accordance
with the terms of this Contract and the terms of the Plan, this Contract remains
solely the property of the Employer subject only to claims of the Employer's
general creditors. This Section shall be construed and administered in
accordance with Section 457(b)(6) of the Code and the regulations thereunder.
No. 92 PEDB Page 14
--------------------------------------------------------------------------------
APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
PROCESSING OFFICE: INDIVIDUAL ANNUITY CENTER, P.O. BOX 2996,
NEW YORK, NEW YORK 10116-2996
QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR:
EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY
--------------------------------------------------------------------------------
TYPE OF PURCHASE (Complete One Plan Only)
A. |_| TSA PUBLIC SCHOOL (GV-PS-I)
B. |_| TSA 501(C)(3) ORGANIZATION (GV-501-I)
C. |_| TSA University (GV-PS-U-I)
D. |_| IRA Individual (Including IRA to IRA transfers) (XX-XXX 4971)
E. |_| IRA Unit Billed (Including IRA to IRA transfers) (XX-XXX 4971)
F. |_| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified
Plan) (XX-XXX 4971-71)
G. |X| EDC (Public Employee Deferred Compensation) (GV-EDC 4991)
H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-080)
I. |_| SEP (Simplified Employee Pension) (GV-SEP 4981)
J. |_| SARSEP (Salary Reduction SEP) _________________________________________
K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41)
L. |_| XXXXX/HR-10 TRUSTEE (GV HR-10 4911-11)
(trustee owned)
M. | | XXXXX/HR-10 (GV-HR-10 4911)
(not trustee owned) (issued to existing units only)
--------------------------------------------------------------------------------
DO NOT COMPLETE THIS SECTION IF 1.D OR 1.F CHECKED ABOVE
2. EMPLOYER/PLAN NAME
|A|B|C|_|C|O|M|P|A|N|Y|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_|
|_| NEW UNIT | | | | | | |-| | | |
(FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM
983-135B IS REQUIRED)
--------------------------------------------------------------------------------
4. PROPOSED ANNUITANT Print name to appear on Contract.
|J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_|
FIRST MIDDLE INITIAL LAST
A. |X| MR. |_| MRS. |_| MS. |_| OTHER ____
B. Date of Birth: Year 1954 Month JANUARY Day 27
---- ------- --
C. Age at Nearest Birthday: 38 D. |X| Male |_| Female
----
X. Xxxxxxxxx's Mailing Address: F. State of Residence: N.J.
----
No., St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_|
City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1|
G. Telephone Number (101) 222 - 3456 |X| Home |_| Work
H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9|
I. Are you associated with or employed by a member of National
Association of Securities Dealers, Inc.(NASD)? |_| Yes |X| No
5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner, for all
other Markets Print Name of Annuitant.
XXXX XXX
-----------------------------------------------------------------------------
a. Title ____________________________________________________________________
6. RETIREMENT AGE 65
---------------------------------------------------------------
7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death
Benefit upon Xxxxxxxxx's death before Retirement Date.) (BENEFICIARY MUST
BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.)
ABC STATE DEFERRED COMPENSATION PROGRAM - EMPLOYER
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
8. CONTRIBUTION ALLOCATION
Guaranteed Interest Division %
-----
Stock Division %
-----
Money Market Division %
-----
Balanced Division %
-----
Aggressive Stock Division %
-----
(PERCENTAGES IN WHOLE NUMBERS) Total 100%
9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F)
A. Reminder Notice (Billing) Required |_| Yes | | No
IF YES, COMPLETE B-C-D-E
B. REMINDER DATE Required for Individual IRA or otherwise must agree
with existing unit or attached 983-135B. MONTH _________ DAY __________
C. REMINDER FREQUENCY
|_| Annual |_| Semi-Annual
|_| Quarterly |_| Monthly
Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA
ONLY:
|_| Semi-Monthly |_| Bi-Weekly
D. REMINDER AMOUNT $_________________________________
E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
10.EXPECTED FIRST CONTRACT YEAR
Contribution. $1000
----------------------------------------------------------------
IF AN ADVANCED BILLING AND/OR CONTRACT DATE ARE REQUESTED, COMPLETE #9B
AND #12.
--------------------------------------------------------------------------------
(FOR PROCESSING OFFICE USE)
Unit Name ___________________________ Reminder Date ___________________________
Cert. or App# _______________________ Amendment Required_______________________
EDC Emp. Add. _______________________ Emp. Fed. ID# ___________________________
Frequency ___________________________ Contract Date ___________________________
--------------------------------------------------------------------------------
Receipt Date Batch # Inquiry # Processor
--------------------------------------------------------------------------------
180-1000
--------------------------------------------------------------------------------
10. Did you receive the Separate Account Prospectus? |X| Yes |_| No
Date shown on Prospectus January 1, 1992
----------------------------------------------------
Date of any supplement to Prospectus _______________________________________
11. Items (a) through (f) are to be answered by the annuitant. We are
required by the NASD to ask these questions.
(a) Name of Employer: ABC Company
------------------------------------------------------
(b) Address of Employer:
10 Main Street
---------------------------------------------------------------------------
Anytown, NJ
---------------------------------------------------------------------------
(c) Occupation Sales
-------------------------------------------------------------
(d) Assuming the contract applied for will be issued, will any existing
insurance or annuity be replaced or changed (or has it been)?
| | Yes |X| No
(e) Estimated Family Annual Income $100,000
----------------------------------------
(f) Estimated Net Worth $250,000
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(g) Investment Objective: |_| Income |X| Income & Growth
|_| Aggressive Growth |_| Growth |_| Safety of Principal
12. SPECIAL INSTRUCTIONS
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13. Amount paid with this form: $1000
(If a check is submitted with this request, no advanced Contract Date is
permitted.) BACKDATING IS NOT PERMITTED.
NOTE: Xxxxxx paid will be credited upon receipt at Equitable's Processing
Office, subject to return if the certificate is not issued. The Contract Date
will be the date of receipt by Equitable of this application, properly signed
and completed, and Contribution at Equitable's Processing Office.
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AGREEMENT
All information and statements furnished in this application are true and
complete to the best of my knowledge and belief. I understand and acknowledge
that no Agent has the authority to make or modify any contract on Equitable's
behalf, or to waive or alter any of Equitable's rights and regulations.
IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO
THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT
PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT.
UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S)
OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND
COMPLETE.
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LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY
APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS.
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X__________________________________ Date_______ City __________ State __________
Signature of Annuitant
X__________________________________ Date_______ City __________ State __________
Signature of Authorized Individual (REQUIRED FOR EDC AND
TRUSTEED) OR OWNER
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AGENT'S SECTION
Will any existing insurance or annuity be replaced or changed (or has it been),
assuming the Contract will be issued? | | Yes | | No
|_| I (we) certify that a prospectus for the Contract has been given to the
proposed Annuitant and that no written sales materials other than those approved
by Equitable have been used.
EQUI-VEST issues must adequately reflect the commission interest of all Agents
on previous contracts.
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Print Agent's Name(s) Initial of Agent Agent Agency District Agent's
(Service Agent first) Last Name Number % Code Manager Code Signature
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FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS___ Date ___ District EQS ___
Date ____
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(FOR ASU USE)
ASU Code and App. No. __________________________________________________________
ASU Rec'd. _____________________________________________________________________
Date to Proc. Off. ________________________________________________ Campaign |_|
Agent(s) shown above is Equity Qualified and is licensed in the state where the
request is signed. Above Agent information verified by XXX (Registered Rep)
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Application reviewed by ________________________________________________________
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180-1000
OWNER: XXXX XXX
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 000
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28, 1992
RETIREMENT DATE: JAN 1, 2020
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York,
New York 10116
AGREES
o TO ALLOCATE the Contributions made to this Contract, after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division (referred to in this Contract as
the "Investment Divisions") or to the Guaranteed Interest Division, in
accordance with Sections 2.02, 2.03, and 2.04 as directed by you, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide the
Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant
is then living, and
o TO PROVIDE the Annuitant with the other rights and benefits of this
Contract.
This is the entire Contract. In this Contract "we", "our", and "us" mean The
Equitable Life Assurance Society of the United States ("Equitable"). "You" and
"your" mean the Annuitant at the time a right is exercised by the Annuitant.
TEN DAYS TO EXAMINE CONTRACT - You may cancel this Contract by returning it to
us within ten days after receipt of it. Upon such cancellation, we will refund
any Contribution made to us under this Contract.
/s/ Xxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxxxx
Vice President and Secretary Chairman of the Board and
Chief Executive Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.22 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE
MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL
ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE
INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE
TRUST.
No. 92 QPIA
The Contract is issued in consideration of the payment to us of the
Contributions made under the terms of the Contract.
The provisions on the following pages are part of this Contract. A copy of the
application is incorporated in and made part of this Contract.
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TABLE OF CONTENTS
DEFINITIONS Page
SECTION 1.01 - Annuitant.........................................4
1.02 - Annuity...........................................4
1.03 - Annuity Account Value.............................4
1.04 - Annuity Benefit...................................4
1.05 - Cash Value........................................4
1.06 - Class of Contracts................................4
1.07 - Code..............................................4
1.08 - Contract..........................................4
1.09 - Contract Date.....................................4
1.10 - Contract Year.....................................4
1.11 - Contribution......................................4
1.12 - Divisions.........................................5
1.13 - Eligible Annuity Certain..........................5
1.14 - Guaranteed Interest Rate..........................5
1.15 - Joint and Survivor Life
Annuity Form......................................5
1.16 - Life Annuity Form.................................5
1.17 - Normal Form.......................................5
1.18 - Period Certain Annuity............................5
1.19 - Processing Office.................................5
1.20 - Retirement Date...................................5
1.21 - Separate Account..................................5
1.22 - Separate Account Definitions......................6
1.23 - Transaction Date..................................6
1.24 - Trust.............................................7
ANNUITY ACCOUNT VALUE
SECTION 2.01 - Contributions.....................................7
2.02 - Separate Account Investment
Divisions.........................................7
2.03 - Guaranteed Interest Division......................7
2.04 - Allocation to Divisions...........................7
2.05 - Transfers Among Divisions.........................7
2.06 - Termination of this Contract......................8
2.07 - Partial Withdrawals...............................8
2.08 - Charges for Partial Withdrawals...................8
2.09 - Free Corridor Amount..............................8
2.10 - Annual Administrative Charge......................8
2.11 - Death Benefit.....................................9
ANNUITY BENEFITS
SECTION 3.01 - Fixed Annuity Benefit.............................9
3.02 - Variable Annuity Benefit..........................9
3.03 - Election and Commencement
of Annuity Benefits...............................9
3.04 - Amount of Annuity Benefits.......................10
3.05 - Payment of Annuity Benefits......................10
GENERAL PROVISIONS
SECTION 4.01 - Contract.........................................12
4.02 - Statutory Compliance.............................12
4.03 - Nonforfeitability
Nontransferability,
and Assignments..................................12
4.04 - Beneficiary......................................12
4.05 - Disqualification.................................13
4.06 - Future Contributions.............................13
4.07 - Deferment........................................13
4.08 - Annual Notice....................................13
4.09 - Age and Sex......................................13
No. 92 QPIA Page 2
OWNER: XXXX XXX
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 000
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28, 1992
RETIREMENT DATE: JAN 1, 2020
INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992
MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992
3.00% AFTER DEC 31, 1992
BENEFICIARY: XXXX XXX
FORM NUMBER: 92QPIA
********************************************************************************
TABLE OF GUARANTEED VALUES
ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION
NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY
SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65
------------------------ ---------- -----------------
1 983 6.61
2 1,958 16.17
3 2,963 26.62
4 3,998 36.76
5 5,064 46.61
6 6,220 56.96
7 7,362 67.37
8 8,538 77.25
9 9,870 86.97
10 11,263 95.47
11 12,719 103.72
12 14,242 111.73
13 15,832 119.50
14 17,337 127.05
15 18,887 134.38
16 20,484 141.49
17 22,129 148.40
18 23,822 155.10
19 25,567 161.61
20 27,364 167.94
24 (Age 62) 35,108 191.43
27 (Age 65) 41,547 207.32
THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000
CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT
DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE
(SEE SECTION 2.10) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ANNUITY ACCOUNT
VALUE (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND
EARNINGS ARE ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION.
YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON
THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS.
THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE
WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY
BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A
SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04).
*ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO
SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT.
No. 92QPIA Page 3
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PART I--DEFINITIONS
SECTION 1.01 ANNUITANT. The term "Annuitant" means the person who owns this
Contract as shown on page 3 and who exercised all rights under the terms of this
Contract.
SECTION 1.02 ANNUITY. The term "Annuity" means an individual retirement annuity
contract meeting the requirements of Section 408(b) of the Code.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts that you have in the Guaranteed Interest Division and the
Investment Divisions of the Separate Account, pursuant to Sections 2.02 and
2.03.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by Equitable pursuant to Section 3.04 of this Contract. Various sections of this
Contract (Sections 1.15, 1.16, 3.01, and 3.02) refer to monthly payments to be
made under an Annuity Benefit. You may wish to have the Annuity Benefit paid at
other intervals, such as quarterly, semi-annually, or annually, instead of
monthly. You may elect this at the time you elect the Annuity Benefit form as
described in Section 3.03; in that event, all references in this Contract to
monthly payments will be deemed to mean payments at the frequency you elect,
subject to our rules at the time of election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value
less any applicable withdrawal charge determined as follows:
The withdrawal charge equals the lesser of (a) or (b) where
(a) equals
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the excess of (i) the sum of the Annuity Account Value over (ii) the
Free Corridor Amount defined in Section 2.09, and
(b) is the excess, if any, of (i) 8% of the total Contributions made during
the current Contract Year and the nine preceding Contract Years over (ii)
the cumulative total of any prior charges for partial withdrawals made
pursuant to Section 2.08.
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
A withdrawal charge will not apply, which means the Cash Value will equal the
Annuity Account Value upon any of the following occurrences:
(i) your attainment of age 59 years and 6 months and your completion of at
least five Contract Years, or
(ii) a request is made for a refund of a contribution in excess of amounts
allowed to be contributed under Section 408 of the Code within one
month of the date on which the contribution is made, or
(iii) you die and a distribution is made to the beneficiary, or
(iv) your attainment of age 55, your completion of at least five Contract
Years and you use the amount withdrawn to purchase from us an Eligible
Annuity Certain, or
(v) your completion of at least three Contract Years and you use the amount
withdrawn to purchase from us a Period Certain Annuity of at least 10
years, or
(vi) your Annuity Account Value is applied to the election of a Life Annuity
Form or Joint and Survivor Life Annuity Form distribution option, or
(vii) your completion of at least twelve Contract Years.
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same calendar year.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as
amended, or any corresponding provisions of prior or subsequent United States
revenue laws.
SECTION 1.08 CONTRACT. The term "Contract" means this Contract, which requires
amounts contributed from rollovers of qualified plan distributions hereunder to
be applied to the purchase of an individual retirement annuity within the
meaning of Section 408(b) of the Code.
SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both an application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made in cash
or by check to us with respect to this Contract. We are under no obligation to
accept any Contribution less than $1,000.
No. 92 QPIA Page 4
Such contributions must qualify as "rollover amounts" within the meaning of
Section 402(a)(5) or 403(b)(8) of the Code or "rollover contributions" from a
"conduit" individual retirement account or annuity described in Section
408(d)(3)(A)(ii) and (iii) of the Code, as the case may be.
SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following Divisions described in this
Contract:
(a) the Guaranteed Interest Division, and
(b) the Investment Divisions of the Separate Account.
SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
an annuity not involving life contingencies issued by us, which extends beyond
your attainment of age 59 years and 6 months and does not permit any prepayment
of the unpaid principal (that is no withdrawal or single sum payment) prior to
your attainment of age 59 years and 6 months.
SECTION 1.14 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrues on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of
this Contract. Section 2.03 describes the determination of the rate to apply
thereafter.
SECTION 1.15 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose life such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected by you. The payments commence on the date as of which the Joint and
Survivor Life Annuity Form is purchased and terminate with the last payment due
before the death of the survivor.
SECTION 1.16 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us providing monthly payments during the lifetime of the person upon
whose life such payments depend. The payments commence on the date as of which
the Life Annuity Form is purchased and terminate with the last payment due
before the death of such person.
SECTION 1.17 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contact means, (i) if you have a living spouse at your Retirement Date, the
Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with
your spouse as the contingent annuitant (with 100% of the monthly payment amount
continued to your spouse), and (ii) if you do not have a living spouse at the
Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form.
SECTION 1.18 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us which does not permit any
prepayment of the unpaid principal (that is, you cannot elect to receive part of
the payments as a single sum payment with the remainder paid in monthly annuity
payments).
SECTION 1.19 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P.O. Box 2996, GPO, New York, New York 10116, or such
other location as we shall designate by advance written notice to you.
SECTION 1.20 RETIREMENT DATE. The term "Retirement Date" means the date on which
you attain your retirement age as shown on page 3 of this Contract. Before the
Retirement Date you may elect to change the Retirement Date to another
Retirement Date, which may be any date after the filing of the election (other
than the 29th, 30th, or 31st day of any month). No Retirement Date shall be
earlier than the day you attain age 59 and 6 months nor shall be later than the
first day of April following the calendar year in which you attain age 70 and 6
months. Any election for such change must be made in writing by you and shall
not take effect until received by us at our Processing Office.
SECTION 1.21 SEPARATE ACCOUNT. The term "Separate Account" means Separate
Account A, which is organized as a unit investment trust, (a type of investment
company). We established the Separate Account and it is maintained in accordance
with the laws of New York State. Realized and unrealized gains and losses from
the assets of the Separate Account are credited to or charged against it without
regard to our other income, gains or losses. Assets are put in the Separate
Account to support this Contract and other variable annuity contracts. Assets
may be put in the Separate Account for other purposes, but not to support
contracts or policies other than variable annuities and variable life insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these Contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust where each class (or series) represents a separate portfolio in
the Trust. We reserve the right to change the designated Trust or to add
designated trusts or investment companies. The Investment Divisions available
are the Stock Division, the Money Market Division, the Balanced Division and the
Aggressive Stock Division. The Guaranteed Interest Division is not part of the
Separate Account rather is an asset of our General Account.
We will value the assets of each Investment Division on each business day. A
business day is any day on which Equitable is open, the New York Stock Exchange
is open for trading and there is a sufficient degree of trading in the portfolio
securities in which an Investment Division is invested to materially affect the
Accumulation Unit Value.
NO. 92 QPIA Page 5
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments it is
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under
the Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable
law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such a committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any
other form;
(v) add Investment Divisions (or sub-divisions of Investment Divisions) to,
or remove Investment Divisions (or sub-divisions of Investment
Divisions) from the Separate Account (the term "Investment Division" in
this Contract shall then refer to any other Investment Division in
which the assets of a class of Contracts to which this Contract
belongs, were placed);
(vi) combine any two or more Investment Divisions (or sub-divisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
class of Contracts to which this Contract belongs.
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, you will be notified of such exercise, as
required by law.
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for any applicable
tax charge) at a rate not to exceed 1.49% per year for each of the Stock, Money
Market and Balanced Divisions, and 1.34% per year, for the Aggressive Stock
Division, for financial accounting, death benefits, mortality risk, expenses and
expense risks. The charge shall be made in accordance with Subsection (c) of the
Net Investment Factor provision in Section 1.22. The relative proportion of
these charges may be modified. This daily charge, plus the investment advisory
fee charges and direct operating expense charges of the Trust, shall not exceed
a total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract. The maximum rate may not be altered
without your approval.
SECTION 1.22 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any preceding consecutive
non-business days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment
Division for the Valuation Period. For this purpose, we use the share
value reported to us by the Trust.
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period
(after taking into account any amounts allocated or withdrawn for that
Valuation Period).
(c) is the daily asset charge for the expenses of this Contract, times the
number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an
Investment Division where your Contributions are invested and which is used in
determining the amount you have in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for that Investment Division for such Valuation Period.
ANNUITY UNIT: The term "Annuity Unit" is a unit used in determining amounts
payable from the Stock Division of the Separate Account under a Variable Annuity
Benefit as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first Contribution was put into the Stock
Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed
Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The
Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value
for the immediately preceding Valuation Period multiplied by the Adjusted Net
Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for a Valuation Period is the Net Investment Factor for such
period reduced for each calendar day in such subsequent Valuation Period by the
Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net
Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net
Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall
be 5%, except in states where the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar
month is equal to the average of the Annuity Unit Values for all Valuation
Periods ending in
No. 92 QPIA Page 6
such month.
SECTION 1.23 TRANSACTION DATE. The term "Transaction Date" means the business
day we receive a Contribution or a written contract transaction request
providing the information we need at the Processing Office. In the case of a
transfer request initiated through the use of a touch tone telephone as
described in Section 2.05, the term "Transaction Date" means the business day
the telephone transaction is received.
SECTION 1.24 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
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PART II -- ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. Contributions under the Contract are Contributions
which qualify as "rollover amounts" within the meaning of Section 402(a)(5) or
403(b)(8) of the Code, or "rollover contributions" from a "conduit" individual
retirement account or annuity described in Section 408(d)(3)(A)(ii) and (iii) of
the Code, as the case may be.
Each Contribution received by us will, before its allocation under this
Contract, be reduced by the amount of any applicable tax charge, as determined
by us. Pursuant to Section 2.06, if no tax has been deducted or if such tax is
due at termination of this Contract, we will deduct the amount due.
Contributions will be allocated to the Divisions in accordance with the
instructions received on your application, unless later changed.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to or withdrawn or transferred from an Investment
Division, you will be credited or charged, as the case may be, with the number
of Accumulation Units determined by dividing said amount by the Accumulation
Unit Value for the appropriate Investment Division for the Valuation Period
which includes that date. The number of units you have in an Investment Division
on any date is equal to (i) the sum of any Accumulation Units that have been
allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units
that have been withdrawn pursuant to Sections 2.07 or 208 or transferred from
the Investment Division pursuant to Section 2.05. The amount in an Investment
Division on any date is equal to the product of (i) the number of Accumulation
Units in the Investment Division on that date and (ii) the Accumulation Unit
Value for the Investment Division for the Valuation Period which includes that
date.
Participation in the Separate Account under the terms of this Contract
terminates on the earliest of (i) your election and commencement of Annuity
Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or
(iii) termination of this Contract pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets, which support
the guarantees of this Contract and other contracts.
The amount in the Guaranteed Interest Division at any time is equal to the sum
of all amounts that have been allocated to the Guaranteed Interest Division
pursuant to Section 2.04 plus the amount of any interest accrued but not
allocated, less the sum of all amounts, that have been withdrawn from the
Guaranteed Interest Division pursuant to Sections 2.07, 208 or 2.10 or
transferred from the Guaranteed Interest Division, pursuant to Section 2.05.
Interest is allocated to the Guaranteed Interest Division on a Transaction Date,
pursuant to Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts, we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division under this Contract terminates
on the earliest of (i) your election and commencement of annuity benefits
pursuant to Section 3.03, (ii) receipt of due proof of your death or (iii)
Termination of this Contract pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction of any applicable tax charge) to one or more
Divisions, at your sole direction as specified to us. Allocation percentages
must be in whole numbers and the sum must equal 100. The allocation is made as
of the Transaction Date on which we have received both such Contribution and
such direction. Contributions made to an Investment Division purchase
Accumulation Units in that Investment Division, using the Accumulation Unit
Value next computed after the Transaction Date.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon termination of this Contract pursuant to Section 2.06, and (vi)
upon your death pursuant to Section 2.11.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request, or
through the use of a touch tone telephone, transfer all or part of the amount
you have
No. 92 QPIA Page 7
in a Division to one or more of the Divisions as follows: (1) amounts in the
Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive
Stock Division may be transferred among such Divisions; and (2) amounts in the
Money Market Division may be transferred to other Divisions. Written
authorization for touch tone telephone initiated transfers is only required when
authorization for telephone transfers is requested. Upon advance written notice
to you, we reserve the right to discontinue the acceptance of transfer requests
through the use of a touch tone telephone. All transfers will be effective on
the Transaction Date and will be subject to our rules in effect at the time of
transfer. With respect to the Investment Division, the transfer will be made at
the Accumulation Unit Value next computed after the Transaction Date. No
transfers are permitted to the Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. You may elect by written notice to
terminate this Contract. We will determine the Cash Value as of the Transaction
Date we receive your written election.
If this Contract is terminated, surrendered or exchanged prior to your
Retirement Date, any applicable tax charges we have paid may be deducted. If we
have previously deducted charges for applicable taxes from Contributions
pursuant to Section 2.01, we will not again deduct charges for the same taxes on
terminations, unless a change in applicable law has occurred with respect to
your Contract.
The payment of such Cash Value may be deferred by us in accordance with the
provisions of Sections 4.07.
We reserve the right to pay the Annuity Account Value under the Contract and
terminate this Contract. This right may be exercised if (i) no Contributions are
made on your behalf during the last three completed Contract Years and the
Annuity Account Value is less than $500, or (ii) a partial withdrawal is made
that would result in your Annuity Account Value falling below $500. We also
reserve the right to terminate this Contract if no Contributions have been made
within 120 months of the Contract Date shown on page 3 of this Contract.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount you have in the Divisions and the Annuity Account Value shall be
zero. We will be released from any and all liability for payments with respect
to the Contributions from which the Annuity Account Value arose.
SECTION 2.07 PARTIAL WITHDRAWALS. You may elect, by written notice to us, to
make a partial withdrawal from the Divisions.
On the Transaction Date, we will pay the lesser of the Cash Value or the amount
of partial withdrawal requested to the person entitled to such payment as
designated in writing by you. The amount paid plus any withdrawal charge
applicable pursuant to Section 2.08 will be withdrawn from the amounts you have
in the Divisions. Unless we are instructed otherwise, the amount withdrawn
(including any withdrawal charge) will be allocated among the Divisions in
proportion to the amounts that you have in such Divisions.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300.
If a withdrawal made under this Section would result in an Annuity Account Value
of less than $500, we will so advise you and reserve the right to pay the
Annuity Account Value to you, and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS.
NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the
amount of partial withdrawal requested is not greater than the Free Corridor
Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity
Account Value, pursuant to Section 1.05.
WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than
the Free Corridor Amount, we will (i) first withdraw from the Divisions an
amount equal to the Free Corridor Amount, in proportion in the amount you have
in them, and (ii) then withdraw an amount equal to the excess of the amount
requested over the Free Corridor Amount, plus a partial withdrawal charge. Such
partial withdrawal charge will be equal to the lesser of (a) or (b) where:
(a) is an amount equal to
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the amount withdrawn in excess of the Free Corridor Amount (including
such charge) pursuant to (ii) of the preceding sentence.
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior partial withdrawal
charges made pursuant to this Section.
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
If withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to your Contract.
No. 92 QPIA Page 8
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means (i) 10%
of the sum of the Annuity Account Value on the Transaction Date over (ii)
cumulative prior withdrawals made pursuant to Section 2.07 in the Current
Contract Year.
SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $10,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value, including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts you have in the
Divisions.
If the Annuity Account Value is less than $10,000, on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03,
or (b) the date of Termination of this Contract pursuant to Section 2.06 or
2.11, we will prorate the Annual Administrative Charge applicable to the
completed portion of the Current Contract Year and withdraw such amount in lieu
of the Annual Administrative Charge applicable to the completed portion of the
Current Contract Year and withdraw such amount in lieu of the full Annual
Administrative Charge described in this Section for the applicable part of that
Contract Year.
If the Annuity Account Value is $10,000, or greater at the end of a Contract
Year, the Annual Administrative Charge is zero.
SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of your death, we will pay
to the beneficiary designated by you to receive such payment, pursuant to
Section 4.04 of this Contract, the amount of death benefit payable with respect
to you. The amount of the death benefit is equal to the greater of (i) the
Annuity Account Value and (ii) the minimum death benefit. Such minimum death
benefit is the sum of all Contributions made pursuant to Section 2.01 (before
reduction for any applicable tax charge) less any withdrawals made pursuant to
Section 2.07. Any such withdrawal will reduce the minimum death benefit (as
adjusted by any previous such withdrawal) by an amount which is in the same
proportion as the amount that was withdrawn is to the Annuity Account Value. If,
in accordance with the provisions of Section 2.01, the cash value of another
annuity contract issued by us, or one of our affiliated or subsidiary life
insurance companies, which provides for a death benefit before retirement equal
to the greater of the contract cash value or an alternate amount based on
premiums paid or contributions made under the annuity contract, is transferred
to this Contract, such cash value or alternative amount as of the date of
transfer will be included in the "sum of all Contributions" in lieu of the
amount of cash value transferred for purposes of the death benefit under this
Contract.
We will pay the death benefit to your beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.04. Also, in accordance with the last paragraph of Section 4.04, if no such
election is in effect at your death, we will pay the death benefit to your
beneficiary in a single sum, unless the beneficiary elects, before we pay the
death benefit, to apply the death benefit to an Annuity Benefit.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value will be zero. We will be released from any and all
liability for payments with respect to the Contributions from which the Annuity
Account Value rose.
--------------------------------------------------------------------------------
PART III -- ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under the terms of this Contract with respect to a payee is the amount provided
pursuant to Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFITS. The term "Variable Annuity Benefit"
means an Annuity Benefit under which the dollar amount of the monthly payments
with respect to a payee may increase or decrease depending on the investment
experience of the Stock Division.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of net
investment return referred to in Section 1.22 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.21, not exceed the maximum rate of 1.75% after any deductions to
provide for any applicable tax charge. These charges include a daily charge for
financial accounting, death benefits, mortality risk, expenses and expense risk,
plus the investment advisory fee charges and direct operating expense charges of
the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under this Contract with respect to a payee is the monthly
amount provided with respect to a payee pursuant to the fifth paragraph of
Section 3.04. The amount of the fourth and each subsequent payment under a
Variable Annuity Benefit will be equal to the number of Annuity Units with
respect to such benefit, multiplied by the Average Annuity Unit Value for the
second calendar month immediately preceding the due date of the payment. The
number of Annuity Units with respect to a benefit is the number determined by
dividing the amount
No. 92 QPIA Page 9
of the first monthly payment under such benefit by the Annuity Unit Value for
the Valuation Period which includes the due date of the first monthly payment.
(As described in Section 3.05, we will notify the payee how each Variable
Annuity payment is determined).
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your
Retirement Date, provided you are then living, the Annuity Account value shall
be applied to provide the Normal Form of Annuity Benefit, unless you elect (i)
to receive the Cash Value of this Contract in a single sum or (ii) to apply the
Annuity Account Value or Cash Value, whichever is applicable pursuant to the
first paragraph of Section 3.04, to provide an Annuity Benefit on any other form
offered by us, or one of our affiliated or subsidiary life insurance companies,
as elected by you, or (iii) to take partial withdrawals in amounts and at times
as required by the Code, pursuant to Sections 2.07 and 3.05, subject to our
rules then in effect and any other applicable requirements under the Code.
We will provide notice and election forms to you not more than six months before
your Retirement Date.
If you elect to terminate this Contract prior to the Retirement Date, pursuant
to Section 2.06, an election may be made to receive an Annuity Benefit in lieu
of the Cash Value.
We will have the right to require you to furnish pertinent information to
provide an Annuity Benefit and will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form, issued by us or one of our affiliated or subsidiary
life insurance companies.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or
third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be (i) the
Annuity Account Value if the annuity form elected involves life contingencies or
(ii) the Cash Value, if the Annuity Form elected does not involve life
contingencies.
The amount applied to provide an Annuity Benefit may be reduced by any
applicable tax charge on annuity considerations, as we determine. If we have
previously deducted any applicable tax charge from Contributions as provided in
Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to your Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed annuity Payments
shown below, or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your contract will be governed by our
supplementary contract then in effect.
If an amount is applied to provide an Annuity Benefit, the amount to be applied
will, in addition to any tax charge reduction, be reduced by an administrative
charge. The amount of such charge will be determined from time to time in
accordance with our general practices applicable on a uniform basis to all
contracts of the same type as this contract.
After the application of an amount to provide an Annuity Benefit, the amounts
you have in the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under the Contract, as
indicated, on the Joint and Survivor Life Annuity Form (with 100% of the amount
of your payment continued to your spouse). The amounts of income provided under
the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and
Survivor Life Annuity Form are based on 3.5% interest and the 1983 Individual
Annuity Table "a". The amount of income initially provided under the Variable
Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life
Annuity Form are based on the 1983 Individual Annuity Table "a" and an Assumed
Base Rate of Net Investment Income Return of 3.5% or 5%, whichever applies
pursuant to Section 1.22.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us based on 3.5% interest and the 1983 Individual Annuity Table
"a" if such annuity form provides for a Fixed Annuity Benefit, and on the same
such Table and an Assumed Base Rate of Net Investment Income Return of 3.5% or
5%, whichever applies pursuant to Section 1.22 if such annuity form provides for
a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract
will be distributed or begin to be distributed, in accordance with Section
401(a)(9) of the Code and the applicable Treasury Regulations thereunder no
later than the first day of April following the calendar year in which you
attain age 70 and 6 months ("Required Beginning Date"). Your entire interest may
be distributed, as you elect, over (a) your life, or the lives of you and your
designated beneficiary, or (b) a period certain not extending beyond your life
expectancy, or the joint and last survivor expectancy of you and your designated
beneficiary. Distributions must be made in periodic payments at intervals of no
longer than one year. In addition, payments must be either non-increasing or
they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the
proposed Treasury Regulations, or any successor Regulation thereto.
All distributions made hereunder shall be made in accordance with the
requirements of Section 401(a)(9) of the Code, including the incidental death
benefit requirements of Section 401(a)(9)(G) of the Code, and applicable
Treasury Regulations, including the minimum distribution incidental benefit
requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or
any successor Regulation thereto.
Notwithstanding the above paragraphs and the following
No. 92 QPIA Page 10
paragraphs of this Section 3.05, while any distribution shall be subject to such
requirements of the Code and regulations, any distribution shall also be subject
to the terms of this Contract. That is, the forms of distribution shall be those
which are made available by us at the time of your election.
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9.
Unless you otherwise elect prior to the time distributions are required to
begin, those life expectancies shall be recalculated annually. Such election
shall be irrevocable and shall apply to all subsequent years. The life
expectancy of a non-spouse beneficiary may not be recalculated. Instead, life
expectancy will be calculated using the attained age of such beneficiary during
the calendar year in which you attain age 70 and 6 months, and payments for
subsequent years shall be calculated based on such life expectancy reduced by
one for each calendar year which has elapsed since the calendar year life
expectancy was first calculated.
If you die after distribution of your interest in this Contract has begun, the
remaining portion of such interest will continue to be distributed at least as
rapidly as under the method of distribution being used prior to your death.
If you die before distribution of your interest begins, distribution of your
entire interest shall be completed no later than December 31 of the calendar
year containing the fifth anniversary of your death, except to the extent that
an election is made to receive death benefit distributions in accordance with
(1) or (2) below:
(1) If your interest is payable to a designated beneficiary, then your entire
interest may be distributed over the life of or over a period certain not
greater than the life expectancy of, the designated beneficiary. Such
distributions must commence on or before December 31 of the calendar year
immediately following the calendar year of your death.
(2) If the designated beneficiary is your surviving spouse, the date that
distributions are required to begin in accordance with (1) above shall
not be earlier than the later of (A) December 31 of the calendar year
immediately following the calendar year of your death or (B) December 31
of the calendar year in which you would have attained age 70 and 6
months.
For purposes of determining the "period certain" referred to in the immediately
preceding paragraph, life expectancy is computed by use of the expected return
multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes
of distributions beginning after your death, unless otherwise elected by the
surviving spouse by the time distributions are required to begin, life
expectancies shall be recalculated annually. Such election shall be irrevocable
by the surviving spouse and shall apply to all subsequent years. In the case of
any other designated beneficiary, life expectancies shall be calculated using
the attained age of such beneficiary during the calendar year in which
distributions are required to begin, pursuant to this Section, and payments for
any subsequent calendar year shall be calculated based on life expectancy
reduced by one for each calendar year which has elapsed since the calendar year
life expectancy was first calculated.
Distributions under this Section are considered to have begun if distributions
are made because you have reached your Required Beginning Date or if prior to
the Required Beginning Date, distribution irrevocably commence to you over a
period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1
of the Proposed Treasury Regulations or any successor Regulation thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under this contract was based on information that is
subsequently found to be incorrect, your benefit will not be invalidated, but an
adjustment on the basis of the correct information will be made in the amount of
the benefit payments, or any amount used to provide the benefit, or any
combination thereof. Overpayments by us will be charged against and
underpayments will be added to any payments thereafter falling due under this
Contract with respect to the payee, affecting as many such payments as are
necessary to correct the overpayment or underpayment. Our liability with respect
to a payee is limited to the correct information and the actual amounts used to
provide the benefits then in force with respect to the payee under this
Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under this Contract is physically or mentally incompetent to receive
such payment or is a minor, (ii) another person or an institution is then
maintaining or has custody of such payee, and (iii) no guardian, committee, or
other representative of the estate of such payee has been appointed, we may make
the payments (in the case of a minor, at a rate not exceeding $200 a month) to
such other person or institution, and will thereupon be fully discharged from
all liability with respect thereto.
If a variable annuity form made available by us provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one of two persons, the payee thereunder
may elect, without the concurrence of any other person, to receive the commuted
value of any remaining payments, provided no person upon whose life the income
depends is surviving.
Pursuant to Section 3.03, upon your election of an annuity form providing
payments for a period certain, you may designate (with the right to change such
designation) a payee or payees to receive any payments that may become due after
the death of the person or persons upon whose life or lives the income may
depend.
The payee may designate (with the right to change such designation and without
the concurrence of any other person) a person or persons to receive any payments
or installments
No 92 QPIA Page 11
TABLES OF
GUARANTEED ANNUITY PAYMENTS
(BASED ON AGE NEAREST BIRTHDAY ON DUE DATE OF FIRST PAYMENT)
FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT
AND SURVIVOR LIFE ANNUITY FORM
100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE
(MINIMUM MONTHLY INCOME PER $1,000 OF ANNUITY ACCOUNT VALUE)
------------------------------------------------------------------------------------------------------------------------------------
Age 60 61 62 63 64 65 66 67 68 69 70
------------------------------------------------------------------------------------------------------------------------------------
60 4.51 4.56 4.61 4.66 4.71 4.76 4.81 4.85 4.90 4.94 4.99
61 4.59 4.65 4.70 4.75 4.81 4.86 4.91 4.96 5.01 5.06
62 4.69 4.74 4.80 4.85 4.91 4.97 5.02 5.07 5.13
63 4.78 4.84 4.90 4.96 5.02 5.08 5.14 5.20
64 4.88 4.95 5.01 5.08 5.14 5.20 5.27
65 4.99 5.06 5.13 5.20 5.27 5.34
66 5.11 5.18 5.26 5.33 5.41
67 5.24 5.31 5.39 5.47
68 5.37 5.45 5.54
69 5.51 5.60
70 5.67
------------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM
(MINIMUM MONTHLY INCOME PER $1,000 OF ANNUITY VALUE)
------------------------------------------------------------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON
THE LIFE ANNUITY FORM IF ASSUMED BASE
RATE OF NET INVESTMENT RETURN IS:
3.5% 5.00%
---- -----
Age Males Females Males Females
------------------------------------------------------------------------------------------------------------------------------------
60 5.67 5.00 6.46 5.89
61 5.71 5.11 6.60 6.00
62 5.86 5.23 6.75 6.11
63 6.03 5.36 6.92 6.24
64 6.20 5.49 7.09 6.37
65 6.39 5.64 7.28 6.51
66 6.58 5.79 7.47 6.66
67 6.80 5.96 7.69 6.83
68 7.02 6.13 7.92 7.00
69 7.27 6.32 8.16 7.19
70 7.53 6.53 8.42 7.40
------------------------------------------------------------------------------------------------------------------------------------
payable after such xxxxx's death, if the absence of such a designation would
result in a single sum payment to such payee's estate in accordance with the
following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments. The commuted value of any such remaining payments will be
determined on the basis of compound interest at the rate utilized in the
actuarial rate basis applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
We will, with respect to each payment under a Variable Annuity Benefit, notify
the payee of the number of Annuity Units and the Average Annuity Unit Value used
in determining the amount of each variable payment. Such notice will be mailed
with each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary,
as described in Section 4.04.
If a commutation right under an annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
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PART IV -- GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire agreement between
the parties and the provisions of this Contract alone will govern with respect
to our rights and obligations. A copy of the application is incorporated in and
made part of this Contract.
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by an authorized officer of Equitable. This
Contract may be changed by amendment or replacement upon agreement between you
and us without the consent of any other person.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend this Contract
without the consent of any other person in order to comply with applicable laws
and regulations. Such right shall include, but not be limited to, the right to
conform this Contract to reflect changes in the Code, applicable Treasury
Regulations, or published rulings of the Internal Revenue Service so that this
Contract will continue to be an Annuity under a qualified plan.
SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY, AND ASSIGNMENTS. Your entire
interest
No. 92 QPIA Page 12
under the Contract is nonforfeitable. This Contract is nontransferable except by
surrender to us. Your interest under this Contract may not be sold, assigned,
discounted, or pledged as collateral for a loan or as security for the
performance of an obligation or for any other purpose to any person other than
Equitable.
No amount payable under this Contract may be assigned, commuted, or encumbered
by the payee, unless otherwise permitted as described herein, and, to the extent
permitted by law, no such amount will in any way be subject to any claim against
such payee.
SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an
initial designation of the beneficiary entitled to receive any death benefit
payable pursuant to Section 2.11. You may change such designation from time to
time during your lifetime and while this Contract is in force. Any such
designation or change will be made by written notice in a form satisfactory to
us. A change will, upon receipt at the Processing Office, take effect as of the
time the written notice was signed, whether or not you are living on the
Transaction Date, but without further liability as to any payment or other
settlement made by us before receipt of such change.
Unless otherwise specified in the designation, if you have designated two or
more persons as beneficiary, the beneficiary will be the designated person or
persons who survive you, and if more than one survive, they will share equally.
Any part of a death benefit payable pursuant to Section 2.11 for which there is
no designated beneficiary living at your death will be payable in a single sum
to your children who survive you, in equal shares, or should none survive, then
to your estate.
If you elect in writing, any amount that would otherwise be payable to a
beneficiary in a single sum may be applied to provide an Annuity Benefit, on the
form annuity elected by you, with respect to the beneficiary, subject to our
rules then in effect. If at your death there is no election in effect to apply
the single sum death benefit to provide an Annuity Benefit, the beneficiary may
make such an election. Any such election must meet the minimum distribution
requirements under the Code, as described in Section 3.05.
SECTION 4.05 DISQUALIFICATION. In the event that this Contract fails to qualify
as an Xxxxxxx as described in Section 1.02, we will have the right, upon
receiving notice of such fact prior to the Retirement Date, to terminate this
Contract and pay to you the Annuity Account Value less a deduction for the
appropriate part attributable to you of any Federal income tax payable which
would not have been payable if you had an Annuity.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you, we reserve the
right, at our sole discretion, to limit contributions under this Contract, as
required by law or if such Contributions are in excess of the maximum amounts as
permitted under the Code.
SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of your Annuity Account Value
(less any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities and
Exchange Commission, by order, permits us to defer payment in order to protect
persons with interests in the Investment Divisions. We can defer payment of any
portion of your Annuity Account Value in the Guaranteed Interest Division for up
to six months while you are living.
SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you
with a notice showing the following:
(1) the amount you have in the Guaranteed Interest Division,
(2) the total number of Accumulation Units you have in the Stock Division,
Balanced Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Values,
(4) the amount you have in the Stock Division, Balanced Division,
Aggressive Stock Division and Money Market Division,
(5) the Annuity Account Value,
(6) the Cash Value, and
(7) the amount of death benefit with respect to you.
We will also furnish annual calendar year reports concerning the status of the
Annuity and any other reports required by the Code or applicable Treasury
Regulations.
After the Retirement Date, we will notify you of the number of Annuity Units and
the Average Annuity Unit Value used in determining the amount of each Variable
Annuity Benefit payment, if any.
SECTION 4.09 AGE AND SEX. If your age or sex has been misstated, any benefits
will be those which would have been purchased at the correct age or sex. Any
overpayments or underpayments made by us will be charged or credited with
interest at the rate of 6% per year, and such interest will be deducted from or
added to benefits falling due thereafter.
No. 92 QPIA Page 13
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APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
PROCESSING OFFICE: INDIVIDUAL ANNUITY CENTER, P.O. BOX 2996,
NEW YORK, NEW YORK 10116-2996
QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR:
EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY
--------------------------------------------------------------------------------
TYPE OF PURCHASE (Complete One Plan Only)
A. |_| TSA PUBLIC SCHOOL (GV-PS-I)
B. |_| TSA 501(C)(3) ORGANIZATION (GV-501-I)
C. |_| TSA University (GV-PS-U-I)
D. |_| IRA Individual (Including IRA to IRA transfers) (XX-XXX 4971)
E. |_| IRA Unit Billed (Including IRA to IRA transfers) (XX-XXX 4971)
F. |x| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified
Plan) (XX-XXX 4971-71)
G. |_| EDC (Public Employee Deferred Compensation) (GV-EDC 4991)
H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-080)
I. |_| SEP (Simplified Employee Pension) (GV-SEP 4981)
J. |_| SARSEP (Salary Reduction SEP) _________________________________________
K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41)
L. |_| XXXXX/HR-10 TRUSTEE (GV HR-10 4911-11)
(trustee owned)
M. |_| XXXXX/HR-10 (GV-HR-10 4911)
(not trustee owned) (issued to existing units only)
--------------------------------------------------------------------------------
DO NOT COMPLETE THIS SECTION IF 1.D OR 1.F CHECKED ABOVE
2. EMPLOYER/PLAN NAME
|A|B|C|_|C|O|M|P|A|N|Y|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_|
|x| NEW UNIT |0|0|0|1|2|3|-|4|5|6|
(FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM
983-135B IS REQUIRED)
--------------------------------------------------------------------------------
4. PROPOSED ANNUITANT Print name to appear on Contract.
|J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_|
FIRST MIDDLE INITIAL LAST
A. |X| MR. |_| MRS. |_| MS. |_| OTHER ____
B. Date of Birth: Year 1954 Month JANUARY Day 27
---- ------- --
C. Age at Nearest Birthday: 38 D. |X| Male |_| Female
----
X. Xxxxxxxxx's Mailing Address: F. State of Residence: N.J.
----
No., St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_|
City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1|
G. Telephone Number (101) 222 - 3456 |X| Home |_| Work
H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9|
I. Are you associated with or employed by a member of National
Association of Securities Dealers, Inc.(NASD)? |_| Yes |X| No
5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner, for all
other Markets Print Name of Annuitant.
XXXX XXX
-----------------------------------------------------------------------------
a. Title ____________________________________________________________________
6. RETIREMENT AGE 65
---------------------------------------------------------------
7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death
Benefit upon Xxxxxxxxx's death before Retirement Date.) (BENEFICIARY MUST
BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.)
XXXX XXX - WIFE
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
8. CONTRIBUTION ALLOCATION
Guaranteed Interest Division 20%
-----
Stock Division 20%
-----
Money Market Division 20%
-----
Balanced Division 20%
-----
Aggressive Stock Division 20%
-----
(PERCENTAGES IN WHOLE NUMBERS) Total 100%
9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F)
A. Reminder Notice (Billing) Required |_| Yes |X| No
IF YES, COMPLETE B-C-D-E
B. REMINDER DATE Required for Individual IRA or otherwise must agree
with existing unit or attached 983-135B. MONTH _________ DAY __________
C. REMINDER FREQUENCY
|_| Annual |_| Semi-Annual
|_| Quarterly |_| Monthly
Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA
ONLY:
|_| Semi-Monthly |_| Bi-Weekly
D. REMINDER AMOUNT $_________________________________
E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
10.EXPECTED FIRST CONTRACT YEAR
Contribution. $1000
----------------------------------------------------------------
IF AN ADVANCED BILLING AND/OR CONTRACT DATE ARE REQUESTED, COMPLETE #9B
AND #12.
--------------------------------------------------------------------------------
(FOR PROCESSING OFFICE USE)
Unit Name ___________________________ Reminder Date ___________________________
Cert. or App# _______________________ Amendment Required_______________________
EDC Emp. Add. _______________________ Emp. Fed. ID# ___________________________
Frequency ___________________________ Contract Date ___________________________
--------------------------------------------------------------------------------
Receipt Date Batch # Inquiry # Processor
--------------------------------------------------------------------------------
180-1000
--------------------------------------------------------------------------------
10. Did you receive the Separate Account Prospectus? |X| Yes |_| No
Date shown on Prospectus January 1, 1992
----------------------------------------------------
Date of any supplement to Prospectus _______________________________________
11. Items (a) through (f) are to be answered by the annuitant. We are
required by the NASD to ask these questions.
(a) Name of Employer: ABC Company
------------------------------------------------------
(b) Address of Employer:
10 Main Street
---------------------------------------------------------------------------
Anytown, NJ
---------------------------------------------------------------------------
(c) Occupation Sales
-------------------------------------------------------------
(d) Assuming the contract applied for will be issued, will any existing
insurance or annuity be replaced or changed (or has it been)?
| | Yes |X| No
(e) Estimated Family Annual Income $100,000
----------------------------------------
(f) Estimated Net Worth $250,000
-----------------------------------------------------
(g) Investment Objective: |_| Income |X| Income & Growth
|_| Aggressive Growth |_| Growth |_| Safety of Principal
12. SPECIAL INSTRUCTIONS
----------------------------------------------------------------------------
----------------------------------------------------------------------------
----------------------------------------------------------------------------
----------------------------------------------------------------------------
----------------------------------------------------------------------------
13. Amount paid with this form: $1000
(If a check is submitted with this request, no advanced Contract Date is
permitted.) BACKDATING IS NOT PERMITTED.
NOTE: Xxxxxx paid will be credited upon receipt at Equitable's Processing
Office, subject to return if the certificate is not issued. The Contract Date
will be the date of receipt by Equitable of this application, properly signed
and completed, and Contribution at Equitable's Processing Office.
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
AGREEMENT
All information and statements furnished in this application are true and
complete to the best of my knowledge and belief. I understand and acknowledge
that no Agent has the authority to make or modify any contract on Equitable's
behalf, or to waive or alter any of Equitable's rights and regulations.
IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO
THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT
PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT.
UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S)
OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND
COMPLETE.
--------------------------------------------------------------------------------
LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY
APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS.
--------------------------------------------------------------------------------
X__________________________________ Date_______ City __________ State __________
Signature of Annuitant
X__________________________________ Date_______ City __________ State __________
Signature of Authorized Individual (REQUIRED FOR EDC AND
TRUSTEED) OR OWNER
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
AGENT'S SECTION
Will any existing insurance or annuity be replaced or changed (or has it been),
assuming the Contract will be issued? | | Yes | | No
|_| I (we) certify that a prospectus for the Contract has been given to the
proposed Annuitant and that no written sales materials other than those approved
by Equitable have been used.
EQUI-VEST issues must adequately reflect the commission interest of all Agents
on previous contracts.
--------------------------------------------------------------------------------
Print Agent's Name(s) Initial of Agent Agent Agency District Agent's
(Service Agent first) Last Name Number % Code Manager Code Signature
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS___ Date ___ District EQS ___
Date ____
--------------------------------------------------------------------------------
(FOR ASU USE)
ASU Code and App. No. __________________________________________________________
ASU Rec'd. _____________________________________________________________________
Date to Proc. Off. ________________________________________________ Campaign |_|
Agent(s) shown above is Equity Qualified and is licensed in the state where the
request is signed. Above Agent information verified by XXX (Registered Rep)
--------------------------------------------------------------------------------
Application reviewed by ________________________________________________________
--------------------------------------------------------------------------------
180-1000
<< 92 QPIB Missing
OWNER: XXXX XXX
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 000
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28, 1992
RETIREMENT DATE: JAN 1, 2020
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York,
New York 10116
AGREES
o TO ALLOCATE the Contributions made to this Contract, after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division (referred to in this Contract as
the "Investment Divisions") or to the Guaranteed Interest Division, in
accordance with Sections 2.02, 2.03 and 2.04 as directed by you, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide the
Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant
is then living, and
o TO PROVIDE the Annuitant with the other rights and benefits of this
Contract.
This is the entire Contract. In this Contract "we", "our", and "us" mean The
Equitable Life Assurance Society of the United States ("Equitable"). "You" and
"your" mean the Annuitant at the time a right is exercised by the Annuitant.
TEN DAYS TO EXAMINE CONTRACT - You may cancel this Contract by returning it to
us within ten days after receipt of it. Upon such cancellation, we will refund
any Contribution made to us under this Contract.
/s/ Xxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxxxx
Vice President and Secretary Chairman of the Board
and Chief Executive Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE
MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL
ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE
INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE
TRUST.
No. 92 SEPA
The Contract is issued in consideration of the payment to us of the
Contributions made under the terms of the Contract.
The provisions on the following pages are part of this Contract. A copy of the
application is incorporated in and made part of this Contract.
--------------------------------------------------------------------------------
TABLE OF CONTENTS
DEFINITIONS Page
Section 1.01 - Annuitant.......................................................4
1.02 - Annuity.........................................................4
1.03 - Annuity Account Value...........................................4
1.04 - Annuity Benefit.................................................4
1.05 - Cash Value......................................................4
1.06 - Class of Contracts..............................................4
1.07 - Code............................................................4
1.08 - Contract........................................................4
1.09 - Contract Date...................................................4
1.10 - Contract Year...................................................5
1.11 - Contribution....................................................5
1.12 - Divisions.......................................................5
1.13 - Eligible Annuity Certain........................................5
1.14 - Employer........................................................5
1.15 - Guaranteed Interest Rate........................................5
1.16 - Joint and Survivor Life Annuity Form............................5
1.17 - Life Annuity Form...............................................5
1.18 - Normal Form.....................................................5
1.19 - Period Certain Annuity..........................................5
1.20 - Plan............................................................5
1.21 - Processing Office...............................................5
1.22 - Retirement Date.................................................5
1.23 - Separate Account................................................5
1.24 - Separate Account Definitions....................................6
1.25 - Transaction Date................................................7
1.26 - Trust...........................................................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions...................................................7
2.02 - Separate Account Investment Divisions...........................7
2.03 - Guaranteed Interest Division....................................7
2.04 - Allocation to Divisions.........................................7
2.05 - Transfers Among Divisions.......................................7
2.06 - Termination of this Contract....................................8
2.07 - Partial Withdrawals.............................................8
2.08 - Charges for Partial Withdrawals.................................8
2.09 - Free Corridor Amount............................................8
2.10 - Annual Administrative Charge....................................8
2.11 - Death Benefit...................................................9
ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit...........................................9
3.02 - Variable Annuity Benefit........................................9
3.03 - Election and Commencement of Annuity Benefits...................9
3.04 - Amount of Annuity Benefits.....................................10
3.05 - Payment of Annuity Benefits....................................10
GENERAL PROVISIONS
Section 4.01 - Contract.......................................................12
4.02 - Statutory Compliance...........................................12
4.03 - Nonforfeitability, Nontransferability, and Assignments.........12
4.04 - Beneficiary....................................................12
4.05 - Disqualification...............................................13
4.06 - Future Contributions...........................................13
4.07 - Deferment......................................................13
4.08 - Annual Notice..................................................13
4.09 - Age............................................................13
No. 92 SEPA Page 2
OWNER: XXXX XXX
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 000
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28, 1992
RETIREMENT DATE: JAN 1, 2020
INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992
MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992
3.00% AFTER DEC 31, 1992
BENEFICIARY: XXXX XXX
FORM NUMBER: 92 SEPA
--------------------------------------------------------------------------------
TABLE OF GUARANTEED VALUES
ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION
NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY
SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65*
-------------------------- ---------- ----------------------------
1 976 6.62
2 1,946 16.20
3 2,944 26.67
4 3,998 36.83
5 5,064 46.70
6 6,220 57.08
7 7,362 67.50
8 8,538 77.40
9 9,870 87.15
10 11,263 95.66
11 12,719 103.93
12 14,242 111.95
13 15,832 119.74
14 17,337 127.30
15 18,887 134.64
16 20,484 141.77
17 22,129 148.69
18 23,822 155.41
19 25,567 161.94
20 27,364 168.27
24 (Age 62) 35,108 191.82
27 (Age 65) 41,547 207.73
THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000
CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT
DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE
(SEE SECTION 2.10) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ANNUITY ACCOUNT
VALUE (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS ARE
ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION.
YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON
THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS.
THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE
WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY
BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A
SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04).
*ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO
SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT.
No. 92 SEPA Page 3
--------------------------------------------------------------------------------
PART I - DEFINITIONS
SECTION 1.01 ANNUITANT. The term "Annuitant" means the person who owns this
Contract as shown on Page 3 and on whose behalf this Contract has been purchased
and maintained, and who exercises all rights under the terms of this Contract.
SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in
accordance with the written program constituting a "Simplified Employee
Pension," as described in Section 408(k) of the Code, as adopted by the
Employer, which meets the requirements for qualification under Section 408(b) of
the Code.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts that you have in the Guaranteed Interest Division and the
Investment Divisions of the Separate Account, pursuant to Sections 2.02 and
2.03.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by Equitable pursuant to Section 3.04 of this Contract. Various sections of this
Contract (Sections 1.16, 1.17, 3.01, and 3.02) refer to monthly payments to be
made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at
other intervals, such as quarterly, semi-annually, or annually, instead of
monthly. You may elect this at the time you elect the Annuity Benefit form
described in Section 3.03; in that event, all references in this Contract to
monthly payments will be deemed to mean payments at the frequency you elect
subject to our rules at the time of election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value
less any applicable withdrawal charge determined as follows:
The withdrawal charge equals the lesser of (a) or (b) where:
(a) equals
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the excess of (i) the Annuity Account Value over (ii) the Free Corridor
Amount defined in Section 2.09; and
(b) is the excess, if any, of (i) 8% of the total Contributions made during
the Current Contract Year and the nine preceding Contract Years over (ii)
the cumulative total of any prior charges for partial withdrawals made
pursuant to Section 2.08.
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
A withdrawal charge will not apply, which means the Cash Value will equal the
Annuity Account Value upon any of the following occurrences:
(i) your attainment of age 59 years and 6 months and your completion of at
least five Contract Years, or
(ii) a distribution is made for a refund of a Contribution which exceeds the
amounts which hay be contributed pursuant to Section 219 and/or 408(o)
of the Code and the request for a distribution is received within one
month of the date on which such Contribution was made, or
(iii) a distribution of deferrals disallowed by reason of failure to meet the
requirements of Section 408(k)(6)(A)(ii) of the Code, including income
thereon and less any loss allowable thereto, is made no later than
April 15 following the calendar year of the Employer's notification of
such disallowance, or
(iv) a distribution of "excess contributions," as such term is defined in
Section 408(k)(6)(C)(ii) of the Code, including the income thereon and
less any loss allowable thereto, is made no later than the end of the
plan year of the Simplified Employee Pension following the plan year in
which such excess contributions were made, or
(v) a distribution of "excess deferrals" as such term is defined in Section
402(g)(2) of the Code, including income thereon and less any loss
allowable thereto, is made no later than April 15 following the year in
which such excess deferrals were made, or
(vi) your completion of at least three Contract Years and you use the amount
withdrawn to purchase from us a Period Certain Annuity of at least 10
years, or
(vii) your Annuity Account Value is applied to the election of a Life Annuity
Form and Joint and Survivor Life Annuity Form distribution option, or
(viii) your completion of at least twelve Contract Years, or
(ix) your attainment of age 55, your completion of at least five Contract
Years and you use the amount withdrawn to purchase from us an Eligible
Annuity Certain, or
(x) you die and a distribution is made to the beneficiary.
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same calendar year.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as
amended, or any corresponding provisions of prior or subsequent United States
revenue laws.
SECTION 1.08 CONTRACT. The term "Contract" means this Contract which is
established for the exclusive benefit of you or your beneficiary.
SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both the application for this Contract, properly signed and completed,
and a Contribution.
No. 92 SEPA Page 4
SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made in cash
or by check to us on your behalf with respect to this Contract. We are under no
obligation to accept any Contribution less than $20.00
Except in the case of a rollover contribution (as permitted by Sections
402(a)(5), 402(a)(6), 402(a)(7), 403(a)(4), 403(b)(8), or 408(d)(3) of the
Code), or a Contribution made in accordance with the terms of a Simplified
Employee Pension ("SEP") as contained in Section 408(k) of the Code, no
Contributions will be accepted unless they are in cash, and the total of such
contributions shall not exceed $2,000 for any taxable year. In addition, amounts
transferred to this Contract, to an individual retirement account, or annuity
contract meeting the requirements of Section 408 of the Code are also not
subject to the $2,000 limit on contributions.
SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following Divisions described in this
Contract:
(a) the Guaranteed Interest Division, and
(b) the Investment Divisions of the Separate Account.
SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
an annuity not involving life contingencies issued by us, which extends beyond
your attainment of age 59 years and 6 months and does not permit any prepayment
of the unpaid principal (that is no withdrawal or single sum payment) prior to
your attainment of age 59 years and 6 months.
SECTION 1.14 EMPLOYER. The term "Employer" means the sole proprietor,
partnership or corporation that assumes in writing the obligations of the
program constituting the Simplified Employee Pension. A sole proprietor is
deemed to be his/her own Employer and a partnership is deemed to be the Employer
of each partner.
SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrues on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of
this Contract. Section 2.03 describes the determination of the rate to apply
thereafter.
SECTION 1.16 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected by you. The payments commence on the date as of which the Joint and
Survivor Life Annuity Form is purchased and terminate with the last payment due
before the death of the survivor.
SECTION 1.17 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us providing monthly payments during the lifetime of the person upon
whose life such payments depend. The payments commence on the date as of which
the Life Annuity Form is purchased and terminate with the last payment due
before the death of such person.
SECTION 1.18 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means, (i) if you have a living spouse at your Retirement Date,
the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form
with your spouse as the contingent annuitant (with 100% of the monthly payment
amount continued to your spouse), and (ii) if you do not have a living spouse at
the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form.
SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us which does not permit any
prepayment of the unpaid principal (that is, you cannot elect to receive part of
your payments as a single sum payment with the remainder paid in monthly annuity
payments).
SECTION 1.20 PLAN. The term "Plan" means a Simplified Employee Pension Plan as
described in Section 408(k) of the Code.
SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116, or
such other location as we shall designate by advance written notice to you.
SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which
you attain your retirement age as shown on page 3 of this Contract. Before the
Retirement Date you may elect to change the Retirement Date to another
Retirement Date, which may be any date after the filing of the election (other
than the 29th, 30th, or 31st day of any month). No Retirement Date shall be
earlier than the date you attain age 59 years and 6 months nor shall be later
than the first day of April following the calendar year in which you attain age
70 years and 6 months. Any election for such change must be made in writing by
you and shall not take effect until received by us at our Processing Office.
SECTION 1.23 SEPARATE ACCOUNT. The term "Separate Account" means our Separate
Account A, which is organized as a unit investment trust (a type of investment
company). We established the Separate Account and it is maintained in accordance
with the laws of New York State. Realized and unrealized gains and losses from
the assets of the Separate Account are credited to or charged against it without
regard to our other income, gains or losses. Assets are put in the Separate
Account to support this Contract and other variable annuity contracts. Assets
may be put in the Separate Account for other purposes, but not to support
contracts or policies other than variable annuities and variable life insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these Contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
No. 92 SEPA Page 5
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust where each class (or series) represents a separate portfolio in
the Trust. We reserve the right to change the designated Trust or to add
designated trusts or investment companies. The Investment Divisions available
are the Stock Division, the Money Market Division, the Balanced Division and the
Aggressive Stock Division. The Guaranteed Interest Division is not part of the
Separate Account, but rather is an asset of our General Account.
We will value the assets of each Investment Division on each business day. A
business day is any day on which Equitable is open, the New York Stock Exchange
is open for trading and there is a sufficient degree of trading in the portfolio
securities in which an Investment Division is invested to materially affect the
Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments it is
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under
the Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such a committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any
other form;
(v) add Investment Divisions (or subdivisions of Investment Divisions) to,
or remove Investment Divisions (or subdivisions of Investment Divisions)
from the Separate Account (the term "Investment Division" in this
Contract shall then refer to any other Investment Division in which the
assets of a Class of Contracts to which this Contract belongs, were
placed);
(vi) combine any two or more Investment Divisions (or subdivisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
Class of Contracts to which this Contract belongs.
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, you will be notified of such exercise, as
required by law.
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for any applicable
tax charges) at a rate not to exceed 1.49% per year for each of the Stock, Money
Market and Balanced Divisions, and 1.34% per year, for the Aggressive Stock
Division, for financial accounting, death benefits, mortality risk, expenses and
expense risks. The charge shall be made in accordance with Subsection (c) of the
Net Investment Factor provision in Section 1.24. The relative proportion of
these charges may be modified. The daily charge, plus the investment advisory
fee charges and direct operating expense charges of the Trust shall not exceed a
total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract. The maximum rate may not be altered
without your approval.
SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any preceding consecutive
non-business days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment
Division for the Valuation Period. For this purpose, we use the share
value reported to us by the Trust.
b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period (after
taking into account any amounts allocated or withdrawn for that Valuation
Period).
c) is the daily asset charge for the expenses of this Contract, times the
number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an
Investment Division where your Contributions are invested and which is used in
determining the amount you have in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for such Valuation Period.
ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981 the date the first Contribution was put into the Stock
Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed
Base Rates of Net Investment Return of 5% or 3.5% a year, respectively. The
Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value
for the immediately preceding Valuation Period multiplied by the Adjusted Net
Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for a Valuation Period is the Net Investment Factor for such
period reduced for each calendar day in such subsequent Valuation Period by the
Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net
Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net
Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall
be
No. 92 SEPA Page 6
5%, except in states where the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar
month is equal to the average of the Annuity Unit Values for all Valuation
Periods ending in a calendar month.
SECTION 1.25 TRANSACTION DATE. The term "Transaction Date" means the business
day we receive a Contribution or a written contract transaction request
providing the information we need at the Processing Office. In the case of a
transfer request initiated through the use of a touch tone telephone as
described in Section 2.05, the term "Transaction Date" means the business day
the telephone transaction is received.
SECTION 1.26 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
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PART II - ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. Contributions under this Contract are not fixed and
may be made at any time and in any amount subject to the limits described in
Section 1.11 of this Contract. (If you make a Contribution which qualifies as a
qualified plan rollover within the meaning of Section 402(a)(5) or 403(b)(8) of
the Code, and such amount will be commingled with other Contributions under this
Contract, such rollover contributions may not be rolled over to a qualified plan
at a future date, unless otherwise provided by the Code).
Each Contribution received by us will, before its allocation under this
Contract, be reduced by the amount of any applicable tax charge, as determined
by us.
Contributions will be allocated to the Division in accordance with the
instructions received on your application, unless later charged.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to or withdrawn or transferred from an Investment
Division, you will be credited or charged, as the case may be, with the number
of Accumulation Units determined by dividing said amount by the Accumulation
Unit Value for the appropriate Investment Division for the Valuation Period
which includes that date. The number of units you have in an Investment Division
on any date is equal to (i) the sum of any Accumulation Units that have been
allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units
that have been withdrawn pursuant to Sections 2.07 or 2.08 or transferred from
the Investment Division pursuant to Section 2.05. The amount in an Investment
Division on any date is equal to the product of (i) the number of Accumulation
Units in the Investment Division on that date and (ii) the Accumulation Unit
Value for the Investment Division for the Valuation Period which includes that
date.
Participation in the Separate Account under this Contract terminates on the
earliest of (i) your election and commencement of Annuity Benefits pursuant to
Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of
this Contract, pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets, which support
the guarantees of this Contract and other contracts.
The amount in the Guaranteed Interest Division at any time is equal to the sum
of all amounts that have been allocated to the Guaranteed Interest Division
pursuant to Section 2.04 plus the amount of any interest accrued but not
allocated, less the sum of all amounts that have been withdrawn from the
Guaranteed Interest Division pursuant to Section 2.07, 2.08, or 2.10 or
transferred from the Guaranteed Interest Division, pursuant to Section 2.05.
Interest is allocated to the Guaranteed Interest Division on a Transaction Date,
pursuant to Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts, we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division under this Contract terminates
on the earliest of (i) your election and commencement of annuity benefits
pursuant to Section 3.03, (ii) receipt of due proof of your death, and (iii)
Termination of this Contract pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction of any applicable tax charge) to one or more
Divisions, at your sole direction as specified to us. Allocation percentages
must be in whole numbers and the sum must equal 100. The allocation is made as
of the Transaction Date on which we have received both such Contribution and
such direction. Contributions made to an Investment Division purchase
Accumulation Units in that Investment Division, using the Accumulation Unit
Value next computed after the Transaction Date.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon termination of this Contract pursuant to Section 2.06, and (vi)
upon your death pursuant to Section 2.11.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request, or
through the use of a touch tone telephone, transfer all or part of the amount
you have in a Division to one or more of the Divisions as follows: (1) amounts
in the Guaranteed Interest Division, Stock Division, Balanced Division and
Aggressive Stock Division may be transferred among such Divisions; (2) amounts
in the Money Market Division may be trans-
No. 92 SEPA Page 7
ferred to other Divisions. Written authorization for touch tone telephone
initiated transfers is only required when authorization for telephone transfers
is requested. Upon advance written notice to you, we reserve the right to
discontinue the acceptance of transfer requests through the use of a touch tone
telephone. All transfers will be effective on the Transaction Date and will be
subject to our rules in effect at the time of transfer. With respect to the
Investment Division, the transfer will be made at the Accumulation Unit Value
next computed after the Transaction Date. No transfers are permitted to the
Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. You may elect by written notice, to
terminate this Contract. We will determine the Cash Value as of the Transaction
Date.
The payment of such Cash Value to you may be deferred by us in accordance with
the provisions of Section 4.07.
If this Contract is terminated, surrendered or exchanged prior to your
Retirement Date, any applicable tax charges we have paid may be deducted. If we
have previously deducted charges for applicable taxes from Contributions
pursuant to Section 2.01, we will not again deduct charges for the same taxes on
terminations, unless a change in applicable law has occurred with respect to
your Contract.
We reserve the right to pay the Annuity Account Value under the Contract and
terminate this Contract. This right may be exercised if (i) no Contributions are
made on your behalf during the last three completed Contract Years and the
Annuity Account Value is less than $500, or (ii) a partial withdrawal is made
that would result in your Annuity Account Value falling below $500. We also
reserve the right to terminate this Contract if no Contributions have been made
within 120 months of the Contract Date shown on Page 3 of this Contract.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount you have in the Divisions and the Annuity Account Value shall be
zero. We will be released from any and all liability for payments with respect
to the Contributions from which the Annuity Account Value arose.
SECTION 2.07 PARTIAL WITHDRAWALS. You may elect, by written notice to us, to
make a partial withdrawal from the Divisions.
On the Transaction Date, we will pay the lesser of the Cash Value or the amount
of partial withdrawal requested to the person entitled to such payment as
designated in writing by you. The amount paid plus any withdrawal charge
applicable pursuant to Section 2.08 will be withdrawn from the amounts you have
in the Divisions. Unless we are instructed otherwise, the amount withdrawn
(including any withdrawal charge) will be allocated among the Divisions in
proportion to the amounts that you have in such Divisions.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300.
If a withdrawal made under this Section would result in an Annuity Account Value
of less than $500, we will so advise you and reserve the right to pay the
Annuity Account Value to you, and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS.
NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the
amount of partial withdrawal requested is not greater than the Free Corridor
Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity
Account Value, pursuant to Section 1.05.
WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than
the Free Corridor Amount, we will (i) first withdraw from the Divisions an
amount equal to the Free Corridor Amount, in proportion to the amount you have
in them, and (ii) then withdraw an amount equal to the excess of the amount
requested over the Free Corridor Amount, plus a partial withdrawal charge. Such
partial withdrawal charge will be equal to the lesser of (a) or (b) where:
(a) is an amount equal to
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the amount withdrawn in excess of the Free Corridor Amount (including
such charge) pursuant to (ii) of the preceding sentence.
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior partial withdrawal
charges made pursuant to this Section.
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
If withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to your Contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means, if you
have completed three Contract Years or attained age 59 years and 6 months, an
amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account
Value on the Transaction Date over (ii) cumulative prior withdrawals made
pursuant to Section 2.07 in the current Contract Year. If you have not completed
three Contract Years or attained age 59 years and 6 months, the Free Corridor
Amount is zero.
SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $10,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the
No. 92 SEPA Page 8
Annuity Account Value, including the amount of any withdrawals pursuant to
Section 2.07 during that Contract Year. The charge will be allocated among the
Divisions in proportion to the amounts that you have in the Divisions.
If the Annuity Account Value is less than $10,000 on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03,
or (b) the date of Termination of this Contract pursuant to Section 2.06 or
2.11, we will prorate the Annual Administrative Charge applicable to the
completed portion of the Current Contract Year and withdraw such amount in lieu
of the Annual Administrative Charge applicable to the completed portion of the
Current Contract Year and withdraw such amount in lieu of the full Annual
Administrative Charge described in this Section for the applicable part of that
Contract Year.
If the Annuity Account Value is $10,000 or greater at the end of a Contract
Year, the Annual Administrative Charge is zero.
SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of your death, we will pay
to the beneficiary designated by you to receive such payment, pursuant to
Section 4.04 of this Contract, the amount of death benefit payable. The amount
of the death benefit is equal to the greater of (i) the Annuity Account Value
and (ii) the minimum death benefit. Such minimum death benefit is the sum of all
Contributions made pursuant to Section 2.01 (before reduction for any applicable
tax charge) less any withdrawals made pursuant to Section 2.07. Any such
withdrawal will reduce the minimum Death Benefit (as adjusted by any previous
such withdrawal) by an amount which is in the same proportion as the amount that
was withdrawn is to the Annuity Account Value. If, in accordance with the
provisions of Section 2.01, the Cash Value of another annuity contract issued by
us, or one of our affiliated or subsidiary life insurance companies, which
provides for a death benefit before retirement equal to the greater of the
Contract Cash Value or an alternate amount based on premiums paid or
contributions made under the annuity contract, is transferred to this Contract,
such Cash Value or alternative amount as of the date of transfer will be
included in the sum of all Contributions in lieu of the amount of Cash Value
transferred for purposes of the death benefit under this Contract.
We will pay the death benefit to your beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.04. Also, in accordance with the last paragraph of Section 4.04, if no such
election is in effect at your death, we will pay the death benefit to your
beneficiary in a single sum, unless the beneficiary elects, before we pay the
death benefit, to apply the death benefit to an Annuity Benefit.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value shall be zero. We will be released from any and all
liability for payments with respect to the Contributions from which the Annuity
Account Value arose.
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PART III - ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under the terms of this Contract with respect to a payee is the amount provided
with respect to the payee pursuant to Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of net
investment return referred to in Section 1.24 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to
provide for any applicable tax charge. These charges include a daily charge for
financial accounting, death benefits, mortality risk, expenses and expense risk,
plus the investment advisory fee charges and direct operating expense charges of
the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under this Contract with respect to a payee is the monthly
amount provided with respect to a payee pursuant to the fifth paragraph of
Section 3.04. The amount of the fourth and each subsequent payment under a
Variable Annuity Benefit will be equal to the number of Annuity Units with
respect to such benefit, multiplied by the Average Annuity Unit Value for the
second calendar month immediately preceding the due date of the payment. The
number of Annuity Units with respect to a benefit is the number determined by
dividing the amount of the first monthly payment under such benefit by the
Annuity Unit Value for the Valuation Period which includes the due date of the
first monthly payment. (As described in Section 3.05, we will notify the payee
how each Variable Annuity payment is determined).
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your
Retirement Date, provided you are then living, the Annuity Account Value shall
be applied to provide the Normal Form of Annuity Benefit, unless you elect (i)
to receive the Cash Value of this Contract in a single sum or (ii) to apply the
Annuity Account Value or Cash Value, whichever is applicable pursuant to the
first paragraph of Section 3.04, to provide an Annuity Benefit on any other form
offered by us, or one of our affiliated or subsidiary life insurance companies,
as elected by you, or (iii) to take partial withdrawals in amounts and at times
as required by the Code and, pursuant to Sections 2.07 and 3.05, subject to our
rules then in effect and any other applicable requirements under the Code.
We will provide notice and election forms to you not more than six months before
your Retirement Date.
No. 92 SEPA Page 9
If you elect to terminate this Contract, prior to the Retirement Date, pursuant
to Section 2.06, an election may be made to receive an Annuity Benefit in Lieu
of the Cash Value.
We will have the right to require you to furnish pertinent information to
provide an Annuity Benefit and will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form, issued by us or one of our affiliated or subsidiary
life insurance companies.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or
third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be (i) the
Annuity Account Value if the annuity form elected involves life contingencies or
(ii) the Cash Value, if the Annuity Form elected does not involve life
contingencies.
The amount applied to provide an Annuity Benefit may be reduced by any
applicable tax charge on annuity considerations, as we determine. If we have
previously deducted any applicable tax charge from Contributions as provided in
Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to your Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below, or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your contract will be governed by our
supplementary contract then in effect.
If an amount is applied to provide an Annuity Benefit, the amount to be applied
will, in addition to any tax charge reduction, be reduced by an administrative
charge. The amount of such charge will be determined from time to time in
accordance with our general practices applicable on a uniform basis to all
contracts of the same type as this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts
you have in the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under this Contract, as
indicated, on the Joint and Survivor Life Annuity Form (with 100% of the amount
of your payment continued to your spouse). The amounts of income provided under
the Fixed Annuity Benefit payable on the Life Annuity form and Joint and
Survivor Life Annuity Form are based on 3.5% interest and the 1983 Individual
Annuity Table "a" adjusted to a unisex basis based on a 50-50 split of males and
females, at age zero. The amount of income initially provided under the Variable
Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life
Annuity Form are based on a 50-50 split of males and females, at age zero and an
Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever
applies pursuant to Section 1.24.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us based on 3.5% interest and the 1983 Individual Annuity Table
"a" adjusted to a unisex basis based on a 50-50 split of males and females, at
age zero, if such annuity form provides for a Fixed Annuity Benefit, and on the
same such projected 1983 Basic Table "a", adjusted to a unisex basis based on a
50-50 split of males and females, at age zero and an Assumed Base Rate of Net
Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section
1.24 if such annuity form provides for a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract
will be distributed or begin to be distributed, in accordance with Section
401(a)(9) of the Code and the applicable Treasury Regulations thereunder no
later than the first day of April following the calendar year in which you
attain age 70 and 6 months ("Required Beginning Date"). Your entire interest may
be distributed, as you elect, over (a) your life, or the lives of you and your
designated beneficiary, or (b) a period certain not extending beyond your life
expectancy, or the joint and last survivor expectancy of you and your designated
beneficiary. Distributions must be made in periodic payments at intervals of no
longer than one year. In addition, payments must be either non-increasing or
they may increase only as provided in Q & A F-3 of Section 1.401(a)(9)-1 of the
proposed Treasury Regulations, or any successor Regulation thereto.
All distributions made hereunder shall be made in accordance with the
requirements of Section 401(a)(9) of the Code, including the incidental death
benefit requirements of Section 401(a)(9)(G) of the Code, and applicable
Treasury Regulations, including the minimum distribution incidental benefit
requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or
any successor Regulation thereto.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.05, while any distribution shall be subject to such requirements of
the Code and regulations, any distribution shall also be subject to the terms of
this Contract. That is, the forms of distribution shall be those which are made
available by us at the time of your election.
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9.
Unless you otherwise elect prior to the time distributions are required to
begin, those life expectancies shall be recalculated annually. Such election
shall be irrevocable and shall apply to all subsequent years. The life
expectancy of a non-spouse beneficiary may not be recalculated. Instead, life
expectancy will be calculated using the attained age of such beneficiary during
the calendar year in which you attain age 70 and six months, and payments for
subsequent years shall be calculated based on such life expectancy reduced by
one for each calendar year which has elapsed since the calendar year life
expectancy was first calculated.
If you die after distribution of your interest in this Contract has begun, the
remaining portion of such interest will continue to be distributed at least as
rapidly as under the method of distribution being used prior to your death.
No.92 SEPA Page 10
If you die before distribution of your interest begins, distribution of your
entire interest shall be completed no later than December 31 of the calendar
year containing the fifth anniversary of your death, except to the extent that
an election is made to receive death benefit distributions in accordance with
(1) or (2) below:
(1) If your interest is payable to a designated beneficiary, then your entire
interest may be distributed over the life of, or over a period certain not
greater than the life expectancy of, the designated beneficiary. Such
distributions must commence on or before December 31 of the calendar year
immediately following the calendar year of your death.
(2) If the designated beneficiary is your surviving spouse, the date that
distributions are required to begin in accordance with (1) above shall not be
earlier than the later of (A) December 31 of the calendar year immediately
following the calendar year of your death or (B) December 31 of the calendar
year in which you would have attained age 70 and 6 months.
For purposes of determining the "period certain" referred to in the immediately
preceding paragraph, life expectancy is computed by use of the expected return
multiples in Table V and VI of Treasury Regulation Section 1.72-9. For purposes
of distributions beginning after your death, unless otherwise elected by the
surviving spouse by the time distributions are required to begin, life
expectancies shall be recalculated annually. Such election shall be irrevocable
by the surviving spouse and shall apply to all subsequent years. In the case of
any other designated beneficiary, life expectancies shall be calculated using
the attained age of such beneficiary during the calendar year in which
distributions are required to begin, pursuant to this Section, and payments for
any subsequent calendar year shall be calculated based on life expectancy
reduced by one for each calendar year which has elapsed since the calendar year
life expectancy was first calculated.
Distributions under this Section are considered to have begun if distributions
are made because you have reached your Required Beginning Date or if prior to
the Required Beginning Date, distributions irrevocably commence to you over a
period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1
of the Proposed Treasury Regulations or any successor Regulation thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under this Contract was based on information that is
subsequently found to be incorrect, your benefit will not be invalidated, but an
adjustment on the basis of the correct information will be made in the amount of
the benefit payments, or any amount used to provide the benefit, or any
combination thereof. Overpayments by us will be charged against and
underpayments will be added to any payments thereafter falling due under this
Contract with respect to the payee, affecting as many such payments as are
necessary to correct the overpayment or underpayment. Our liability with respect
to a payee is limited to the correct information and the actual amounts used to
provide the benefits then in force with respect to the payee under this
Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under this Contract is physically or mentally incompetent to receive
such payment or is a minor, (ii) another person or an institution is then
maintaining or has custody of such payee, and (iii) no guardian, committee, or
other representative of the estate of such payee has been appointed, we may make
the payments (in the case of a minor, at a rate not exceeding $200 a month) to
such other person or institution, and will thereupon be fully discharged from
all liability with respect thereto.
If a variable annuity form made available by us provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one of two persons, the payee thereunder
may elect, without the concurrence of any other person, to receive the commuted
value of any remaining payments, provided no person upon whose life the income
depends is surviving.
Pursuant to Section 3.03, upon your election of an annuity form providing
payments for a period certain, you may designate (with the right to change such
designation) a payee or payees to receive any payments that may become due after
the death of the person or persons upon whose life or lives the income may
depend.
The payee may designate (with the right to change such designation and without
the concurrence of any other person) a person or persons to receive any payments
or installments payable after such payee's death, if the absence of such a
designation would result in a single sum payment to such payee's estate in
accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments. The commuted value of any such remaining payments will be
determined on the basis of compound interest at the rate utilized in the
actuarial rate basis applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
No. 92 SEPA Page 11
TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT
AND SURVIVOR LIFE ANNUITY FORM
100% OF PAYMENT AMOUNT CONTINUED TO SPOUSE
(Minimum Monthly Income per $1,000 of Annuity Account Value)
---------------------------------------------------------------------------------------------------------------------------------
Age 60 61 62 63 64 65 66 67 68 69 70
---------------------------------------------------------------------------------------------------------------------------------
60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88
61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96
62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03
63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11
64 4.89 4.94 5.00 5.05 5.10 5.14 5.19
65 5.00 5.06 5.11 5.17 5.22 5.27
66 5.12 5.18 5.24 5.29 5.35
67 5.24 5.31 5.37 5.43
68 5.37 5.44 5.51
69 5.52 5.59
70 5.67
---------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE
ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1,000 of Annuity Account Value)
-----------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON
THE LIFE ANNUITY FORM IF ASSUMED BASE
RATE OF NET INVESTMENT RETURN IS
Age 3.5% 5.0%
-----------------------------------------------------------------------
60 5.27 6.16
61 5.39 6.28
62 5.52 6.41
63 5.66 6.55
64 5.81 6.70
65 5.97 6.86
66 6.15 7.03
67 6.33 7.21
68 6.53 7.41
69 6.74 7.62
70 6.97 7.85
-----------------------------------------------------------------------
We will, with respect to each payment under a Variable Annuity Benefit, notify
the payee of the number of Annuity Units and the Average Annuity Unit Value used
in determining the amount of each variable payment. Such notice will be mailed
with each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary,
as described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
--------------------------------------------------------------------------------
PART IV -- GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire agreement between
the parties and the provisions of this Contract alone govern with respect to our
rights and obligations. A copy of the application is incorporated in and made
part of this Contract.
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by an authorized officer of Equitable. This
Contract may be changed by amendment or replacement upon agreement between you
and us without the consent of any other person.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend this Contract
without the consent of any other person in order to comply with applicable laws
and regulations. Such rights shall include, but not be limited to, the right to
conform this Contract to reflect changes in the Code, applicable Treasury
Regulations, or published rulings of the Internal Revenue Service so that this
Contract will continue to be an Annuity.
SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY, AND ASSIGNMENTS. Your entire
interest under the Contract is nonforfeitable. This Contract is non-transferable
except by surrender to us. Your interest under this Contract may not be sold,
assigned, discounted, or pledged as collateral for a loan or as security for the
performance of an obligation or for any other purpose to any person other than
Equitable.
No amount payable under this Contract may be assigned, commuted, or encumbered
by the payee, unless otherwise permitted as described herein, and, to the extent
permitted by law, no such amount will in any way be subject to any claim against
such payee.
SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an
initial designation of the beneficiary entitled to receive any Death Benefit
payable pursuant to Section 2.11. Subject to Section 3.06, you may change such
designation from time to time during your lifetime and while this Contract is in
force. Any such designation or change will be made by written notice in a form
satisfactory to us. A change will, upon receipt at the Processing Office, take
effect as of the time the written notice was signed, whether or not you are
living on the Transaction Date, but without further liability as to any payment
or other settlement made by us before receipt of such change.
Unless otherwise specified in the designation, if you have designated two or
more persons as beneficiary, the beneficiary will be the designated person or
persons who survive you, and if more than one survive, they will share equally.
No 92 SEPA Page 12
Any part of a death benefit payable pursuant to Section 2.11 for which there is
no designated beneficiary living at your death will be payable in a single sum
to your children who survive you, in equal shares, or should none survive, then
to your estate.
If you elect in writing, any amount that would otherwise be payable to a
beneficiary in a single sum may be applied to provide an Annuity Benefit, on the
form of annuity elected by you, with respect to the beneficiary, subject to our
rules then in effect. If at your death there is no election in effect to apply
the single sum death benefit to provide an Annuity Benefit, the beneficiary may
make such an election. Any such election must meet the minimum distribution
requirements under the Code, as described in Section 3.05.
SECTION 4.05 DISQUALIFICATION. In the event that this Contract fails to qualify
as an Annuity, we will have the right, upon receiving notice of such fact, to
terminate this Contract and pay to you the Annuity Account Value less a
deduction for the appropriate part attributable to you of any Federal income tax
payable which would not have been payable if you had an Annuity.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you or the Employer,
as applicable, we reserve the right, at our sole discretion, to limit
Contributions under this Contract, as required by law or if such contributions
are in excess of the maximum amounts as permitted under the Code.
SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of your Annuity Account Value
(less any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities and
Exchange Commission, by order, permits us to defer payment in order to protect
persons with interests in the Investment Divisions. We can defer payment of any
portion of your Annuity Account Value in the Guaranteed Interest Division for up
to six months while you are living.
SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you
with a notice showing the following:
(1) the amount you have in the Guaranteed Interest Division,
(2) the total number of Accumulation Units you have in the Stock Division,
Balanced Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Values,
(4) the amount you have in the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division,
(5) the Annuity Account Value,
(6) the Cash Value, and
(7) the amount of death benefit payable with respect to you.
We will also furnish annual calendar year reports concerning the status of the
Annuity and any other reports required by the Code or applicable Treasury
Regulations.
After the Retirement Date, we will notify you of the number of Annuity Units and
the Average Annuity Unit Value used in determining the amount of each variable
Annuity Benefit payment, if any.
SECTION 4.09 AGE. If your age has been misstated, any benefits will be those
which would have been purchased at the correct age. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
No. 92 SEPA Page 13
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APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
PROCESSING OFFICE: INDIVIDUAL ANNUITY CENTER, P.O. BOX 2996,
NEW YORK, NEW YORK 10116-2996
QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR:
EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY
--------------------------------------------------------------------------------
TYPE OF PURCHASE (Complete One Plan Only)
A. |_| TSA PUBLIC SCHOOL (GV-PS-I)
B. |_| TSA 501(C)(3) ORGANIZATION (GV-501-I)
C. |_| TSA University (GV-PS-U-I)
D. |_| IRA Individual (Including IRA to IRA transfers) (XX-XXX 4971)
E. |_| IRA Unit Billed (Including IRA to IRA transfers) (XX-XXX 4971)
F. |_| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified
Plan) (XX-XXX 4971-71)
G. |_| EDC (Public Employee Deferred Compensation) (GV-EDC 4991)
H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-080)
I. |X| SEP (Simplified Employee Pension) (GV-SEP 4981)
J. |_| SARSEP (Salary Reduction SEP) _________________________________________
K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41)
L. |_| XXXXX/HR-10 TRUSTEE (GV HR-10 4911-11)
(trustee owned)
M. |_| XXXXX/HR-10 (GV-HR-10 4911)
(not trustee owned) (issued to existing units only)
--------------------------------------------------------------------------------
DO NOT COMPLETE THIS SECTION IF 1.D OR 1.F CHECKED ABOVE
2. EMPLOYER/PLAN NAME
|A|B|C|_|C|O|M|P|A|N|Y|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_|
|x| NEW UNIT |0|0|0|1|2|3|-|4|5|6|
(FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM
983-135B IS REQUIRED)
--------------------------------------------------------------------------------
4. PROPOSED ANNUITANT Print name to appear on Contract.
|J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_|
FIRST MIDDLE INITIAL LAST
A. |X| MR. |_| MRS. |_| MS. |_| OTHER ____
B. Date of Birth: Year 1954 Month JANUARY Day 27
---- ------- --
C. Age at Nearest Birthday: 38 D. |X| Male |_| Female
----
X. Xxxxxxxxx's Mailing Address: F. State of Residence: N.J.
----
No., St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_|
City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1|
G. Telephone Number (101) 222 - 3456 |X| Home |_| Work
H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9|
I. Are you associated with or employed by a member of National
Association of Securities Dealers, Inc.(NASD)? |_| Yes |X| No
5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner, for all
other Markets Print Name of Annuitant.
XXXX XXX
-----------------------------------------------------------------------------
a. Title ____________________________________________________________________
6. RETIREMENT AGE 65
---------------------------------------------------------------
7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death
Benefit upon Xxxxxxxxx's death before Retirement Date.) (BENEFICIARY MUST
BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.)
XXXX XXX - WIFE
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
8. CONTRIBUTION ALLOCATION
Guaranteed Interest Division 20%
-----
Stock Division 20%
-----
Money Market Division 20%
-----
Balanced Division 20%
-----
Aggressive Stock Division 20%
-----
(PERCENTAGES IN WHOLE NUMBERS) Total 100%
9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F)
A. Reminder Notice (Billing) Required |_| Yes |X| No
IF YES, COMPLETE B-C-D-E
B. REMINDER DATE Required for Individual IRA or otherwise must agree
with existing unit or attached 983-135B. MONTH _________ DAY __________
C. REMINDER FREQUENCY
|_| Annual |_| Semi-Annual
|_| Quarterly |_| Monthly
Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA
ONLY:
|_| Semi-Monthly |_| Bi-Weekly
D. REMINDER AMOUNT $_________________________________
E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
10.EXPECTED FIRST CONTRACT YEAR
Contribution. $1000
----------------------------------------------------------------
IF AN ADVANCED BILLING AND/OR CONTRACT DATE ARE REQUESTED, COMPLETE #9B
AND #12.
--------------------------------------------------------------------------------
(FOR PROCESSING OFFICE USE)
Unit Name ___________________________ Reminder Date ___________________________
Cert. or App# _______________________ Amendment Required_______________________
EDC Emp. Add. _______________________ Emp. Fed. ID# ___________________________
Frequency ___________________________ Contract Date ___________________________
--------------------------------------------------------------------------------
Receipt Date Batch # Inquiry # Processor
--------------------------------------------------------------------------------
180-1000
--------------------------------------------------------------------------------
10. Did you receive the Separate Account Prospectus? |X| Yes |_| No
Date shown on Prospectus January 1, 1992
----------------------------------------------------
Date of any supplement to Prospectus _______________________________________
11. Items (a) through (f) are to be answered by the annuitant. We are
required by the NASD to ask these questions.
(a) Name of Employer: ABC Company
------------------------------------------------------
(b) Address of Employer:
10 Main Street
---------------------------------------------------------------------------
Anytown, NJ
---------------------------------------------------------------------------
(c) Occupation Sales
-------------------------------------------------------------
(d) Assuming the contract applied for will be issued, will any existing
insurance or annuity be replaced or changed (or has it been)?
| | Yes |X| No
(e) Estimated Family Annual Income $100,000
----------------------------------------
(f) Estimated Net Worth $250,000
-----------------------------------------------------
(g) Investment Objective: |_| Income |X| Income & Growth
|_| Aggressive Growth |_| Growth |_| Safety of Principal
12. SPECIAL INSTRUCTIONS
----------------------------------------------------------------------------
----------------------------------------------------------------------------
----------------------------------------------------------------------------
----------------------------------------------------------------------------
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13. Amount paid with this form: $1000
(If a check is submitted with this request, no advanced Contract Date is
permitted.) BACKDATING IS NOT PERMITTED.
NOTE: Xxxxxx paid will be credited upon receipt at Equitable's Processing
Office, subject to return if the certificate is not issued. The Contract Date
will be the date of receipt by Equitable of this application, properly signed
and completed, and Contribution at Equitable's Processing Office.
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
AGREEMENT
All information and statements furnished in this application are true and
complete to the best of my knowledge and belief. I understand and acknowledge
that no Agent has the authority to make or modify any contract on Equitable's
behalf, or to waive or alter any of Equitable's rights and regulations.
IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO
THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT
PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT.
UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S)
OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND
COMPLETE.
--------------------------------------------------------------------------------
LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY
APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS.
--------------------------------------------------------------------------------
X__________________________________ Date_______ City __________ State __________
Signature of Annuitant
X__________________________________ Date_______ City __________ State __________
Signature of Authorized Individual (REQUIRED FOR EDC AND
TRUSTEED) OR OWNER
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
AGENT'S SECTION
Will any existing insurance or annuity be replaced or changed (or has it been),
assuming the Contract will be issued? | | Yes | | No
|_| I (we) certify that a prospectus for the Contract has been given to the
proposed Annuitant and that no written sales materials other than those approved
by Equitable have been used.
EQUI-VEST issues must adequately reflect the commission interest of all Agents
on previous contracts.
--------------------------------------------------------------------------------
Print Agent's Name(s) Initial of Agent Agent Agency District Agent's
(Service Agent first) Last Name Number % Code Manager Code Signature
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
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FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS___ Date ___ District EQS ___
Date ____
--------------------------------------------------------------------------------
(FOR ASU USE)
ASU Code and App. No. __________________________________________________________
ASU Rec'd. _____________________________________________________________________
Date to Proc. Off. ________________________________________________ Campaign |_|
Agent(s) shown above is Equity Qualified and is licensed in the state where the
request is signed. Above Agent information verified by XXX (Registered Rep)
--------------------------------------------------------------------------------
Application reviewed by ________________________________________________________
--------------------------------------------------------------------------------
180-1000
[EQUITABLE LOGO]
Owner:
Annuitant:
Contract Number:
Issue Date:
Contract Date:
Retirement Date:
--------------------------------------------------------------------------------
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P O Box 2996, New York,
New York 10116-2996
AGREES
o TO ALLOCATE the Contributions made to this Contract, after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division (referred to in this Contract as the
"Investment Divisions") or to the Guaranteed Interest Division, in accordance
with Sections 2.02, 2.03 and 2.04 as directed by you, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide the
Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is
then living, and
o TO PROVIDE the Annuitant with the other rights and benefits of this Contract.
This is the entire Contract. In this Contract "we", "our", and "us" mean The
Equitable Life Assurance Society of the United States ("Equitable"). "You" and
"your" mean the Annuitant at the time a right is exercised by the Annuitant.
TEN DAYS TO EXAMINE CONTRACT -- You may cancel this Contract by returning it to
us within ten days after receipt of it. Upon such cancellation, we will refund
any Contribution made to us under this Contract, plus or minus any investment
gain or loss experienced in the Investment Divisions of the Separate Account
from the date such Contribution is allocated to such Investment Division to the
date we receive the returned Contract.
/s/Xxxxx X. Xxxxxx /s/Xxxxxx X. Xxxxxx
Xxxxx X. Xxxxxx Xxxxxx X. Xxxxxx
Vice President and Secretary Chairman of the Board and Chief
Executive Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT 1S EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.24 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE
MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL
ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS
THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE
TRUST.
No. 92 SEPB
The Contract is issued in consideration of the payment to us of the
Contributions made under the terms of the Contract.
The provisions on the following pages are part of this Contract. A copy of the
application is incorporated in and made part of this Contract.
--------------------------------------------------------------------------------
TABLE OF CONTENTS
Section 1.01 - Annuitant.....................................................4
1.02 - Annuity.......................................................4
1.03 - Annuity Account Value.........................................4
1.04 - Annuity Benefit...............................................4
1.05 - Cash Value....................................................4
1.06 - Class of Contracts............................................4
1.07 - Code..........................................................4
1.08 - Contract .....................................................4
1.09 - Contract Date.................................................4
1.10 - Contract Year.................................................5
1.11 - Contribution..................................................5
1.12 - Divisions.....................................................5
1.13 - Eligible Annuity Certain......................................5
1.14 - Employer......................................................5
1.15 - Guaranteed Interest Rate......................................5
1.16 - Joint and Survivor Life
Annuity Form..................................................5
1.17 - Life Annuity Form.............................................5
1.18 - Normal Form...................................................5
1.19 - Period Certain Annuity........................................5
1.20 - Plan..........................................................5
1.21 - Processing Office.............................................5
1.22 - Retirement Date...............................................5
1.23 - Separate Account..............................................5
1.24 - Separate Account
Definitions...................................................6
1.25 - Transaction Date..............................................7
1.26 - Trust.........................................................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions.................................................7
2.02 - Separate Account
Investment Divisions..........................................7
2.03 - Guaranteed Interest
Division......................................................7
2.04 - Allocation to Divisions.......................................7
2.05 - Transfers Among Divisions.....................................7
2.06 - Termination of this Contract..................................8
2.07 - Partial Withdrawals...........................................8
2.08 - Charges for Partial Withdrawals...............................8
2.09 - Free Corridor Amount..........................................8
2.10 - Annual Administrative Charge..................................8
2.11 - Death Benefit.................................................9
ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit.........................................9
3.02 - Variable Annuity Benefit......................................9
3.03 - Election and Commencement
of Annuity Benefits...........................................9
3.04 - Amount of Annuity Benefits...................................10
3.05 - Payment of Xxxxxxx Xxxxxxxx..................................10
ANNUITY BENEFITS
Section 4.01 - Contract.....................................................12
4.02 - Statutory Compliance.........................................12
4.03 - Nonforfeitability,
Nontransferability, and Assignments..........................12
4.04 - Beneficiary..................................................12
4.05 - Disqualification.............................................12
4.06 - Future Contributions.........................................12
4.07 - Deferment....................................................13
4.08 - Annual Notice................................................13
4.09 - Age..........................................................13
No. 92 SEPB Page 2
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PART I -- DEFINITIONS
SECTION 1.01 ANNUITANT. The term "Annuitant" means the person who owns this
Contract as shown on Page 3 and on whose behalf this Contract has been purchased
and maintained, and who exercises all rights under the terms of this Contract.
SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in
accordance with the written program constituting a "Simplified Employee
Pension," as described in Section 408(k) of the Code, as adopted by the
Employer, which meets the requirements for qualification under Section 408(b) of
the Code.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts that you have in the Guaranteed Interest Division and the
Investment Divisions of the Separate Account, pursuant to Sections 2.02 and
2.03.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by Equitable pursuant to Section 3.04 of this Contract. Various sections of this
Contract (Sections 1.16, 1.17, 3.01, and 3.02) refer to monthly payments to be
made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at
other intervals, such as quarterly, semi-annually, or annually, instead of
monthly. You may elect this at the time you elect the Annuity Benefit form
described in Section 3.03; in that event, all references in this Contract to
monthly payments will be deemed to mean payments at the frequency you elect,
subject to our rules at the time of election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value
less any applicable withdrawal charge determined as follows:
The withdrawal charge equals the lesser of (a) or (b) where:
(a) equals
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the excess of (i) the Annuity Account Value over (ii) the Free Corridor
Amount defined in Section 2.09; and
(b) is the excess, if any, of (i) 8% of the total Contributions made during the
Current Contract Year and the nine preceding Contract Years over (ii) the
cumulative total of any prior charges for partial withdrawals made pursuant
to Section 2.08.
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount. A withdrawal
charge will not apply, which means the Cash Value will equal the Annuity Account
Value upon any of the following occurrences:
(i) your attainment of age 59 years and 6 months and your completion of at
least five Contract Years, or
(ii) a distribution is made for a refund of a Contribution which exceeds the
amounts which may be contributed pursuant to Section 219 and/or 408(o) of
the Code and the request for a distribution is received within one month
of the date on which such Contribution was made, or
(iii) a distribution of deferrals disallowed by reason of failure to meet the
requirements of Section 408(k)(6)(A)(ii) of the Code, including income
thereon and less any loss allowable thereto, is made no later than April
15 following the calendar year of the Employer's notification of such
disallowance, or
(iv) a distribution of "excess contributions," as such term is defined in
Section 408(k)(6)(C)(ii) of the Code, including the income thereon and
less any loss allowable thereto, is made no later than the end of the
plan year of the Simplified Employee Pension following the plan year in
which such excess contributions were made, or
(v) a distribution of "excess deferrals" as such term is defined in Section
402(g)(2) of the Code, including income thereon and less any loss
allowable thereto, is made no later than April 15 following the year in
which such excess deferrals were made, or
(vi) your completion of at least three Contract Years and you use the amount
withdrawn to purchase from us a Period Certain Annuity of at least 10
years, or
(vii) your Annuity Account Value is applied to the election of a Life Annuity
Form and Joint and Survivor Life Annuity Form distribution option, or
(viii) your completion of at least twelve Contract Years, or
(ix) your attainment of age 55, your completion of at least five Contract
Years and you use the amount withdrawn to purchase from us an Eligible
Annuity certain, or
(x) you die and a distribution is made to the beneficiary.
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same calendar year.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as
amended, or any corresponding provisions of prior or subsequent United States
revenue laws.
SECTION 1.08 CONTRACT. The term "Contract" means this Contract which is
established for the exclusive benefit of you or your beneficiary.
SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both the application for this Contract, properly signed and completed,
and a Contribution.
No. 92 SEPB Page 4
SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made in cash
or by check to us on your behalf with respect to this Contract. We are under no
obligation to accept any Contribution less than $20.00.
Except in the case of a rollover contribution (as permitted by Sections
402(a)(5), 402(a)(6), 402(a)(7), 403(a)(4), 403(b)(8), or 408(d)(3) of the
Code), or a Contribution made in accordance with the terms of a Simplified
Employee Pension ("SEP") as contained in Section 408(k) of the Code, no
Contributions will be accepted unless they are in cash, and the total of such
contributions shall not exceed $2,000 for any taxable year. In addition, amounts
transferred to this Contract, to an individual retirement account, or annuity
contract meeting the requirements of Section 408 of the Code are also not
subject to the $2,000 limit on contributions.
SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following Divisions described in this
Contract:
(a) the Guaranteed Interest Division, and
(b) the Investment Divisions of the Separate Account.
SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
an annuity not involving life contingencies issued by us, which extends beyond
your attainment of age 59 years and 6 months and does not permit any prepayment
of the unpaid principal (that is no withdrawal or single sum payment) prior to
your attainment of age 59 years and 6 months.
SECTION 1.14 EMPLOYER. The term "Employer" means the sole proprietor,
partnership or corporation that assumes in writing the obligations of the
program constituting the Simplified Employee Pension. A sole proprietor is
deemed to be his/her own Employer and a partnership is deemed to be the Employer
of each partner.
SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrues on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of
this Contract. Section 2.03 describes the determination of the rate to apply
thereafter.
SECTION 1.16 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payment depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. The
percentage may be 50% or any higher percentage up to and including 100%, as
elected by you. The payments commence on the date as of which the Joint and
Survivor Life Annuity Form is purchased and terminate with the last payment due
before the death of the survivor.
SECTION 1.17 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us providing monthly payments during the lifetime of the person upon
whose life such payments depend. The payments commence on the date as of which
the Life Annuity Form is purchased and terminate with the last payment due
before the death of such person.
SECTION 1.18 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means, (i) if you have a living spouse at your Retirement Date,
the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form
with your spouse as the contingent annuitant (with 100% of the monthly payment
amount continued to your spouse), and (ii) if you do not have a living spouse at
the Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form.
SECTION 1.19 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us which does not permit any
prepayment of the unpaid principal (that is, you cannot elect to receive part of
your payments as a single sum payment with the remainder paid in monthly annuity
payments).
SECTION 1.20 PLAN. The term "Plan" means a Simplified Employee Pension Plan, as
described in Section 408(k) of the Code.
SECTION 1.21 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such
other location as we shall designate by advance written notice to you.
SECTION 1.22 RETIREMENT DATE. The term "Retirement Date" means the date on which
you attain your retirement age as shown on Page 3 of this Contract. Before the
Retirement Date you may elect to change the Retirement Date to another
Retirement Date, which may be any date after the filing of the election (other
than the 29th, 30th, or 31st day of any month). No Retirement Date shall be
earlier than the date you attain age 59 years and 6 months nor shall be later
than the first day of April following the calendar year in which you attain age
70 years and 6 months. Any election for such change must be made in writing by
you and shall not take effect until received by us at our Processing Office.
SECTION 1.23 SEPARATE ACCOUNT. The term the "Separate Account" means our
Separate Account A, which is organized as a unit investment trust (a type of
investment company). We established the Separate Account and it is maintained in
accordance with the laws of New York State. Realized and unrealized gains and
losses from the assets of the Separate Account are credited to or charged
against it without regard to our other income, gains or losses. Assets are put
in the Separate Account to support this Contract and other variable annuity
contracts. Assets may be put in the Separate Account for other purposes, but not
to support contracts or policies other than variable annuities and variable life
insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these Contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
No. 92 SEPB Page 5
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust where each class (or series) represents a separate portfolio in
the Trust. We reserve the right to change the designated Trust or to add
designated trusts or investment companies. The Investment Divisions available
are the Stock Division, the Money Market Division, the Balanced Division and the
Aggressive Stock Division. The Guaranteed Interest Division is not part of the
Separate Account, but rather is an asset of our General Account.
We will value the assets of each Investment Division on each business day. A
business day is any day on which Equitable is open, the New York Stock Exchange
is open for trading and there is a sufficient degree of trading in the portfolio
securities in which an Investment Division is invested to materially affect the
Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments it is
permitted by law to make. We reserve the right to
(i) cause the registration or deregistration of the Separate Account under the
Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such a committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any other
form;
(v) add Investment Divisions (or subdivisions of Investment Divisions) to, or
remove Investment Divisions (or subdivisions of Investment Divisions) from
the Separate Account (the term "Investment Division" in this Contract
shall then refer to any other Investment Division in which the assets of a
Class of Contracts to which this Contract belongs, were placed);
(vi) combine any two or more Investment Divisions (or subdivisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
Class of Contracts to which this Contract belongs.
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, you will be notified of such exercise, as
required by law. Assets of the Investment Divisions attributable to this
Contract shall be subject to a daily charge (after any deductions to provide for
any applicable tax charges) at a rate not to exceed 1.49% per year for each of
the Stock, Money Market and Balanced Divisions, and 1.34% per year, for the
Aggressive Stock Division, for financial accounting, death benefits, mortality
risk, expenses and expense risks. The charge shall be made in accordance with
Subsection (c) of the Net Investment Factor provision in Section 1.24. The
relative proportion of these charges may be modified. The daily charge, plus the
investment advisory fee charges and direct operating expense charges of the
Trust shall not exceed a total annual rate of 1.75% of the value of the assets
of the Investment Divisions attributable to this Contract. The maximum rate may
not be altered without your approval.
SECTION 1.24 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any preceding consecutive
non-business days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment Division
for the Valuation Period. For this purpose, we use the share value reported
to us by the Trust.
b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period (after
taking into account any amounts allocated or withdrawn for that Valuation
Period).
c) is the daily asset charge for the expenses of this Contract, times the
number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an
Investment Division where your Contributions are invested and which is used in
determining the amount you have in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for such Valuation Period.
ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first Contribution was put into the Stock
Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed
Base Rates of Net Investment Return of 5% or 3.5% a year, respectively. The
Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value
for the immediately preceding Valuation Period multiplied by the Adjusted Net
Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for a Valuation Period is the Net Investment Factor for such
period reduced for each calendar day in such subsequent Valuation Period by the
Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net
Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net
Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall
be 5%, except in states where the rate is not permitted by law.
No. 92 SEPB Page 6
AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar
month is equal to the average of the Annuity Unit Values for all Valuation
Periods ending in a calendar month.
SECTION 1.25 TRANSACTION DATE. The term "Transaction Date" means the business
day we receive a Contribution or a written contract transaction request
providing the information we need at the Processing Office. In the case of a
transfer request initiated through the use of a touch tone telephone as
described in Section 2.05, the term "Transaction Date" means the business day
the telephone transaction is received.
SECTION 1.26 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
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PART II -- ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. Contributions under this Contract are not fixed and
may be made at any time and in any amount subject to the limits described in
Section 1.11 of this Contract. (If you make a Contribution which qualifies as a
qualified plan rollover within the meaning of Section 402(a)(5) or 403(b)(8) of
the Code, and such amount will be commingled with other Contributions under this
Contract, such rollover contributions may not be rolled over to a qualified plan
at a future date, unless otherwise provided by the Code). Each Contribution
received by us will, before its allocation under this Contract, be reduced by
the amount of any applicable tax charge, as determined by us.
Contributions will be allocated to the Division in accordance with the
instructions received on your application, unless later changed.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to or withdrawn or transferred from an Investment
Division, you will be credited or charged, as the case may be, with the number
of Accumulation Units determined by dividing said amount by the Accumulation
Unit Value for the appropriate Investment Division for the Valuation Period
which includes that date. The number of units you have in an Investment Division
on any date is equal to (i) the sum of any Accumulation Units that have been
allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation Units
that have been withdrawn pursuant to Sections 2.07 or 2.08 or transferred from
the Investment Division pursuant to Section 2.05. The amount in an Investment
Division on any date is equal to the product of (i) the number of Accumulation
Units in the Investment Division on that date and (ii) the Accumulation Unit
Value for the Investment Division for the Valuation Period which includes that
date.
Participation in the Separate Account under this Contract terminates on the
earliest of (i) your election and commencement of Annuity Benefits pursuant to
Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of
this Contract, pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets, which support
the guarantees of this Contract and other contracts.
The amount in the Guaranteed Interest Division at any time is equal to the sum
of all amounts that have been allocated to the Guaranteed Interest Division
pursuant to Section 2.04 plus the amount of any interest accrued but not
allocated, less the sum of all amounts that have been withdrawn from the
Guaranteed Interest Division pursuant to Section 2.07, 2.08, or 2.10 or
transferred from the Guaranteed Interest Division, pursuant to Section 2.05.
Interest is allocated to the Guaranteed Interest Division on a Transaction Date,
pursuant to Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts, we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division under this Contract terminates
on the earliest of (i) your election and commencement of annuity benefits
pursuant to Section 3.03, (ii) receipt of due proof of your death, and (iii)
termination of this Contract, pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction of any applicable tax charge) to one or more
Divisions, at your sole direction as specified to us. Allocation percentages
must be in whole numbers and the sum must equal 100. The allocation is made as
of the Transaction Date on which we have received both such Contribution and
such direction. Contributions made to an Investment Division purchase
Accumulation Units in that Investment Division, using the Accumulation Unit
Value next computed after the Transaction Date.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon termination of this Contract pursuant to Section 2.06, and (vi)
upon your death pursuant to Section 2.11.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request, or
through the use of a touch tone telephone, transfer all or part of the amount
you have in a Division to one or more of the Divisions as follows: (1) amounts
in the Guaranteed Interest Division, Stock Division, Balanced Division and
Aggressive Stock Division may be transferred among such Divisions; (2) amounts
in the Money Market Division may be transferred to other Divisions. Written
authorization for touch tone telephone initiated transfers is only required when
authorization for telephone transfers is requested. Upon advance written notice
to you, we reserve the right to discontinue the acceptance of transfer requests
No. 92 SEPB Page 7
through the use of a touch tone telephone. All transfers will be effective on
the Transaction Date and will be subject to our rules in effect at the time of
transfer. With respect to the Investment Division, the transfer will be made at
the Accumulation Unit Value next computed after the Transaction Date. No
transfers are permitted to the Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. You may elect by written notice, to
terminate this Contract. We will determine the Cash Value as of the Transaction
Date.
The payment of such Cash Value to you may be deferred by us in accordance with
the provisions of Section 4.07.
If this Contract is terminated, surrendered or exchanged prior to your
Retirement Date, any applicable tax charges we have paid may be deducted. If we
have previously deducted charges for applicable taxes from Contributions
pursuant to Section 2.01, we will not again deduct charges for the same taxes on
terminations, unless a change in applicable law has occurred with respect to
your Contract.
We reserve the right to pay the Annuity Account Value under the Contract and
terminate this Contract. This right may be exercised if (i) no Contributions are
made on your behalf during the last three completed Contract Years and the
Annuity Account Value is less than $500, or (ii) a partial withdrawal is made
that would result in your Annuity Account Value falling below $500. We also
reserve the right to terminate this Contract if no Contributions have been made
within 120 days of the Contract Date shown on Page 3 of this Contract.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount you have in the Divisions and the Annuity Account Value shall be
zero. We will be released from any and all liability for payments with respect
to the Contributions from which the Annuity Account Value arose.
SECTION 2.07 PARTIAL WITHDRAWALS. You may elect, by written notice to us, to
make a partial withdrawal from the Divisions.
On the Transaction Date, we will pay the lesser of the Cash Value or the amount
of partial withdrawal requested to the person entitled to such payment as
designated in writing by you. The amount paid plus any withdrawal charge
applicable pursuant to Section 2.08 will be withdrawn from the amounts you have
in the Divisions. Unless we are instructed otherwise, the amount withdrawn
(including any withdrawal charge) will be allocated among the Divisions in
proportion to the amounts that you have in such Divisions.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300.
If a withdrawal made under this Section would result in an Annuity Account Value
of less than $500, we will so advise you and reserve the right to pay the
Annuity Account Value to you, and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS.
NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the
amount of partial withdrawal requested is not greater than the Free Corridor
Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity
Account Value, pursuant to Section 1.05.
WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than
the Free Corridor Amount, we will (i) first withdraw from the Divisions an
amount equal to the Free Corridor Amount, in proportion to the amount you have
in them, and (ii) then withdraw an amount equal to the excess of the amount
requested over the Free Corridor Amount, plus a partial withdrawal charge. Such
partial withdrawal charge will be equal to the lesser of (a) or (b) where:
(a) is an amount equal to
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the amount withdrawn in excess of the Free Corridor Amount (including
such charge) pursuant to (ii) of the preceding sentence.
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the current Contract Year and the nine preceding Contract Years
over (ii) the cumulative total of any prior partial withdrawal charges made
pursuant to this Section.
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
If withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to your Contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means, if you
have completed three Contract Years or attained age 59 years and 6 months, an
amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account
Value on the Transaction Date over (ii) cumulative prior withdrawals made
pursuant to Section 2.07 in the current Contract Year. If you have not completed
three Contract Years or attained age 59 years and 6 months, the Free Corridor
Amount is zero.
SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $10,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value, including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts that you have in
the Divisions.
No. 92 SEPB Page 8
If the Annuity Account Value is less than $10,000, on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03,
or (b) the date of Termination of this Contract pursuant to Section 2.06 or
2.11, we will prorate the Annual Administrative Charge applicable to the
completed portion of the Current Contract Year and withdraw such amount in lieu
of the full Annual Administrative Charge described in this Section for the
applicable part of that Contract Year.
If the Annuity Account Value is $10,000 or greater at the end of a Contract
Year, the Annual Administrative Charge is zero.
SECTION 2.11 DEATH BENEFIT. Upon receipt of due proof of your death, we will pay
to the beneficiary designated by you to receive such payment, pursuant to
Section 4.04 of this Contract, the amount of death benefit payable. The amount
of the death benefit is equal to the greater of (i) the Annuity Account Value
and (ii) the minimum death benefit. Such minimum death benefit is the sum of all
Contributions made pursuant to Section 2.01 (before reduction for any applicable
tax charge) less any withdrawals made pursuant to Section 2.07. Any such
withdrawal will reduce the minimum Death Benefit (as adjusted by any previous
such withdrawal) by an amount which is in the same proportion as the amount that
was withdrawn is to the Annuity Account Value. If, in accordance with the
provisions of Section 2.01, the Cash Value of another annuity contract issued by
us, or one of our affiliated or subsidiary life insurance companies, which
provides for a death benefit before retirement equal to the greater of the
Contract Cash Value or an alternate amount based on premiums paid or
contributions made under the annuity contract, is transferred to this Contract,
such Cash Value or alternative amount as of the date of transfer will be
included in the sum of all Contributions in lieu of the amount of Cash Value
transferred for purposes of the death benefit under this Contract.
We will pay the death benefit to your beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.04. Also, in accordance with the last paragraph of Section 4.04, if no such
election is in effect at your death, we will pay the death benefit to your
beneficiary in a single sum, unless the beneficiary elects, before we pay the
death benefit, to apply the death benefit to an Annuity Benefit.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value shall be zero. We will be released from any and all
liability for payments with respect to the Contributions from which the Annuity
Account Value arose.
--------------------------------------------------------------------------------
PART III -- ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under the terms of this Contract with respect to a payee is the amount provided
with respect to the payee pursuant to Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of net
investment return referred to in Section 1.24 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.23, not to exceed the maximum rate of 1.75% after any deductions to
provide for any applicable tax charge. These charges include a daily charge for
financial accounting, death benefits, mortality risk, expenses and expense risk,
plus the investment advisory fee charges and direct operating expense charges of
the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under this Contract with respect to a payee is the monthly
amount provided with respect to a payee pursuant to the fifth paragraph of
Section 3.04. The amount of the fourth and each subsequent payment under a
Variable Annuity Benefit will be equal to the number of Annuity Units with
respect to such benefit, multiplied by the Average Annuity Unit Value for the
second calendar month immediately preceding the due date of the payment. The
number of Annuity Units with respect to a benefit is the number determined by
dividing the amount of the first monthly payment under such benefit by the
Annuity Unit Value for the Valuation Period which includes the due date of the
first monthly payment. (As described in Section 3.05, we will notify the payee
how each Variable Annuity payment is determined).
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your
Retirement Date, provided you are then living, the Annuity Account Value shall
be applied to provide the Normal Form of Annuity Benefit, unless you elect (i)
to receive the Cash Value of this Contract in a single sum or (ii) to apply the
Annuity Account Value or Cash Value, whichever is applicable pursuant to the
first paragraph of Section 3.04, to provide an Annuity Benefit on any other form
offered by us, or one of our affiliated or subsidiary life insurance companies,
as elected by you, or (iii) to take partial withdrawals in amounts and at times
as required by the Code and, pursuant to Sections 2.07 and 3.05, subject to our
rules then in effect and any other applicable requirements under the Code.
We will provide notice and election forms to you not more than six months before
your Retirement Date.
If you elect to terminate this Contract, prior to the Retirement Date, pursuant
to Section 2.06, an election may be made to receive an Annuity Benefit in lieu
of the Cash Value.
No. 92 SEPB Page 9
We will have the right to require you to furnish pertinent information to
provide an Annuity Benefit and will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form, issued by us or one of our affiliated or subsidiary
life insurance companies.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or
third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be (i) the
Annuity Account Value if the annuity form elected involves life contingencies or
(ii) the Cash Value, if the Annuity Form elected does not involve life
contingencies.
The amount applied to provide an Annuity Benefit may be reduced by any
applicable tax charge on annuity considerations, as we determine. If we have
previously deducted any applicable tax charge from Contributions as provided in
Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to your Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below, or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your contract will be governed by our
supplementary contract then in effect.
If an amount is applied to provide an Annuity Benefit, the amount to be applied
will, in addition to any tax charge reduction, be reduced by an administrative
charge. The amount of such charge will be determined from time to time in
accordance with our general practices applicable on a uniform basis to all
contracts of the same type as this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts
you have in the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under this Contract, as
indicated, on the Joint and Survivor Life Annuity Form (with 100% of the amount
of your payment continued to your spouse). The amounts of income provided under
the Fixed Annuity Benefit payable on the Life Annuity Form and Joint and
Survivor Life Annuity Form are based on 3.5% interest and the 1983 Individual
Annuity Table "a" adjusted to a unisex basis based on a 50-50 split of males and
females, at age zero. The amount of income initially provided under the Variable
Annuity Benefit payable on the Life Annuity Form and the Joint and Survivor Life
Annuity Form are based on a 50-50 split of males and females, at age zero and an
Assumed Base Rate of Net Investment Income Return of 3.5% or 5%, whichever
applies pursuant to Section 1.24.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us based on 3.5% interest and the 1983 Individual Annuity Table
"a" adjusted to a unisex basis based on a 50-50 split of males and females, at
age zero, if such annuity form provides for a Fixed Annuity Benefit, and on the
same such projected 1983 Basic Table "a", adjusted to a unisex basis based on a
50-50 split of males and females, at age zero and an Assumed Base Rate of Net
Investment Income Return of 3.5% or 5%, whichever applies pursuant to Section
1.24 if such annuity form provides for a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract
will be distributed or begin to be distributed, in accordance with Section
401(a)(9) of the Code and the applicable Treasury Regulations thereunder no
later than the first day of April following the calendar year in which you
attain age 70 years and 6 months ("Required Beginning Date"). Your entire
interest may be distributed, as you elect, over (a) your life, or the lives of
you and your designated beneficiary, or (b) a period certain not extending
beyond your life expectancy, or the joint and last survivor expectancy of you
and your designated beneficiary. Distributions must be made in periodic payments
at intervals of no longer than one year. In addition, payments must be either
non-increasing or they may increase only as provided in Q & A F-3 of Section
1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation
thereto.
All distributions made hereunder shall be made in accordance with the
requirements of Section 401(a)(9) of the Code, including the incidental death
benefit requirements of Section 401(a)(9)(G) of the Code, and applicable
Treasury Regulations, including the minimum distribution incidental benefit
requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or
any successor Regulation thereto.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.05, while any distribution shall be subject to such requirements of
the Code and regulations, any distribution shall also be subject to the terms of
this Contract. That is, the forms of distribution shall be those which are made
available by us at the time of your election.
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9.
Unless you otherwise elect prior to the time distributions are required to
begin, those life expectancies shall be recalculated annually. Such election
shall be irrevocable and shall apply to all subsequent years. The life
expectancy of a non-spouse beneficiary may not be recalculated. Instead, life
expectancy will be calculated using the attained age of such beneficiary during
the calendar year in which you attain age 70 years and 6 months, and payments
for subsequent years shall be calculated based on such life expectancy reduced
by one for each calendar year which has elapsed since the calendar year life
expectancy was first calculated.
If you die after distribution of your interest in this Contract has begun, the
remaining portion of such interest will continue to be distributed at least as
rapidly as under the method of distribution being used prior to your death.
No. 92 SEPB Page 10
If you die before distribution of your interest begins, distribution of your
entire interest shall be completed no later than December 31 of the calendar
year containing the fifth anniversary of your death, except to the extent that
an election is made to receive death benefit distributions in accordance with
(1) or (2) below:
(1) If your interest is payable to a designated beneficiary, then your entire
interest may be distributed over the life of, or over a period certain not
greater than the life expectancy of, the designated beneficiary. Such
distributions must commence on or before December 31 of the calendar year
immediately following the calendar year of your death.
(2) If the designated beneficiary is your surviving spouse, the date that
distributions are required to begin in accordance with (1) above shall not be
earlier than the later of (A) December 31 of the calendar year immediately
following the calendar year of your death or (B) December 31 of the calendar
year in which you would have attained age 70 years and 6 months.
For purposes of determining the "period certain" referred to in the immediately
preceding paragraph, life expectancy is computed by use of the expected return
multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes
of distributions beginning after your death, unless otherwise elected by the
surviving spouse by the time distributions are required to begin, life
expectancies shall be recalculated annually. Such election shall be irrevocable
by the surviving spouse and shall apply to all subsequent years. In the case of
any other designated beneficiary, life expectancies shall be calculated using
the attained age of such beneficiary during the calendar year in which
distributions are required to begin, pursuant to this Section, and payments for
any subsequent calendar year shall be calculated based on life expectancy
reduced by one for each calendar year which has elapsed since the calendar year
life expectancy was first calculated.
Distributions under this Section are considered to have begun if distributions
are made because you have reached your Required Beginning Date or if prior to
the Required Beginning Date, distributions irrevocably commence to you over a
period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1
of the Proposed Treasury Regulations or any successor Regulation thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under this Contract was based on information that is
subsequently found to be incorrect, your benefit will not be invalidated, but an
adjustment on the basis of the correct information will be made in the amount of
the benefit payments, or any amount used to provide the benefit, or any
combination thereof. Overpayments by us will be charged against and
underpayments will be added to any payments thereafter falling due under this
Contract with respect to the payee, affecting as many such payments as are
necessary to correct the overpayment or underpayment. Our liability with respect
to a payee is limited to the correct information and the actual amounts used to
provide the benefits then in force with respect to the payee under this
Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under this Contract is physically or mentally incompetent to receive
such payment or is a minor, (ii) another person or an institution is then
maintaining or has custody of such payee, and (iii) no guardian, committee, or
other representative of the estate of such payee has been appointed, we may make
the payments (in the case of a minor, at a rate not exceeding $200 a month) to
such other person or institution, and will thereupon be fully discharged from
all liability with respect thereto.
If a variable annuity form made available by us provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one of two persons, the payee thereunder
may elect, without the concurrence of any other person, to receive the commuted
value of any remaining payments, provided no person upon whose life the income
depends is surviving.
Pursuant to Section 3.03, upon your election of an annuity form providing
payments for a period certain, you may designate (with the right to change such
designation) a payee or payees to receive any payments that may become due after
the death of the person or persons upon whose life or lives the income may
depend.
The payee may designate (with the right to change such designation and without
the concurrence of any other person) a person or persons to receive any payments
or installments payable after such payee's death, if the absence of such a
designation would result in a single sum payment to such payee's estate in
accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments. The commuted value of any such remaining payments will be
determined on the basis of compound interest at the rate utilized in the
actuarial rate basis applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
No. 92 SEPB Page 11
--------------------------------------------------------------------------------
TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT
AND SURVIVOR LIFE ANNUITY FORM
100% OF PAYMENT AMOUNT CONTINUED TO SPOUSE
(Minimum Monthly Income per $1,000 of Annuity Account Value)
------------------------------------------------------------------------------------------------------------------------------
Age 60 61 62 63 64 65 66 67 68 69 70
------------------------------------------------------------------------------------------------------------------------------
60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88
61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96
62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03
63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11
64 4.89 4.94 5.00 5.05 5.10 5.14 5.19
65 5.00 5.06 5.11 5.17 5.22 5.27
66 5.12 5.18 5.24 5.29 5.35
67 5.24 5.31 5.37 5.43
68 5.37 5.44 5.51
69 5.52 5.59
70 5.67
------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE
ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1,000 of Annuity Account Value)
------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON
THE LIFE ANNUITY FORM IF ASSUMED BASE
RATE OF NET INVESTMENT RETURN IS:
Age 3.5% 5.0%
------------------------------------------------------------------------
60 5.27 6.16
61 5.39 6.28
62 5.52 6.41
63 5.66 6.55
64 5.81 6.70
65 5.97 6.86
66 6.15 7.03
67 6.33 7.21
68 6.53 7.41
69 6.74 7.62
70 6.97 7.85
------------------------------------------------------------------------
We will, with respect to each payment under a Variable Annuity Benefit, notify
the payee of the number of Annuity Units and the Average Annuity Unit Value used
in determining the amount of each variable payment. Such notice will be mailed
with each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary,
as described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
--------------------------------------------------------------------------------
PART IV - GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire agreement between
the parties and the provisions of this Contract alone govern with respect to our
rights and obligations. A copy of the application is incorporated in and made
part of this Contract.
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by an authorized officer of Equitable. This
Contract may be changed by amendment or replacement upon agreement between you
and us without the consent of any other person.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend this Contract
without the consent of any other person in order to comply with applicable laws
and regulations. Such rights shall include, but not be limited to, the right to
conform this Contract to reflect changes in the Code, applicable Treasury
Regulations, or published rulings of the Internal Revenue Service so that this
Contract will continue to be an Annuity.
SECTION 4.03 NONFORFEITABILITY, NONTRANSFERABILITY, AND ASSIGNMENTS. Your entire
interest under the Contract is nonforfeitable. This Contract is non-transferable
except by surrender to us. Your interest under this Contract may not be sold,
assigned, discounted, or pledged as collateral for a loan or as security for the
performance of an obligation or for any other purpose to any person other than
Equitable.
No amount payable under this Contract may be assigned, commuted, or encumbered
by the payee, unless otherwise permitted as described herein, and, to the extent
permitted by law, no such amount will in any way be subject to any claim against
such payee.
SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an
initial designation of the beneficiary entitled to receive any Death Benefit
payable pursuant to Section 2.11. Subject to Section 3.06, you may change such
designation from time to time during your lifetime and while this Contract is in
force. Any such designation or change will be made by written notice in a form
satisfactory to us. A change will, upon receipt at the Processing Office, take
effect as of the time the written notice was signed, whether or not you are
living on the Transaction Date, but without further liability as to any payment
or other settlement made by us before receipt of such change.
Unless otherwise specified in the designation, if you have designated two or
more persons as beneficiary, the beneficiary will be the designated person or
persons who survive you, and if more than one survive, they will share equally.
No. 92 SEPB Page 12
Any part of a death benefit payable pursuant to Section 2.11 for which there is
no designated beneficiary living at your death will be payable in a single sum
to your children who survive you, in equal shares, or should none survive, then
to your estate.
If you elect in writing, any amount that would otherwise be payable to a
beneficiary in a single sum may be applied to provide an Annuity Benefit, on the
form of annuity elected by you, with respect to the beneficiary, subject to our
rules then in effect. If at your death there is no election in effect to apply
the single sum death benefit to provide an Annuity Benefit, the beneficiary may
make such an election. Any such election must meet the minimum distribution
requirements under the Code, as described in Section 3.05.
SECTION 4.05 DISQUALIFICATION. In the event that this Contract fails to qualify
as an Annuity, we will have the right, upon receiving notice of such fact, to
terminate this Contract and pay to you the Annuity Account Value less a
deduction for the appropriate part attributable to you of any Federal income tax
payable which would not have been payable if you had an Annuity.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to you or the Employer,
as applicable, we reserve the right, at our sole discretion, to limit
Contributions under this Contract, as required by law or if such contributions
are in excess of the maximum amounts as permitted under the Code.
SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of your Annuity Account Value
(less any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities and
Exchange Commission, by order, permits us to defer payment in order to protect
persons with interests in the Investment Divisions. We can defer payment of any
portion of your Annuity Account Value in the Guaranteed Interest Division for up
to six months while you are living.
SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you
with a notice showing the following:
(1)the amount you have in the Guaranteed Interest Division,
(2)the total number of Accumulation Units you have in the Stock Division,
Balanced Division, Aggressive Stock Division and Money Market Division,
(3)the Accumulation Unit Values,
(4)the amount you have in the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division,
(5)the Annuity Account Value,
(6)the Cash Value, and
(7)the amount of death benefit payable with respect to you.
We will also furnish annual calendar year reports concerning the status of the
Annuity and any other reports required by the Code or applicable Treasury
Regulations.
After the Retirement Date, we will notify you of the number of Annuity Units and
the Average Annuity Unit Value used in determining the amount of each Variable
Annuity Benefit payment, if any.
SECTION 4.09 AGE. If your age has been misstated, any benefits will be those
which would have been purchased at the correct age. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
No. 92 SEPB Page 13
OWNER: XXXX XXX
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 00
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28, 1992
RETIREMENT DATE: JAN 1, 2020
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O. New York,
New York 10116
AGREES
o TO ALLOCATE the Contributions made to this Contract, after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division of the Separate Account (referred to
in this Contract as the "Investment Divisions") or to the Guaranteed Interest
Division, in accordance with Sections 2.02, 2.03 and 2.04 or in part to any
one, as directed by you, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide the
Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is
then living, and
o TO PROVIDE the Annuitant with the other rights and benefits of this Contract.
This is the entire Contract. In this Contract, "We", "our" and "us" mean the
Equitable Life Assurance Society of the United States. "You" and "your" mean the
Annuitant at the time a right is exercised by the Annuitant.
TEN DAYS TO EXAMINE CONTRACT--You may cancel this Contract by returning it to us
within ten days after receipt of it. Upon such cancellation, we will refund any
Contribution made to us on your behalf under this Contract.
/s/Xxxxx X. Xxxxxx /s/Xxxxxxx X. Xxxxxxxx
VICE PRESIDENT AND SECRETARY CHAIRMAN OF THE BOARD
AND CHIEF EXECUTIVE OFFICER
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.26 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE NOT TO
EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR
FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK,
PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF
THE TRUST.
No. 92 TSAA
This Contract is issued in consideration of the payment to us of the
Contributions made under the terms of this Contract.
The provisions on the following pages are part of this Contract.
--------------------------------------------------------------------------------
TABLE OF CONTENTS
DEFINITIONS Page
Section 1.00 - Agreement..........................................4
1.01 - Annuitant..........................................4
1.02 - Annuity............................................4
1.03 - Annuity Account Value..............................4
1.04 - Annuity Benefit....................................4
1.05 - Cash Value.........................................4
1.06 - Class of Contracts.................................5
1.07 - Code...............................................5
1.08 - Contract...........................................5
1.09 - Contract Date......................................5
1.10 - Contract Year......................................5
1.11 - Contribution.......................................5
1.12 - Divisions..........................................5
1.13 - Elective Deferrals.................................5
1.14 - Xxxxxxxx Annuity Certain...........................5
1.15 - Employer...........................................5
1.16 - ERISA..............................................5
1.17 - Guaranteed Interest Rate...........................5
1.18 - Joint and Survivor Life Annuity Form...............5
1.19 - Life Annuity Form..................................5
1.20 - Normal Form........................................5
1.21 - Period Certain Annuity.............................5
1.22 - Plan...............................................6
1.23 - Processing Office..................................6
1.24 - Retirement Date....................................6
1.25 - Separate Account...................................6
1.26 - Separate Account Definitions.......................7
1.27 - Transaction Date...................................7
1.28 - Trust..............................................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions......................................8
2.02 - Separate Account Investment Divisions..............8
2.03 - Guaranteed Interest Division.......................8
2.04 - Allocation to Divisions............................8
2.05 - Transfers Among Divisions..........................8
2.06 - Termination of this Contract.......................9
2.07 - Partial Withdrawals................................9
2.08 - Charges for Partial Withdrawals....................9
2.09 - Free Corridor Amount..............................10
2.10 - Restrictions on Distributions.....................10
2.11 - Annual Administrative Charge......................10
2.12 - Death Benefit.....................................10
2.13 - Loans.............................................11
ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit.............................12
3.02 - Variable Annuity Benefit..........................12
3.03 - Election and Commencement of Xxxxxxx Xxxxxxxx.....12
3.04 - Amount of Xxxxxxx Xxxxxxxx........................13
3.05 - Payment of Annuity Benefits.......................13
3.06 - Special Annuity and Spousal Consent Provisions....15
GENERAL PROVISIONS
Section 4.01 - Contract..........................................16
4.02 - Statutory Compliance..............................16
4.03 - Nontransferability and Assignments................16
4.04 - Beneficiary.......................................16
4.05 - Disqualification of Plan or Contract..............17
4.06 - Future Contributions..............................17
4.07 - Deferment.........................................17
4.08 - Annual Notice.....................................17
4.09 - Age...............................................17
No. 92 TSAA Page 2
OWNER: XXXX XXX
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 00
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28, 1992
RETIREMENT DATE: JAN 1, 2020
INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992
MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992
3.00% AFTER DEC 31, 1992
BENEFICIARY: XXXX XXX
FORM NUMBER: 92 TSAA
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TABLE OF GUARANTEED VALUES
ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION
NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY
SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65*
------------------------ ---------- ------------------
1 977 6.63
2 1,946 16.20
3 2,944 26.67
4 3,998 36.84
5 5,064 46.70
6 6,220 56.28
7 7,362 65.59
8 8,538 74.62
9 9,841 83.38
10 11,204 91.90
11 12,629 100.16
12 14,118 108.18
13 15,673 115.97
14 17,144 123.54
15 18,658 131.18
16 20,218 138.64
17 21,824 145.90
18 23,479 152.80
19 25,213 159.70
20 27,000 166.03
24 (Age 62) 34,697 189.57
27 (Age 65) 41,098 205.49
THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000
CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT
DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE
(SEE SECTION 2.11) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ANNUITY ACCOUNT
VALUE (SEE SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND
EARNINGS ARE ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION.
YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON
THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS.
THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE
WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY
BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A
SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04).
*ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO
SURVIVOR)WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT.
No. 92 TSAA Page 3
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PART I--DEFINITIONS
SECTION 1.00 AGREEMENT. The term "Agreement" means an agreement described in
Treasury Regulation Section 1.403(b)-1(b)(3) between an Employer and an employee
of the Employer, in which the Employer agrees to purchase an Annuity for the
employee. If Employer contributions to purchase the Annuity result from the
employee's agreement to take a reduction in future salary or forgo a future
salary increase, such Agreement is referred to as a "Salary Reduction Agreement"
within the meaning of Sections 402(g)(3)(C) and 3121(a)(5)(D) of the Code.
SECTION 1.01 ANNUITANT. The term "Annuitant" means the owner of this Contract,
as shown on page 3 and on whose behalf this Contract has been purchased and is
maintained, and who exercises all rights under this Contract.
SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in
accordance with the terms of the Plan or Agreement, which contract meets the
requirements for qualification under Section 403(b) of the Code.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts that you have in the Guaranteed Interest Division and the
Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03,
plus any reserve or suspense account pursuant to loans under Section 2.13.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by us pursuant to Section 3.04 of this Contract. Various sections of this
Contract (Sections 1.18, 1.19, 1.20, 3.01 and 3.02) refer to monthly payments to
be made under an Annuity Benefit. You may wish to have your Annuity Benefit paid
at other intervals, such as quarterly, semi-annually, or annually, instead of
monthly. You may elect this at the time you elect the Annuity Benefit form as
described in Section 3.03; in that event, all references in this Contract to
monthly payments will be deemed to mean payments at the frequency you elect,
subject to our rules at the time of election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value
less any applicable withdrawal charge determined as follows:
The withdrawal charge equals the lesser of (a) or (b) where
(a) equals
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the excess of (i) the Annuity Account Value over (ii) the Free
Corridor Amount defined in Section 2.09; and
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior charges for partial
withdrawals made pursuant to Section 2.08.
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
A withdrawal charge will not apply, which means the Cash Value will equal the
Annuity Account Value upon any of the following occurrences:
(i) your attainment of age 59 and 6 months, and your completion of at least
five Contract Years, or
(ii) you die and a distribution is made to your beneficiary, or
(iii) your attainment of age 55, your completion of at least five Contract
Years and the receipt by us of a properly completed settlement election
form providing for the application of the Annuity Account Value to
purchase an Eligible Annuity Certain, defined in Section 1.14, or
(iv) your completion of at least three Contract Years and the receipt by us
of a properly completed settlement election form providing for the
application of the Annuity Account Value to purchase a Period Certain
Annuity, defined in Section 1.21, where the certain period of such
annuity is at least ten years, or
(v) the receipt by us of a properly completed settlement election form
providing for the application of the Annuity Account Value to purchase
a Life Annuity distribution option, or
(vi) your attainment of age 55, your completion of at least five Contract
Years, and separation from service, or
(vii) your completion of at least twelve Contract Years.
No. 92 TSAA Page 4
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same Calendar Year.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, or
any corresponding provisions of prior or subsequent United States revenue laws.
SECTION 1.08 CONTRACT. The term "Contract" means this Contract.
SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both the application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us
for you with respect to an Annuity purchased for you under the Plan. We are
under no obligation to accept any Contribution less than $20.00. Contributions
may be either Elective Deferrals or Employer Contributions pursuant to the Plan.
The Employer shall indicate to us the amount and type of each Contribution.
SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following Divisions described in this
Contract:
(a) the Guaranteed Interest Division, and
(b) the Investment Division of the Separate Account.
SECTION 1.13 ELECTIVE DEFERRALS. The term "Elective Deferrals" means
Contributions made pursuant to a Salary Reduction Agreement as defined in
Section 1.00.
SECTION 1.14 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
an annuity not involving life contingencies issued by us which extends beyond
your attainment of age 59 and 6 months and does not permit any prepayment of the
unpaid principal (that is, no withdrawal or single sum payment) prior to your
attainment of age 59 and 6 months.
SECTION 1.15 EMPLOYER. The term "Employer" means (i) an organization described
in Section 501(c)(3) of the Code which is exempt from Federal income tax under
Section 501(a) of the Code; or (ii) a State, political subdivision of a State,
or an agency or instrumentality of any one or more of the foregoing, in
connection with services performed by an employee for an educational
organization described in Section 170(b)(1)(A)(ii) of the Code.
SECTION 1.16 ERISA. The term ERISA means the Employee Retirement Income Security
Act as amended.
SECTION 1.17 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrues on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on page 3 of
this Contract. Section 2.03 describes the determination of the Rate to apply
thereafter.
SECTION 1.18 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected by you. The payments commence on the date as of which the Joint and
Survivor Life Annuity Form is purchased and terminate with the last payment due
before the death of the survivor.
SECTION 1.19 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us or one of our affiliated or subsidiary life insurance companies,
providing fixed monthly payments during the lifetime of the person upon whose
life such payments depend. The payments commence on the date as of which the
Life Annuity Form is purchased and terminate with the last payment due before
the death of such person.
SECTION 1.20 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means (i) if you have a living spouse at the Retirement Date, the
Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with
such spouse as the contingent annuitant (with 100% of the monthly amount payable
to your spouse), and (ii) if you do not have a living spouse at the Retirement
Date, the Fixed Annuity Benefit payable on the Life Annuity Form.
SECTION 1.21 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us or one of our affiliated
or subsidiary life insurance companies, which does not permit any prepayment of
the unpaid principal (that is, you cannot elect to receive part of your payments
as a single sum payment with the remainder paid in monthly annuity payments).
No. 92 TSAA Page 5
SECTION 1.22 PLAN. The term "Plan" means a program established by an Employer,
for the purchase of Annuities on behalf of employees. The Employer shall be the
"Plan Administrator" within the meaning of Section 414(g) of the Code and
applicable Treasury Regulations.
SECTION 1.23 PROCESSING OFFICE. The term "Processing Office" mean our Individual
Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116, or such other
location as we shall designate by advance written notice to the Employer, or the
Plan's Trustee, as applicable, and to you.
SECTION 1.24 RETIREMENT DATE. The term "Retirement Date" means the date on which
you attain your retirement age as shown on page 3 of this Contract. Before the
Retirement Date you may elect to change the Retirement Date to another
Retirement Date, which may be any date after the filing of the election (other
than the 29th, 30th, or 31st day of any month). The Retirement Date selected
either initially or by later change must be in accordance with the terms of the
Plan. No Retirement Date shall be later than the date of your attainment of age
70 and 6 months. Any election for such change must be made in writing by you and
shall not take effect until received by us at our Processing Office.
SECTION 1.25 SEPARATE ACCOUNT. The term "Separate Account" means Separate
Account A which is organized as a unit investment trust (a type of investment
company). We have established the Separate Account and it is maintained in
accordance with the laws of New York State. Realized and unrealized gains and
losses from the assets of the Separate Account are credited to or charged
against it without regard to our other income, gains or losses. Assets are put
in the Separate Account to support this Contract and other variable annuity
contracts. Assets may be put in the Separate Account for other purposes, but not
to support contracts or policies other than variable annuities and variable life
insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these Contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust where each class (or series) represents a separate portfolio in
the Trust. We reserve the right to change the designated trust or investment
company or to add designated trusts or investment companies. The Investment
Divisions available are the Stock Division, the Money Market Division, the
Balanced Division and the Aggressive Stock Division. The Guaranteed Interest
Division is not a part of the Separate Account, but rather is an asset of our
General Account.
We will value the assets of each Investment Division on each business day. A
business day is any day on which we are open, the New York Stock Exchange is
open for trading and there is a sufficient degree of trading in the portfolio of
the securities in which an Investment Division is invested to materially affect
the Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments we are
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under
the Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any
other form;
(v) add Investment Divisions (or sub-divisions of Investment Divisions) to,
or remove Investment Divisions (or sub-divisions of Investment
Divisions) from the Separate Account; (The term "Investment Division" in
this Contract shall then refer to any other Investment Division in which
the asset of a Class of Contracts to which this Contract belongs, were
placed);
(vi) combine any two or more Investment Divisions (or sub-divisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
Class of Contracts to which this Contract belongs.
No. 92 TSAA Page 6
If the exercise of these rights in a material change in the underlying
investments of an Investment Division, you will be notified of such exercise, as
required by law.
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for any applicable
tax charges) at a rate not to exceed 1.49% per year for the Stock, Money Market
and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division,
for financial accounting, death benefits, mortality risk, expenses and expense
risk. The charge shall be made in accordance with Subsection (c) of the Net
Investment Factor provision in Section 1.25. The relative proportion of these
charges may be modified. The daily charge, plus the investment advisory fee
charges and direct operating expense charges of the Trust shall not exceed a
total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract. The maximum rate may not be altered
without your approval.
SECTION 1.26 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any preceding consecutive
non-business days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment
Division for the Valuation Period. For this purpose, we use the share
value reported to us by the Trust.
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period
(after any amounts allocated to or withdrawn for that Valuation Period).
(c) is the daily asset charge for the expenses of this Contract, times the
number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an
Investment Division where your Contributions are invested and which is used in
determining the amount you have in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for such Valuation Period.
ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first Contribution was put into the Stock
Division, the Annuity Account Value was $1.26 and $1.52 for contracts with
Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively.
The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit
Value for the immediately preceding Valuation Period multiplied by the Adjusted
Net Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for a Valuation Period is the Net Investment Factor for such
period reduced for each calendar day in such subsequent Valuation Period by the
Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net
Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net
Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall
be 5%, except in states where the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: The Average Annuity Unit Value for a calendar month
is equal to the average of the Annuity Unit Values for all Valuation Periods
ending in such month.
SECTION 1.27 TRANSACTION DATE. The Transaction Date is the business day we
receive a Contribution or a written contract transaction request providing the
information we need at the Processing Office. In the case of a transfer request
initiated through the use of a touch tone telephone as described in Section
2.05, the term Transaction Date is the business day the telephone transaction is
received.
SECTION 1.28 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
NO. 92 TSAA Page 7
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PART II--ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. The Employer is to make Contributions, from time to
time on such dates and in such amounts as determined by the Employer pursuant to
the terms of the Plan or Agreement. You are to specify the amount to be
allocated to each Division.
Each Contribution received by us with respect to you will, before its allocation
under this Contract, be reduced by the amount of any applicable tax charge, as
determined by us.
Pursuant to the terms of the Plan, if applicable, you may, with our agreement,
(i) transfer to this Contract any amount held under a contract or account that
meets the requirements of Section 403(b) of the Code ("Transferred Funds"), or
(ii) roll over contributions from a contract or account that meets the
requirements of Section 403(b) of the Code, or from a conduit individual
retirement arrangement described in (i) above, as to what portion, if any, of
the amounts of the Transferred Funds which are exempt from the distribution
restrictions described in Section 2.10, and the minimum distribution rules
described in Section 3.05, we will treat all such amounts as being subject to
such restrictions. Any Transferred Funds from a contract not issued by us will,
before allocation under this Contract, be reduced by the amount of any
applicable tax charge, as determined by us.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to or withdrawn or transferred from an Investment
Division, the Annuity Account Value will be credited or charged, as the case may
be, with the number of Accumulation Units determined by dividing said amount by
the Accumulation Unit Value for the appropriate Investment Division for the
Valuation Period which includes that date. The number of units you have in an
Investment Division on any date is equal to (i) the sum of any Accumulation
Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of
any Accumulation Units that have been withdrawn pursuant to Sections 2.07, 2.08
or 2.13, or transferred from the Investment Division pursuant to Section 2.05.
The amount you have in an Investment Division on any date is equal to the
product of (i) the number of Accumulation Units in the Investment Division on
that date, and (ii) the Accumulation Unit Value for the Investment Division for
the Valuation Period which includes that date.
Participation in the Separate Account under this Contract terminates on the
earliest of (i) your election and commencement of annuity benefits pursuant to
Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of
this Contract pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets, which support
the guarantees of this Contract and other contracts. The amount in the
Guaranteed Interest Division at any time is equal to the sum of all amounts that
have been allocated to the Guaranteed Interest Division pursuant to Section 2.04
or 2.13, plus the amount of any interest accrued but not allocated, less the sum
of all amounts that have been withdrawn from the Guaranteed Interest Division
pursuant to Section 2.07, 2.08 or 2.13 or transferred from the Guaranteed
Interest Division, pursuant to Section 2.05. Interest is allocated to the
Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division under the terms of this
Contract terminates on the earliest of (i) election and commencement of Annuity
Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, and
(iii) Termination of this Contract pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction of any applicable tax charge) to one or more
Divisions, at your sole direction as specified to us. Allocation percentages
must be in whole numbers and the sum must equal 100. The allocation is made as
of the Transaction Date on which we have received both such Contribution and
such direction. Contributions made to an Investment Division purchase
Accumulation Units in that Investment Division, using the Accumulation Unit
Value next computed after the Transaction Date.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon Termination of this Contract, pursuant to Section 2.06, and (vi)
upon your death pursuant to Section 2.12.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through
the use of a touch tone telephone, transfer all or part of the amount you have
in a Division to one or more of the Divisions as follows: (1) amounts in the
Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive
Stock Division may be transferred among such Divisions; (2) amounts in the Money
Market Division may be transferred to other Divisions. Written authorization for
touch tone telephone initiated transfers is only required when authorization for
No. 92 TSAA Page 8
telephone transfers is requested. Upon advance written notice to you, we reserve
the right to discontinue the acceptance of transfer requests through the use of
a touch tone telephone. All transfers will be effective on the Transaction Date
and will be subject to our rules in effect at the time of transfer. With respect
to the Investment Division, the transfer will be made at the Accumulation Unit
Value next computed after the Transaction Date. No transfers are permitted to
the Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the
terms of the Plan, including, for Plans subject to Title I of ERISA, if
applicable, the spousal consent rules set forth in Section 3.06, you may elect,
by written notice, to terminate this Contract. In addition, termination of the
Contract is subject to the restrictions on distributions set forth in Section
2.10 of this Contract. We will determine the Cash Value as of the Transaction
Date we receive your written election.
The payment of such Cash Value to you may be deferred by us in accordance with
the provisions of Section 4.07.
Subject to the terms of the Plan, and the restrictions on distributions set
forth in Section 2.10, we reserve the right to pay the Annuity Account Value
under this Contract and terminate this Contract. This right may be exercised
only if both (i) you made no Contributions during the last three completed
Contract Years, and the Annuity Account Value is less than $500, or (ii) a
partial withdrawal is made that would result in your Annuity Account Value
falling below $500. We also reserve the right to terminate this Contract if no
Contributions have been made within 120 months of the Contract Date shown on
page 3 of this Contract.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount in the Divisions and the Annuity Account Value shall be zero. We will
be released from any and all liability for payments with respect to the
Contributions from which the Annuity Account Value arose.
If this Contract is terminated, surrendered or exchanged prior to your
Retirement Date, any applicable tax charges we have paid may be deducted. If we
have previously deducted charges for applicable taxes from Contributions
pursuant to Section 2.01, we will not again deduct charges for the same taxes on
terminations, unless a change in applicable law has occurred with respect to
your Contract.
SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under
the terms of the Plan, and the restrictions on distributions set forth in
Section 2.10, you may elect, by written notice to us, to make partial withdrawal
from the Divisions. For Plans subject to Title I of ERISA, partial withdrawals
may be subject to the spousal consent rules if applicable, set forth in Section
3.06.
Following receipt of your written notice, we will pay the lesser of the Cash
Value, less any funds restricted pursuant to Section 2.13, or the amount of
partial withdrawal requested to the person entitled to receive such payment as
you designate to us in writing. The amount paid plus any withdrawal charge
applicable pursuant to Section 2.08 will be withdrawn from the amounts you have
in the Divisions. Unless instructed otherwise, the amount withdrawn (including
any withdrawal charge) will be allocated among the Divisions in proportion to
the amounts that you have in such Divisions.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300,
or where the request violates the provisions of Sections 2.07 or 3.06. If a
withdrawal made under this Section would result in an Annuity Account Value of
less than $500, we will so advise you and reserve the right to pay the Annuity
Account Value to you and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS.
NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the
amount of partial withdrawal requested is not greater than the Free Corridor
Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity
Account Value, pursuant to Section 1.05.
WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than
the Free Corridor Amount, we will (i) first withdraw from the Divisions an
amount equal to the Free Corridor Amount, in proportion to the amount you have
in them, and (ii) then withdraw an amount equal to the excess of the amount
requested over the Free Corridor Amount, plus a partial withdrawal charge. Such
partial withdrawal charge will be equal to the lesser of (a) or (b) where:
(a) is an amount equal to
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
NO. 92 TSAA Page 9
of the amount withdrawn in excess of the Free Corridor Amount (including
such charge) pursuant to (ii) of the preceding sentence.
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior partial withdrawal
charges made pursuant to this Section.
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
If withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to your Contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if you
have completed three Contract Years or attained age 59 and 6 months an amount
equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value
on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to
Section 2.07 in the current Contract Year or pursuant to the repayment of
interest or principal on a loan, in the Current Contract Year. If you have not
completed three Contract Years or attained age 59 and 6 months, the Free
Corridor Amount is zero.
SECTION 2.10 RESTRICTIONS ON DISTRIBUTIONS. Notwithstanding anything in this
Contract to the contrary, payments of Cash Value pursuant to the termination of
this Contract under Section 2.06, partial withdrawals under Section 2.07, death
benefits under Section 2.12 or Annuity Benefits under Section 3.03 may be
limited as provided in Section 403(b)(11) of the Code and in this Section, to
the extent they are attributable to Elective Deferral Contributions made to this
Contract after December 31, 1988 and earnings credited after December 31, 1998
on Elective Deferral Contributions made before and after December 31, 1988
(collectively, "Restricted Amounts").
Distributions of Restricted Amounts may not be made until you attain age 59
years and six months, separate from service, die, or become disabled (within the
meaning of Section 72(m)(7) of the Code). Distributions of Elective Deferral
Contributions made after December 31, 1988--(but not any earnings credited after
December 31, 1988 attributable to Elective Deferral Contributions made before or
after December 31, 1988) may also be made in the case of hardship (within the
meaning of Section 403(b)(11) of the Code and applicable Treasury Regulations).
If you request payment of Restricted Amounts on the grounds of disability or
hardship you must furnish to us proof of such disability or hardship as may be
required by the Plan, the Code, and applicable Treasury Regulations in a form
satisfactory to us.
SECTION 2.11 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $25,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts that you have in
the Divisions. For this purpose, any loan reserve amount is included within the
Guaranteed Interest Division. The portion of the charge attributable to the
Guaranteed Interest Division and any loan reserve account will be first
withdrawn from the Guaranteed Interest Division and then, if the amount you have
in the Guaranteed Interest Division is not sufficient, the remaining allocation
will be withdrawn from the portion of the loan reserve account that earns
interest at the Guaranteed Interest Rate.
If the Annuity Account Value is less than $25,000, on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03
or (b) the date of Termination of this Contract pursuant to Section 2.06 or
2.12, we will prorate the Annual Administrative Charge applicable to the
completed portion of the Current Contract Year and withdraw such amount in lieu
of the Annual Administrative Charge described in this Section for the applicable
part of that Contract Year.
If the Annuity Account Value is $25,000 or greater at the end of a Contract
Year, the Annual Administrative Charge is zero.
SECTION 2.12 DEATH BENEFIT. Upon receipt of due proof of your death, we will pay
to the beneficiary designated to receive such payment, pursuant to Section 4.04
of this Contract, the amount of death benefit payable. The amount of the death
benefit is equal to the greater of (i) the Annuity Account Value less any
outstanding loan and (ii) the minimum death benefit. Such minimum death benefit
is the sum of all Contributions made pursuant to Section 2.01 (before reduction
for any applicable tax charge) less any withdrawals made pursuant to Section
2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by
any previous such withdrawal) by an amount which is in the same proportion as
the amount that was withdrawn is to the Annuity Account Value. If, in accordance
with the provisions of Section 2.01, the Cash Value of another annuity contract
issued by us, or one of our affiliated or subsidiary life insurance companies,
which provides for a death benefit before retirement is equal to the greater of
the contract Cash Value or alternate amount based on premiums paid or
Contributions made under the annuity contract, is transferred to this Contract,
such Cash Value or an alternative amount as of the date of transfer, will be
included in the "sum of all Contributions" in lieu of the amount of Cash Value
transferred for purposes of the death benefit under this Contract.
We will pay the death benefit to the beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.04. Also in accordance with the last paragraph of Section 4.04, if no such
election is in effect at your death, we will pay the death benefit to the
beneficiary in a single sum, unless the beneficiary elects, before we pay the
death benefit, to apply the death benefit to an Annuity Benefit, for Plans
subject to Title I of ERISA.
NO. 92 TSAA Page 10
Distributions pursuant to this Section are subject to the terms of the Plan and
the Spousal Consent Rules set forth in Section 3.06 for Plans subject to Title I
of ERISA.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value shall be zero. We will be released from any and all
liability for payments with respect to the Contributions from which the Annuity
Account Value arose.
SECTION 2.13 LOANS. Unless otherwise restricted by the Plan or the Code, you may
effect a loan under this Contract before the election and commencement of
Annuity Benefits. However, if the issuance of this Contract is pursuant to the
terms of a Plan subject to Title I of ERISA, then loans shall not be available
under this Contract. Future restrictions in the Code may require revision or
withdrawal of the loan provisions as provided below. Your Annuity Account Value
(including the loan reserve account as described below) will be the sole
security for the loan. A loan is effective on the first day of the month
following the date your loan agreement form is approved by us.
The amount of the loan may not be more than (i) 80% of the Annuity Account Value
of this Contract, if such total Annuity Account Value is greater than or equal
to $3,750 and less than $12,500, (ii) $10,000, if the Annuity Account Value is
greater than or equal to $12,500 and less than $20,000, and (iii) 50% of the
Annuity Account Value if the Annuity Account Value is greater than or equal to
$20,000, but in no event shall the loan amount exceed $50,000 less the highest
outstanding balance under this Contract during the one year period ending the
day before the effective date of the loan. The minimum loan permitted is $3,000.
For this purpose, the Annuity Account Value is taken as of the loan effective
date. Only one outstanding loan is permitted at a time under this Contract.
As a condition for granting a loan, we will require you to represent that the
loan amount requested, when aggregated with loans (principal plus interest) from
all qualified plans of your Employer, does not exceed the greater of $10,000 or
50% of the value of your nonforfeitable accrued benefits, and in no event
exceeds $50,000 less the highest outstanding balance of all loans from qualified
plans during the one year period ending on the day before the effective date of
the loan. We reserve the right to also require that you elect not to have income
tax withholding apply with respect to an interest and/or loan principal that
would otherwise be subject to withholding.
The loan term will be either (i) ten years, if you represent that the purpose of
the loan is to acquire, build or substantially rehabilitate a dwelling unit
which, within a reasonable period of time, is to be used as your principal
residence or (ii) five years. In any event, the loan term may not extend beyond,
that is, full repayment of the loan will be required upon the earlier of (i) the
election and commencement of Annuity Benefits pursuant to Section 3.03, (ii) the
date we received written notice from you to terminate this Contract pursuant to
Section 2.06, (iii) the date we pay a Death Benefit pursuant to Section 2.12,
and (iv) any date provided for such loans by Federal tax rules including
acceleration of the loan repayment in order that the operation of the loan
provisions do not adversely affect the tax treatment of this Contract.
On the loan effective date, we will transfer to a loan reserve account an amount
equal to the sum of (i) the loan amount, which will earn interest at the
effective annual rate of 4% during the loan term and (ii) 25% of the loan
amount, which will earn interest at the Guaranteed Interest Rate, as defined in
this Contract. You may specify from which Divisions these amounts are to be
transferred. In the absence of your direction, or if your directions cover only
part of the amount required to be transferred to the loan reserve account, we
will transfer the required (or additional required) amounts from each Division
in proportion to the amount that you have in such Divisions. On the first day of
the third month following the effective date of the loan and quarterly
thereafter (or first business day thereafter, if such day is not a business
day), the amount of interest earned at 4% annually during the prior quarter will
be transferred to the portion of the loan reserve account that earns interest at
the Guaranteed Interest Rate. You may not make any partial withdrawals or
transfers from the loan reserve account.
Beginning the first day of the third month of each quarter following the
effective date of the loan and quarterly on the first day of the month
thereafter, loan payments must be made to us. Such payments shall be amortized
in substantially level payments over the term of the loan and will be equal to
the sum of (a) and (b) where
(a) is the loan interest, calculated at an effective annual rate of 6%, and
(b) is a portion of the loan principal.
The loan must be repaid in part on each quarterly due date and may be repaid in
full at any time on or after the first loan anniversary and must include the
full interest due. Any payments received will first be applied to interest due,
with the balance applied towards repayment of the loan. Any partial loan
repayment will result in a transfer of the amount equal to the principal repaid
from (i) the portion of the loan reserve account that earns interest at the
effective annual rate of 4% to (ii) the Guaranteed Interest Division and may be
withdrawn, transferred or annuitized as directed in this Contract.
By each due date, if the amount of the loan payment is less than the amount due
or the loan payment is not received at our Processing Office, we will deduct and
treat as a partial withdrawal from the loan reserve account an amount equal to
the interest and principal payments due plus any applicable withdrawal charges
and any required income tax withholding, if such partial withdrawal will not be
a withdrawal of "restricted amounts" as described in Section 2.10 of this
Contract. Specifically, an amount equal to the principal payment will be
deducted from the portion of the loan reserve account which earns interest at
4%, and an amount equal to the interest payment plus any applicable withdrawal
charges and required income tax withholding will be deducted from the portion of
the loan reserve account which earns interest at the Guaranteed Interest Rate.
NO. 92 TSAA Page 11
To the extent a loan repayment is required and a partial withdrawal cannot be
made due to the restrictions described in Section 2.10 of this Contract, a
default in a loan payment will occur. We will transfer from the loan reserve
account to a suspense account an amount equal to the interest and principal
payments due. We will deduct from the loan reserve account a default charge (as
defined in this Section) as well as any required income tax withholding. We will
treat the amount transferred to the suspense account, plus any required income
tax withholding, as a "deemed distribution," that is, such amount will be
considered to have been distributed as provided under Section 72(p) of the Code.
Specifically, an amount equal to the principal payment due will be transferred
from the portion of the loan reserve account which earns interest at 4%, and an
amount equal to the interest payment due will be transferred from the portion of
the loan reserve account which earns interest at the Guaranteed Interest Rate.
Any applicable default charge and required income tax withholding will be
deducted from the portion of the loan reserve account which earns interest at
the Guaranteed Interest Rate.
The default charge on the amount of the deemed distribution is equal to the
applicable withdrawal charges which would have applied if such amount had been
withdrawn from this Contract at such time. Amounts transferred to the suspense
account for the purpose of securing the loan and interest payment due will not
be subject to future withdrawal charges when the liability for any such
defaulted payment is satisfied by a deduction from the suspense account.
Amounts transferred to a suspense account will be held there until Federal
income tax rules permit such amounts to be deducted from the Contract to satisfy
the defaulted loan and interest payment obligation which will be no later than
the date you attain age 59 years and 6 months or notify us in writing that an
event has occurred which would permit Restricted Amounts to be distributed from
the contract under Section 2.10.
Amounts held in the suspense account will earn interest at an effective annual
rate of 3%. You will also be charged interest on your defaulted loan and
interest payment obligation at an effective annual rate of 3% until such time as
any such default payment liability can be satisfied by a deduction from the
suspense account.
The default charge on such deemed distribution is equal to the applicable
withdrawal charges for a withdrawal of an amount equal to the interest and
principal payments due plus required income tax withholding.
Upon your full repayment of the loan, any amounts remaining in the loan reserve
account will be transferred to the Guaranteed Interest Division and may be
withdrawn, transferred or annuitized as described in this Contract.
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PART III--ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under the terms of this Contract with respect to a payee is the amount provided
with respect to the payee pursuant to Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division of the Separate Account.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of net
investment return referred to in Section 1.26 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.25, not to exceed the maximum rate of 1.75% after any deductions to
provide for any applicable tax charge. These charges include a daily charge for
financial accounting, death benefits, mortality risk, expenses and expense risk,
plus the investment advisory fee charges and direct operating expense charges of
the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under the terms of this Contract with respect to a payee is the
monthly amount provided pursuant to the fifth paragraph of Section 3.04. The
amount of the fourth and each subsequent payment under a Variable Annuity
Benefit will be equal to the number of Annuity Units with respect to such
benefit, multiplied by the Average Annuity Unit Value for the second calendar
month immediately preceding the due date of the payment. The number of Annuity
Units with respect to a benefit is the number determined by dividing the amount
of the first monthly payment under such benefit by the Annuity Unit Value for
the Valuation Period which includes the due date of the first monthly payment.
As described in Section 3.05, we will notify the payee how each Variable Annuity
Benefit is determined.
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your
Retirement Date, provided you are then living, the Annuity Account Value shall
be applied to provide the Normal Form of Annuity Benefit, unless you elect (i)
to receive the Cash Value in a single sum, or (ii) to apply the Annuity Account
Value, (less any outstanding loan as set forth in Section 2.13) or Cash Value,
whichever is applicable pursuant to the first paragraph in Section 3.04, to
provide an Annuity Benefit on any other annuity form offered by us, or one of
our affiliated or subsidiary life insurance companies, as elected by you, or
(iii) to take partial withdrawals in amounts and at times as required by the
Code, pursuant to Sections 2.07 and 3.05, subject to our rules then in effect
and any other applicable requirements under the Code.
NO. 92 TSAA Page 12
We will provide notice and election forms to you not more than six months before
your Retirement Date.
If you elect to terminate this Contract, prior to the Retirement Date, pursuant
to Section 2.06, an election may be made to receive an Annuity Benefit in lieu
of the Cash Value.
We will have the right to require that you furnish pertinent information to
provide an Annuity Benefit, and we will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary
life insurance companies. If the issuance of this Contract is pursuant to a Plan
subject to Title I of ERISA, the rules set forth in Section 3.06 shall apply to
your election and the commencement of annuity benefits.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or
third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be (i) the
Annuity Account Value if the payments under the annuity form involves life
contingencies, or (ii) the Cash Value if the Annuity Form elected does not
involve life contingencies.
The amount applied to provide an Annuity Benefit may be reduced by any
applicable tax charge on annuity considerations, as we determine. If we have
previously deducted any applicable tax charge from Contributions as provided in
Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to your Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your Contract will be governed by our
supplementary contract then in effect.
The amount to be applied to provide an Annuity Benefit will, in addition to any
tax charge reduction, be reduced by an administrative charge. The amount of such
charge will be determined from time to time in accordance with our general
practices applicable on a uniform basis to all contracts of the same type as
this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts
you have in the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under the terms of this
Contract, as indicated, on either the Life Annuity Form or the Joint and
Survivor Life Annuity Form (with 100% of the amount of your payment continued to
your spouse). The amount of income provided under the Fixed Annuity Benefit
payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are
based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a"
adjusted to a unisex basis based on a 50-50 split of males and females, at age
zero. The amount of income initially provided under the Variable Annuity Benefit
payable on the Life Annuity Form and the Joint and Survivor Life Annuity Form
are based on a 50-50 split of males and females, at age zero and an Assumed Base
Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to
Section 1.26.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us based on 3.5% interest and the 1983 Individual Annuity
Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males
and females, at age zero, if such annuity form provides for a Fixed Annuity
Benefit, and on the projected 1983 Basic Table "a" adjusted to a unisex basis
based on a 50-50 split of males and females, at age zero and an Assumed Base
Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant
to Section 1.26, if such annuity form provides for a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Distributions attributed to
Contributions of Transferred Funds pursuant to Section 2.01 (where you have
provided to us written evidence of such balance as of December 31, 1986 must
commence no later than age 75. Such distributions will be made in the normal
Form of Annuity Benefit, unless you elect to take payments in a single sum or
another form of Annuity Benefit then offered by us.
Your entire interest in this Contract attributable to all other Contributions
made, and earnings credited hereon must be distributed, or begin to be
distributed no later than the first day of April following the calendar year in
which you attain age 70 and 6 months ("Required Beginning Date"). Your entire
interest may be distributed, as you elect, over (a) your life, or the lives of
you and your designated beneficiary, or (b) a period certain not extending
beyond your life expectancy, or the joint and last survivor expectancy of you
and your designated beneficiary. Distributions must be made in periodic payments
at intervals of no longer than one year. In addition, payments must be either
nonincreasing or they may increase only as provided in Q & A F-3 of Section
1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation
thereto.
All distributions made hereunder shall be made in accordance with the
requirements of Section 403(b)(10) and 401(a)(9) of the Code, including the
incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and
applicable Treasury Regulations, including the minimum distribution incidental
benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury
Regulations, or any successor Regulation thereto.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.05, while any distribution shall be subject to such requirements of
the Code and regulations, any distribution shall also be subject to the terms of
this Contract. That is, the forms of distribution shall be those which are made
available by us at the time of your election.
NO. 92 TSAA Page 13
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9.
Unless you otherwise elect prior to the time distributions are required to
begin, those life expectancies shall be recalculated annually. Such election
shall be irrevocable and shall apply to all subsequent years. The life
expectancy of a non-spouse beneficiary may not be recalculated. Instead, life
expectancy will be calculated using the attained age of such beneficiary during
the calendar year in which you attain age 70 and 6 months and payments for
subsequent years shall be calculated based on such life expectancy reduced by
one for each calendar year which has elapsed since the calendar year life
expectancy was first calculated.
If you die after distribution of your interest in this Contract has begun, the
remaining portion of such interest will continue to be distributed at least as
rapidly as under the method of distribution being used prior to your death.
If you die before distribution of your interest begins, distribution of your
entire interest shall be completed no later than December 31 of the calendar
year containing the fifth anniversary of your death, except to the extent that
an election is made to receive death benefit distributions in accordance with
(1) or (2) below:
(1) If your entire interest is payable to a designated beneficiary, then
your entire interest may be distributed over the life of, or over a
period certain not greater than the life expectancy of, the designated
beneficiary. Such distributions must commence on or before December 31
of the calendar year immediately following the calendar year of your
death.
(2) If the designated beneficiary is your surviving spouse, the date
distributions that are required to begin in accordance with (1) above
shall not be earlier than the later of (A) December 31 of the calendar
year immediately following the calendar year of your death or (B)
December 31 of the calendar year in which you would have attained age 70
and 6 months.
For purposes of determining the "period certain" referred to in the immediately
preceding paragraph, life expectancy is computed by use of the expected return
multiples in tables V and VI of Treasury Regulation Section 1.72-9. For purposes
of distributions beginning after your death, unless otherwise elected by the
surviving spouse by the time distributions are required to begin, life
expectancies shall be recalculated annually. Such election shall be irrevocable
by the surviving spouse and shall apply to all subsequent years. In the case of
any other designated beneficiary, life expectancies shall be calculated using
the attained age of such beneficiary during the calendar year in which
distributions are required to begin pursuant to this Section, and payments for
any subsequent calendar year shall be calculated based on such life expectancy
reduced by one for each calendar year which has elapsed since the calendar year
life expectancy was first calculated.
Distributions under this Section are considered to have begun if distributions
are made because you have reached your Required Beginning Date or if prior to
the Required Beginning Date distributions irrevocably commence to you over a
period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1
of the Proposed Treasury Regulations or any successor Regulation thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under the terms of this Contract was based on information
that is subsequently found to be incorrect, your benefit will not be
invalidated, but an adjustment on the basis of the correct information will be
made in the amount of the benefit payments, or any amount used to provide the
benefit, or any combination thereof. Overpayments by us will be charged against
and underpayments will be added to any payments thereafter falling due under the
terms of this Contract with respect to the payee, affecting as many such
payments as are necessary to correct the overpayment or underpayment. Our
liability, with respect to a payee, is limited to the correct information and
the actual amounts used to provide the benefits then in force with respect to
the payee under this Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under the terms of this Contract is physically or mentally
incompetent to receive such payment or is a minor, (ii) another person or an
institution is then maintaining or has custody of such payee, and (iii) no
guardian, committee, or other representative of the estate of such payee has
been appointed, we may make the payments (in the case of a minor, at a rate not
exceeding $200 a month) to such other person or institution, and will thereupon
be fully discharged from all liability with respect thereto.
If a variable annuity form made available by us provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one of two persons, a payee for payments
thereunder may elect, without the concurrence of any other person, to receive
the commuted value of any remaining payments, provided no person upon whose life
the income depends is surviving.
Pursuant to Section 3.03, upon your election, pursuant to Section 3.03 of an
annuity form providing payments for a period certain, you may designate (with
the right to change such designation) a person or persons to receive any
payments that may become due after the death of the person or persons upon whose
life or lives the income may depend.
The payee may designate (with the right to change such designation and without
the concurrence of any other person) a payee to receive any payments or
installments payable after such payee's death, if the absence of such a
designation would result in a single sum payment to such payee's estate in
accordance with the following paragraph.
No. 92 TSAA Page 14
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments. The commuted value of any such remaining payments will be
determined on the basis of compound interest at the rate utilized in the
actuarial rate basis applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
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TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT AND SURVIVOR LIFE ANNUITY FORM
100% OF PAYMENT TO CONTINUE TO SPOUSE
(Minimum Monthly Income per $1,000 of Annuity Account Value)
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Age 60 61 62 63 64 65 66 67 68 69 70
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60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88
61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96
62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03
63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11
64 4.89 4.94 5.00 5.05 5.10 5.14 5.19
65 5.00 5.06 5.11 5.17 5.22 5.27
66 5.12 5.18 5.24 5.29 5.35
67 5.24 5.31 5.37 5.43
68 5.37 5.44 5.51
69 5.52 5.59
70 5.67
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ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1,000 of Annuity Account Value)
--------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT
PAYABLE ON THE LIFE ANNUITY FORM
IF ASSUMED BASE RATE OF NET
INVESTMENT RETURN IS
--------------------------------------------------------------------------------
Age 3.5% 5%
--------------------------------------------------------------------------------
60 5.27 6.16
61 5.39 6.28
62 5.52 6.41
63 5.66 6.55
64 5.81 6.70
65 5.97 6.86
66 6.15 7.03
67 6.33 7.21
68 6.53 7.41
69 6.74 7.62
70 6.97 7.85
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We will notify the payee, with respect to each payment under a Variable Annuity
Benefit, the number of Annuity Units and the Average Annuity Unit Value used in
determining the amount of each variable payment. Such notice will be mailed with
each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary,
as described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If this Contract is
issued pursuant to a Plan subject to Title I of ERISA, then the provisions of
this Section shall supersede any contrary provisions in this Contract. If you
are married, your interest in the Contract shall be paid in the Normal Form
joint and survivor annuity, and if you are unmarried, your interest shall be
paid in the Normal Form life annuity, unless you elect otherwise as described in
this Section. If you are married and die before payment of your interest has
commenced, your interest shall be paid to your surviving spouse in the form of a
life annuity, unless at the time of your death there was a contrary election
made pursuant to this Section. The foregoing notwithstanding, your surviving
spouse may elect, before payment is to commence, to have payment made in any
form permitted under the terms of this Contract.
You may elect, at any time within the 90 consecutive day period before the first
day of the first period for which your interest is paid as an annuity or in any
other form, not to have your interest paid in the Normal Form, in which case it
shall be paid in any other form elected under the terms of this Contract. If
such interest is to be paid to your spouse upon your death, you may elect,
during the period beginning on the first day of the plan year of the Plan in
which you attain age 35 (or, if you separate from service prior to that plan
year, beginning on the date of separation) and ending with your death, for a
beneficiary other than your spouse to receive payment of the value of your
interest. In
No. 92 TSAA Page 15
addition, if you will not yet attain age 35 by the end of any current plan year,
you may make a special qualified election to designate a beneficiary other than
your spouse to receive payment of the value of your interest, which special
qualified election shall be effective for the period beginning on the date of
such election and ending on the first day of the plan year in which you will
attain age 35. Amounts payable in accordance with this Section will be
automatically reinstated as of the first day of the plan year in which you
attain age 35 unless a new election designating a beneficiary other than the
spouse is made in accordance with the requirements of this Section.
Any election described in the foregoing paragraph must be consented to by your
spouse in writing before a notary or a representative of the Plan unless you can
prove that there is no spouse or that the spouse cannot be located. Also, if you
have become legally separated from your spouse or have been abandoned (within
the meaning of local law) and have a court order to such effect, spousal consent
is not required unless a qualified domestic relations order provides otherwise.
Your election must designate a specific beneficiary (including any class of
beneficiaries or any contingent beneficiaries) that may not be changed without
further consent of the spouse, unless the spouse's consent expressly permits
designation by you without further consent of the spouse. The spouse's consent
under this section shall acknowledge the effect of the election. In addition,
the spouse's consent (or the establishment that the consent of the spouse may
not be obtained) shall only be valid with respect to such spouse. Your waiver of
the Normal Form joint and survivor annuity shall not be effective unless the
election designates a form of benefit payment which may not be changed without
spousal consent (or the spouse expressly permits designations by you without any
further spousal consent). A consent that permits designations by you without any
requirement of further consent by such spouse must acknowledge that the spouse
has the right to limit consent to a specific beneficiary and a specific form of
benefit where applicable, and that the spouse voluntarily elects to relinquish
either or both of such rights. If you make an election under this Section, you
may revoke that election, without spousal consent, at any time before the first
day of the first period for which an amount is paid as an annuity or in any
other form.
The provisions requiring spousal consent in this Section shall also apply with
regard to your election to terminate this Contract or make partial withdrawals
pursuant to Sections 2.06 and 2.07, and with respect to a beneficiary
designation set forth in Section 4.04. A spouse's written consent, witnessed by
a representative of the Plan or a notary public, must be given on a form
acceptable to the Employer and us, within the 90 consecutive day period prior to
any such payment, or withdrawal, or beneficiary designation, unless you can show
that you have no spouse or that the spouse cannot be located.
If the Annuity Account Value applied to provide the spousal benefits on the date
payment is to commence is in the aggregate less than $3,500, we may choose to
make payment in a single sum rather than in the form of a Qualified Joint and
Survivor Annuity or Life Annuity as described herein. Upon any payment made
pursuant to this Section, we will be released from any and all liability for
payment with respect to the Contributions made for you.
--------------------------------------------------------------------------------
PART IV - GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the
parties and the terms of this Contract alone will govern with respect to our
rights and obligations. A copy of the application is incorporated in and made
part of this Contract.
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by our authorized officer. The terms of this
Contract may be changed by amendment or replacement upon agreement between you
and us without the consent of any other person.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of
this Contract without the consent of any other person in order to comply with
applicable laws and regulations. Such right shall include, but not be limited
to, the right to conform the terms of this Contract to reflect changes in the
Code, or applicable Treasury Regulations, or in regulations or published rulings
of the Internal Revenue Service so that this Contract will continue to be an
Annuity.
SECTION 4.03 NONTRANSFERABILITY AND ASSIGNMENTS. Your entire interest under this
Contract is nonforfeitable. No interest of yours (or of a beneficiary) under
this Contract may be transferred to any person other than us upon the surrender
of this Contract. Except as permitted under applicable law, no right or interest
of you or any other payee or beneficiary in this Contract shall be (a)
assignable; (b) subject to any lien; (c) liable for, or subject to, any
obligation or liability of any person. The preceding sentence shall not apply to
any assignment, transfer or attachment pursuant to a qualified domestic
relations order (as defined in Section 414(p) of the Code).
SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an
initial designation of the beneficiary entitled to receive any death benefit
payable pursuant to Section 2.12. You may change such designation from time to
time during your lifetime, and while this Contract is in force. Any such
designation or change must be made by written notice in a form satisfactory to
us. A change will, upon receipt at the Processing Office, take effect as of the
time the written notice was signed, whether or not you are living on the date of
receipt, but without further liability as to any payment or other settlement
made by us before receipt of such change. Beneficiary designations are subject
to the rules of Section 3.06 if the Contract is issued pursuant to a Plan
subject to Title I of ERISA.
No. 92 TSAA Page 16
Unless otherwise specified in the designation, if you have designated two or
more persons as beneficiary, the beneficiary will be the designated person or
persons who survive you, and if more than one survive, they will share equally.
Any part of a death benefit payable pursuant to Section 2.12 for which there is
no designated beneficiary living at the time of your death, will be payable in a
single sum to your children who survive you, in equal shares, or should none
survive, then to your estate.
If you elect in writing, any amount that would otherwise be payable to a
beneficiary in a single sum may be applied to provide an Annuity Benefit, on the
form of annuity previously elected by you, with respect to the beneficiary,
subject to our rules then in effect. If, at your death, there is no election in
effect to apply the single sum death benefit to provide an Annuity Benefit, the
beneficiary may make such an election. Any such election must meet the minimum
distribution requirements under the Code, as described in Section 3.05.
SECTION 4.05 DISQUALIFICATION. In the event that the Plan fails to qualify as a
Plan under Section 403(b) of the Code and applicable Treasury Regulations, we
reserve the right, upon receiving notice of such fact, to transfer the Annuity
Account Value under this Contract to another annuity contract issued by us, an
affiliate subsidiary, on your life, or to terminate this Contract and pay to you
the Annuity Account Value less deduction for applicable taxes, solely at our
option.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Employer, we
reserve the right at our sole discretion to limit Contributions under this
Contract.
SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of your Annuity Account Value
(less any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities and
Exchange Commission, by order, permits us to defer payment in order to protect
persons with interests in the Investment Divisions. We can defer payment of any
portion of your Annuity Account Value in the Guaranteed Interest Division for up
to six months while you are living.
SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you
with a notice showing the following:
(1) the amount you have in the Guaranteed Interest Division,
(2) the total number of Accumulation Units you have in the Stock Division,
Balanced Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Values,
(4) the amount you have in the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division,
(5) the amount you have in the loan reserve account,
(6) the Cash Value, and
(7) the amount of death benefit payable with respect to you.
We will also furnish annual calendar year reports concerning the status of the
annuity and any other reports required by the Code or applicable Treasury
Regulations.
After the Retirement Date, we will notify you of the number of Annuity Units and
the Average Annuity Unit Value used in determining the amount of each Variable
Annuity Benefit payment, if any.
SECTION 4.09 AGE. If your age has been misstated, any benefits will be those
which would have been purchased at the correct age. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
No. 92 TSAA Page 17
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APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
PROCESSING OFFICE: INDIVIDUAL ANNUITY CENTER, P.O. BOX 2996,
NEW YORK, NEW YORK 10116-2996
QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR:
EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY
--------------------------------------------------------------------------------
TYPE OF PURCHASE (Complete One Plan Only)
A. |X| TSA PUBLIC SCHOOL (GV-PS-I)
B. |_| TSA 501(C)(3) ORGANIZATION (GV-501-I)
C. |_| TSA University (GV-PS-U-I)
D. |_| IRA Individual (Including IRA to IRA transfers) (XX-XXX 4971)
E. |_| IRA Unit Billed (Including IRA to IRA transfers) (XX-XXX 4971)
F. |_| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified
Plan) (XX-XXX 4971-71)
G. |_| EDC (Public Employee Deferred Compensation) (GV-EDC 4991)
H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-080)
I. |_| SEP (Simplified Employee Pension) (GV-SEP 4981)
J. |_| SARSEP (Salary Reduction SEP) _________________________________________
K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41)
L. |_| XXXXX/HR-10 TRUSTEE (GV HR-10 4911-11)
(trustee owned)
M. |_| XXXXX/HR-10 (GV-HR-10 4911)
(not trustee owned) (issued to existing units only)
--------------------------------------------------------------------------------
DO NOT COMPLETE THIS SECTION IF 1.D OR 1.F CHECKED ABOVE
2. EMPLOYER/PLAN NAME
|A|B|C|_|C|O|M|P|A|N|Y|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_|
|x| NEW UNIT |0|0|0|1|2|3|-|4|5|6|
(FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM
983-135B IS REQUIRED)
--------------------------------------------------------------------------------
4. PROPOSED ANNUITANT Print name to appear on Contract.
|J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_|
FIRST MIDDLE INITIAL LAST
A. |X| MR. |_| MRS. |_| MS. |_| OTHER ____
B. Date of Birth: Year 1954 Month JANUARY Day 27
---- ------- --
C. Age at Nearest Birthday: 38 D. |X| Male |_| Female
----
X. Xxxxxxxxx's Mailing Address: F. State of Residence: N.J.
----
No., St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_|
City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1|
G. Telephone Number (101) 222 - 3456 |X| Home |_| Work
H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9|
I. Are you associated with or employed by a member of National
Association of Securities Dealers, Inc.(NASD)? |_| Yes |X| No
5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner, for all
other Markets Print Name of Annuitant.
XXXX XXX
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a. Title ____________________________________________________________________
6. RETIREMENT AGE 65
---------------------------------------------------------------
7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death
Benefit upon Xxxxxxxxx's death before Retirement Date.) (BENEFICIARY MUST
BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.)
XXXX XXX - WIFE
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8. CONTRIBUTION ALLOCATION
Guaranteed Interest Division 20%
-----
Stock Division 20%
-----
Money Market Division 20%
-----
Balanced Division 20%
-----
Aggressive Stock Division 20%
-----
(PERCENTAGES IN WHOLE NUMBERS) Total 100%
9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F)
A. Reminder Notice (Billing) Required |_| Yes |X| No
IF YES, COMPLETE B-C-D-E
B. REMINDER DATE Required for Individual IRA or otherwise must agree
with existing unit or attached 983-135B. MONTH _________ DAY __________
C. REMINDER FREQUENCY
|_| Annual |_| Semi-Annual
|_| Quarterly |_| Monthly
Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA
ONLY:
|_| Semi-Monthly |_| Bi-Weekly
D. REMINDER AMOUNT $_________________________________
E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY
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10.EXPECTED FIRST CONTRACT YEAR
Contribution. $1000
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IF AN ADVANCED BILLING AND/OR CONTRACT DATE ARE REQUESTED, COMPLETE #9B
AND #12.
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(FOR PROCESSING OFFICE USE)
Unit Name ___________________________ Reminder Date ___________________________
Cert. or App# _______________________ Amendment Required_______________________
EDC Emp. Add. _______________________ Emp. Fed. ID# ___________________________
Frequency ___________________________ Contract Date ___________________________
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Receipt Date Batch # Inquiry # Processor
--------------------------------------------------------------------------------
180-1000
--------------------------------------------------------------------------------
10. Did you receive the Separate Account Prospectus? |X| Yes |_| No
Date shown on Prospectus January 1, 1992
----------------------------------------------------
Date of any supplement to Prospectus _______________________________________
11. Items (a) through (f) are to be answered by the annuitant. We are
required by the NASD to ask these questions.
(a) Name of Employer: ABC Company
------------------------------------------------------
(b) Address of Employer:
10 Main Street
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Anytown, NJ
---------------------------------------------------------------------------
(c) Occupation Sales
-------------------------------------------------------------
(d) Assuming the contract applied for will be issued, will any existing
insurance or annuity be replaced or changed (or has it been)?
| | Yes |X| No
(e) Estimated Family Annual Income $100,000
----------------------------------------
(f) Estimated Net Worth $250,000
-----------------------------------------------------
(g) Investment Objective: |_| Income |X| Income & Growth
|_| Aggressive Growth |_| Growth |_| Safety of Principal
12. SPECIAL INSTRUCTIONS
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13. Amount paid with this form: $1000
(If a check is submitted with this request, no advanced Contract Date is
permitted.) BACKDATING IS NOT PERMITTED.
NOTE: Xxxxxx paid will be credited upon receipt at Equitable's Processing
Office, subject to return if the certificate is not issued. The Contract Date
will be the date of receipt by Equitable of this application, properly signed
and completed, and Contribution at Equitable's Processing Office.
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
AGREEMENT
All information and statements furnished in this application are true and
complete to the best of my knowledge and belief. I understand and acknowledge
that no Agent has the authority to make or modify any contract on Equitable's
behalf, or to waive or alter any of Equitable's rights and regulations.
IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO
THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT
PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT.
UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S)
OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND
COMPLETE.
--------------------------------------------------------------------------------
LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY
APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS.
--------------------------------------------------------------------------------
X__________________________________ Date_______ City __________ State __________
Signature of Annuitant
X__________________________________ Date_______ City __________ State __________
Signature of Authorized Individual (REQUIRED FOR EDC AND
TRUSTEED) OR OWNER
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
AGENT'S SECTION
Will any existing insurance or annuity be replaced or changed (or has it been),
assuming the Contract will be issued? | | Yes | | No
|_| I (we) certify that a prospectus for the Contract has been given to the
proposed Annuitant and that no written sales materials other than those approved
by Equitable have been used.
EQUI-VEST issues must adequately reflect the commission interest of all Agents
on previous contracts.
--------------------------------------------------------------------------------
Print Agent's Name(s) Initial of Agent Agent Agency District Agent's
(Service Agent first) Last Name Number % Code Manager Code Signature
--------------------------------------------------------------------------------
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FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS___ Date ___ District EQS ___
Date ____
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(FOR ASU USE)
ASU Code and App. No. __________________________________________________________
ASU Rec'd. _____________________________________________________________________
Date to Proc. Off. ________________________________________________ Campaign |_|
Agent(s) shown above is Equity Qualified and is licensed in the state where the
request is signed. Above Agent information verified by XXX (Registered Rep)
--------------------------------------------------------------------------------
Application reviewed by ________________________________________________________
--------------------------------------------------------------------------------
180-1000
[EQUITABLE LOGO]
Owner:
Annuitant:
Contract Number:
Issue Date:
Contract Date:
Retirement Date:
--------------------------------------------------------------------------------
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P O Box 2996,
New York, New York 10116-2996
AGREES
o TO ALLOCATE the Contributions made to this Contract, after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division of the Separate Account (referred
to in this Contract as the "Investment Divisions") or to the Guaranteed
Interest Division, in accordance with Sections 2.02, 2.03 and 2.04 or in
part to any one, as directed by you, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide the
Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant
is then living, and
o TO PROVIDE the Annuitant with the other rights and benefits of this
Contract.
This is the entire Contract. In this Contract, "we", "our" and "us" mean the
Equitable Life Assurance Society of the United States. "You" and "your" mean the
Annuitant at the time a right is exercised by the Annuitant.
TEN DAYS TO EXAMINE CONTRACT-You may cancel this Contract by returning it to us
within ten days after receipt of it. Upon such cancellation, we will refund any
Contribution made to us on your behalf under this Contract, plus or minus any
investment gain or loss experienced in the Investment Divisions of the Separate
Account from the date such Contribution is allocated to such Investment Division
to the date we receive the returned Contract.
/s/Xxxxxxx Xxxxxxx /s/Xxxxxx X. Xxxxxx
Xxxxxxx Xxxxxxx, Vice President Xxxxxx X. Xxxxxx
Secretary & Associate General Counsel President and Chief Executive Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.26 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE NOT TO
EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR
FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK,
PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF
THE TRUST.
No 92 TSAB
This Contract is issued in consideration of the payment to us of the
Contributions made under the terms of this Contract.
The provisions on the following pages are part of this Contract.
--------------------------------------------------------------------------------
TABLE OF CONTENTS
DEFINITIONS Page
Section 1.00 - Agreement...................................................4
1.01 - Annuitant...................................................4
1.02 - Annuity.....................................................4
1.03 - Annuity Account Value.......................................4
1.04 - Annuity Benefit.............................................4
1.05 - Cash Value..................................................4
1.06 - Class of Contracts..........................................5
1.07 - Code........................................................5
1.08 - Contract ...................................................5
1.09 - Contract Date...............................................5
1.10 - Contract Year...............................................5
1.11 - Contribution................................................5
1.12 - Divisions...................................................5
1.13 - Elective Deferrals..........................................5
1.14 - Eligible Annuity Certain....................................5
1.15 - Employer....................................................5
1.16 - ERISA.......................................................5
1.17 - Guaranteed Interest Rate....................................5
1.18 - Joint and Survivor Life Annuity Form........................5
1.19 - Life Annuity Form...........................................5
1.20 - Normal Form.................................................5
1.21 - Period Certain Annuity......................................5
1.22 - Plan........................................................6
1.23 - Processing Office...........................................6
1.24 - Retirement Date.............................................6
1.25 - Separate Account............................................6
1.26 - Separate Account Definitions................................7
1.27 - Transaction Date............................................7
1.28 - Trust.......................................................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions...............................................8
2.02 - Separate Account Investment Divisions.......................8
2.03 - Guaranteed Interest Division................................8
2.04 - Allocation to Divisions.....................................8
2.05 - Transfers Among Divisions...................................8
2.06 - Termination of this Contract................................9
2.07 - Partial Withdrawals.........................................9
2.08 - Charges for Partial Withdrawals.............................9
2.09 - Free Corridor Amount.......................................10
2.10 - Restrictions on Distributions..............................10
2.11 - Annual Administrative Charge...............................10
2.12 - Death Benefit..............................................10
2.13 - Loans......................................................11
ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit......................................12
3.02 - Variable Annuity Benefit...................................12
3.03 - Election and Commencement Of Annuity Benefits..............12
3.04 - Amount of Annuity Benefits.................................13
3.05 - Payment of Annuity Benefits................................13
3.06 - Special Annuity and Spousal Consent Provisions.............15
GENERAL PROVISIONS
Section 4.01 - Contract...................................................16
4.02 - Statutory Compliance.......................................16
4.03 - Nontransferability and Assignments.........................16
4.04 - Beneficiary................................................16
4.05 - Disqualification Of Plan or Contract.......................17
4.06 - Future Contributions.......................................17
4.07 - Deferment..................................................17
4.08 - Annual Notice..............................................17
4.09 - Age........................................................17
No. 92 TSAB Page 2
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PART I - DEFINITIONS
SECTION 1.00 AGREEMENT. The term "Agreement" means an agreement described in
Treasury Regulation Section 1.403(b)-l(b)(3) between an Employer and an employee
of the Employer, in which the Employer agrees to purchase an Annuity for the
employee. If Employer contributions to purchase the Annuity result from the
employee's agreement to take a reduction in future salary or forgo a future
salary increase, such Agreement is referred to as a "Salary Reduction Agreement"
within the meaning of Sections 402(g)(3)(C) and 3121(a)(5)(D) of the Code.
SECTION 1.01 ANNUITANT. The term "Annuitant" means the owner of this Contract,
as shown on page 3 and on whose behalf this Contract has been purchased and is
maintained, and who exercises all rights under this Contract.
SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in
accordance with the terms of the Plan or Agreement, which contract meets the
requirements for qualification under Section 403(b) of the Code.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts that you have in the Guaranteed Interest Division and the
Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03,
plus any reserve or suspense account pursuant to loans under Section 2.13.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by us pursuant to Section 3.04 of this Contract. Various sections of this
Contract (Sections 1.18, 1.19, 1.20, 3.01 and 3.02) refer to monthly payments to
be made under an Annuity Benefit. You may wish to have your Annuity Benefit paid
at other intervals, such as quarterly, semi-annually, or annually, instead of
monthly. You may elect this at the time you elect the Annuity Benefit form as
described in Section 3.03; in that event, all references in this Contract to
monthly payments will be deemed to mean payments at the frequency you elect,
subject to our rules at the time of election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value
less any applicable withdrawal charge determined as follows:
The withdrawal charge equals the lesser of (a) or (b) where
(a) equals
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the excess of (i) the Annuity Account Value over (ii) the Free Corridor
Amount defined in Section 2.09; and
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior charges for partial
withdrawals made pursuant to Section 2.08.
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
A withdrawal charge will not apply, which means the Cash Value will equal the
Annuity Account Value upon any of the following occurrences:
(i) your attainment of age 59 and 6 months, and your completion of at least
five Contract Years, or
(ii) you die and a distribution is made to your beneficiary, or
(iii) your attainment of age 55, your completion of at least five Contract Years
and the receipt by us of a properly completed settlement election form
providing for the application of the Annuity Account Value to purchase an
Eligible Annuity Certain, defined in Section 1.14, or
(iv) your completion of at least three Contract Years and the receipt by us of
a properly completed settlement election form providing for the
application of the Annuity Account Value to purchase a Period Certain
Annuity, defined in Section 1.21, where the certain period of such annuity
is at least ten years, or
(v) the receipt by us of a properly completed settlement election form
providing for the application of the Annuity Account Value to purchase a
Life Annuity distribution option, or
(vi) your attainment of age 55, your completion of at least five Contract
Years, and separation from service, or
(vii) your completion of at least twelve Contract Years.
No. 92 TSAB Page 4
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same Calendar Year.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, or
any corresponding provisions of prior or subsequent United States revenue laws.
SECTION 1.08 CONTRACT. The term "Contract" means this Contract.
SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both the application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us
for you with respect to an Annuity purchased for you under the Plan. We are
under no obligation to accept any Contribution less than $20.00. Contributions
may be either Elective Deferrals or Employer Contributions pursuant to the Plan.
The Employer shall indicate to us the amount and type of each Contribution.
SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following Divisions described in this
Contract:
(a) the Guaranteed Interest Division, and
(b) the Investment Division of the Separate Account.
SECTION 1.13 ELECTIVE DEFERRALS. The term "Elective Deferrals" means
Contributions made pursuant to a Salary Reduction Agreement as defined in
Section 1.00.
SECTION 1.14 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
an annuity not involving life contingencies issued by us which extends beyond
your attainment of age 59 and 6 months and does not permit any prepayment of the
unpaid principal (that is, no withdrawal or single sum payment) prior to your
attainment of age 59 and 6 months.
SECTION 1.15 EMPLOYER. The term "Employer" means (i) an organization described
in Section 501(c)(3) of the Code which is exempt from Federal income tax under
Section 501(a) of the Code; or (ii) a State, political subdivision of a State,
or an agency or instrumentality of any one or more of the foregoing, in
connection with services performed by an employee for an educational
organization described in Section 170(b)(1)(A)(ii) of the Code.
SECTION 1.16 ERISA. The term ERISA means the Employee Retirement Income Security
Act as amended.
SECTION 1.17 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrues on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on page 3 of
this Contract. Section 2.03 describes the determination of the Rate to apply
thereafter.
SECTION 1.18 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected by you. The payments commence on the date as of which the Joint and
Survivor Life Annuity Form is purchased and terminate with the last payment due
before the death of the survivor.
SECTION 1.19 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us or one of our affiliated or subsidiary life insurance companies,
providing fixed monthly payments during the lifetime of the person upon whose
life such payments depend. The payments commence on the date as of which the
Life Annuity Form is purchased and terminate with the last payment due before
the death of such person.
SECTION 1.20 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means (i) if you have a living spouse at the Retirement Date, the
Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with
such spouse as the contingent annuitant (with 100% of the monthly amount payable
to your spouse), and (ii) if you do not have a living spouse at the Retirement
Date, the Fixed Annuity Benefit payable on the Life Annuity Form.
SECTION 1.21 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us or one of our affiliated
or subsidiary life insurance companies, which does not permit any prepayment of
the unpaid principal (that is, you cannot elect to receive part of your payments
as a single sum payment with the remainder paid in monthly annuity payments).
No. 92 TSAB Page 5
SECTION 1.22 PLAN. The term "Plan" means a program established by an Employer,
for the purchase of Annuities on behalf of employees. The Employer shall be the
"Plan Administrator" within the meaning of Section 414(g) of the Code and
applicable Treasury Regulations.
SECTION 1.23 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such
other location as we shall designate by advance written notice to the Employer,
or the Plan's Trustee, as applicable, and to you.
SECTION 1.24 RETIREMENT DATE. The term "Retirement Date" means the date on which
you attain your retirement age as shown on page 3 of this Contract. Before the
Retirement Date you may elect to change the Retirement Date to another
Retirement Date, which may be any date after the filing of the election (other
than the 29th, 30th, or 31st day of any month). The Retirement Date selected
either initially or by later change must be in accordance with the terms of the
Plan. No Retirement Date shall be later than the date of your attainment of age
70 and 6 months. Any election for such change must be made in writing by you and
shall not take effect until received by us at our Processing Office.
SECTION 1.25 SEPARATE ACCOUNT. The term "Separate Account" means Separate
Account A, which is organized as a unit investment trust (a type of investment
company). We have established the Separate Account and it is maintained in
accordance with the laws of New York State. Realized and unrealized gains and
losses from the assets of the Separate Account are credited to or charged
against it without regard to our other income, gains or losses. Assets are put
in the Separate Account to support this Contract and other variable annuity
contracts. Assets may be put in the Separate Account for other purposes, but not
to support contracts or policies other than variable annuities and variable life
insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these Contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust where each class (or series) represents a separate portfolio in
the Trust. We reserve the right to change the designated trust or investment
company or to add designated trusts or investment companies. The Investment
Divisions available are the Stock Division, the Money Market Division, the
Balanced Division and the Aggressive Stock Division. The Guaranteed Interest
Division is not a part of the Separate Account, but rather is an asset of our
General Account.
We will value the assets of each Investment Division on each business day. A
business day is any day on which we are open, the New York Stock Exchange is
open for trading and there is a sufficient degree of trading in the portfolio of
the securities in which an investment Division is invested to materially affect
the Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments we are
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under the
Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any other
form;
(v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or
remove Investment Divisions (or sub-divisions of Investment Divisions)
from the Separate Account; (The term "Investment Division" in this
Contract shall then refer to any other Investment Division in which the
asset of a Class of Contracts to which this Contract belongs, were
placed);
(vi) combine any two or more Investment Divisions (or sub-divisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
Class of Contracts to which this Contract belongs.
No. 92 TSAB Page 6
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, you will be notified of such exercise, as
required by law.
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for any applicable
tax charges) at a rate not to exceed 1.49% per year for the Stock, Money Market
and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division,
for financial accounting, death benefits, mortality risk, expenses and expense
risk. The charge shall be made in accordance with Subsection (c) of the Net
Investment Factor provision in Section 1.26. The relative proportion of these
charges may be modified. The daily charge, plus the investment advisory fee
charges and direct operating expense charges of the Trust shall not exceed a
total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract. The maximum rate may not be altered
without your approval.
SECTION 1.26 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any preceding consecutive
non-business days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment
Division for the Valuation Period. For this purpose, we use the share
value reported to us by the Trust.
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period (after
any amounts allocated to or withdrawn for that Valuation Period).
(c) is the daily asset charge for the expenses of this Contract, times the
number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an
Investment Division where your Contributions are invested and which is used in
determining the amount you have in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for such Valuation Period.
ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first Contribution was put into the Stock
Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed
Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The
Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value
for the immediately preceding Valuation Period multiplied by the Adjusted Net
Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for a Valuation Period is the Net Investment Factor for such
period reduced for each calendar day in such subsequent Valuation Period by the
Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net
Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net
Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall
be 5%, except in states where the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar
month is equal to the average of the Annuity Unit Values for all Valuation
Periods ending in such month.
SECTION 1.27 TRANSACTION DATE. The Transaction Date is the business day we
receive a Contribution or a written contract transaction request providing the
information we need at the Processing Office. In the case of a transfer request
initiated through the use of a touch tone telephone as described in Section
2.05, the term Transaction Date is the business day the telephone transaction
is received.
SECTION 1.28 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
No. 92 TSAB Page 7
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PART II - ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. The Employer is to make Contributions, from time to
time on such dates and in such amounts as determined by the Employer pursuant to
the terms of the Plan or Agreement. You are to specify the amount to be
allocated to each Division.
Each contribution received by us with respect to you will, before its allocation
under this Contract, be reduced by the amount of any applicable tax charge, as
determined by us.
Pursuant to the terms of the Plan, if applicable, you may, with our agreement,
(i) transfer to this Contract any amount held under a contract or account that
meets the requirements of Section 403(b) of the Code ("Transferred Funds"), or
(ii) roll over contributions from a contract or account that meets the
requirements of Section 403(b) of the Code, or from a conduit individual
retirement arrangement described in Section 408(d)(3)(A)(iii) of the Code. If
you do not provide to us at the time of such transfer as described in (i) above,
as to what portion, if any, of the amounts of the Transferred Funds which are
exempt from the distribution restrictions described in Section 2.10, and the
minimum distribution rules described in Section 3.05, we will treat all such
amounts as being subject in such restrictions. Any Transferred Funds from a
contract not issued by us will, before allocation under this Contract, be
reduced by the amount of any applicable tax charge, as determined by us.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to or withdrawn or transferred from an Investment
Division, the Annuity Account Value will be credited or charged, as the case may
be, with the number of Accumulation Units determined by dividing said amount by
the Accumulation Unit Value for the appropriate Investment Division for the
Valuation Period which includes that date. The number of units you have in an
Investment Division on any date is equal to (i) the sum of any Accumulation
Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of
any Accumulation Units that have been withdrawn pursuant to Sections 2.07, 2.08
or 2.13, or transferred from the Investment Division pursuant to Section 2.05.
The amount you have in an Investment Division on any date is equal to the
product of (i) the number of Accumulation Units in the Investment Division on
that date, and (ii) the Accumulation Unit Value for the Investment Division for
the Valuation Period which includes that date.
Participation in the Separate Account under this Contract terminates on the
earliest of (i) your election and commencement of annuity benefits pursuant to
Section 3.03, (ii) receipt of due proof of your death, or (iii) termination of
this Contract pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division as part of our general assets, which support the
guarantees of this Contract and other contracts. The amount in the Guaranteed
Interest Division at any time is equal to the sum of all amounts that have been
allocated to the Guaranteed Interest Division pursuant to Section 2.04 or 2.13,
plus the amount of any interest accrued but not allocated, less the sum of all
amounts that have been withdrawn from the Guaranteed Interest Division pursuant
to Section 2.07, 2.08 or 2.13 or transferred from the Guaranteed Interest
Division, pursuant to Section 2.05. Interest is allocated to the Guaranteed
Interest Division on a Transaction Date pursuant to Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division under the terms of this
Contract terminates on the earliest of (i) election and commencement of Annuity
Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, iii)
Termination of this Contract pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction of any applicable tax charge) to one or more
Divisions, at your sole direction as specified to us. Allocation percentages
must be in whole numbers and the sum must equal 100. The allocation is made as
of the Transaction Date on which we have received both such Contribution and
such direction. Contributions made to an Investment Division purchase
Accumulation Units in that Investment Division, using the Accumulation Unit
Value next computed after the Transaction Date.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon Termination of this Contract, pursuant to Section 2.06, and (vi)
upon your death pursuant to Section 2.12.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through
the use of a touch tone telephone, transfer all or part of the amount you have
in a Division to one or more of the Divisions as follows: (1) amounts in the
Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive
Stock Division may be transferred among such Divisions; (2) amounts in the Money
Market Division may be transferred to other Divisions. Written authorization for
touch tone telephone initiated transfers is only required when authorization for
telephone transfers is requested. Upon advance written notice to you, we reserve
the right to
No. 92 TSAB Page 8
discontinue the acceptance of transfer requests through the use of a touch tone
telephone. All transfers will be effective on the Transaction Date and will be
subject to our rules in effect at the time of transfer. With respect to
Investment Division, the transfer will be made at the Accumulation Unit Value
next computed after the Transaction Date. No transfers are permitted to the
Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the
terms of the Plan, including, for Plans subject to Title I of ERISA, if
applicable, the spousal consent rules set forth in Section 3.06, you may elect,
by written notice, to terminate this Contract. In addition, termination of the
Contract is subject to restrictions on distributions set forth in Section 2.10
of this Contract. We will determine the Cash Value as of the Transaction Date we
receive your written election.
The payment of such Cash Value to you may be deferred by us in accordance with
the provisions of Section 4.07.
Subject to the terms of the Plan, and the restrictions on distributions set
forth in Section 2.10, we reserve the right to pay the Annuity Account Value
under this Contract and terminate this Contract. This right may be exercised
only if both (i) you made no Contributions during the last three completed
Contract Years, and the Annuity Account Value is less than $500, or (ii) a
partial withdrawal is made that would result in your Annuity Account Value
falling below $500. We also reserve the right to terminate this Contract if no
Contributions have been made within 120 days of the Contract Date shown on page
3 of this Contract.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount in the Divisions and the Annuity Account Value shall be zero. We will
be released from any and all liability for payments with respect to the
Contributions from which the Annuity Account Value arose.
If this Contract is terminated, surrendered or exchanged prior to your
Retirement Date, any applicable tax charges we have paid may be deducted. If we
have previously deducted charges for applicable taxes from Contributions
pursuant to Section 2.01, we will not again deduct charges for the same taxes on
terminations, unless a change in applicable law has occurred with respect to
your Contract.
SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under
the terms of the Plan, and the restrictions on distributions set forth in
Section 2.10, you may elect, by written notice to us, to make a partial
withdrawal from the Divisions. For Plans subject to Title I of ERISA, partial
withdrawals may be subject to the spousal consent rules if applicable, set forth
in Section 3.06.
Following receipt of your written notice, we will pay the lesser of the Cash
Value, less any funds restricted pursuant to Section 2.13, or the amount of
partial withdrawal requested to the person entitled to receive such payment as
you designate to us in writing. The amount paid plus any withdrawal charge
applicable pursuant to Section 2.08 will be withdrawn from the amounts you have
in the Divisions. Unless instructed otherwise, the amount withdrawn (including
any withdrawal charge) will be allocated among the Divisions in proportion to
the amounts that you have in such Divisions.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300,
or where the request violates the provisions of Sections 2.07 or 3.06. If a
withdrawal made under this Section would result in an Annuity Account Value of
less than $500, we will so advise you and reserve the right to pay the Annuity
Account Value to you and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS.
NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the
amount of partial withdrawal requested is not greater than the Free Corridor
Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity
Account Value, pursuant to Section 1.05.
WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than
the Free Corridor Amount, we will (i) first withdraw from the Divisions an
amount equal to the Free Corridor Amount, in proportion to the amount you have
in them, and (ii) then withdraw an amount equal to the excess of the amount
requested over the Free Corridor Amount, plus a partial withdrawal charge. Such
partial withdrawal charge will be equal to the lesser of (a) or (b) where:
(a) is an amount equal to
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
No. 92 TSAB Page 9
of the amount withdrawn in excess of the Free Corridor Amount (including such
charge) pursuant to (ii) of the preceding sentence.
(b) the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior partial withdrawal
charges made pursuant to this Section.
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount. If
withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to your Contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if you
have completed three Contract Years or attained age 59 and 6 months an amount
equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value
on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to
Section 2.07 in the current Contract Year or pursuant to the repayment of
interest or principal on a loan, in the Current Contract Year. If you have not
completed three Contract Years or attained age 59 and 6 months, the Free
Corrider Amount is zero.
SECTION 2.10 RESTRICTIONS ON DISTRIBUTIONS. Notwithstanding anything in this
Contract to the contrary, payments of Cash Value pursuant to the termination of
this Contract under Section 2.06, partial withdrawals under Section 2.07, death
benefits under Section 2.12 or Annuity Benefits under Section 3.03 may be
limited as provided in Section 403(b)(11) of the Code and in this Section, to
the extent they are attributable to Elective Deferral Contributions made to this
Contract after December 31, 1988 and earnings credited after December 31, 1988
on Elective Deferral Contributions made before and after December 31, 1988
(collectively, "Restricted Amounts").
Distributions of Restricted Amounts may not be made until you attain age 59
years and six months, separate from service, die, or become disabled (within the
meaning of Section 72(m)(7) of the Code). Distributions of Elective Deferral
Contributions made after December 31, 1988-(but not any earnings credited after
December 31, 1988 attributable to Elective Deferral Contributions made before or
after December 31, 1988) may also be made in the case of hardship (within the
meaning of Section 403(b)(ll) of the Code and applicable Treasury Regulations).
If you request payment of Restricted Amounts on the grounds of disability or
hardship you must furnish to us proof of such disability or hardship as may be
required by the Plan, the Code, and applicable Treasury Regulations in a form
satisfactory to us.
SECTION 2.11 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $25,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts that you have in
the Divisions. For this purpose, any loan reserve amount is included within the
Guaranteed Interest Division. The portion of the charge attributable to the
Guaranteed Interest Division and any loan reserve account will be first
withdrawn from the Guaranteed Interest Division and then, if the amount you have
in the Guaranteed Interest Division is not sufficient, the remaining allocation
will be withdrawn from the portion of the loan reserve account that earns
interest at the Guaranteed Interest Rate.
If the Annuity Account Value is less than $25,000, on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03,
or (b) the date of Termination of this Contract pursuant to Section or 2.12, we
will prorate the Annual Administrative Charge applicable to the completed
portion of the Current Contract Year and withdraw such amount in lieu of the
Annual Administrative Charge described in this Section for the applicable part
of that Contract Year.
If the Annuity Account Value is $25,000 or greater at the end of a Contract
Year, the Annual Administrative Charge is zero.
SECTION 2.12 DEATH BENEFIT. Upon receipt of due proof of your death, we will pay
to the beneficiary designated to receive such payment, pursuant to Section 4.04
of this Contract, the amount of death benefit payable. The amount of the death
benefit is equal to the greater of (i) the Annuity Account Value less any
outstanding loan and (ii) the minimum death benefit. Such minimum death benefit
is the sum of all Contributions made pursuant to Section 2.01 (before reduction
for any applicable tax charge) less any withdrawals made pursuant to Section
2.07. Any such withdrawal will reduce the minimum death benefit (as adjusted by
any previous such withdrawal) by an amount which is in the same proportion as
the amount that was withdrawn is to the Annuity Account Value. If, in accordance
with the provisions of Section 2.01, the Cash Value of another annuity contract
issued by us, or one of our affiliated or subsidiary life insurance companies,
which provides for a death benefit before retirement is equal to the greater of
the contract Cash Value or alternate amount based or premiums paid or
Contributions made under the annuity contract, is transferred to this Contract,
such Cash Value a alternative amount as of the date of transfer, will be
included in the "sum of all Contributions" in lieu of the amount of Cash Value
transferred for purposes of the death benefit under this Contract.
We will pay the death benefit to the beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.04. Also, in accordance with the last paragraph of Section 4.04, if no such
election is in effect at your death, we will pay the death benefit to the
beneficiary in a single sum, unless the beneficiary elects, before we pay the
death benefit, to apply the death benefit to an Annuity Benefit, for Plans
subject to Title I of ERISA.
No. 92 TSAB Page 10
Distributions pursuant to this Section are subject to the terms of the Plan and
the Spousal Consent Rules set forth in Section 3.06 for Plans subject to Title I
of ERISA.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value shall be zero. We will be released from any and all
liability for payments with respect to the Contributions from which the Annuity
Account Value arose.
SECTION 2.13 LOANS. Unless otherwise restricted by the Plan or the Code, you may
effect a loan under this Contract before the election and commencement of
Annuity Benefits. However, if the issuance of this Contract is pursuant to the
terms of a Plan subject to Title I of ERISA, then loans shall not be available
under this Contract. Future restrictions in the Code may require revision or
withdrawal of the loan provisions as provided below. Your Annuity Account Value
(including the loan reserve account as described below) will be the sole
security for the loan. A loan is effective on the first day of the month
following the date your loan agreement form is approved by us.
The amount of the loan may not be more than (i) 80% of the Annuity Account Value
of this Contract, if such total Annuity Account Value is greater than or equal
to $3,750 and less than $12,500, (ii) $10,000, if the Annuity Account Value is
greater than or equal to $12,500 and less than $20,000, and (iii) 50% of the
Annuity Account Value if the Annuity Account Value is greater than or equal to
$20,000, but in no event shall the loan amount exceed $50,000 less the highest
outstanding balance under this Contract during the one year period ending the
day before the effective date of the loan. The minimum loan permitted is $3,000.
For this purpose, the Annuity Account Value is taken as of the loan effective
date. Only one outstanding loan is permitted at a time under this Contract.
As a condition for granting a loan, we will require you to represent that the
loan amount requested, when aggregated with loans (principal plus interest) from
all qualified plans of your Employer, does not exceed the greater of $10,000 or
50% of the value of your nonforfeitable accrued benefits, and in no event
exceeds $50,000 less the highest outstanding balance of all loans from qualified
plans during the one year period ending on the day before the effective date of
the loan. We reserve the right to also require that you elect not to have income
tax withholding apply with respect to an interest and/or loan principal that
would otherwise be subject to withholding.
The loan term will be either (i) ten years, if you represent that the purpose of
the loan is to acquire, build or substantially rehabilitate a dwelling unit
which, within a reasonable period of time, is to be used as your principal
residence or (ii) five years. In any event, the loan term may not extend beyond,
that is, full repayment of the loan will be required upon the earlier of (i) the
election and commencement of Annuity Benefits pursuant to Section 3.03, (ii) the
date we received written notice from you to terminate this Contract pursuant to
Section 2.06, (iii) the date we pay a Death Benefit pursuant to Section 2.12,
and (iv) any date provided for such loans by Federal tax rules including
acceleration of the loan repayment in order that the operation of the loan
provisions do not adversely affect the tax treatment of this Contract.
On the loan effective date, we will transfer to a loan reserve account an amount
equal to the sum of (i) the loan amount, which will earn interest at the
effective annual rate of 4% during the loan term and (ii) 25% of the loan
amount, which will earn interest at the Guaranteed Interest Rate, as defined in
this Contract. You may specify from which Divisions these amounts are to be
transferred. In the absence of your direction, or if your directions cover only
part of the amount required to be transferred to the loan reserve account, we
will transfer the required (or additional required) amounts from each Division
in proportion to the amount that you have in such Divisions. On the first day of
the third month following the effective date of the loan and quarterly
thereafter (or first business day thereafter, if such day is not a business
day), the amount of interest earned at 4% annually during the prior quarter will
be transferred to the portion of the loan reserve account that earns interest at
the Guaranteed Interest Rate. You may not make any partial withdrawals or
transfers from the loan reserve account.
Beginning the first day of the third month of each quarter following the
effective date of the loan and quarterly on the first day of the month
thereafter, loan payments must be made to us. Such payments shall be amortized
in substantially level payments over the term of the loan and will be equal to
the sum of (a) and (b) where
(a) is the loan interest, calculated at an effective annual rate of 6%, and
(b) is a portion of the loan principal.
The loan must be repaid in part on each quarterly due date and may be repaid in
full at any time on or after the first loan anniversary and must include the
full interest due. Any payments received will first be applied to interest due,
with the balance applied towards repayment of the loan. Any partial loan
repayment will result in a transfer of the amount equal to the principal repaid
from (i) the portion of the loan reserve account that earns interest at the
effective annual rate of 4% to (ii) the Guaranteed Interest Division and may be
withdrawn, transferred or annuitized as directed in this Contract.
By each due date, if the amount of the loan payment is less than the amount due
or the loan payment is not received at our Processing Office, we will deduct and
treat as a partial withdrawal from the loan reserve account an amount equal to
the interest and principal payments due plus any applicable withdrawal charges
and any required income tax withholding, if such partial withdrawal will not be
a withdrawal of "restricted amounts" as described in Section 2.10 of this
Contract. Specifically, an amount equal to the principal payment will be
deducted from the portion of the loan reserve account which earns interest at
4%, and an amount equal to the interest payment plus any applicable withdrawal
charges and required income tax withholding will be deducted from the portion of
the loan reserve account which earns interest at the Guaranteed Interest Rate.
No. 92 TSAB Page 11
To the extent a loan repayment is required and a partial withdrawal cannot be
made due to the restrictions described in Section 2.10 of this Contract, a
default in a loan payment will occur. We will transfer from the loan reserve
account to a suspense account an amount equal to the interest and principal
payments due. We will deduct from the loan reserve account a default charge (as
defined in this Section) as well as any required income tax withholding. We will
treat the amount transferred to the suspense account, plus any required income
tax withholding, as a "deemed distribution," that is, such amount will be
considered to have been distributed as provided under Section 72(p) of the Code.
Specifically, an amount equal to the principal payment due will be transferred
from the portion of the loan reserve account which earns interest at 4%, and an
amount equal to the interest payment due will be transferred from the portion of
the loan reserve account which earns interest at the Guaranteed Interest Rate.
Any applicable default charge and required income tax withholding will be
deducted from the portion of the loan reserve account which earns interest at
the Guaranteed Interest Rate.
The default charge on the amount of the deemed distribution is equal to the
applicable withdrawal charges which would have applied if such amount had been
withdrawn from this Contract at such time. Amounts transferred to the suspense
account for the purpose of securing the loan and interest payment due will not
be subject to future withdrawal charges when the liability for any such
defaulted payment is satisfied by a deduction from the suspense account.
Amounts transferred to a suspense account will be held there until Federal
income tax rules permit such amounts to be deducted from the Contract to satisfy
the defaulted loan and interest payment obligation which will be no later than
the date you attain age 59 years and 6 months or notify us in writing that an
event has occurred which would permit Restricted Amounts to be distributed from
the contract under Section 2.10.
Amounts held in the suspense account will earn interest at an effective annual
rate of 3%. You will also be charged interest on your defaulted loan and
interest payment obligation at an effective annual rate of 3% until such time as
any such defaulted payment liability can be satisfied by a deduction from the
suspense account.
The default charge on such deemed distribution is equal to the applicable
withdrawal charges for a withdrawal of an amount equal to the interest and
principal payments due plus required income tax withholding.
Upon your full repayment of the loan, any amounts remaining in the loan reserve
account will be transferred to the Guaranteed Interest Division and may be
withdrawn, transferred or annuitized as described in this Contract.
--------------------------------------------------------------------------------
PART III - ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under the terms of this Contract with respect to a payee is the amount provided
with respect to the payee pursuant to Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division of the Separate Account.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of net
investment return referred to in Section 1.26 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.25, not to exceed the maximum rate of 1.75% after any deductions to
provide for any applicable tax charge. These charges include a daily charge for
financial accounting, death benefits, mortality risk, expenses and expense risk,
plus the investment advisory fee charges and direct operating expense charges of
the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under the terms of this Contract with respect to a payee is the
monthly amount provided pursuant to the fifth paragraph of Section 3.04. The
amount of the fourth and each subsequent payment under a Variable Annuity
Benefit will be equal to the number of Annuity Units with respect to such
benefit, multiplied by the Average Annuity Unit Value for the second calendar
month immediately preceding the due date of the payment. The number of Annuity
Units with respect to a benefit is the number determined by dividing the amount
of the first monthly payment under such benefit by the Annuity Unit Value for
the Valuation Period which includes the due date of the first monthly payment.
As described in Section 3.05, we will notify the payee how each Variable Annuity
Benefit is determined.
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your
Retirement Date, provided you are then living, the Annuity Account Value shall
be applied to provide the Normal Form of Annuity Benefit, unless you elect (i)
to receive the Cash Value in a single sum, or (ii) to apply the Annuity Account
Value, (less any outstanding loan as set forth in Section 2.13) or Cash Value,
whichever is applicable pursuant to the first paragraph of Section 3.04, to
provide an Annuity Benefit on any other annuity form offered by us, or one of
our affiliated or subsidiary life insurance companies, as elected by you, or
(iii) to take partial withdrawals in amounts and at times as required by the
Code, pursuant to Sections 2.07 and 3.05, subject to our rules then in effect
and any other applicable requirements under the Code.
No. 92 TSAB Page 12
We will provide notice and election forms to you not more than six months before
your Retirement Date.
If you elect to terminate this Contract, prior to the Retirement Date, pursuant
to Section 2.06, an election may be made to receive an Annuity Benefit in lieu
of the Cash Value.
We will have the right to require that you furnish pertinent information to
provide an Annuity Benefit, and we will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary
life insurance companies. If the issuance of this Contract is pursuant to a Plan
subject to Title I of ERISA, the rules set forth in Section 3.06 shall apply to
your election and the commencement of annuity benefits.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or
third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be (i) the
Annuity Account Value if the payments under the annuity form involves life
contingencies, or (ii) the Cash Value if the Annuity Form elected does not
involve life contingencies.
The amount applied to provide an Annuity Benefit may be reduced by any
applicable tax charge on annuity considerations, as we determine. If we have
previously deducted any applicable tax charge from Contributions as provided in
Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to your Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your Contract will be governed by our
supplementary contract then in effect.
The amount to be applied to provide an Annuity Benefit will, in addition to any
tax charge reduction, be reduced by an administrative charge. The amount of such
charge will be determined from time to time in accordance with our general
practices applicable on a uniform basis to all contracts of the same type as
this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts
you have in the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under the terms of this
Contract, as indicated, on either the Life Annuity Form or the Joint and
Survivor Life Annuity Form (with 100% of the amount of your payment continued to
your spouse). The amount of income provided under the Fixed Annuity Benefit
payable on the Life Annuity Form and Joint and Survivor Life Annuity Form, are
based on 3.5% interest and the 1983 Individual Annuity Mortality Table "a"
adjusted to a unisex basis based on a 50-50 split of males and females, at age
zero. The amount of income initially provided under the Variable Annuity Benefit
payable on the Life Annuity Form and the Joint and Survivor Life Annuity Form
are based on a 50-50 split of males and females, at age zero and an Assumed Base
Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to
Section 1.26.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us based on 3.5% interest and the 1983 Individual Annuity
Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males
and females, at age zero, if such annuity form provides for a Fixed Annuity
Benefit, and on the projected 1983 Basic Table "a" adjusted to a unisex basis
based on a 50-50 split of males and females, at age zero and an Assumed Base
Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant
to Section 1.26, if such annuity form provides for a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Distributions attributed to
Contributions of Transferred Funds pursuant to Section 2.01 (where you have
provided to us written evidence of such balance as of December 31, 1986) must
commence no later than age 75. Such distributions will be made in the normal
Form of Annuity Benefit, unless you elect to take payments in a single sum or
another form of Annuity Benefit then offered by us.
Your entire interest in this Contract attributable to all other Contributions
made, and earnings credited thereon must be distributed, or begin to be
distributed no later than the first day of April following the calendar year in
which you attain age 70 and 6 months ("Required Beginning Date"). Your entire
interest may be distributed, as you elect, over (a) your life, or the lives of
you and your designated beneficiary, or (b) a period certain not extending
beyond your life expectancy, or the joint and last survivor expectancy of you
and your designated beneficiary. Distributions must be made in periodic payments
at intervals of no longer than one year. In addition, payments must be either
nonincreasing or they may increase only as provided in Q & A F-3 of Section
1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation
thereto.
All distributions made hereunder shall be made in accordance with the
requirements of Section 403(b)(10) and 401(a)(9) of the Code, including the
incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and
applicable Treasury Regulations, including the minimum distribution incidental
benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury
Regulations, or any successor Regulation thereto.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.05, while any distribution shall be subject to such requirements of
the Code and regulations, any distribution shall also be subject to the terms of
this Contract. That is, the forms of distribution shall be those which are made
available by us at the time of your election.
No. 92 TSAB Page 13
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9.
Unless you otherwise elect prior to the time distributions are required to
begin, those life expectancies shall be recalculated annually. Such election
shall be irrevocable and shall apply to all subsequent years. The life
expectancy of a non-spouse beneficiary may not be recalculated. Instead, life
expectancy will be calculated using the attained age of such beneficiary during
the calendar year in which you attain age 70 and 6 months, and payments for
subsequent years shall be calculated based on such life expectancy reduced by
one for each calendar year which has elapsed since the calendar year life
expectancy was first calculated.
If you die after distribution of your interest in this Contract has begun, the
remaining portion of such interest will continue to be distributed at least as
rapidly as under the method of distribution being used prior to your death.
If you die before distribution of your interest begins, distribution of your
entire interest shall be completed no later than December 31 of the calendar
year containing the fifth anniversary of your death, except to the extent that
an election is made to receive death benefit distributions in accordance with
(1) or (2) below:
(1) If your interest is payable to a designated beneficiary, then your entire
interest may be distributed over the life of, or over a period certain not
greater than the life expectancy of, the designated beneficiary. Such
distributions must commence on or before December 31 of the calendar year
immediately following the calendar year of your death.
(2) If the designated beneficiary is your surviving spouse, the date that
distributions are required to begin in accordance with (1) above shall not
be earlier than the later of (A) December 31 of the calendar year
immediately following the calendar year of your death or (B) December 31 of
the calendar year in which you would have attained age 70 and 6 months.
For purposes of determining the "period certain" referred to in the immediately
preceding paragraph, life expectancy is computed by use of the expected return
multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes
of distributions beginning after your death, unless otherwise elected by the
surviving spouse by the time distributions are required to begin, life
expectancies shall be recalculated annually. Such election shall be irrevocable
by the surviving spouse and shall apply to all subsequent years. In the case of
any other designated beneficiary, life expectancies shall be calculated using
the attained age of such beneficiary during the calendar year in which
distributions are required to begin pursuant to this Section, and payments for
any subsequent calendar year shall be calculated based on such life expectancy
reduced by one for each calendar year which has elapsed since the calendar year
life expectancy was first calculated.
Distributions under this Section are considered to have begun if distributions
are made because you have reached your Required Beginning Date or if prior to
the Required Beginning Date distributions irrevocably commence to you over a
period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1
of the Proposed Treasury Regulations or any successor Regulation thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under the terms of this Contract was based on information
that is subsequently found to be incorrect, your benefit will not be
invalidated, but an adjustment on the basis of the correct information will be
made in the amount of the benefit payments, or any amount used to provide the
benefit, or any combination thereof. Overpayments by us will be charged against
and underpayments will be added to any payments thereafter falling due under the
terms of this Contract with respect to the payee, affecting as many such
payments as are necessary to correct the overpayment or underpayment. Our
liability, with respect to a payee, is limited to the correct information and
the actual amounts used to provide the benefits then in force with respect to
the payee under this Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under the terms of this Contract is physically or mentally
incompetent to receive such payment or is a minor, (ii) another person or an
institution is then maintaining or has custody of such payee, and (iii) no
guardian, committee, or other representative of the estate of such payee has
been appointed, we may make the payments (in the case of a minor, at a rate not
exceeding $200 a month) to such other person or institution, and will thereupon
be fully discharged from all liability with respect thereto.
If a variable annuity form made available by us provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one of two persons, a payee for payments
thereunder may elect, without the concurrence of any other person, to receive
the commuted value of any remaining payments, provided no person upon whose life
the income depends is surviving.
Pursuant to Section 3.03, upon your election, pursuant to Section 3.03 of an
annuity form providing payments for a period certain, you may designate (with
the right to change such designation) a person or persons to receive any
payments that may become due after the death of the person or persons upon whose
life or lives the income may depend.
The payee may designate (with the right to change such designation and without
the concurrence of any other person) a payee to receive any payments or
installments payable after such payee's death, if the absence of such a
designation would result in a single sum payment to such payee's estate in
accordance with the following paragraph.
No. 92 TSAB Page 14
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments. The commuted value of any such remaining payments will be
determined on the basis of compound interest at the rate utilized in the
actuarial rate basis applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later. We will require
satisfactory evidence of the age of any person upon whose life an annuity form
depends.
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TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE
JOINT AND SURVIVOR LIFE ANNUITY FORM
100% OF PAYMENT TO CONTINUE TO SPOUSE
(Minimum Monthly Income Per $1,000 OF Annuity Account Value)
----------------------------------------------------------------------------
Age 60 61 62 63 64 65 66 67 68 69 70
----------------------------------------------------------------------------
60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88
61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96
62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03
63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11
64 4.89 4.94 5.00 5.05 5.10 5.14 5.19
65 5.00 5.06 5.11 5.17 5.22 5.27
66 5.12 5.18 5.24 5.29 5.35
67 5.24 5.31 5.37 5.43
68 5.37 5.44 5.51
69 5.52 5.59
70 5.67
----------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE
ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1,000 of Annuity Account Value)
-----------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON
THE LIFE ANNUITY FORM IF ASSUMED
BASE RATE OF NET INVESTMENT RETURN IS
Age 3.5% 5.0%
-----------------------------------------------------------------------
60 5.27 6.16
61 5.39 6.28
62 5.52 6.41
63 5.66 6.55
64 5.81 6.70
65 5.97 6.86
66 6.15 7.03
67 6.33 7.21
68 6.53 7.41
69 6.74 7.62
70 6.97 7.85
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We will notify the payee, with respect to each payment under a Variable Annuity
Benefit, the number of Annuity Units and the Average Annuity Unit Value used in
determining the amount of each variable payment. Such notice will be mailed with
each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary,
as described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If this Contract is
issued pursuant to a Plan subject to Title I of ERISA, then the provisions of
this Section shall supersede any contrary provisions in this Contract. If you
are married, your interest in the Contract shall be paid in the Normal Form
joint and survivor annuity, and if you are unmarried, your interest shall be
paid in the Normal Form life annuity, unless you elect otherwise as described in
this Section. If you are married and die before payment of your interest has
commenced, your interest shall be paid to your surviving spouse in the form of a
life annuity, unless at the time of your death there was a contrary election
made pursuant to this Section. The foregoing notwithstanding, your surviving
spouse may elect, before payment is to commence, to have payment made in any
form permitted under the terms of this Contract.
You may elect, at any time within the 90 consecutive day period before the first
day of the first period for which your interest is paid as an annuity or in any
other form, not to have your interest paid in the Normal Form, in which case it
shall be paid in any other form elected under the terms of this Contract. If
such interest is to be paid to your spouse upon your death, you may elect,
during the period beginning on the first day of the plan year of the Plan in
which you attain age 35 (or, if you separate from service prior to that plan
year, beginning on the date of separation) and ending with your death, for a
beneficiary other than your spouse to receive payment of the
No. 92 TSAB Page 15
value of your interest. In addition, if you will not yet attain age 35 by the
end of any current plan year, you may make a special qualified election to
designate a beneficiary other than your spouse to receive payment of the value
of your interest, which special qualified election shall be effective for the
period beginning on the date of such election and ending on the first day of the
plan year in which you attain age 35. Amounts payable in accordance with this
Section will be automatically reinstated as of the first day of the plan year in
which you attain age 35 unless a new election designating a beneficiary other
than the spouse is made in accordance with the requirements of this Section.
Any election described in the foregoing paragraph must be consented to by your
spouse in writing before a notary or a representative of the Plan unless you can
prove that there is no spouse or that the spouse cannot be located. Also, if you
have become legally separated from your spouse or have been abandoned (within
the meaning of local law) and have a court order to such effect, spousal consent
is not required unless a qualified domestic relations order provides otherwise.
Your election must designate a specific beneficiary (including any class of
beneficiaries or any contingent beneficiaries) that may not be changed without
further consent of the spouse, unless the spouse's consent expressly permits
designation by you without further consent of the spouse. The spouse's consent
under this section shall acknowledge the effect of the election. In addition,
the spouse's consent (or the establishment that the consent of the spouse may
not be obtained) shall only be valid with respect to such spouse. Your waiver of
the Normal Form joint and survivor annuity shall not be effective unless the
election designates a form of benefit payment which may not be changed without
spousal consent (or the spouse expressly permits designations by you without any
further spousal consent). A consent that permits designations by you without any
requirement of further consent by such spouse must acknowledge that the spouse
has the right to limit consent to a specific beneficiary and a specific form of
benefit where applicable, and that the spouse voluntarily elects to relinquish
either or both of such rights. If you make an election under this Section, you
may revoke that election, without spousal consent, at any time before the first
day of the first period for which an amount is paid as an annuity or in any
other form.
The provisions requiring spousal consent in this Section shall also apply with
regard to your election to terminate this Contract or make partial withdrawals
pursuant to Sections 2.06 and 2.07, and with respect to a beneficiary
designation set forth in Section 4.04. A spouse's written consent, witnessed by
a representative of the Plan or a notary public, must be given on a form
acceptable to the Employer and us, within the 90 consecutive day period prior to
any such payment or withdrawal, or beneficiary designation, unless you can show
that you have no spouse or that the spouse cannot be located.
If the Annuity Account Value applied to provide the spousal benefits on the date
payment is to commence is in the aggregate less than $3,500, we may choose to
make payment in a single sum rather than in the form of a Qualified Joint and
Survivor Annuity or Life Annuity as described herein. Upon any payment made
pursuant to this Section, we will be released from any and all liability for
payment with respect to the Contributions made for you.
--------------------------------------------------------------------------------
PART IV - GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the
parties and the terms of this Contract alone will govern with respect to our
rights and obligations. A copy of the application is incorporated in and made
part of this Contract.
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by our authorized officer. The terms of this
Contract may be changed by amendment or replacement upon agreement between you
and us without the consent of any other person.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of
this Contract without the consent of any other person in order to comply with
applicable laws and regulations. Such right shall include, but not be limited
to, the right to conform the terms of this Contract to reflect changes in the
Code, or applicable Treasury Regulations, or in regulations or published rulings
of the Internal Revenue Service so that this Contract will continue to be an
Annuity.
SECTION 4.03 NONTRANSFERABILITY AND ASSIGNMENTS. Your entire interest under this
Contract is nonforfeitable. No interest of yours (or of a beneficiary) under
this Contract may be transferred to any person other than us upon the surrender
of this Contract. Except as permitted under applicable law, no right or interest
of you or any other payee or beneficiary in this Contract shall be (a)
assignable; (b) subject to any lien; or (c) liable for, or subject to, any
obligation or liability of any person. The preceding sentence shall not apply to
any assignment, transfer or attachment pursuant to a qualified domestic
relations order (as defined in Section 414(p) of the Code).
SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an
initial designation of the beneficiary entitled to receive any death benefit
payable pursuant to Section 2.12. You may change such designation from time to
time during your lifetime, and while this Contract is in force. Any such
designation or change must be made by written notice in a form satisfactory to
us. A change will, upon receipt at the Processing Office, take effect as of the
time the written notice was signed, whether or not you are living on the date of
receipt, but without further liability as to any payment or other settlement
made by us before receipt of such change. Beneficiary designations are subject
to the rules of Section 3.06 if the Contract is issued pursuant to a Plan
subject to Title I of ERISA.
No. 92 TSAB Page 16
Unless otherwise specified in the designation, if you have designated two or
more persons as beneficiary, the beneficiary will be the designated person or
persons who survive you, and if more than one survive, they will share equally.
Any part of a death benefit payable pursuant to Section 2.12 for which there is
no designated beneficiary living at the time of your death, will be payable in a
single sum to your children who survive you, in equal shares, or should none
survive, then to your estate.
If you elect in writing, any amount that would otherwise be payable to a
beneficiary in a single sum may be applied to provide an Annuity Benefit, on the
form of annuity previously elected by you, with respect to the beneficiary,
subject to our rules then in effect. If, at your death, there is no election in
effect to apply the single sum death benefit to provide an Annuity Benefit, the
beneficiary may make such an election. Any such election must meet the minimum
distribution requirements under the Code, as described in Section 3.05.
SECTION 4.05 DISQUALIFICATION. In the event that the Plan fails to qualify as a
Plan under Section 403(b) of the Code and applicable Treasury Regulations, we
reserve the right, upon receiving notice of such fact, to transfer the Annuity
Account Value under this Contract to another annuity contract issued by us, an
affiliate subsidiary, on your life, or to terminate this Contract and pay to you
the Annuity Account Value less deduction for applicable taxes, solely at our
option.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Employer, we
reserve the right at our sole discretion to limit Contributions under this
Contract.
SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of your Annuity Account Value
(less any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities and
Exchange Commission, by order, permits us to defer payment in order to protect
persons with interests in the Investment Divisions. We can defer payment of any
portion of your Annuity Account Value in the Guaranteed Interest Division for up
to six months while you are living.
SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you
with a notice showing the following:
(1) the amount you have in the Guaranteed Interest Division,
(2) the total number of Accumulation Units you have in the Stock Division,
Balanced Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Values,
(4) the amount you have in the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division,
(5) the amount you have in the loan reserve account,
(6) the Cash Value, and
(7) the amount of death benefit payable with respect to you.
We will also furnish annual calendar year reports concerning the status of the
annuity and any other reports required by the Code or applicable Treasury
Regulations.
After the Retirement Date, we will notify you of the number of Annuity Units and
the Average Annuity Unit Value used in determining the amount of each Variable
Annuity Benefit payment, if any.
SECTION 4.09 AGE. If your age has been misstated, any benefits will be those
which would have been purchased at the correct age. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
No. 92 TSAB Page 17
OWNER: XXXX XXX
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 000
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28,1992
RETIREMENT DATE: JAN 1, 2020
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES Processing Office:
Individual Annuity Center, P.O. Box 2996, G.P.O. New York, New York 10116
AGREES
o TO ALLOCATE the Contributions made to this Contract, after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division of the Separate Account (referred to
in this Contract as the "Investment Divisions") or to the Guaranteed Interest
Division, in accordance with Sections 2,02, 2.03 and 2.04 or in part to any
one, as directed by you, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide the
Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant is
then living, and
o TO PROVIDE the Annuitant with the other rights and benefits of this Contract.
This is the entire Contract. In this Contract "we", "our", and "us" mean The
Equitable Life Assurance Society of the United States. "You" and "your" mean the
Annuitant at the time a right is exercised by the Annuitant.
TEN DAYS TO EXAMINE CONTRACT--You may cancel this Contract by returning it to us
within ten days after receipt of it. Upon such cancellation, we will refund any
Contribution made to us on your behalf under this Contract.
/s/ Xxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxxxx
Vice President and Secretary Chairman of the Board and
Chief Executive Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.26 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE NOT TO
EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR
FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK,
PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF
THE TRUST.
No. 92 TSUA
The Contract is issued in consideration of the payment to us of the
Contributions made under the terms of this Contract.
The provisions on the following pages are part of this Contract.
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TABLE OF CONTENTS
DEFINITIONS
Page
Section 1.00 - Agreement..........................................4
1.01 - Annuitant..........................................4
1.02 - Annuity............................................4
1.03 - Annuity Account Value..............................4
1.04 - Annuity Benefit....................................4
1.05 - Cash Value.........................................4
1.06 - Class of Contracts.................................5
1.07 - Code...............................................5
1.08 - Contract...........................................5
1.09 - Contract Date......................................5
1.10 - Contract Year......................................5
1.11 - Contribution.......................................5
1.12 - Divisions..........................................5
1.13 - Elective Deferrals.................................5
1.14 - Xxxxxxxx Annuity Certain...........................5
1.15 - Employer...........................................5
1.16 - ERISA..............................................5
1.17 - Guaranteed Interest Rate...........................5
1.18 - Joint and Survivor Life
Annuity Form....................................5
1.19 - Life Annuity Form..................................5
1.20 - Normal Form........................................5
1.21 - Period Certain Annuity.............................6
1.22 - Plan...............................................6
1.23 - Processing Office..................................6
1.24 - Retirement Date....................................6
1.25 - Separate Account...................................6
1.26 - Separate Account Definitions.......................7
1.27 - Transaction Date...................................7
1.28 - Trust..............................................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions......................................8
2.02 - Separate Account Investment
Divisions.......................................8
2.03 - Guaranteed Interest Division.......................8
2.04 - Allocation to Divisions............................8
2.05 - Transfers Among Divisions..........................8
2.06 - Termination of this Contract.......................9
2.07 - Partial Withdrawals................................9
2.08 - Charges for Partial Withdrawals....................9
2.09 - Free Corridor Amount..............................10
2.10 - Restrictions on Distributions.....................10
2.11 - Annual Administrative Charge......................10
2.12 - Death Benefit.....................................10
ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit.............................11
3.02 - Variable Annuity Benefit..........................11
3.03 - Election and Commencement of
Annuity Benefits...............................11
3.04 - Amount of Annuity Benefits........................11
3.05 - Payment of Annuity Benefits.......................12
3.06 - Special Annuity and Spousal
Consent Provisions.............................14
GENERAL PROVISIONS
Section 4.01 - Contract..........................................15
4.02 - Statutory Compliance..............................15
4.03 - Nontransferability and
Assignments....................................15
4.04 - Beneficiary.......................................15
4.05 - Disqualification of Plan or
Contract.......................................16
4.06 - Future Contributions..............................16
4.07 - Deferment.........................................16
4.08 - Annual Notice.....................................16
4.09 - Age...............................................16
No. 92 TSUA Page 2
OWNER: XXXX XXX
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 000
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28,1992
RETIREMENT DATE: JAN 1, 2020
INITIAL GUARANTEED INTEREST RATE: 7.50% to MAR 31, 1992
MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992
3.00% AFTER DEC 31, 1992
BENEFICIARY: XXXX XXX
FORM NUMBER: 92TSUA
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TABLE OF GUARANTEED VALUES
ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION
NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY
SINCE FIRST CONTRIBUTION CASH VALUE ANNUITY AT AGE 65*
------------------------ ---------- -----------------
1 977 6.63
2 1,946 16.20
3 2,944 26.67
4 3,998 36.84
5 5,064 46.70
6 6,220 56.28
7 7,362 65.59
8 8,538 74.62
9 9,841 83.38
10 11,204 91.90
11 12,629 100.16
12 14,118 108.18
13 15,673 115.97
14 17,144 123.54
15 18,658 131.18
16 20,218 138.64
17 21,824 145.90
18 23,479 152.80
19 25,213 159.70
20 27,000 166.03
24 (Age 62) 34,697 189.57
27 (Age 65) 41,098 205.49
THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000
CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT
DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE
(SEE SECTION 2.11) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE ACCOUNT VALUE (SEE
SECTION 1.05). THE TABLES ASSUME THAT 100% OF ALL CONTRIBUTIONS AND EARNINGS ARE
ALLOCATED TO AND REMAIN IN THE GUARANTEED INTEREST DIVISION.
YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON
THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS.
THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE
WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY
BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A
SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04).
*ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO
SURVIVOR) WITH JOINT ANNUITANT THE SAME AGE AS THE ANNUITANT.
No. 92 TSUA Page 3
PART I--DEFINITIONS
SECTION 1.00 AGREEMENT. The term "Agreement" means an agreement described in
Treasury Regulation Section 1.403(b)-1(b)(3) between an Employer and an employee
of the Employer, in which the Employer agrees to purchase an Annuity for the
employee. If Employer contributions to purchase the Annuity result from the
employee's agreement to take a reduction in future salary or forgo a future
salary increase, such Agreement is referred to as a "Salary Reduction Agreement"
within the meaning of Sections 402(g)(3)(C) and 3121(a)(5)(D) of the Code.
SECTION 1.01 ANNUITANT. The term "Annuitant" means the owner of this Contract,
as shown on page 3 and on whose behalf this Contract has been purchased and is
maintained, and who exercises all rights under this Contract.
SECTION 1.02 ANNUITY. The Term "Annuity" means an annuity contract purchased in
accordance with the terms of the Plan or Agreement, which contract meets the
requirements for qualification under Section 403(b) of the Code.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts that you have in the Guaranteed Interest Division and the
Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by us pursuant to Section 3.04 of this Contract. Various sections of this
Contract (Sections 1.18, 1.19, 1.20, 3.01, and 3.02) refer to monthly payments
to be made under an Annuity Benefit. You may wish to have your Annuity Benefit
paid at other intervals, such as quarterly, semi-annually, or annually, instead
of monthly. You may elect this at the time you elect the Annuity Benefit form as
described in Section 3.03; in that event, all references in this Contract to
monthly payments will be deemed to mean payments at the frequency you elect,
subject to our rules at the time of election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value
less any applicable withdrawal charge determined as follows:
The withdrawal charge equals the lesser of (a) or (b) where
(a) equals
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the excess of (i) the Annuity Account Value over (ii) the Free Corridor
Amount defined in Section 2.09; and
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior charges for partial
withdrawals made pursuant to Section 2.08.
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
A withdrawal charge will not apply, which means the Cash Value will equal the
Annuity Account Value upon any of the following occurrences:
(i) your attainment of age 59 and 6 months and your completion of at least
five Contract Years, or
(ii) you die and a distribution is made to your beneficiary, or
(iii) your attainment of age 55, your completion of at least five Contract Years
and the receipt by us of a properly completely settlement election form
providing for the application of the Annuity Account Value to purchase an
Eligible Annuity Certain, defined in Section 1.14, or
(iv) your completion of at least three Contract Years and the receipt by us of
a properly completed settlement election form providing for the
application of the Annuity Account Value to purchase a period certain
Annuity, defined in Section 1.21, where the certain period of such annuity
is at least ten years, or
(v) the receipt by us of a properly completed settlement election form
providing for the application of the Annuity Account Value to purchase a
Life Annuity distribution option, or
(vi) the attainment of age 55, your completion of at least five Contract Years,
and separation from service, or
(vii) your completion of at least twelve Contract Years.
No. 92 TSUA Page 4
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same calendar year.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, or
any corresponding provisions of prior or subsequent United States revenue laws.
SECTION 1.08 CONTRACT. The term "Contract" means this Contract.
SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both an application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us
for you with respect to an Annuity purchased for you under the Plan. We are
under no obligation to accept any Contribution less than $20.00. Contributions
may be either Elective Deferrals or Employer Contributions pursuant to the Plan.
The Employer shall indicate to us the amount and type of each Contribution.
SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following Divisions described in this
Contract:
(a) the Guaranteed Interest Division, and
(b) the Investment Division of the Separate Account.
SECTION 1.13 ELECTIVE DEFERRALS. The term "Elective Deferrals" means
Contributions made pursuant to a Salary Reduction Agreement as defined in
Section 1.00.
SECTION 1.14 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
an annuity not involving life contingencies issued by us which extends beyond
your attainment of age 59 and 6 months and does not permit any prepayment of the
unpaid principal (that is, no withdrawal or single sum payment) prior to your
attainment of age 59 and 6 months.
SECTION 1.15 EMPLOYER. The term "Employer" means (i) an organization described
in Section 501(c)(3) of the Code which is exempt from Federal income tax under
Section 501(a) of the Code; or (ii) a State, political subdivision of a State,
or an agency or instrumentality of any one or more of the foregoing, in
connection with services performed by an employee for an educational
organization described in Section 170(b)(1)(A)(ii) of the Code.
SECTION 1.16 ERISA. The term ERISA means the Employee Retirement Income Security
Act as amended.
SECTION 1.17 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrues on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on page 3 of
this Contract. Section 2.03 describes the determination of the Rate to apply
thereafter.
SECTION 1.18 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected by you. The payments commence on the date as of which the Joint and
Survivor Life Annuity Form is purchased and terminate with the last payment due
before the death of the survivor.
SECTION 1.19 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us or one of our affiliated or subsidiary life insurance companies,
providing fixed monthly payments during the lifetime of the person upon whose
life such payments depend. The payments commence on the date as of which the
Life Annuity Form is purchased and terminate with the last payment due before
the death of such person.
SECTION 1.20 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means (i) if you have a living spouse at the Retirement Date, the
Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with
such spouse as the contingent annuitant (with 100% of the monthly amount payable
to your spouse), and (ii) if you do not have a living spouse at the Retirement
Date, the Fixed Annuity Benefit payable on the Life Annuity Form.
No. 92TSUA Page 5
SECTION 1.21 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us or one of our affiliated
or subsidiary live insurance companies which does not permit any prepayment of
the unpaid principal (that is, you cannot elect to receive part of your payments
as a single sum payment with the remainder paid in monthly annuity payments).
SECTION 1.22 PLAN. The term "Plan" means a program established by an Employer
for the purchase of Annuities on behalf of employees. The Employer shall be the
"Plan Administrator" within the meaning of Section 414(g) of the Code and
applicable Treasury Regulations.
SECTION 1.23 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116, or
such other location as we shall designate by advance written notice to the
Employer, or the Plan's Trustee, as applicable, and to you.
SECTION 1.24 RETIREMENT DATE. The term "Retirement Date" means the date on which
you attain the retirement age as shown on page 3 of this Contract. Before the
Retirement Date you may elect to change the Retirement Date to another
Retirement Date, which may be any date after the filing of the election (other
than the 29th, 30th, or 31st day of any month), either initially or by later
change, must be in accordance with the terms of the Plan. No Retirement Date
shall be later than the date of your attainment of age 70 and 6 months. Any
election for such change must be made in writing by you and shall not take
effect until received by us at our Processing Office.
SECTION 1.25 SEPARATE ACCOUNT. The term "Separate Account" means Separate
Account A which is organized as a unit investment trust (a type of investment
company). We have established the Separate Account and it is maintained in
accordance with the laws of New York State. Realized and unrealized gains and
losses from the assets of the Separate Account are credited to or charged
against it without regard to our other income, gains or losses. Assets are put
in the Separate Account to support this Contract and other variable annuity
contracts. Assets may be put in the Separate Account for other purposes, but not
to support contracts or policies other than variable annuities and variable life
insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these Contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust where each class (or series) represents a separate portfolio in
the Trust. We reserve the right to change the designated trust or investment
company or to add designated trusts or investment companies. The Investment
Divisions available are the Stock Division, the Money Market Division, the
Balanced Division and the Aggressive Stock Division. The Guaranteed Interest
Division is not a party of the Separate Account, but rather is an asset of our
General Account.
We will value the assets of each Investment Division on each business day. A
business day is any day on which we are open, the New York Stock Exchange is
open for trading and there is a sufficient degree of trading in the portfolio of
the securities in which an Investment Division is invested to materially affect
the Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments we are
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under the
Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any other
form;
(v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or
remove Investment Divisions (or sub-divisions of Investment Divisions)
from the Separate Account (the term "Investment Division" in this Contract
shall then refer to any other Investment Division in which the asset of a
Class of Contracts to which this Contract belongs, were placed);
(vi) combine any two or more Investment Divisions (or sub-divisions of
Investment Divisions) of the Separate Account; and
No. 92TSUA Page 6
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
Class of Contracts to which this Contract belongs.
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, you will be notified of such exercise, as
required by law.
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for any applicable
tax charges) at a rate not to exceed 1.49% per year for the Stock, Money Market
and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division,
for financial accounting, death benefits, mortality risk, expenses and expense
risk. The charge shall be made in accordance with Subsection (c) of the Net
Investment Factor provision in Section 1.25. The relative proportion of these
charges may be modified. The daily charge, plus the investment advisory fee
charges and direct operating expense charges of the Trust shall not exceed a
total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract. The maximum rate may not be altered
without your approval.
SECTION 1.26 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any preceding consecutive
non-business days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment
Division for the Valuation Period. For this purpose, we use the share value
reported to us by the Trust.
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period (after
any amounts allocated to or withdrawn for that Valuation period).
(c) is the daily asset charge for the expenses of this Contract, times the
number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an
Investment Division where your Contributions are invested and which is used in
determining the amount you have in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for such Valuation Period.
ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first Contribution was put into the Stock
Division, the Annuity Account Value was $1.26 and $1.52 for contracts with
Assumed Base Rates of Net Investment Return of 5% and 3.5% a year, respectively.
The Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit
Value for the immediately preceding Valuation Period multiplied by the Adjusted
Net Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for a Valuation Period is the Net Investment Factor for such
period reduced for each calendar day in such subsequent Valuation Period by the
Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net
Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net
Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall
be 5%, except in states where the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: The Average Annuity Unit Value for a calendar month
is equal to the average of the Annuity Unit Values for all Valuation Periods
ending in such month.
SECTION 1.27 TRANSACTION DATE. The Transaction Date is the business day we
receive a Contribution or a written contract transaction request providing the
information we need at the Processing Office. In the case of a transfer request
initiated through the use of a touch tone telephone as described in Section
2.05, the Transaction Date is the business day the telephone transaction is
received.
SECTION 1.28 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
No. 92 TSUA Page 7
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PART II-ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. The Employer is to make Contributions, from time to
time on such dates and in such amounts as determined by the Employer pursuant to
the terms of the Plan or Agreement. You are to specify the amount to be
allocated to each Division.
Each Contribution received by us with respect to you will, before its allocation
under this Contract, be reduced by the amount of any applicable tax charge, as
determined by us.
Pursuant to the terms of the Plan, if applicable, you may, with our agreement,
(i) transfer to this Contract any amount held under a contract or account that
meets the requirements of Section 403(b) of the Code ("Transferred Funds"), or
(ii) roll over contributions from a contract or account that meets the
requirements of Section 403(b) of the Code, or from a conduit individual
retirement arrangement described in Section 408(d)(3)(A)(iii) of the Code. If
you do not provide to us at the time of such transfer as described in (i) above,
as to what portion, if any, of the amounts of the Transferred Funds which are
exempt from the distribution restrictions described in Section 2.10, and the
minimum distribution rules described in Section 3.05, we will treat all such
amounts as being subject to such restrictions. Any Transferred Funds from a
contract not issued by us will, before allocation under this Contract, be
reduced by the amount of any applicable tax charge, as determined by us.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to or withdrawn or transferred from an Investment
Division, the Annuity Account Value will be credited or charged, as the case may
be, with the number of Accumulation Units determined by dividing said amount by
the Accumulation Unit Value for the appropriate Investment Division for the
Valuation Period which includes that date. The number of units you have in an
Investment Division on any date is equal to (i) the sum of any Accumulation
Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of
any Accumulation Units that have been withdrawn pursuant to Sections 2.07, 2.08
or 2.13, or transferred from the Investment Division pursuant to Section 2.05.
The amount you have in an Investment Division on any date is equal to the
product of (i) the number of Accumulation Units in the Investment Division on
that date, and (ii) the Accumulation Unit Value for the Investment Division for
the Valuation Period which includes that date.
Participation in the Separate Account under this Contract terminates on the
earliest of (i) your election and commencement of annuity benefits pursuant to
Section 3.03, (ii) receipt of due proof of your death, or (iii) Termination of
this Contract pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets, which support
the guarantees of this Contract and other contracts. The amount in the
Guaranteed Interest Division at any time is equal to the sum of all amounts that
have been allocated to the Guaranteed Interest Division pursuant to Section 2.04
or 2.13, plus the amount of any interest accrued but not allocated, less the sum
of all amounts that have been withdrawn from the Guaranteed Interest Division
pursuant to Section 2.07, 2.08 or 2.13 or transferred from the Guaranteed
Interest Division, pursuant to Section 2.05. Interest is allocated to the
Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division under the terms of this
Contract terminates on the earliest of (i) election and commencement of Annuity
Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, and
(iii) Termination of this Contract pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction of any applicable tax charge) to one or more
Divisions, at your sole direction as specified to us. Allocation percentages
must be in whole numbers and the sum must equal 100. The allocation is made as
of the Transaction Date on which we have received both such Contribution and
such direction. Contributions made to an Investment Division purchase
Accumulation Units in that Investment Division, using the Accumulation Unit
Value next computed after the Transaction Date.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon Termination of this Contract, pursuant to Section 2.06, and (vi)
upon your death pursuant to Section 2.12.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through
the use of a touch tone telephone, transfer all of part of the amount you have
in a Division to one or more of the Divisions as follows: (i) amounts in the
Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive
Stock Division may be transferred among such Divisions; (2) amounts in the Money
Market Division may be transferred to other Divisions. Written authorization for
touch tone telephone initiated transfers is only required when authorization for
telephone transfers is requested. Upon advance written notice to you, we reserve
the right to discontinue the acceptance of transfer requests through the use of
a touch tone telephone. All transfers will be effective on the Trans-
No. 92TSUA Page 8
action Date and will be subject to our rules in effect at the time of transfer.
With respect to the Investment Division, the transfer will be made at the
Accumulation Unit Value next computed after the Transfer Date. No transfers are
permitted to the Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the
terms of the Plan, including, for Plans subject to Title I of ERISA, if
applicable, the spousal consent rules set forth in Section 3.06, you may elect,
by written notice, to terminate this Contract. In addition, termination of this
Contract is subject to the restrictions on distributions set forth in Section
2.10 of this Contract. We will determine the Cash Value as of the Transaction
Date we receive your written election.
The payment of such Cash Value to you may be deferred by us in accordance with
the provisions of Section 4.07.
Subject to the terms of the Plan, and the restrictions on distributions set
forth in Section 2.10, we reserve the right to pay the Annuity Account Value
under this Contract and terminate this Contract. This right may be exercised
only if both (i) you made no Contributions during the last three completed
Contract Years, and the Annuity Account Value is less than $500, or (ii) a
partial withdrawal is made that would result in your Annuity Account Value
falling below $500. We also reserve the right to terminate this Contract if no
Contributions have been made within 120 months of the Contract Date shown on
page 3 of this Contract.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount in the Divisions and the Annuity Account Value shall be zero. We will
be released from any and all liability for payments with respect to the
Contributions from which the Annuity Account Value arose.
If this Contract is terminated, surrendered or exchanged prior to your
Retirement Date, any applicable tax charges we have paid may be deducted. If we
have previously deducted charges for applicable taxes from Contributions
pursuant to Section 2.01, we will not again deduct charges for the same taxes on
terminations, unless a change in applicable law has occurred with respect to
your Contract.
SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under
the terms of the Plan, and the restrictions on distributions set forth in
Section 2.10, you may elect, by written notice to us, to make a partial
withdrawal from the Divisions. For Plans subject to Title I of ERISA, partial
withdrawals may be subject to the spousal consent rules, if applicable, set
forth in Section 3.06.
Following receipt of your written notice, we will pay the lesser of the Cash
Value, or the amount of partial withdrawal requested to the person entitled to
receive such payment as you designate to us in writing. The amount paid plus any
withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the
amounts you have in the Divisions. Unless instructed otherwise, the amount
withdrawn (including any withdrawal charge) will be allocated among the
Divisions in proportion to the amounts that you have in such Divisions.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300,
or where the request violates the provisions of Sections 2.07 or 3.06. If a
withdrawal made under this Section would result in an Annuity Account Value of
less than $500, we will so advise you and reserve the right to pay the Annuity
Account Value to you and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS.
NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the
amount of partial withdrawal requested is not greater than the Free Corridor
Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity
Account Value, pursuant to Section 1.05.
WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than
the Free Corridor Amount, we will (i) first withdraw from the Divisions an
amount equal to the Free Corridor Amount, in proportion to the amount you have
in them, and (ii) then withdraw an amount equal to the excess of the amount
requested over the Free Corridor Amount, plus a partial withdrawal charge. Such
partial withdrawal charge will be equal to the lesser of (a) or (b) where:
(a) is an amount equal to
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
0% thereafter
of the amount withdrawn in excess of the Free Corridor Amount (including
such charge) pursuant to (ii) of the preceding sentence.
No. 92TSUA Page 9
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the Current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior partial withdrawal
charges made pursuant to this Section.
However, notwithstanding the above, if your are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
If withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to your Contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if you
have completed three Contract Years or attained age 59 and six months an amount
equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value
on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to
Section 2.07 in the current Contract Year. If you have not completed three
Contract years or attained age 59 and six months, the Free Corridor Amount is
zero.
SECTION 2.10 RESTRICTIONS ON DISTRIBUTIONS. Notwithstanding anything in this
Contract to the contrary, payments of Cash Value pursuant to the termination of
this Contract under Section 2.06, partial withdrawals under Section 2.07, death
benefits under Section 2.12, or Annuity Benefits under Section 3.03 may be
limited as provided in Section 403(b)(11) of the Code and in this Section, to
the extent they are attributable to Elective Deferral Contributions made to this
Contract after December 31, 1988 and earnings credited after December 31, 1988
on Elective Deferral Contributions made before and after December 31, 1988
(collectively, "Restricted Amounts").
Distributions of Restricted Amounts may not be made until you attain age 59
years and six months, separate from service, die, or become disabled (within the
meaning of Section 72(m)(7) of the Code). Distributions of Elective Deferral
Contributions made after December 31, 1988 - (but not any earnings credited
after December 31, 1988 attributable to Elective Deferral Contributions made
before or after December 31, 1988) may also be made in the case of hardship
(within the meaning of Section 403(b)(11) of the Code and applicable Treasury
Regulations). If you request payment of Restricted Amounts on the grounds of
disability or hardship you must furnish to us proof of such disability or
hardship as may be required by the Plan, the Code, and applicable Treasury
Regulations in a form satisfactory to us.
SECTION 2.11 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $25,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts that you have in
the Divisions.
If the Annuity Account Value is less than $25,000, on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03,
or (b) the date of Termination of this Contract pursuant to Section 2.06 or
2.12, we will prorate the Annual Administrative Charge applicable to the
completed portion of the Current Contract Year and withdraw such amount in lieu
of the Annual Administrative Charge described in this Section for the applicable
part of that Contract Year.
If the Annuity Account Value is $25,000 or greater at the end of a Contract
Year, the Annual Administrative Charge is zero.
SECTION 2.12 DEATH BENEFIT. Upon receipt of due proof of your death , we will
pay to the beneficiary designated to receive such payment, pursuant to Section
4.04 of this Contract, the amount of death benefit payable. The amount of the
death benefit is equal to the greater of (i) the Annuity Account Value and (ii)
the minimum death benefit. Such minimum death benefit is the sum of all
Contributions made pursuant to Section 2.01 (before reduction for any applicable
tax charge) less any withdrawals made pursuant to Section 2.07. Any such
withdrawal will reduce the minimum death benefit (as adjusted by any previous
such withdrawal) by an amount which is in the same proportion as the amount that
was withdrawn is to the Annuity Account Value. If, in accordance with the
provisions of Section 2.01, the Cash Value of another Annuity Contract issued by
us, or one of our affiliated or subsidiary Life Insurance Companies, which
provides for a death benefit before retirement is equal to the greater of the
contract Cash Value or alternate amount based on premiums paid or Contributions
made under the Annuity Contract, is transferred to this Contract, such Cash
Value or an alternative amount as of the date of transfer, will be included in
the "sum of all Contributions" in lieu of the amount of Cash Value transferred
for purposes of the death benefit under this Contract.
No. 92TSUA Page 10
We will pay the death benefit to the beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.04. Also in accordance with the last paragraph of Section 4.04, if no such
election is in effect at your death, we will pay the death benefit to the
beneficiary in a single sum, unless the beneficiary elects, before we pay the
death benefit, to apply the death benefit to an Annuity Benefit, for Plans
subject to Title I of ERISA.
Distributions pursuant to this Section are subject to the terms of the Plan and
the Spousal Consent Rules set forth in Section 3.06 for Plans subject to Title I
of ERISA.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value shall be zero. We will be released from any and all
liability for payments with respect to the Contributions from which the Annuity
Account Value arose.
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PART III-ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under this Contract with respect to a payee is the amount provided pursuant to
Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division of the Separate Account.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of net
investment return referred to in Section 1.26 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.25, not to exceed the maximum rate of 1.75% after any deductions to
provide for any applicable tax charge. These charges include a daily charge for
financial accounting, death benefits, mortality risk, expenses and expense risk,
plus the investment advisory fee charges and direct operating expense charges of
the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under the terms of this Contract with respect to a payee is the
monthly amount provided pursuant to the fifth paragraph of Section 3.04. The
amount of the fourth and each subsequent payment under a Variable Annuity
Benefit will be equal to the number of Annuity Units with respect to such
benefit, multiplied by the Average Annuity Unit Value for the second calendar
month immediately preceding the due date of the payment. The number of Annuity
Units with respect to a benefit is the number determined by dividing the amount
of the first monthly payment under such benefit by the Annuity Unit Value for
the Valuation Period which includes the due date of the first monthly payment.
As described in Section 3.05, we will notify the payee how each Variable Annuity
Benefit is determined.
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your
Retirement Date, provided you are then living, the Annuity Account Value shall
be applied to provide the Normal Form of Annuity Benefit, unless you elect (i)
to receive the Cash Value in a single sum or (ii) to apply the Annuity Account
Value, or Cash Value, whichever is applicable pursuant to the first paragraph of
Section 3.04, to provide an Annuity Benefit on any other annuity form offered by
us, or one of our affiliated or subsidiary life insurance companies as elected
by you, or (iii) to take partial withdrawals in amounts and at times as required
by the Code, pursuant to Sections 2.07 and 3.05, subject to our rules then in
effect and any other applicable requirements under the Code.
We will provide notice and election forms to you not more than six months before
your Retirement Date.
If you elect to terminate this Contract, prior to the Retirement Date, pursuant
to Section 2.06, an election may be made to receive an Annuity Benefit in lieu
of the Cash Value, unless restricted by the Plan.
We will have the right to require that you furnish pertinent information to
provide an Annuity Benefit, and we will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary
life insurance companies. If the issuance of this Contract is pursuant to a Plan
subject to Title I of ERISA, the rules set forth in Section 3.06 shall apply to
your election and the commencement of annuity benefits.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or
third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be (i) the
Annuity Account Value if the payments under the annuity form involves life
contingencies, or (ii) the Cash Value if the Annuity Form elected does not
involve life contingencies.
No. 92TSUA Page 11
The amount applied to provide an Annuity Benefit may be reduced by any
applicable tax charge on annuity considerations, as we determine. If we have
previously deducted any applicable tax charge from Contributions as provided in
Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to your Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below, or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your Contract will be governed by our
supplementary contract then in effect.
The amount to be applied to provide an Annuity Benefit will, in addition to any
tax charge reduction, be reduced by an administrative charge. The amount of such
charge will be determined from time to time in accordance with our general
practices applicable on a uniform basis to all contracts of the same type as
this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts
you have in the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under the terms of this
Contract, as indicated, on either the Life Annuity Form or the Joint and
Survivor Life Annuity Form (with 100% of the amount of your payment continued to
your spouse). The amount of income provided under the Fixed Annuity Benefit
payable on the Life Annuity Form and Joint and Survivor Life Annuity Mortality
Form, are based on 3.5% interest and the 1983 Individual Annuity Mortality Table
"a" adjusted to a unisex basis based on a 50-50 split of males and females, at
age zero. The amount of income initially provided under the Variable Annuity
Benefit payable on the Life Annuity Form and Joint and Survivor Life Annuity
Form are based on a 50-50 split of males and females, at age zero and an Assumed
Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to
Section 1.26.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us based on 3.5% interest and the 1983 Individual Annuity
Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males
and females, at age zero, if such annuity form provides for a Fixed Annuity
Benefit, and on the projected 1983 Basic Table "a" adjusted to a unisex basis
based on a 50-50 split of males and females, at age zero and an Assumed Base
Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant
to Section 1.26, if such annuity form provides for a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Distributions attributed to
Contributions of Transferred Funds pursuant to Section 2.01 (where you have
provided to us written evidence of such balance as of December 31, 1986) must
commence no later than age 75. Such distributions will be made in the normal
form of Annuity Benefit, unless you elect to take payments in a single sum or
another form of Annuity Benefit then offered by us.
Your entire interest in this Contract attributable to all other Contributions
made, and earnings credited thereon must be distributed, or begin to be
distributed no later than the first day of April following the calendar year in
which you attain age 70 and 6 months ("Required Beginning Date"). Your entire
interest may be distributed, as you elect, over (a) your life, or the lives of
you and your designated beneficiary, or (b) a period certain not extending
beyond your life expectancy, or the joint and last survivor expectancy of you
and your designated beneficiary. Distributions must be made in periodic payments
at intervals of no longer than one year. In addition, payments must be either
nonincreasing or they may increase only as provided in Q & A F-3 of Section
1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation
thereto.
All distributions made hereunder shall be made in accordance with the
requirements of Section 403(b)(10) and 401(a)(9) of the Code, including the
incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and
applicable Treasury Regulations, including the minimum distribution incidental
benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury
Regulations, or any successor Regulation thereto.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.05, while any distribution shall be subject to such requirements of
the Code and regulations, any distribution shall also be subject to the terms of
this Contract. That is, the forms of distribution shall be those which are made
available by us at the time of your election.
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9 unless
you otherwise elect prior to the time distributions are required to begin, those
life expectancies shall be recalculated annually. Such election shall be
irrevocable and shall apply to all subsequent years. The life expectancy of a
non-spouse beneficiary may not be recalculated. Instead, life expectancy will be
calculated using the attained age of such beneficiary during the calendar year
in which you attain age 70 and 6 months and payments for subsequent years shall
be calculated based on such life expectancy reduced by one for each calendar
year which has elapsed since the calendar year life expectancy was first
calculated.
If you die after distribution of your interest in this Contract has begun, the
remaining portion of such interest will continue to be distributed at least as
rapidly as under the method of distribution being used prior to your death.
If you die before distribution of your interest begins, distribution of your
entire interest shall be completed no later than December 31 of the calendar
year containing the fifth anniversary of your death, except to the extent that
an election is made to receive death benefit distributions in accordance with
(1) or (2) below:
No. 92TSUA Page 12
(1) If your interest is payable to a designated beneficiary, then your entire
interest may be distributed over the life of, or over a period certain not
greater than the life expectancy of, the designated beneficiary. Such
distributions must commence on or before December 31 of the calendar year
immediately following the calendar year of your death.
(2) If the designated beneficiary is your surviving spouse, the date
distributions are required to begin in accordance with (1) above shall not
be earlier than the later of (A) December 31 of the calendar year
immediately following the calendar year of your death or (B) December 31 of
the calendar year in which you would have attained age 70 and 6 months.
For purposes of determining the "period certain" referred to in the immediately
preceding paragraph, life expectancy is computed by use of the expected return
multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes
of distributions beginning after your death, unless otherwise elected by the
surviving spouse by the time distributions are required to begin, life
expectancies shall be recalculated annually. Such election shall be irrevocable
by the surviving spouse and shall apply to all subsequent years. In the case of
any other designated beneficiary, life expectancies shall be calculated using
the attained age of such beneficiary during the calendar year in which
distributions are required to begin pursuant to this Section, and payments for
any subsequent calendar year shall be calculated based on life expectancy
reduced by one for each calendar year which has elapsed since the calendar year
life expectancy was first calculated.
Distributions under this Section are considered to have begun if distributions
are made because you have reached your Required Beginning Date or if prior to
the Required Beginning Date distributions irrevocably commence to you over a
period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1
of the Proposed Treasury Regulations or any successor Regulation thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under this Contract was based on information that is
subsequently found to be incorrect, your benefit will not be invalidated, but an
adjustment on the basis of the correct information will be made in the amount of
the benefit payments, or any amount used to provide the benefit, or any
combination thereof. Overpayments by us will be charged against and
underpayments will be added to any payments thereafter falling due under the
terms of this Contract with respect to the payee, affecting as many such
payments as are necessary to correct the overpayment or underpayment. Our
liability, with respect to a payee, is limited to the correct information and
the actual amounts used to provide the benefits then in force with respect to
the payee under this Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under this Contract is physically or mentally incompetent to receive
such payment or is a minor, (ii) another person or an institution is then
maintaining or has custody of such payee, and (iii) no guardian, committee, or
other representative of the estate of such payee has been appointed, we may make
the payments (in the case of a minor, at a rate not exceeding $200 a month) to
such other person or institution, and will thereupon be fully discharged from
all liability with respect thereto.
If a variable annuity form made available by us provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one of two persons, a payee for payments
thereunder may elect, without the concurrence of any other person, to receive
the commuted value of any remaining payments, provided no person upon whose life
the income depends is surviving.
Pursuant to Section 3.03, upon your election, pursuant to Section 3.03 of an
annuity form providing payments for a period certain, you may designate (with
the right to change such designation) a person or persons to receive any
payments that may become due after the death of the person or persons upon whose
life or lives the income may depend.
The Payee may designate (with the right to change such designation and without
the concurrence of any other person) a payee to receive any payments or
installments payable after such payee's death, if the absence of such a
designation would result in a single sum payment to such payee's estate in
accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments. The commuted value of any such remaining payments will be
determined on the basis of compound interest at the rate utilized in the
actuarial rate basis applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
No. 92TSUA Page 13
--------------------------------------------------------------------------------
TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT
AND SURVIVOR LIFE ANNUITY FORM
100% OF PAYMENT TO CONTINUE TO SPOUSE
(Minimum Monthly Income per $1,000 of Annuity Account Value)
---------------------------------------------------------------------------------------------------------------------------------
Age 60 61 62 63 64 65 66 67 68 69 70
---------------------------------------------------------------------------------------------------------------------------------
60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88
61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96
62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03
63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11
64 4.89 4.94 5.00 5.05 5.10 5.14 5.19
65 5.00 5.06 5.11 5.17 5.22 5.27
66 5.12 5.18 5.24 5.29 5.35
67 5.24 5.31 5.37 5.43
68 5.37 5.44 5.51
69 5.52 5.59
70 5.67
---------------------------------------------------------------------------------------------------------------------------------
ANNUITY BENEFIT PAYABLE ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1000 of Annuity Account Value)
-------------------------------------------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE ON
THE LIFE ANNUITY FORM IF ASSUMED BASE
RATE OF NET INVESTMENT RETURN IS:
Age 3.5% 5.0%
----------- ---------- --------- ---------- ----------
60 5.27 6.16
61 5.39 6.28
62 5.52 6.41
63 5.66 6.55
64 5.81 6.70
65 5.97 6.86
66 6.15 7.03
67 6.33 7.21
68 6.53 7.41
69 6.74 7.62
70 6.97 7.85
----------- ---------- --------- ---------- ----------
We will notify the payee, with respect to each payment under a Variable Annuity
Benefit, the number of Annuity Units and the Average Annuity Unit Value used in
determining the amount of each variable payment. Such notice will be mailed with
each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary,
as described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If this Contract is
issued pursuant to a Plan subject to Title I of ERISA, then the provisions of
this Section shall supersede any contrary provisions in this Contract. If you
are married, your interest in the Contract shall be paid in the Normal Form
joint and survivor annuity, and if you are unmarried, your interest shall be
paid in the Normal Form life annuity, unless you elect otherwise as described in
this Section. If you are married and die before payment of your interest has
commenced, your interest shall be paid to your surviving spouse in the form of a
life annuity, unless at the time of your death there was a contrary election
made pursuant to this Section. The foregoing notwithstanding, your surviving
spouse may elect, before payment is to commence, to have payment made in any
form permitted under the terms of this Contract.
You may elect, at any time within the 90 consecutive day period before the first
day of the first period for which your interest is paid as an annuity or in any
other form, not to have your interest paid in the Normal Form, in which case it
shall be paid in any other form elected under the terms of this Contract. If
such interest is to be paid to your spouse upon your death, you may elect,
during the period beginning on the first day of the plan year of the Plan in
which you attain age 35 (or, if you separate from service prior to that plan
year, beginning on the date of separation) and ending with your death, for a
beneficiary other than your spouse to receive payment of the value of your
interest. In addition, if you will not yet attain age 35 by the end of any
current plan year, you may make a special qualified election to designate a
beneficiary other than your spouse to receive payment of the value of your
interest, which special qualified election shall be effective for the period
beginning on the date of such election and ending on the first day of the plan
year in which you will attain age 35. Amounts payable in accordance with this
Section will be automatically reinstated as of the first day of the plan year in
which you attain age 35 unless a new election designating a beneficiary other
than the spouse is made in accordance with the requirements of this Section.
Any election described in the foregoing paragraph must be consented to by your
spouse in writing before a notary or a representative of the Plan unless you can
prove that there is no spouse or that the spouse cannot be located. Also, if you
have become legally separated from your spouse or have been abandoned (within
the meaning of local law) and have a court order to such effect, spousal consent
is not required unless a qualified domestic relations order provides otherwise.
Your election must designate a specific beneficiary (including any class of
beneficiaries or any contingent beneficiaries) that may not be changed without
further consent of the spouse, unless the spouse's consent expressly permits
designation by you without further consent of the spouse. The spouse's consent
under
No. 92TSUA Page 14
this section shall acknowledge the effect of the election. In addition, the
spouse's consent (or establishment that the consent of the spouse may not be
obtained) shall only be valid with respect to such spouse. Your waiver of the
Normal Form joint and survivor annuity shall not be effective unless the
election designates a form of benefit payment which may not be changed without
spousal consent (or the spouse expressly permits designations by you without any
further spousal consent). A consent that permits designations by you without any
requirement of further consent by such spouse must acknowledge that the spouse
has the right to limit consent to a specific beneficiary and a specific form of
benefit where applicable, and that the spouse voluntarily elects to relinquish
either or both of such rights. If you make an election under this Section, you
may revoke that election, without spousal consent, at any time before the first
day of the first period for which an amount is paid as an annuity or in any
other form.
The provisions requiring spousal consent in this Section shall also apply with
regard to your election to terminate this Contract or make partial withdrawals
pursuant to Sections 2.06 and 2.07, and with respect to a beneficiary
designation set forth in Section 4.04. A spouse's written consent, witnessed by
a representative of the Plan or a notary public, must be given on a form
acceptable to the Employer and us, within the 90 consecutive day period prior to
any such payment or withdrawal, or beneficiary designation, unless you can show
that you have no spouse or that the spouse cannot be located.
If the Annuity Account Value applied to provide the spousal benefits on the date
payment is to commence is in the aggregate less than $3,500, we may choose to
make payment in a single sum rather than in the form of a Qualified Joint and
Survivor Annuity or Life Annuity as described herein. Upon any payment made
pursuant to this Section, we will be released from any and all liability for
payment with respect to the Contributions made for you.
-------------------------------------------------------------------------------
PART IV - GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the
parties and the terms of this Contract alone will govern with respect to our
rights and obligations. A copy of the application is incorporated in and made
part of this Contract.
This Contract may not be modified, nor many any of our rights or requirements be
waived, except in writing and by our authorized officer. The terms of this
Contract may be changed by amendment or replacement upon agreement between you
and us without the consent of any other person.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of
this Contract without the consent of any other person in order to comply with
applicable laws and regulations. Such right shall include, but not be limited
to, the right to conform the terms of this Contract to reflect changes in the
Code, or applicable Treasury Regulations, or in regulations or published rulings
of the Internal Revenue Service so that this Contract will continue to be an
Annuity.
SECTION 4.03 NONTRANSFERABILITY AND ASSIGNMENTS. Your entire interest under this
Contract is nonforfeitable. No interest of yours (or of a beneficiary) under
this Contract may be transferred to any person other than us upon the surrender
of this Contract. Except as permitted under applicable law, no right or interest
of you or any other payee or beneficiary in this Contract shall be (a)
assignable; (b) subject to any lien; or (c) liable for, or subject to, any
obligation or liability of any person. The preceding sentence shall not apply to
any assignment, transfer or attachment pursuant to a qualified domestic
relations order (as defined in Section 414(p) of the Code).
SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an
initial designation of the beneficiary entitled to receive any death benefit
payable pursuant to Section 2.12. You may change such designation from time to
time during your lifetime, and while this Contract is in force. Any such
designation or change must be made by written notice in a form satisfactory to
us. A change will, upon receipt at the Processing Office, take effect as of the
time the written notice was signed, whether or not you are living on the date of
receipt, but without further liability as to any payment or other settlement
made by us before receipt of such change. Beneficiary designations are subject
to the rules of Section 3.06 if the Contract is issued pursuant to a Plan
subject to Title I of ERISA.
Unless otherwise specified in the designation, if you have designated two or
more persons as beneficiary, the beneficiary will be the designated person or
persons who survive you, and if more than one survive, they will share equally.
Any part of a death benefit payable pursuant to Section 2.12 for which there is
no designated beneficiary living at the time of your death, will be payable in a
single sum to your children who survive you, in equal shares, or should none
survive, then to your estate.
No. 92TSUA Page 15
If you elect in writing, any amount that would otherwise be payable to a
beneficiary in a single sum may be applied to provide an Annuity Benefit, on the
form of annuity previously elected by you, with respect to the beneficiary,
subject to our rules then in effect. If, at your death, there is no election in
effect to apply the single sum death benefit to provide an Annuity Benefit, the
beneficiary may make such an election. Any such election must meet the minimum
distribution requirements under the Code, as described in Section 3.05.
SECTION 4.05 DISQUALIFICATION OF PLAN OR CONTRACT. In the event that the Plan
fails to qualify as a Plan under Section 403(b) of the Code and applicable
Treasury Regulations, we reserve the right, upon receiving notice of such fact,
to transfer the Annuity Account Value under this Contract to another annuity
contract issued by us, an affiliate subsidiary, on your life, or to terminate
this Contract and pay to you the Annuity Account Value less deduction for
applicable taxes, solely at our option.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Employer, we
reserve the right at our sole discretion to limit Contributions under this
Contract.
SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of your Annuity Account Value
(less any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities and
Exchange Commission, by order, permits us to defer payment in order to protect
persons with interests in the Investment Divisions. We can defer payment of any
portion of your Annuity Account Value in the Guaranteed Interest Division for up
to six months while you are living.
SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish you
with a notice showing the following:
(1) the amount you have in the Guaranteed Interest Division,
(2) the total number of Accumulation Units you have in the Stock Division,
Balanced Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulation Unit Values,
(4) the amount you have in the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division,
(5) the Cash Value, and
(6) the amount of death benefit payable with respect to you.
We will also furnish annual calendar year reports concerning the status of the
annuity and any other reports required by the Code or applicable Treasury
Regulations.
After the Retirement Date, we will notify you of the number of Annuity Units and
the Average Annuity Unit Value used in determining the amount of each Variable
Annuity Benefit payment, if any.
SECTION 4.09 AGE. If your age has been misstated, any benefits will be those
which would have been purchased at the correct age. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
No. 92TSUA Page 16
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APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
PROCESSING OFFICE: INDIVIDUAL ANNUITY CENTER, P.O. BOX 2996,
NEW YORK, NEW YORK 10116-2996
QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR:
EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY
--------------------------------------------------------------------------------
TYPE OF PURCHASE (Complete One Plan Only)
A. |_| TSA PUBLIC SCHOOL (GV-PS-I)
B. |_| TSA 501(C)(3) ORGANIZATION (GV-501-I)
C. |X| TSA University (GV-PS-U-I)
D. |_| IRA Individual (Including IRA to IRA transfers) (XX-XXX 4971)
E. |_| IRA Unit Billed (Including IRA to IRA transfers) (XX-XXX 4971)
F. |_| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified
Plan) (XX-XXX 4971-71)
G. |_| EDC (Public Employee Deferred Compensation) (GV-EDC 4991)
H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-080)
I. |_| SEP (Simplified Employee Pension) (GV-SEP 4981)
J. |_| SARSEP (Salary Reduction SEP) _________________________________________
K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41)
L. |_| XXXXX/HR-10 TRUSTEE (GV HR-10 4911-11)
(trustee owned)
M. |_| XXXXX/HR-10 (GV-HR-10 4911)
(not trustee owned) (issued to existing units only)
--------------------------------------------------------------------------------
DO NOT COMPLETE THIS SECTION IF 1.D OR 1.F CHECKED ABOVE
2. EMPLOYER/PLAN NAME
|A|B|C|_|C|O|M|P|A|N|Y|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_|
|x| NEW UNIT |0|0|0|1|2|3|-|4|5|6|
(FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM
983-135B IS REQUIRED)
--------------------------------------------------------------------------------
4. PROPOSED ANNUITANT Print name to appear on Contract.
|J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_|
FIRST MIDDLE INITIAL LAST
A. |X| MR. |_| MRS. |_| MS. |_| OTHER ____
B. Date of Birth: Year 1954 Month JANUARY Day 27
---- ------- --
C. Age at Nearest Birthday: 38 D. |X| Male |_| Female
----
X. Xxxxxxxxx's Mailing Address: F. State of Residence: N.J.
----
No., St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_|
City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1|
G. Telephone Number (101) 222 - 3456 |X| Home |_| Work
H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9|
I. Are you associated with or employed by a member of National
Association of Securities Dealers, Inc.(NASD)? |_| Yes |X| No
5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner, for all
other Markets Print Name of Annuitant.
XXXX XXX
-----------------------------------------------------------------------------
a. Title ____________________________________________________________________
6. RETIREMENT AGE 65
---------------------------------------------------------------
7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death
Benefit upon Xxxxxxxxx's death before Retirement Date.) (BENEFICIARY MUST
BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.)
XXXX XXX - WIFE
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
8. CONTRIBUTION ALLOCATION
Guaranteed Interest Division 20%
-----
Stock Division 20%
-----
Money Market Division 20%
-----
Balanced Division 20%
-----
Aggressive Stock Division 20%
-----
(PERCENTAGES IN WHOLE NUMBERS) Total 100%
9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F)
A. Reminder Notice (Billing) Required |_| Yes |X| No
IF YES, COMPLETE B-C-D-E
B. REMINDER DATE Required for Individual IRA or otherwise must agree
with existing unit or attached 983-135B. MONTH _________ DAY __________
C. REMINDER FREQUENCY
|_| Annual |_| Semi-Annual
|_| Quarterly |_| Monthly
Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA
ONLY:
|_| Semi-Monthly |_| Bi-Weekly
D. REMINDER AMOUNT $_________________________________
E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
-----------------------------------------------------------------------------
10.EXPECTED FIRST CONTRACT YEAR
Contribution. $1000
----------------------------------------------------------------
IF AN ADVANCED BILLING AND/OR CONTRACT DATE ARE REQUESTED, COMPLETE #9B
AND #12.
--------------------------------------------------------------------------------
(FOR PROCESSING OFFICE USE)
Unit Name ___________________________ Reminder Date ___________________________
Cert. or App# _______________________ Amendment Required_______________________
EDC Emp. Add. _______________________ Emp. Fed. ID# ___________________________
Frequency ___________________________ Contract Date ___________________________
--------------------------------------------------------------------------------
Receipt Date Batch # Inquiry # Processor
--------------------------------------------------------------------------------
180-1000
--------------------------------------------------------------------------------
10. Did you receive the Separate Account Prospectus? |X| Yes |_| No
Date shown on Prospectus January 1, 1992
----------------------------------------------------
Date of any supplement to Prospectus _______________________________________
11. Items (a) through (f) are to be answered by the annuitant. We are
required by the NASD to ask these questions.
(a) Name of Employer: ABC Company
------------------------------------------------------
(b) Address of Employer:
10 Main Street
---------------------------------------------------------------------------
Anytown, NJ
---------------------------------------------------------------------------
(c) Occupation Sales
-------------------------------------------------------------
(d) Assuming the contract applied for will be issued, will any existing
insurance or annuity be replaced or changed (or has it been)?
| | Yes |X| No
(e) Estimated Family Annual Income $100,000
----------------------------------------
(f) Estimated Net Worth $250,000
-----------------------------------------------------
(g) Investment Objective: |_| Income |X| Income & Growth
|_| Aggressive Growth |_| Growth |_| Safety of Principal
12. SPECIAL INSTRUCTIONS
----------------------------------------------------------------------------
----------------------------------------------------------------------------
----------------------------------------------------------------------------
----------------------------------------------------------------------------
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13. Amount paid with this form: $1000
(If a check is submitted with this request, no advanced Contract Date is
permitted.) BACKDATING IS NOT PERMITTED.
NOTE: Xxxxxx paid will be credited upon receipt at Equitable's Processing
Office, subject to return if the certificate is not issued. The Contract Date
will be the date of receipt by Equitable of this application, properly signed
and completed, and Contribution at Equitable's Processing Office.
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
AGREEMENT
All information and statements furnished in this application are true and
complete to the best of my knowledge and belief. I understand and acknowledge
that no Agent has the authority to make or modify any contract on Equitable's
behalf, or to waive or alter any of Equitable's rights and regulations.
IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO
THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT
PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT.
UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S)
OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND
COMPLETE.
--------------------------------------------------------------------------------
LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY
APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS.
--------------------------------------------------------------------------------
X__________________________________ Date_______ City __________ State __________
Signature of Annuitant
X__________________________________ Date_______ City __________ State __________
Signature of Authorized Individual (REQUIRED FOR EDC AND
TRUSTEED) OR OWNER
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
AGENT'S SECTION
Will any existing insurance or annuity be replaced or changed (or has it been),
assuming the Contract will be issued? | | Yes | | No
|_| I (we) certify that a prospectus for the Contract has been given to the
proposed Annuitant and that no written sales materials other than those approved
by Equitable have been used.
EQUI-VEST issues must adequately reflect the commission interest of all Agents
on previous contracts.
--------------------------------------------------------------------------------
Print Agent's Name(s) Initial of Agent Agent Agency District Agent's
(Service Agent first) Last Name Number % Code Manager Code Signature
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS___ Date ___ District EQS ___
Date ____
--------------------------------------------------------------------------------
(FOR ASU USE)
ASU Code and App. No. __________________________________________________________
ASU Rec'd. _____________________________________________________________________
Date to Proc. Off. ________________________________________________ Campaign |_|
Agent(s) shown above is Equity Qualified and is licensed in the state where the
request is signed. Above Agent information verified by XXX (Registered Rep)
--------------------------------------------------------------------------------
Application reviewed by ________________________________________________________
--------------------------------------------------------------------------------
180-1000
Owner: [THE EQUITABLE LOGO]
Annuitant:
Contract Number:
Issue Date:
Contract Date:
Retirement Date:
--------------------------------------------------------------------------------
THE EQUITABLE LIFE ASSURANCE SOCIETY OP THE UNITED STATES
Processing Office: Individual Annuity Center, P O Box 2996,
New York, New York 10116-2996
AGREES
o TO ALLOCATE the Contributions made to this Contract, after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division of the Separate Account (referred
to in this Contract as the "Investment Divisions") or to the Guaranteed
Interest Division, in accordance with Sections 2.02, 2.03 and 2.04 or in
part to any one, as directed by you, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide the
Annuitant with an Annuity Benefit or a Cash Value benefit if the Annuitant
is then living, and
o TO PROVIDE the Annuitant with the other rights and benefits of this
Contract.
This is the entire Contract. In this Contract, "we", "our" and "us" mean the
Equitable Life Assurance Society of the United States. "You" and "your" mean the
Annuitant at the time a right is exercised by the Annuitant.
TEN DAYS TO EXAMINE CONTRACT -- may cancel this Contract by returning it to us
within ten days after receipt of it. Upon such cancellation, we will refund any
Contribution made to us on your behalf under this Contract, plus or minus any
investment gain or loss experienced in the Investment Divisions of the Separate
Account from the date such Contribution is allocated to such Investment Division
to the date we receive the returned Contract.
/S/Xxxxxxx Xxxxxxx /s/Xxxxxx X. Xxxxxx
Xxxxxxx Xxxxxxx, Vice President, Xxxxxx X. Xxxxxx
Secretary & Associate General Counsel President and Chief Executive Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.26 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF AN ANNUAL CHARGE NOT TO
EXCEED THE MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR
FINANCIAL ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK,
PLUS THE INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF
THE TRUST.
No. 92 TSUB
This Contract is issued in consideration of the payment to us of the
Contributions made under the terms of this Contract.
The provisions on the following pages are part of this Contract.
--------------------------------------------------------------------------------
TABLE OF CONTENTS
DEFINITIONS Page
Section 1.00 - Agreement...............................4
1.01 - Annuitant...............................4
1.02 - Annuity.................................4
1.03 - Annuity Account Value...................4
1.04 - Annuity Benefit.........................4
1.05 - Cash Value..............................4
1.06 - Class of Contracts......................5
1.07 - Code....................................5
1.08 - Contract................................5
1.09 - Contract Date...........................5
1.10 - Contract Year...........................5
1.11 - Contribution............................5
1.12 - Divisions...............................5
1.13 - Elective Deferrals......................5
1.14 - Xxxxxxxx Xxxxxxx Xxxxxxx................5
1.15 - Employer................................5
1.16 - ERISA...................................5
1.17 - Guaranteed Interest Rate................5
1.18 - Joint and Survivor Life
Annuity Form...........................5
1.19 - Life Annuity Form.......................5
1.20 - Normal Form.............................5
1.21 - Period Certain Annuity .................6
1.22 - Plan....................................6
1.23 - Processing Office.......................6
1.24 - Retirement Date.........................6
1.25 - Separate Account........................6
1.26 - Separate Account
Definitions............................7
1.27 - Transaction Date .......................7
1.28 - Trust ..................................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions...........................8
2.02 - Separate Account
Investment Divisions...................8
2.03 - Guaranteed Interest
Division...............................8
2.04 - Allocation to Divisions.................8
2.05 - Transfers Among Divisions...............8
2.06 - Termination of this Contract............9
2.07 - Partial Withdrawals.....................9
2.08 - Charges for Partial
Withdrawals............................9
2.09 - Free Corridor Amount...................10
2.10 - Restrictions on Distributions..........10
2.11 - Annual Administrative Charge ..........10
2.12 - Death Benefit..........................10
ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit .................11
3.02 - Variable Annuity Benefit...............11
3.03 - Election and Commencement
of Annuity Benefits....................11
3.04 - Amount of Annuity Benefits.............11
3.05 - Payment of Annuity Benefits ...........12
3.06 - Special Annuity and Spousal
Consent Provisions....................14
GENERAL PROVISIONS
Section 4.01 - Contract...............................15
4.02 - Statutory Compliance...................15
4.03 - Nontransferability and
Assignments...........................15
4.04 - Beneficiary ...........................15
4.05 - Disqualification of Plan
or Contract...........................16
4.06 - Future Contributions ..................16
4.07 - Deferment .............................16
4.08 - Annual Notice..........................16
4.09 - Age....................................16
No. 92 TSUB Page 2
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PART I - DEFINITIONS
SECTION 1.00 AGREEMENT. The term "Agreement" means an agreement described in
Treasury Regulation Section 1.403(b)-l(b)(3) between an Employer and an employee
of the Employer, in which the Employer agrees to purchase an Annuity for the
employee. If Employer contributions to purchase the Annuity result from the
employee's agreement to take a reduction in future salary or forgo a future
salary increase, such Agreement is referred to as a "Salary Reduction Agreement"
within the meaning of Sections 402(g)(3)(C) and 3121(a)(5)D) of the Code.
SECTION 1.01 ANNUITANT. The term "Annuitant" means the owner of this Contract,
as shown on page 3 and on whose behalf this Contract has been purchased and is
maintained, and who exercises all rights under this Contract.
SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in
accordance with the terms of the Plan or Agreement, which contract meets the
requirements for qualification under Section 403(b) of the Code.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts that you have in the Guaranteed Interest Division and the
Investment Divisions of the Separate Account pursuant to Sections 2.02 and 2.03.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by us pursuant to Section 3.04 of this Contract. Various sections of this
Contract (Sections 1.18, 1.19, 1.20, 3.01, and 3.02) refer to monthly payments
to be made under an Annuity Benefit. You may wish to have your Annuity Benefit
paid at other intervals, such as quarterly, semi-annually, or annually, instead
of monthly. You may elect this at the time you elect the Annuity Benefit form as
described in Section 3.03; in that event, all references in this Contract to
monthly payments will be deemed to mean payments at the frequency you elect,
subject to our rules at the time of election.
SECTION 1.05 CASH VALUE. The term "Cash Value" means the Annuity Account Value
less any applicable withdrawal charge determined as follows:
The withdrawal charge equals the lesser of (a) or (b) where
(a) equals
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
O% thereafter
of the excess of (i) the Annuity Account Value over (ii) the Free Corridor
Amount defined in Section 2.09; and
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior charges for partial
withdrawals made pursuant to Section 2.08.
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
A withdrawal charge will not apply, which means the Cash Value will equal the
Annuity Account Value upon any of the following occurrences:
(i) your attainment of age 59 and 6 months, and your completion of at least
five Contract Years, or
(ii) you die and a distribution is made to your beneficiary, or
(iii) your attainment of age 55, your completion of at least five Contract Years
and the receipt by us of a properly completed settlement election form
providing for the application of the Annuity Account Value to purchase an
Eligible Annuity Certain, defined in Section 1.14, or
(iv) your completion of at least three Contract Years and the receipt by us of
a properly completed settlement election form providing for the
application of the Annuity Account Value to purchase a Period Certain
Annuity, defined in Section 1.21, where the certain period of such annuity
is at least ten years, or
(v) the receipt by us of a properly completed settlement election form
providing for the application of the Annuity Account Value to purchase a
Life Annuity distribution option, or
(vi) your attainment of age 55, your completion of at least five Contract
Years, and separation from service, or
(vii) your completion of at least twelve Contract Years.
No. 92 TSUB Page 4
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same Calendar Year.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, or
any corresponding provisions of prior or subsequent United States revenue laws.
SECTION 1.08 CONTRACT. The term "Contract" means this Contract.
SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both the application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us
for you with respect to an Annuity purchased for you under the Plan. We are
under no obligation to accept any Contribution less than $20.00. Contributions
may be either Elective Deferrals or Employer Contributions pursuant to the Plan.
The Employer shall indicate to us the amount and type of each Contribution.
SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following Divisions described in this
Contract:
(a) the Guaranteed Interest Division, and
(b) the Investment Division of the Separate Account.
SECTION 1.13 ELECTIVE DEFERRALS. The term "Elective Deferrals" means
Contributions made pursuant to a Salary Reduction Agreement as defined in
Section 1.00.
SECTION 1.14 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
an annuity not involving life contingencies issued by us which extends beyond
your attainment of age 59 and 6 months and does not permit any prepayment of the
unpaid principal (that is, no withdrawal or single sum payment) prior to your
attainment of age 59 and 6 months.
SECTION 1.15 EMPLOYER. The term "Employer" means (i) an organization described
in Section 501(c)(3) of the Code which is exempt from Federal income tax under
Section 501(a) of the Code; or (ii) a State, political subdivision of a State,
or an agency or instrumentality of any one or more of the foregoing, in
connection with services performed by an employee for an educational
organization described in Section 170(b)(l)(A)(ii) of the Code.
SECTION 1.16 ERISA. The term ERISA means the Employee Retirement Income Security
Act as amended.
SECTION 1.17 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrues on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on page 3 of
this Contract. Section 2.03 describes the determination of the Rate to apply
thereafter.
SECTION 1.18 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100%, as
elected by you. The payments commence on the date as of which the Joint and
Survivor Life Annuity Form is purchased and terminate with the last payment due
before the death of the survivor.
SECTION 1.19 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us or one of our affiliated or subsidiary life insurance companies,
providing fixed monthly payments during the lifetime of the person upon whose
life such payments depend. The payments commence on the date as of which the
Life Annuity Form is purchased and terminate with the last payment due before
the death of such person.
SECTION 1.20 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means (i) if you have a living spouse at the Retirement Date, the
Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form with
such spouse as the contingent annuitant (with 100% of the monthly amount payable
to your spouse), and (ii) if you do not have a living spouse at the Retirement
Date, the Fixed Annuity Benefit payable on the Life Annuity Form.
No. 92 TSUB Page 5
SECTION 1.21 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us or one of our affiliated
or subsidiary life insurance companies, which does not permit any prepayment of
the unpaid principal (that is, you cannot elect to receive part of your payments
as a single sum payment with the remainder paid in monthly annuity payments).
SECTION 1.22 PLAN. The term "Plan" means a program established by an Employer
for the purchase of Annuities on behalf of employees. The Employer shall be the
"Plan Administrator" within the meaning of Section 414(g) of the Code and
applicable Treasury Regulations.
SECTION 1.23 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P O Box 2996, New York, New York 10116-2996, or such
other location as we shall designate by advance written notice to the Employer,
or the Plan's Trustee, as applicable, and to you.
SECTION 1.24 RETIREMENT DATE. The term "Retirement Date" means the date on which
you attain the retirement age as shown on page 3 of this Contract. Before the
Retirement Date you may elect to change the Retirement Date to another
Retirement Date, which may be any date after the filing of the election (other
than the 29th, 30th, or 31st day of any month), either initially or by later
change, must be in accordance with the terms of the Plan. No Retirement Date
shall be later than the date of your attainment of age 70 and 6 months. Any
election for such change must be made in writing by you and shall not take
effect until received by us at our Processing Office.
SECTION 1.25 SEPARATE ACCOUNT. The term "Separate Account" means Separate
Account A, which is organized as a unit investment trust (a type of investment
company). We have established the Separate Account and it is maintained in
accordance with the laws of New York State. Realized and unrealized gains and
losses from the assets of the Separate Account are credited to or charged
against it without regard to our other income, gains or losses. Assets are put
in the Separate Account to support this Contract and other variable annuity
contracts. Assets may be put in the Separate Account for other purposes, but not
to support contracts or policies other than variable annuities and variable life
insurance.
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these Contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust where each class (or series) represents a separate portfolio in
the Trust. We reserve the right to change the designated trust or investment
company or to add designated trusts or investment companies. The Investment
Divisions available are the Stock Division, the Money Market Division, the
Balanced Division and the Aggressive Stock Division. The Guaranteed Interest
Division is not a part of the Separate Account, but rather is an asset of our
General Account.
We will value the assets of each Investment Division on each business day. A
business day is any day on which we are open, the New York Stock Exchange is
open for trading and there is a sufficient degree of trading in the portfolio of
the securities in which an Investment Division is invested to materially affect
the Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments we are
permitted by law to make.
We reserve the right to
(i) cause the registration or deregistration of the Separate Account under the
Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any other
form;
(v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or
remove Investment Divisions (or sub-divisions of Investment Divisions)
from the Separate Account; (The term "Investment Division" in this
Contract shall then refer to any other Investment Division in which the
asset of a Class of Contracts to which this Contract belongs, were
placed);
(vi) combine any two or more Investment Divisions (or sub-divisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
Class of Contracts to which this Contract belongs.
No. 92 TSUB Page 6
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, you will be notified of such exercise, as
required by law.
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for any applicable
tax charges) at a rate not to exceed 1.49% per year for the Stock, Money Market
and Balanced Divisions, and 1.34% per year for the Aggressive Stock Division,
for financial accounting, death benefits, mortality risk, expenses and expense
risk. The charge shall be made in accordance with Subsection (c) of the Net
Investment Factor provision in Section 1.26. The relative proportion of these
charges may be modified. The daily charge, plus the investment advisory fee
charges and direct operating expense charges of the Trust shall not exceed a
total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract. The maximum rate may not be altered
without your approval.
SECTION 1.26 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD: Each business day together with any preceding consecutive
non-business days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b), minus (c), where
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment
Division for the Valuation Period. For this purpose, we use the share value
reported to us by the Trust.
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period (after
any amounts allocated to or withdrawn for that Valuation Period).
(c) is the daily asset charge for the expenses of this Contract, times the
number of calendar days in the Valuation Period.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an
Investment Division where your Contributions are invested and which is used in
determining the amount you have in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for such Valuation Period.
ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first Contribution was put into the Stock
Division, the Annuity Unit Value was $1.26 and $1.52 for contracts with Assumed
Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The
Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value
for the immediately preceding Valuation Period multiplied by the Adjusted Net
Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for a Valuation Period is the Net Investment Factor for such
period reduced for each calendar day in such subsequent Valuation Period by the
Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net
Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net
Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall
be 5%, except in states where the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: The "Average Annuity Unit Value" for a calendar
month is equal to the average of the Annuity Unit Values for all Valuation
Periods ending in such month.
SECTION 1.27 TRANSACTION DATE. The Transaction Date is the business day we
receive a Contribution or a written contract transaction request providing the
information we need at the Processing Office. In the case of a transfer request
initiated through the use of a touch tone telephone as described in Section
2.05, the term Transaction Date is the business day the telephone transaction is
received.
SECTION 1.28 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
No. 92 TSUB Page 7
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PART II - ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. The Employer is to make Contributions, from time to
time on such dates and in such amounts as determined by the Employer pursuant to
the terms of the Plan or Agreement. You are to specify the amount to be
allocated to each Division.
Each Contribution received by us with respect to you will, before its allocation
under this Contract, be reduced by the amount of any applicable tax charge, as
determined by us.
Pursuant to the terms of the Plan, if applicable, you may, with our agreement,
(i) transfer to this Contract any amount held under a contract or account that
meets the requirements of Section 403(b) of the Code ("Transferred Funds"), or
(ii) roll over contributions from a contract or account that meets the
requirements of Section 403(b) of the Code, or from a conduit individual
retirement arrangement described in Section 408(d)(3)(A)(iii) of the Code. If
you do not provide to us at the time of such transfer as described in (i) above,
as to what portion, if any, of the amounts of the Transferred Funds which are
exempt from the distribution restrictions described in Section 2.10, and the
minimum distribution rules described in Section 3.05, we will treat all such
amounts as being subject to such restrictions. Any Transferred Funds from a
contract not issued by us will, before allocation under this Contract, be
reduced by the amount of any applicable tax charge, as determined by us.
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to or withdrawn or transferred from an Investment
Division, the Annuity Account Value will be credited or charged, as the case may
be, with the number of Accumulation Units determined by dividing said amount by
the Accumulation Unit Value for the appropriate Investment Division for the
Valuation Period which includes that date. The number of units you have in an
Investment Division on any date is equal to (i) the sum of any Accumulation
Units that have been allocated pursuant to Section 2.04 minus (ii) the sum of
any Accumulation Units that have been withdrawn pursuant to Sections 2.07, 2.08
or 2.13, or transferred from the Investment Division pursuant to Section 2.05.
The amount you have in an Investment Division on any date is equal to the
product of (i) the number of Accumulation Units in the Investment Division on
that date, and (ii) the Accumulation Unit Value for the Investment Division for
the Valuation Period which includes that date.
Participation in the Separate Account under this Contract terminates on the
earliest of (i) your election and commencement of annuity benefits pursuant to
Section 3.03, (ii) receipt of due proof of your death, or (iii) Termination of
this Contract pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets, which support
the guarantees of this Contract and other contracts. The amount in the
Guaranteed Interest Division at any time is equal to the sum of all amounts that
have been allocated to the Guaranteed Interest Division pursuant to Section 2.04
or 2.13, plus the amount of any interest accrued but not allocated, less the sum
of all amounts that have been withdrawn from the Guaranteed Interest Division
pursuant to Section 2.07, 2.08 or 2.13 or transferred from the Guaranteed
Interest Division, pursuant to Section 2.05. Interest is allocated to the
Guaranteed Interest Division on a Transaction Date pursuant to Section 2.04.
We will credit the amount you have in the Guaranteed Interest Division with
interest at effective annual rates that we determine. For each Class of
Contracts we determine a yearly guaranteed interest rate that will remain in
effect throughout the next year. We guarantee that this yearly guaranteed
interest rate will never be less than 3%.
Participation in the Guaranteed Interest Division under the terms of this
Contract terminates on the earliest of (i) election and commencement of Annuity
Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, and
(iii) Termination of this Contract pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction of any applicable tax charge) to one or more
Divisions, at your sole direction as specified to us. Allocation percentages
must be in whole numbers and the sum must equal 100. The allocation is made as
of the Transaction Date on which we have received both such Contribution and
such direction. Contributions made to an Investment Division purchase
Accumulation Units in that Investment Division, using the Accumulation Unit
Value next computed after the Transaction Date.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon Termination of this Contract, pursuant to Section 2.06, and (vi)
upon your death pursuant to Section 2.12.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. You may, upon written request or through
the use of a touch tone telephone, transfer all or part of the amount you have
in a Division to one or more of the Divisions as follows: (1) amounts in the
Guaranteed Interest Division, Stock Division, Balanced Division and Aggressive
Stock Division may be transferred among such Divisions; (2) amounts in the Money
Market Division may be transferred to other Divisions. Written authorization for
touch tone telephone initiated transfers is only required when authorization for
telephone transfers is requested. Upon advance written notice to you, we reserve
the right to
No. 92 TSUB Page 8
discontinue the acceptance of transfer requests through the use of a touch tone
telephone. All transfers will be effective on the Transaction Date and will be
subject to our rules in effect at the time of transfer. With respect to the
Investment Division, the transfer will be made at the Accumulation Unit Value
next computed after the Transaction Date. No transfers are permitted to the
Money Market Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the
terms of the Plan, including, for Plans subject to Title I of ERISA, if
applicable, the spousal consent rules set forth in Section 3.06, you may elect,
by written notice, to terminate this Contract. In addition, termination of this
Contract is subject to the restrictions on distributions set forth in Section
2.10 of this Contract. We will determine the Cash Value as of the Transaction
Date we receive your written election.
The payment of such Cash Value to you may be deferred by us in accordance with
the provisions of Section 4.07.
Subject to the terms of the Plan, and the restrictions on distributions set
forth in Section 2.10, we reserve the right to pay the Annuity Account Value
under this Contract and terminate this Contract. This right may be exercised
only if both (i) you made no Contributions during the last three completed
Contract Years, and the Annuity Account Value is less than $500, or (ii) a
partial withdrawal is made that would result in your Annuity Account Value
falling below $500. We also reserve the right to terminate this Contract if no
Contributions have been made within 120 days of the Contract Date shown on page
3 of this Contract.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount in the Divisions and the Annuity Account Value shall be zero. We will
be released from any and all liability for payments with respect to the
Contributions from which the Annuity Account Value arose.
If this Contract is terminated, surrendered or exchanged prior to your
Retirement Date, any applicable tax charges we have paid may be deducted. If we
have previously deducted charges for applicable taxes from Contributions
pursuant to Section 2.01, we will not again deduct charges for the same taxes on
terminations, unless a change in applicable law has occurred with respect to
your Contract.
SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any applicable restrictions under
the terms of the Plan, and the restrictions on distributions set forth in
Section 2.10, you may elect, by written notice to us, to make a partial
withdrawal from the Divisions. For Plans subject to Title I of ERISA, partial
withdrawals may be subject to the spousal consent rules, if applicable, set
forth in Section 3.06.
Following receipt of your written notice, we will pay the lesser of the Cash
Value, or the amount of partial withdrawal requested to the person entitled to
receive such payment as you designate to us in writing. The amount paid plus any
withdrawal charge applicable pursuant to Section 2.08 will be withdrawn from the
amounts you have in the Divisions. Unless instructed otherwise, the amount
withdrawn (including any withdrawal charge) will be allocated among the
Divisions in proportion to the amounts that you have in such Divisions.
Upon any partial withdrawal payment, we will be released from any and all
liability for payments with respect to the Contributions from which the amounts
so withdrawn arose. Partial withdrawal payments may be deferred by us in
accordance with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300,
or where the request violates the provisions of Sections 2.07 or 3.06. If a
withdrawal made under this Section would result in an Annuity Account Value of
less than $500, we will so advise you and reserve the right to pay the Annuity
Account Value to you and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS.
NO WITHDRAWAL CHARGE: There will be no partial withdrawal charge if (a) the
amount of partial withdrawal requested is not greater than the Free Corridor
Amount defined in Section 2.09 or (b) the Cash Value is equal to the Annuity
Account Value, pursuant to Section 1.05.
WITHDRAWAL CHARGE: If the amount of partial withdrawal requested is greater than
the Free Corridor Amount, we will (i) first withdraw from the Divisions an
amount equal to the Free Corridor Amount, in proportion to the amount you have
in them, and (ii) then withdraw an amount equal to the excess of the amount
requested over the Free Corridor Amount, plus a partial withdrawal charge. Such
partial withdrawal charge will be equal to the lesser of (a) or (b) where:
(a) is an amount equal to
6% during Contract Years 1 through 5
5% during Contract Years 6 through 8
4% during Contract Year 9
3% during Contract Year 10
2% during Contract Year 11
1% during Contract Year 12
O% thereafter
No. 92 TSUB Page 9
of the amount withdrawn in excess of the Free Corridor Amount (including
such charge) pursuant to (ii) of the preceding sentence.
(b) is the excess, if any, of (i) 8% of the total Contributions made on your
behalf during the current Contract Year and the nine preceding Contract
Years over (ii) the cumulative total of any prior partial withdrawal
charges made pursuant to this Section.
However, notwithstanding the above, if you are age 60 or older on the Contract
Date, the withdrawal charges in Contract Year 5 shall not exceed 5% of the
excess of the Annuity Account Value over the Free Corridor Amount.
If withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to your Contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount" means if you
have completed three Contract Years or attained age 59 and 6 months an amount
equal to the excess, if any, of (i) 10% of the sum of the Annuity Account Value
on the Transaction Date over (ii) cumulative prior withdrawals made pursuant to
Section 2.07 in the current Contract Year. If you have not completed three
Contract Years or attained age 59 and 6 months, the Free Corridor Amount is
zero.
SECTION 2.10 RESTRICTIONS ON DISTRIBUTIONS. Notwithstanding anything in this
Contract to the contrary, payments of Cash Value pursuant to the termination of
this Contract under Section 2.06, partial withdrawals under Section 2.07, death
benefits under Section 2.12 or Annuity Benefits under Section 3.03 may be
limited as provided in Section 403(b)(ll) of the Code and in this Section, to
the extent they are attributable to Elective Deferral Contributions made to this
Contract after December 31, 1988 and earnings credited after December 31, 1988
on Elective Deferral Contributions made before and after December 31, 1988
(collectively, "Restricted Amounts").
Distributions of Restricted Amounts may not be made until you attain age 59
years and six months, separate from service, die, or become disabled (within the
meaning of Section 72(m)(7) of the Code). Distributions of Elective Deferral
Contributions made after December 31, 1988-(but not any earnings credited after
December 31, 1988 attributable to Elective Deferral Contributions made before or
after December 31, 1988) may also be made in the case of hardship (within the
meaning of Section 403(b)(l1) of the Code and applicable Treasury Regulations).
If you request payment of Restricted Amounts on the grounds of disability or
hardship you must furnish to us proof of such disability or hardship as may be
required by the Plan, the Code, and applicable Treasury Regulations in a form
satisfactory to us.
SECTION 2.11 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annuity Account Value on that date is less than $25,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts that you have in
the Divisions.
If the Annuity Account Value is less than $25,000, on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03,
or (b) the date of Termination of this Contract pursuant to Section 2.06 or
2.12, we will prorate the Annual Administrative Charge applicable to the
completed portion of the Current Contract Year and withdraw such amount in lieu
of the Annual Administrative Charge described in this Section for the applicable
part of that Contract Year.
If the Annuity Account Value is $25,000 or greater at the end of a Contract
Year, the Annual Administrative Charge is zero.
SECTION 2.12 DEATH BENEFIT. Upon receipt of due proof of your death, we will pay
to the beneficiary designated to receive such payment, pursuant to Section 4.04
of this Contract, the amount of death benefit payable. The amount of the death
benefit is equal to the greater of (i) the Annuity Account Value and (ii) the
minimum death benefit. Such minimum death benefit is the sum of all
Contributions made pursuant to Section 2.01 (before reduction for any applicable
tax charge) less any withdrawals made pursuant to Section 2.07. Any such
withdrawal will reduce the minimum death benefit (as adjusted by any previous
such withdrawal) by an amount which is in the same proportion as the amount that
was withdrawn is to the Annuity Account Value. If, in accordance with the
provisions of Section 2.01, the Cash Value of another Annuity Contract issued by
us, or one of our affiliated or subsidiary Life Insurance Companies, which
provides for a death benefit before retirement is equal to the greater of the
contract Cash Value or alternate amount based on premiums paid or Contributions
made under the Annuity Contract, is transferred to this Contract, such Cash
Value or an alternative amount as of the date of transfer, will be included in
the "sum of all Contributions" in lieu of the amount of Cash Value transferred
for purposes of the death benefit under this Contract.
No. 92 TSUB Page 10
We will pay the death benefit to the beneficiary in the form of an Annuity
Benefit if you have made the election described in the last paragraph of Section
4.04. Also, in accordance with the last paragraph of Section 4.04, if no such
election is in effect at your death, we will pay the death benefit to the
beneficiary in a single sum, unless the beneficiary elects, before we pay the
death benefit, to apply the death benefit to an Annuity Benefit, for Plans
subject to Title I of ERISA.
Distributions pursuant to this Section are subject to the terms of the Plan and
the Spousal Consent Rules set forth in Section 3.06 for Plans subject to Title I
of ERISA.
Upon payment of the death benefit, the amount you have in the Divisions and the
Annuity Account Value shall be zero. We will be released from any and all
liability for payments with respect to the Contributions from which the Annuity
Account Value arose.
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PART III - ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments with respect to a payee are
payable in a specified dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under the terms of this Contract with respect to a payee is the amount provided
with respect to the payee pursuant to Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division of the Separate Account.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of net
investment return referred to in Section 1.26 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.25, not to exceed the maximum rate of 1.75% after any deductions to
provide for any applicable tax charge. These charges include a daily charge for
financial accounting, death benefits, mortality risk, expenses and expense risk,
plus the investment advisory fee charges and direct operating expense charges of
the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under the terms of this Contract with respect to a payee is the
monthly amount provided pursuant to the fifth paragraph of Section 3.04. The
amount of the fourth and each subsequent payment under a Variable Annuity
Benefit will be equal to the number of Annuity Units with respect to such
benefit, multiplied by the Average Annuity Unit Value for the second calendar
month immediately preceding the due date of the payment. The number of Annuity
Units with respect to a benefit is the number determined by dividing the amount
of the first monthly payment under such benefit by the Annuity Unit Value for
the Valuation Period which includes the due date of the first monthly payment.
As described in Section 3.05, we will notify the payee how each Variable Annuity
Benefit is determined.
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. As of your
Retirement Date, provided you are then living, the Annuity Account Value shall
be applied to provide the Normal Form of Annuity Benefit, unless you elect (i)
to receive the Cash Value in a single sum, or (ii) to apply the Annuity Account
Value, or Cash Value, whichever is applicable pursuant to the first paragraph of
Section 3.04, to provide an Annuity Benefit on any other annuity form offered by
us, or one of our affiliated or subsidiary life insurance companies, as elected
by you, or (iii) to take partial withdrawals in amounts and at times as required
by the Code, pursuant to Sections 2.07 and 3.05, subject to our rules then in
effect and any other applicable requirements under the Code.
We will provide notice and election forms to you not more than six months before
your Retirement Date.
If you elect to terminate this Contract, prior to the Retirement Date, pursuant
to Section 2.06, an election may be made to receive an Annuity Benefit in lieu
of the Cash Value, unless restricted by the Plan.
We will have the right to require that you furnish pertinent information to
provide an Annuity Benefit, and we will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary
life insurance companies. If the issuance of this Contract is pursuant to a Plan
subject to Title I of ERISA, the rules set forth in Section 3.06 shall apply to
your election and the commencement of annuity benefits.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If you elect, pursuant to the first or
third paragraph of Section 3.03, to receive an Annuity Benefit in lieu of the
Cash Value, the amount applied to provide the Annuity Benefit will be (i) the
Annuity Account Value if the payments under the annuity form involves life
contingencies, or (ii) the Cash Value if the Annuity Form elected does not
involve life contingencies.
No. 92 TSUB Page 11
The amount applied to provide an Annuity Benefit may be reduced by any
applicable tax charge on annuity considerations, as we determine. If we have
previously deducted any applicable tax charge from Contributions as provided in
Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to your Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your Contract will be governed by our
supplementary contract then in effect.
The amount to be applied to provide an Annuity Benefit will, in addition to any
tax charge reduction, be reduced by an administrative charge. The amount of such
charge will be determined from time to time in accordance with our general
practices applicable on a uniform basis to all contracts of the same type as
this Contract.
After the application of an amount to provide an Annuity Benefit, the amounts
you have in the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under the terms of this
Contract, as indicated, on either the Life Annuity Form or the Joint and
Survivor Life Annuity Form (with 100% of the amount of your payment continued to
your spouse). The amount of income provided under the Fixed Annuity Benefit
payable on the Life Annuity Form and Joint and Survivor Life Annuity Mortality
Form, are based on 3.5% interest and the 1983 Individual Annuity Mortality Table
"a" adjusted to a unisex basis based on a 50-50 split of males and females, at
age zero. The amount of income initially provided under the Variable Annuity
Benefit payable on the Life Annuity Form and the Joint and Survivor Life Annuity
Form are based on a 50-50 split of males and females, at age zero and an Assumed
Base Rate of Net Investment Return of 3.5% or 5%, whichever applies pursuant to
Section 1.26.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us based on 3.5% interest and the 1983 Individual Annuity
Mortality Table "a" adjusted to a unisex basis based on a 50-50 split of males
and females, at age zero, if such annuity form provides for a Fixed Annuity
Benefit, and on the projected 1983 Basic Table "a" adjusted to a unisex basis
based on a 50-50 split of males and females, at age zero and an Assumed Base
Rate of Net Investment Income Return of 3.5% or 5%, whichever applies pursuant
to Section 1.26, if such annuity form provides for a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Distributions attributed to
Contributions of Transferred Funds pursuant to Section 2.01 (where you have
provided to us written evidence of such balance as of December 31, 1986) must
commence no later than age 75. Such distributions will be made in the normal
form of Annuity Benefit, unless you elect to take payments in a single sum or
another form of Annuity Benefit then offered by us.
Your entire interest in this Contract attributable to all other Contributions
made, and earnings credited thereon must be distributed, or begin to be
distributed no later than the first day of April following the calendar year in
which you attain age 70 and 6 months ("Required Beginning Date"). Your entire
interest may be distributed, as you elect, over (a) your life, or the lives of
you and your designated beneficiary, or (b) a period certain not extending
beyond your life expectancy, or the joint and last survivor expectancy of you
and your designated beneficiary. Distributions must be made in periodic payments
at intervals of no longer than one year. In addition, payments must be either
nonincreasing or they may increase only as provided in Q & A F-3 of Section
1.401(a)(9)-1 of the proposed Treasury Regulations, or any successor Regulation
thereto.
All distributions made hereunder shall be made in accordance with the
requirements of Section 403(b)(10) and 401(a)(9) of the Code, including the
incidental death benefit requirements of Section 401(a)(9)(G) of the Code, and
applicable Treasury Regulations, including the minimum distribution incidental
benefit requirement of Section 1.401(a)(9)-2 of the Proposed Treasury
Regulations, or any successor Regulation thereto.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.05, while any distribution shall be subject to such requirements of
the Code and regulations, any distribution shall also be subject to the terms of
this Contract. That is, the forms of distribution shall be those which are made
available by us at the time of your election.
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9 unless
you otherwise elect prior to the time distributions are required to begin, those
life expectancies shall be recalculated annually. Such election shall be
irrevocable and shall apply to all subsequent years. The life expectancy of a
non-spouse beneficiary may not be recalculated. Instead, life expectancy will be
calculated using the attained age of such beneficiary during the calendar year
in which you attain age 70 and 6 months, and payments for subsequent years shall
be calculated based on such life expectancy reduced by one for each calendar
year which has elapsed since the calendar year life expectancy was first
calculated.
If you die after distribution of your interest in this Contract has begun, the
remaining portion of such interest will continue to be distributed at least as
rapidly as under the method of distribution being used prior to your death.
If you die before distribution of your interest begins, distribution of your
entire interest shall be completed no later than December 31 of the calendar
year containing the fifth anniversary of your death, except to the extent that
an election is made to receive death benefit distributions in accordance with
(1) or (2) below:
No. 92 TSUB Page 12
(1) If your entire interest is payable to a designated beneficiary, then your
entire interest may be distributed over the life of, or over a period
certain not greater than the life expectancy of, the designated
beneficiary. Such distributions must commence on or before December 31 of
the calendar year immediately following the calendar year of your death.
(2) If the designated beneficiary is your surviving spouse, the date
distributions are required to begin in accordance with (1) above shall not
be earlier than the later of (A) December 31 of the calendar year
immediately following the calendar year of your death or (B) December 31
of the calendar year in which you would have attained age 70 and 6 months.
For purposes of determining the "period certain" referred to in the immediately
preceding paragraph, life expectancy is computed by use of the expected return
multiples in Tables V and VI of Treasury Regulation Section 1.72-9. For purposes
of distributions beginning after your death, unless otherwise elected by the
surviving spouse by the time distributions are required to begin, life
expectancies shall be recalculated annually. Such election shall be irrevocable
by the surviving spouse and shall apply to all subsequent years. In the case of
any other designated beneficiary, life expectancies shall be calculated using
the attained age of such beneficiary during the calendar year in which
distributions are required to begin pursuant to this Section, and payments for
any subsequent calendar year shall be calculated based on such life expectancy
reduced by one for each calendar year which has elapsed since the calendar year
life expectancy was first calculated.
Distributions under this Section are considered to have begun if distributions
are made because you have reached your Required Beginning Date or if prior to
the Required Beginning Date distributions irrevocably commence to you over a
period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1
of the Proposed Treasury Regulations or any successor Regulation thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under the terms of this Contract was based on information
that is subsequently found to be incorrect, your benefit will not be
invalidated, but an adjustment on the basis of the correct information will be
made in the amount of the benefit payments, or any amount used to provide the
benefit, or any combination thereof. Overpayments by us will be charged against
and underpayments will be added to any payments thereafter falling due under the
terms of this Contract with respect to the payee, affecting as many such
payments as are necessary to correct the overpayment or underpayment. Our
liability, with respect to a payee, is limited to the correct information and
the actual amounts used to provide the benefits then in force with respect to
the payee under this Contract.
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under the terms of this Contract is physically or mentally
incompetent to receive such payment or is a minor, (ii) another person or an
institution is then maintaining or has custody of such payee, and (iii) no
guardian, committee, or other representative of the estate of such payee has
been appointed, we may make the payments (in the case of a minor, at a rate not
exceeding $200 a month) to such other person or institution, and will thereupon
be fully discharged from all liability with respect thereto.
If a variable annuity form made available by us provides for payment for a
period certain, such as 120 or 180 months, and thereafter during the remaining
lifetime of one person, or of at least one of two persons, a payee for payments
thereunder may elect, without the concurrence of any other person, to receive
the commuted value of any remaining payments, provided no person upon whose life
the income depends is surviving.
Pursuant to Section 3.03, upon your election, pursuant to Section 3.03 of an
annuity form providing payments for a period certain, you may designate (with
the right to change such designation) a person or persons to receive any
payments that may become due after the death of the person or persons upon whose
life or lives the income may depend.
The payee may designate (with the right to change such designation and without
the concurrence of any other person) a payee to receive any payments or
installments payable after such payee's death, if the absence of such a
designation would result in a single sum payment to such payee's estate in
accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments. The commuted value of any such remaining payments will be
determined on the basis of compound interest at the rate utilized in the
actuarial rate basis applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
No. 92 TSUB Page 13
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TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based on Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE
JOINT AND SURVIVOR LIFE ANNUITY FORM
100% OF PAYMENT TO CONTINUE TO SPOUSE
(Minimum Monthly Income Per $1,000 OF Annuity Account Value)
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Age 60 61 62 63 64 65 66 67 68 69 70
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60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88
61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96
62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03
63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11
64 4.89 4.94 5.00 5.05 5.10 5.14 5.19
65 5.00 5.06 5.11 5.17 5.22 5.27
66 5.12 5.18 5.24 5.29 5.35
67 5.24 5.31 5.37 5.43
68 5.37 5.44 5.51
69 5.52 5.59
70 5.67
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ANNUITY BENEFIT PAYABLE
ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1,000 of Annuity Account Value)
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VARIABLE ANNUITY BENEFIT PAYABLE ON
THE LIFE ANNUITY FORM IF ASSUMED
BASE RATE OF NET INVESTMENT RETURN IS
Age 3.5% 5.0%
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60 5.27 6.16
61 5.39 6.28
62 5.52 6.41
63 5.66 6.55
64 5.81 6.70
65 5.97 6.86
66 6.15 7.03
67 6.33 7.21
68 6.53 7.41
69 6.74 7.62
70 6.97 7.85
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We will notify the payee, with respect to each payment under a Variable Annuity
Benefit, the number of Annuity Units and the Average Annuity Unit Value used in
determining the amount of each variable payment. Such notice will be mailed with
each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary,
as described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. if this Contract is
issued pursuant to a Plan subject to Title I of ERISA, then the provisions of
this Section shall supersede any contrary provisions in this Contract. If you
are married, your interest in the Contract shall be paid in the Normal Form
joint and survivor annuity, and if you are unmarried, your interest shall be
paid in the Normal Form life annuity, unless you elect otherwise as described in
this Section. If you are married and die before payment of your interest has
commenced, your interest shall be paid to your surviving spouse in the form of a
life annuity, unless at the time of your death there was a contrary election
made pursuant to this Section. The foregoing notwithstanding, your surviving
spouse may elect, before payment is to commence, to have payment made in any
form permitted under the terms of this Contract.
You may elect, at any time within the 90 consecutive day period before the first
day of the first period for which your interest is paid as an annuity or in any
other form, not to have your interest paid in the Normal Form, in which case it
shall be paid in any other form elected under the terms of this Contract. If
such interest is to be paid to your spouse upon your death, you may elect,
during the period beginning on the first day of the plan year of the Plan in
which you attain age 35 (or, if you separate from service prior to that plan
year, beginning on the date of separation) and ending with your death, for a
beneficiary other than your spouse to receive payment of the value of your
interest. In addition, if you will not yet attain age 35 by the end of any
current plan year, you may make a special qualified election to designate a
beneficiary other than your spouse to receive payment of the value of your
interest, which special qualified election shall be effective for the period
beginning on the date of such election and ending on the first day of the plan
year in which you will attain age 35. Amounts payable in accordance with this
Section will be automatically reinstated as of the first day of the plan year in
which you attain age 35 unless a new election designating a beneficiary other
than the spouse is made in accordance with the requirements of this Section.
Any election described in the foregoing paragraph must be consented to by your
spouse in writing before a notary or a representative of the Plan unless you can
prove that there is no spouse or that the spouse cannot be located. Also, if you
have become legally separated from your spouse or have been abandoned (within
the meaning of local law) and have a court order to such effect, spousal consent
is not required unless a qualified domestic relations order provides otherwise.
Your election must designate a specific beneficiary (including any class of
beneficiaries or any contingent beneficiaries) that may not be changed without
further consent of the spouse, unless the
No. 92 TSUB Page 14
spouse's consent expressly permits designation by you without further consent of
the spouse. The spouse's consent under this section shall acknowledge the effect
of the election. In addition, the spouse's consent (or the establishment that
the consent of the spouse may not be obtained) shall only be valid with respect
to such spouse. Your waiver of the Normal Form joint and survivor annuity shall
not be effective unless the election designates a form of benefit payment which
may not be changed without spousal consent (or the spouse expressly permits
designations by you without any further spousal consent). A consent that permits
designations by you without any requirement of further consent by such spouse
must acknowledge that the spouse has the right to limit consent to a specific
beneficiary and a specific form of benefit where applicable, and that the spouse
voluntarily elects to relinquish either or both of such rights. If you make an
election under this Section, you may revoke that election, without spousal
consent, at any time before the first day of the first period for which an
amount is paid as an annuity or in any other form.
The provisions requiring spousal consent in this Section shall also apply with
regard to your election to terminate this Contract or make partial withdrawals
pursuant to Sections 2.06 and 2.07, and with respect to a beneficiary
designation set forth in Section 4.04. A spouse's written consent, witnessed by
a representative of the Plan or a notary public, must be given on a form
acceptable to the Employer and us, within the 90 consecutive day period prior to
any such payment or withdrawal, or beneficiary designation, unless you can show
that you have no spouse or that the spouse cannot be located.
If the Annuity Account Value applied to provide the spousal benefits on the date
payment is to commence is in the aggregate less than $3,500, we may choose to
make payment in a single sum rather than in the form of a Qualified Joint and
Survivor Annuity or Life Annuity as described herein. Upon any payment made
pursuant to this Section, we will be released from any and all liability for
payment with respect to the Contributions made for you.
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PART IV - GENERAL PROVISIONS
SECTION 4.01 CONTRACT. This Contract constitutes the entire Contract between the
parties and the terms of this Contract alone will govern with respect to our
rights and obligations. A copy of the application is incorporated in and made
part of this Contract.
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by our authorized officer. The terms of this
Contract may be changed by amendment or replacement upon agreement between you
and us without the consent of any other person.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of
this Contract without the consent of any other person in order to comply with
applicable laws and regulations. Such right shall include, but not be limited
to, the right to conform the terms of this Contract to reflect changes in the
Code, or applicable Treasury Regulations, or in regulations or published rulings
of the Internal Revenue Service so that this Contract will continue to be an
Annuity.
SECTION 4.03 NONTRANSFERABILITY AND ASSIGNMENTS. Your entire interest under this
Contract is nonforfeitable. No interest of yours (or of a beneficiary) under
this Contract may be transferred to any person other than us upon the surrender
of this Contract. Except as permitted under applicable law, no right or interest
of you or any other payee or beneficiary in this Contract shall be (a)
assignable; (b) subject to any lien; or (c) liable for, or subject to, any
obligation or liability of any person. The preceding sentence shall not apply to
any assignment, transfer or attachment pursuant to a qualified domestic
relations order (as defined in Section 414(p) of the Code).
SECTION 4.04 BENEFICIARY. As of the Contract Date, you are to provide us with an
initial designation of the beneficiary entitled to receive any death benefit
payable pursuant to Section 2.12. You may change such designation from time to
time during your lifetime, and while this Contract is in force. Any such
designation or change must be made by written notice in a form satisfactory to
us. A change will, upon receipt at the Processing Office, take effect as of the
time the written notice was signed, whether or not you are living on the date of
receipt, but without further liability as to any payment or other settlement
made by us before receipt of such change. Beneficiary designations are subject
to the rules of Section 3.06 if the Contract is issued pursuant to a Plan
subject to Title I of ERISA.
Unless otherwise specified in the designation, if you have designated two or
more persons as beneficiary, the beneficiary will be the designated person or
persons who survive you, and if more than one survive, they will share equally.
Any part of a death benefit payable pursuant to Section 2.12 for which there is
no designated beneficiary living at the time of your death, will be payable in a
single sum to your children who survive you, in equal shares, or should none
survive, then to your estate.
No. 92 TSUB Page 15
If you elect in writing, any amount that would otherwise be payable to a
beneficiary in a single sum may be applied to provide an Annuity Benefit, on the
form of annuity previously elected by you, with respect to the beneficiary,
subject to our rules then in effect. If, at your death, there is no election in
effect to apply the single sum death benefit to provide an Annuity Benefit, the
beneficiary may make such an election. Any such election must meet the minimum
distribution requirements under the Code, as described in Section 3.05.
SECTION 4.05 DISQUALIFICATION OF PLAN OR CONTRACT. In the event that the Plan
fails to qualify as a Plan under Section 403(b) of the Code and applicable
Treasury Regulations, we reserve the right, upon receiving notice of such fact,
to transfer the Annuity Account Value under this Contract to another annuity
contract issued by us, an affiliate subsidiary, on your life, or to terminate
this Contract and pay to you the Annuity Account Value less deduction for
applicable taxes, solely at our option.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Employer, we
reserve the right at our sole discretion to limit Contributions under this
Contract.
SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of your Annuity Account Value
(less any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicably because of an emergency, or (3) the Securities and
Exchange Commission, by order, permits us to defer payment in order to protect
persons with interests in the Investment Divisions. We can defer payment of any
portion of your Annuity Account Value in the Guaranteed Interest Division for up
to six months while you are living.
SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year we will furnish
you with a notice showing the following:
(1) the amount you have in the Guaranteed Interest Division,
(2) the total number of Accumulation Units you have in the Stock Division,
Balanced Division, Aggressive Stock Division and Money Market
Division,
(3) the Accumulation Unit Values,
(4) the amount you have in the Stock Division, Balanced Division,
Aggressive Stock Division and Money Market Division,
(5) the Cash Value, and
(6) the amount of death benefit payable with respect to you.
We will also furnish annual calendar year reports concerning the status of the
annuity and any other reports required by the Code or applicable Treasury
Regulations.
After the Retirement Date, we will notify you of the number of Annuity Units and
the Average Annuity Unit Value used in determining the amount of each Variable
Annuity Benefit payment, if any.
SECTION 4.09 AGE. If your age has been misstated, any benefits will be those
which would have been purchased at the correct age. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
No. 92 TSUB Page 16
OWNER: XXXX XXX
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 000
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28, 1992
RETIREMENT DATE: JAN 1, 2020
THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
Processing Office: Individual Annuity Center, P.O. Box 2996, G.P.O New York, New
York 10116
AGREES
o TO ALLOCATE the Contributions made to this Contract, after deduction of any
applicable tax charge, to the Stock Division, Balanced Division, Aggressive
Stock Division and Money Market Division of the Separate Account (referred to
in this Contract as the "Investment Divisions") or to the Guaranteed Interest
Division, in accordance with Sections 2.02, 2.03 and 2.04, as directed by the
Owner, and
o TO APPLY the Annuity Account Value at the Retirement Date to provide you with
an Annuity Benefit or a Cash Value benefit if you are then living, and
o TO PROVIDE the Owner with the other rights and benefits of this Contract.
This is the entire Contract. In this Contract, "we" "our" and "us" mean The
Equitable Life Assurance Society of the United States. "You" and "your" mean
the Annuitant.
TEN DAYS TO EXAMINE CONTRACT - The Owner may cancel this Contract by returning
it to us within ten days after receipt of it. Upon such cancellation, we will
refund any Contribution made to us under this Contract.
/s/ Xxxxx X. Xxxxxx /s/ Xxxxxxx X. Xxxxxxxx
Vice President and Secretary Chairman of the Board
and Chief Executive Officer
THE PORTION OF ANNUITY ACCOUNT VALUE HELD IN THE SEPARATE ACCOUNT MAY INCREASE
OR DECREASE IN VALUE AS DESCRIBED IN THIS CONTRACT.
THE AMOUNT OF THE ANNUITY BENEFIT WILL BE EQUAL TO THE SUM OF ANY FIXED ANNUITY
BENEFIT AND ANY VARIABLE ANNUITY BENEFIT. THE AMOUNT OF ANY VARIABLE ANNUITY
BENEFIT MAY INCREASE OR DECREASE, DEPENDING ON THE INVESTMENT EXPERIENCE OF THE
STOCK DIVISION. SUCH VARIABLE ANNUITY BENEFIT WILL INCREASE IF THE AVERAGE DAILY
RATE OF INVESTMENT RETURN IN THE STOCK DIVISION IS EQUIVALENT TO MORE THAN 6.75%
OR 5.25% ANNUALLY AND WILL DECREASE IF IT IS EQUIVALENT TO LESS THAN 6.75% OR
5.25% ANNUALLY, DEPENDING ON WHETHER THE APPLICABLE ASSUMED BASE RATE OF NET
INVESTMENT RETURN REFERRED TO IN SECTION 1.25 IS 5% OR 3.5%, RESPECTIVELY. THE
DAILY RATE OF INVESTMENT RETURN IS BEFORE DEDUCTION OF CHARGES NOT TO EXCEED THE
MAXIMUM RATE OF 1.75%. THESE CHARGES INCLUDE A DAILY CHARGE FOR FINANCIAL
ACCOUNTING, DEATH BENEFITS, MORTALITY RISK, EXPENSES AND EXPENSE RISK, PLUS THE
INVESTMENT ADVISORY FEE CHARGES AND DIRECT OPERATING EXPENSE CHARGES OF THE
TRUST.
No. 92UTRA
This Contract is issued in consideration of the payment to us of the
Contributions made under the terms of this Contract.
The provisions on the following pages are part of this Contract.
------------------------------------------------------------------------------
TABLE OF CONTENTS
DEFINITIONS PAGE
Section 1.01 - Annuitant.............................4
1.02 - Annuity...............................4
1.03 - Annuity Account Value.................4
1.04 - Annuity benefit.......................4
1.05 - Cash Value............................4
1.06 - Class of Contracts....................4
1.07 - Code..................................4
1.08 - Contract..............................4
1.09 - Contract Date.........................4
1.10 - Contract Year.........................4
1.11 - Contribution..........................4
1.12 - Divisions.............................4
1.13 - Xxxxxxxx Xxxxxxx Xxxxxxx..............5
1.14 - Employer..............................5
1.15 - Guaranteed Interest Rate..............5
1.16 - Joint and Survivor Life
Annuity Form..........................5
1.17 - Life Annuity Form.....................5
1.18 - Normal Form...........................5
1.19 - Owner.................................5
1.20 - Period Certain Annuity................5
1.21 - Plan..................................5
1.22 - Processing Office.....................5
1.23 - Retirement Date.......................5
1.24 - Separate Account......................5
1.25 - Separate Account Definitions..........6
1.26 - Transaction Date......................7
1.27 - Trust.................................7
1.28 - Trustee...............................7
1.29 - Trusteed Plan.........................7
ANNUITY ACCOUNT VALUE
Section 2.01 - Contributions.........................7
2.02 - Separate Account Investment
Divisions.............................8
2.03 - Guaranteed Interest Division..........8
2.04 - Allocation to Divisions...............8
2.05 - Transfers Among Divisions.............8
2.06 - Termination of this Contract..........8
2.07 - Partial Withdrawals...................9
2.08 - Charges for Partial Withdrawals.......9
2.09 - Free Corridor Amount..................9
2.10 - Annual Administrative Charge..........9
2.11 - Death Benefit........................10
ANNUITY BENEFITS
Section 3.01 - Fixed Annuity Benefit................10
3.02 - Variable Annuity Benefit.............10
3.03 - Election and Commencement
of Annuity Benefits..................11
3.04 - Amount of Annuity Benefits...........11
3.05 - Payment of Annuity Benefits..........11
3.06 - Special Annuity and Spousal
Consent Provisions...................14
GENERAL PROVISIONS
Section 4.01 - Contract.............................14
4.02 - Statutory Compliance.................15
4.03 - Assignments and
Nontransferability...................15
4.04 - Beneficiary..........................15
4.05 - Disqualification.....................15
4.06 - Future Contributions.................15
4.07 - Deferment............................15
4.08 - Annual Notice........................15
4.09 - Trustee's Responsibility.............16
4.10 - Age..................................16
No. 92UTRA Page 2
OWNER: XXXX XXX
ANNUITANT: XXXX XXX
CONTRACT NUMBER: 00 000 000
ISSUE DATE: FEB 28, 1992
CONTRACT DATE: FEB 28, 1992
RETIREMENT DATE: JAN 1, 2020
INITIAL GUARANTEED INTEREST RATE: 7.50% TO MAR 31, 1992
MINIMUM GUARANTEED INTEREST RATE: 6.00% TO DEC 31, 1992
3.00% AFTER DEC 31, 1992
BENEFICIARY: XXXX XXX
FORM NUMBER 92UTRA
********************************************************************************
TABLE OF GUARANTEED VALUES
ISSUE AGE 38 MALE $1000 ANNUAL CONTRIBUTION
NUMBER OF YEARS GUARANTEED GUARANTEED PAID-UP MONTHLY
SINCE FIRST YEAR OF CONTRIBUTION CASH VALUE ANNUITY AT AGE 65
-------------------------------- ---------- -----------------
1 983 6.62
2 1,958 16.20
3 2,963 26.67
4 3,998 36.83
5 5,064 46.70
6 6,162 56.28
7 7,349 65.58
8 8,580 74.61
9 9,848 83.38
10 11,154 91.89
11 12,500 100.16
12 13,886 108.18
13 15,313 115.97
14 16,783 123.53
15 18,298 131.18
16 19,857 138.63
17 21,464 145.90
18 23,118 152.80
19 24,853 159.69
20 26,639 166.03
24 (Age 62) 34,697 189.57
27 (Age 65) 41,098 205.49
THE TABLES ILLUSTRATE MINIMUM GUARANTEED VALUES AND ASSUME A HYPOTHETICAL $1,000
CONTRIBUTION MADE ANNUALLY ON THE FIRST OF THE MONTH FOLLOWING THE CONTRACT
DATE. THE GUARANTEED CASH VALUE TABLE REFLECTS AN ANNUAL ADMINISTRATIVE CHARGE
(SEE SECTION 2.10) AND A WITHDRAWAL CHARGE OF UP TO 6% OF THE CONTRIBUTIONS MADE
IN THE CURRENT AND 5 PRIOR CONTRACT YEARS (SEE SECTION 1.05). THE TABLES ASSUME
THAT 100% OF ALL CONTRIBUTIONS AND EARNINGS ARE ALLOCATED TO AND REMAIN IN THE
GUARANTEED INTEREST DIVISION.
YOUR ACTUAL GUARANTEED VALUES MAY DIFFER FROM THOSE SHOWN ABOVE, DEPENDING ON
THE LEVEL AND FREQUENCY OF YOUR CONTRIBUTIONS.
THE GUARANTEED PAID-UP MONTHLY ANNUITY SHOWN ABOVE WILL BE REDUCED BY ANY CHARGE
WE MAKE FOR ANY APPLICABLE TAXES (SEE SECTION 3.04). OTHER FORMS OF ANNUITY
BENEFITS MAY BE AVAILABLE; HOWEVER, ANY ANNUITY BENEFIT CONTRACT ELECTED AS A
SETTLEMENT WILL BE SUBJECT TO A CHARGE (SEE SECTION 3.04).
* ASSUMES FIXED BENEFIT JOINT AND SURVIVOR LIFE ANNUITY (100% CONTINUATION TO
SURVIVOR) WITH JOINT ANNUITANT THE SAME AS THE ANNUITANT.
No. 92UTRA Page 3
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PART I - DEFINITIONS
SECTION 1.01 ANNUITANT. The term "Annuitant" means the individual shown on Page
3 of this Contract.
SECTION 1.02 ANNUITY. The term "Annuity" means an annuity contract purchased in
accordance with the terms of the Plan.
SECTION 1.03 ANNUITY ACCOUNT VALUE. The term "Annuity Account Value" means the
sum of the amounts in the Guaranteed Interest Division and the Investment
Divisions of the Separate Account pursuant to Sections 2.02 and 2.03.
SECTION 1.04 ANNUITY BENEFIT. The term "Annuity Benefit" means a benefit payable
by us pursuant to Section 3.04 of this Contract. Various sections of this
Contract (Sections 1.16, 1.17, 3.01 and 3.02) refer to monthly payments to be
made under an Annuity Benefit. You may wish to have your Annuity Benefit paid at
other intervals, such as quarterly, semi-annually, or annually, instead of
monthly. You may elect this at the time you elect the Annuity Benefit form as
described in Section 3.03; in that event, all references in this Contract to
monthly payments will be deemed to mean payments at the frequency you elect,
subject to our rules at the time of election.
SECTION 1.05 CASH VALUE.
The term "Cash Value" means an amount equal to the greater of (i) or (ii) where:
(i) is the Annuity Account Value less 6% of the Contributions made during the
current and five prior Contract Years, which had not been previously
withdrawn pursuant to Section 2.08.
(ii) is the sum of (a) the Free Corridor Amount as defined in Section 2.09 and
(b) 94% of the Annuity Account Value less the Free Corridor Amount.
However, if the Annuitant is age 60 years or older on the Contract Date and it
is Contract Year 5, item (ii)(b) above will be 95% of the Annuity Account Value
less the Free Corridor Amount.
NO WITHDRAWAL CHARGE: If you have attained the age of 59 years and 6 months, the
term "Cash Value" means an amount equal to the Annuity Account Value for
withdrawals due to retirement or termination of employment. Your retirement or
termination of employment must be verified by the Trustee. Such verification
should be in the form of a statement signed by the Trustee and accompanying the
request for withdrawal. The request for withdrawal must be signed by both you
and the Trustee. The withdrawal charge will be imposed if this verification is
not received at our Processing Office together with the withdrawal request.
SECTION 1.06 CLASS OF CONTRACTS. The term "Class of Contracts" refers to all
Contracts with a Contract Date in the same calendar year.
SECTION 1.07 CODE. The term "Code" means the Internal Revenue Code of 1986, as
amended, or any corresponding provisions of prior or subsequent United States
revenue laws.
SECTION 1.08 CONTRACT. The term "Contract" means this Contract.
SECTION 1.09 CONTRACT DATE. The term "Contract Date" means the date of receipt
by us of both the application for this Contract, properly signed and completed,
and a Contribution.
SECTION 1.10 CONTRACT YEAR. The term "Contract Year" means the twelve month
period beginning on (i) the Contract Date, and (ii) each anniversary thereafter,
unless otherwise agreed to in writing by us.
SECTION 1.11 CONTRIBUTION. The term "Contribution" means a payment made to us
for you with respect to an Annuity purchased for you under the Plan. We are
under no obligation to accept any Contribution less than $20.00.
SECTION 1.12 DIVISIONS. The terms "Division" or "Divisions" mean, singly or
severally as the case may be, the following divisions described in this
contract:
(i) the Guaranteed Interest Division, and
(ii) the Investment Divisions of the Separate Account.
No. 92UTRA Page 4
SECTION 1.13 ELIGIBLE ANNUITY CERTAIN. The term "Eligible Annuity Certain" means
an annuity not involving life contingencies issued by us, which extends beyond
your attainment of age 59 years and 6 months and does not permit any prepayment
of the unpaid principal (that is, no withdrawal or single sum payment prior to
your attainment of age 59 years and 6 months).
SECTION 1.14 EMPLOYER. The term "Employer" means the unincorporated employer
adopting the Plan, or any such employer that assumes in writing the obligations
of the Plan. A sole proprietor is deemed to be his own Employer and a
partnership is deemed to be the Employer of each partner.
SECTION 1.15 GUARANTEED INTEREST RATE. The term "Guaranteed Interest Rate" means
the effective annual rate at which interest accrues on the amount in the
Guaranteed Interest Division. The initial rate to apply is shown on Page 3 of
this Contract. Section 2.03 describes determination of the rate to apply
thereafter.
SECTION 1.16 JOINT AND SURVIVOR LIFE ANNUITY FORM. The term "Joint and Survivor
Life Annuity Form" means an annuity providing monthly payments while either of
two persons upon whose lives such payments depend is living. The monthly amount
to be continued when only one of the persons is living will be equal to a
percentage of the monthly amount that was paid while both were living. This
percentage may be 50% or any higher percentage up to and including 100% , as
elected by the Owner. The payments commence on the date as of which the Joint
and Survivor Life Annuity Form is purchased and terminate with the last payment
due before the death of the survivor.
SECTION 1.17 LIFE ANNUITY FORM. The term "Life Annuity Form" means an annuity
issued by us providing monthly payments during the lifetime of the person upon
whose life such payments depend. The payments commence on the date as of which
the Life Annuity Form is purchased and terminate with the last payment due
before the death of such person.
SECTION 1.18 NORMAL FORM. The term "Normal Form" of an Annuity Benefit under
this Contract means, (i) if you have a living spouse at your Retirement Date,
the Fixed Annuity Benefit payable on the Joint and Survivor Life Annuity Form
with your spouse as the contingent annuitant (with 100% of the monthly payment
continued to your spouse), and (ii) if you do not have a living spouse at your
Retirement Date, the Fixed Annuity Benefit payable on the Life Annuity Form.
SECTION 1.19 OWNER. The Owner of this Contract is as stated on Page 3 of this
Contract. Notwithstanding any provisions in this Contract to the contrary, only
the Owner can exercise all the rights under this Contract while you are living.
The Owner does not need the consent of anyone who has only a conditional or
future interest in this Contract.
While you are living, the Owner of this Contract on your behalf may change the
Owner by written notice satisfactory to us. The change will take effect on the
date the Owner signs the notice, except it will not apply to any payment we make
or other actions we take before we receive the notice.
SECTION 1.20 PERIOD CERTAIN ANNUITY. The term "Period Certain Annuity" means an
annuity not involving life contingencies issued by us which does not permit any
prepayment of the unpaid principal (that is, you cannot elect to receive part of
your payments as a single sum payment with the remainder paid in monthly annuity
payments).
SECTION 1.21 PLAN. The term "Plan" means a defined contribution plan adopted by
the Employer that is intended to meet the requirements for qualification under
Section 401(a) of the Code.
SECTION 1.22 PROCESSING OFFICE. The term "Processing Office" means our
Individual Annuity Center, P.O. Box 2996, G.P.O., New York, New York 10116, or
such other location as we shall designate by advance written notice to the
Owner, the Employer or the Plan's Trustee, as applicable, and to you.
SECTION 1.23 RETIREMENT DATE. The term "Retirement Date" means the date on which
you attain the retirement age as shown on Page 3 of this Contract, pursuant to
the terms of the Plan. Before the Retirement Date the Owner may elect to change
the Retirement Date to another Retirement Date permitted under the Plan, which
may be any date after the filing of the election (other than the 29th, 30th or
31st day of any month). No Retirement Date shall be later than the date you
attain age 70 years and 6 months. Any election for such change must be made in
writing by the Owner and shall not take effect until received by us at our
Processing Office.
SECTION 1.24 SEPARATE ACCOUNT. The term "Separate Account" means our Separate
Account A which is organized as a unit investment trust, a type of investment
company. We have established the Separate Account and it is maintained in
accordance with the laws of New York State. Realized and unrealized gains and
losses from the assets of the Separate Account are credited to or charged
against it without regard to our other income, gains or losses. Assets are put
in the Separate Account to support this Contract and other variable annuity
contracts and certificates. Assets may be put in the Separate Account for other
purposes, but not to support contracts or policies other than variable annuities
and variable life insurance.
No. 92UTRA Page 5
The assets of the Separate Account are our property. The portion of its assets
equal to the reserves and other liabilities with respect to these contracts will
not be chargeable with liabilities arising out of any other business we conduct.
We may transfer assets of an Investment Division in excess of the reserves and
other liabilities with respect to such Investment Division to another Investment
Division or to our General Account.
The Separate Account consists of "Investment Divisions". Each Investment
Division may invest its assets in a separate class (or series) of shares of a
designated Trust where each class (or series) represents a separate portfolio in
the Trust. We reserve the right to change the designated trust or investment
company or to add designated trusts or investment companies. The Investment
Divisions available are the Stock Division, the Money Market Division, the
Balanced Division and the Aggressive Stock Division. The Guaranteed Interest
Division is not part of the Separate Account but rather is an asset of our
General Account.
We will value the assets of each Investment Division on each business day. A
business day is any day on which we are open, the New York Stock Exchange is
open for trading and there is a sufficient degree of trading in the portfolio
securities in which an Investment Division is invested to materially affect the
Accumulation Unit Value.
We may, at our discretion, invest the assets of any Investment Division in any
investment permitted by applicable law. We may rely conclusively on the opinion
of counsel (including attorneys in our employ) as to what investments we are
permitted by law to make.
We reserve the right to:
(i) cause the registration or deregistration of the Separate Account under the
Investment Company Act of 1940, provided that such registration or
deregistration is in conformity with the requirements of applicable law;
(ii) run the Separate Account under the direction of a committee, and to
discharge such committee at any time;
(iii) restrict or eliminate any voting rights as to the Separate Account;
(iv) operate the Separate Account by making direct investments, or in any other
form;
(v) add Investment Divisions (or sub-divisions of Investment Divisions) to, or
remove Investment Divisions (or sub-divisions of Investment Divisions)
from the Separate Account (the term "Investment Division" in this Contract
shall then refer to any other Investment Division in which the assets, of
a Class of Contracts to which this Contract belongs, were placed);
(vi) combine any two or more Investment Divisions (or sub-divisions of
Investment Divisions) of the Separate Account; and
(vii) withdraw from any Investment Division and to allocate to another
Investment Division assets determined by us to be associated with the
Class of Contracts to which this Contract belongs.
If the exercise of these rights results in a material change in the underlying
investments of an Investment Division, the Owner and you will be notified of
such exercise, as required by law.
Assets of the Investment Divisions attributable to this Contract shall be
subject to a daily charge (after any deductions to provide for applicable tax
charges) at a rate not to exceed 1.49% per year for each of the Stock, Money
Market and Balanced Divisions, and 1.34% per year for the Aggressive Stock
Division, for financial accounting, death benefits, mortality risk, expenses and
expense risk. The charge shall be made in accordance with Subsection (c) of the
Net Investment Factor provision in Section 1.25. The relative proportion of
these charges may be modified. This daily charge, plus the investment advisory
fee charges and direct operating expense charges of the Trust, shall not exceed
a total annual rate of 1.75% of the value of the assets of the Investment
Divisions attributable to this Contract.
SECTION 1.25 SEPARATE ACCOUNT DEFINITIONS.
VALUATION PERIOD. Each business day together with any consecutive preceding
nonbusiness days.
NET INVESTMENT FACTOR: For this Contract, the Net Investment Factor for each
Investment Division of the Separate Account for a Valuation Period is (a)
divided by (b) minus (c), where
(a) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the Valuation Period before giving
effect to any amounts allocated to or withdrawn from the Investment
Division for the Valuation Period. For this purpose, we use the share
value reported to us by the Trust.
No. 92UTRA Page 6
(b) is the value of the Investment Division's shares of the corresponding
portfolio of the Trust at the end of the preceding Valuation Period (after
any amounts allocated or withdrawn for that Valuation Period).
(c) is the daily Separate Account charge for the expenses of this Contract
times the number of calendar days in the Valuation Period.
The net asset value of the shares of a trust or investment company held by an
Investment Division shall be the value reported to us by that trust or
investment company.
The value of the assets in the Investment Divisions, referred to above, shall be
taken at their fair market value, or where there is no readily available market,
their fair value, as determined in accordance with generally accepted accounting
practices and applicable laws and regulations.
ACCUMULATION UNIT: An "Accumulation Unit" is a unit which is purchased in an
Investment Division where Contributions are invested and which is used in
determining the amount in an Investment Division.
ACCUMULATION UNIT VALUE: An "Accumulation Unit Value" is the dollar value of
each Accumulation Unit in an Investment Division on a given date.
The Accumulation Unit Value for a Valuation Period is the Accumulation Unit
Value for the immediately preceding Valuation Period multiplied by the Net
Investment Factor for that Investment Division for such Valuation Period.
ANNUITY UNIT: An "Annuity Unit" is a unit used in determining amounts payable
from the Stock Division of the Separate Account under a Variable Annuity Benefit
as defined in Section 3.02.
ANNUITY UNIT VALUE: The "Annuity Unit Value" was fixed at $1.00 on November 1,
1968. On August 27, 1981, the date the first contribution was put into the Stock
Division, the Annuity Unit Value was $1.26 and $1.52 for Contracts with Assumed
Base Rates of Net Investment Return of 5% and 3.5% a year, respectively. The
Annuity Unit Value for any subsequent Valuation Period is the Annuity Unit Value
for the immediately preceding Valuation Period multiplied by the Adjusted Net
Investment Factor for such subsequent Valuation Period. The Adjusted Net
Investment Factor for a Valuation Period is the Net Investment Factor for such
period reduced for each calendar day in such subsequent Valuation Period by the
Net Investment Factor times (i) .00013366, if the Assumed Base Rate of Net
Investment Return is 5%, and (ii) .00009425, if the Assumed Base Rate of Net
Investment Return is 3.5%. The Assumed Base Rate of Net Investment Return shall
be 5%, except in states where the rate is not permitted by law.
AVERAGE ANNUITY UNIT VALUE: The Average Annuity Unit Value for a calendar month
is equal to the average of the Annuity Unit Values for all Valuation Periods
ending in such month.
SECTION 1.26 TRANSACTION DATE. The term "Transaction Date" means the business
day we receive a Contribution or a written contract transaction request
providing the information we need at the Processing Office. In the case of a
transfer request initiated through the use of a touch tone telephone as
described in Section 2.05, the term Transaction Date means the business day the
telephone transaction is received.
SECTION 1.27 TRUST. The term "Trust" means the designated trust or investment
company in which Separate Account assets are invested.
SECTION 1.28 TRUSTEE. The term "Trustee" means the person or persons named as
trustee under a Trusteed Plan and such trustee's successors.
SECTION 1.29 TRUSTEED PLAN. The term "Trusteed Plan" means a plan under which
there is maintained a trust forming a part of the Plan.
--------------------------------------------------------------------------------
PART II - ANNUITY ACCOUNT VALUE
SECTION 2.01 CONTRIBUTIONS. The Employer or the Trustee as applicable is to make
Contributions from time to time on such dates and in such amounts as determined
by the Employer or the Trustee pursuant to the terms of the Plan. Each
Contribution received by us will, before its allocation under this Contract, be
reduced by the amount of any applicable tax charge, as determined by us.
Contributions will be allocated to the Division in accordance with the
instructions received on the application unless later changed.
Pursuant to the terms of the Plan, we will accept rollover contributions and
transfers made on your behalf from a plan qualified under Section 401(a) of the
Code or from a conduit individual retirement arrangement as described in Section
408 of the Code.
No. 92UTRA Page 7
SECTION 2.02 SEPARATE ACCOUNT INVESTMENT DIVISIONS. On any Transaction Date when
an amount is allocated to, or withdrawn or transferred from, an Investment
Division, the Annuity Account Value will be credited or charged, as the case may
be, with the number of Accumulation Units determined by dividing said amount by
the Accumulation Unit Value for the appropriate Investment Division for the
Valuation Period which includes that date. The number of units in an Investment
Division on any date is equal to (i) the sum of any Accumulation Units that have
been allocated pursuant to Section 2.04 minus (ii) the sum of any Accumulation
Units that have been withdrawn pursuant to Section 2.07 or 2.10 or transferred
from the Investment Division pursuant to Section 2.05. The amount in an
Investment Division on any date is equal to the product of (i) the number of
Accumulation Units in the Investment Division on that date, and (ii) the
Accumulation Unit Value for the Investment Division for the Valuation Period
which includes that date.
Participation in the Separate Account under the terms of this Contract
terminates on the earliest of (i) Election and Commencement of Annuity Benefits
pursuant to Section 3.03, (ii) receipt of due proof of your death, or (iii)
Termination of this Contract pursuant to Section 2.06.
SECTION 2.03 GUARANTEED INTEREST DIVISION. Any amount allocated to the
Guaranteed Interest Division becomes part of our general assets, which support
the guarantees of this Contract and other contracts.
The amount in the Guaranteed Interest Division at any time is equal to the sum
of all amounts that have been allocated to the Guaranteed Interest Division
pursuant to Section 2.04 plus the amount of any interest accrued but not
allocated, less the sum of all amounts that have been withdrawn from the
Guaranteed Interest Division pursuant to Section 2.07, 2.10 or 2.11 or
transferred from the Guaranteed Interest Division, pursuant to Section 2.05.
Interest is allocated to the Guaranteed Interest Division on a Transaction Date
pursuant to Section 2.04.
We will credit the amount in the Guaranteed Interest Division with interest at
effective annual rates that we determine. For each Class of Contracts we
determine a yearly guaranteed interest rate that will remain in effect
throughout the next year. We guarantee that this yearly guaranteed interest rate
will never be less than 3%.
Participation in the Guaranteed Interest Division under the terms of this
Contract terminates on the earliest of (i) Election and Commencement of Annuity
Benefits pursuant to Section 3.03, (ii) receipt of due proof of your death, or
(iii) Termination of this Contract pursuant to Section 2.06.
SECTION 2.04 ALLOCATION TO DIVISIONS. Each Contribution made pursuant to Section
2.01 is allocated (after deduction of any applicable tax charge) to one or more
Divisions, at the Owner's sole discretion as specified to us in writing.
Allocation percentages must be in whole numbers and the sum must equal 100. The
allocation is made as of the Transaction Date on which we have received both
such Contribution and such direction. Contributions made to an Investment
Division purchase Accumulation Units in that Investment Division, using the
Accumulation Unit Value next computed after the Transaction Date.
Interest determined at the Guaranteed Interest Rate is allocated to the
Guaranteed Interest Division (i) at the end of each Contract Year, (ii) on the
Transaction Date with respect to each transfer from the Division pursuant to
Section 2.05, (iii) on the Transaction Date with respect to each withdrawal
pursuant to Section 2.07, (iv) at the time of application of amounts in the
Guaranteed Interest Division to provide Annuity Benefits pursuant to Section
3.04, (v) upon Termination of this Contract pursuant to Section 2.06, and (vi)
upon your death pursuant to Section 2.11.
SECTION 2.05 TRANSFERS AMONG DIVISIONS. The Owner, unless the Owner transfers to
you the right to transfer all or part of the amounts in the Divisions under this
Contract, upon written request or through the use of a touch tone telephone, may
transfer all or part of the amount in a Division to one or more of the Divisions
as follows: (1) amounts in the Guaranteed Interest Division, Stock Division,
Balanced Division and Aggressive Stock Division may be transferred among such
Divisions; (2) amounts in the Money Market Division may be transferred to other
Divisions. Written authorization for touch tone telephone initiated transfers is
only required when authorization for telephone transfers is requested. Upon
advance written notice to the Owner, we reserve the right to discontinue the
acceptance of transfer requests through the use of a touch tone telephone. All
transfers will be effective on the Transaction Date and will be subject to our
rules in effect at the time of transfer. With respect to the Investment
Division, the transfer will be made at the Accumulated Unit Value next computed
after the Transaction Date. No transfers are permitted to the Money Market
Division from the other Divisions.
SECTION 2.06 TERMINATION OF THIS CONTRACT. Subject to any restrictions under the
terms of the Plan, including the spousal consent rules set forth in Section
3.06, the Owner may elect, by written notice, to terminate this Contract. We
will determine the Cash Value under this Contract as of the Transaction Date.
If this Contract is terminated, surrendered or exchanged prior to the Retirement
Date, any applicable tax charges we have paid may be deducted. If we have
previously deducted charges for applicable taxes form Contributions pursuant to
Section 2.01, we will not again deduct charges for the same taxes on
terminations, unless a change in applicable law has occurred with respect to
this Contract.
No. 92UTRA Page 8
The payment of such Cash Value may be deferred by us in accordance with the
provisions of Section 4.07.
Subject to the terms of the Plan, we reserve the right to pay the Annuity
Account Value under this Contract and terminate this Contract if (i) no
Contributions are made on your behalf during the last three completed Contract
Years, and the Annuity Account Value is less than $500 and (ii) a partial
withdrawal is made that would result in your Annuity Account Value falling below
$500. We also reserve the right to terminate this Contract if no Contributions
have been made and at least 120 days have elapsed since the Contract Date shown
on Page 3 of this Contract.
Upon payment pursuant to this Section or the fourth paragraph of Section 2.07,
the amount in the Divisions and the Annuity Account Value shall be zero. We will
be released from any and all liability for payments with respect to the
Contributions from which the Annuity Account Value arose.
SECTION 2.07 PARTIAL WITHDRAWALS. Subject to any restrictions under the terms of
the Plan, the Owner may elect, by written notice to us, to make a partial
withdrawal form the Divisions. Partial withdrawals are subject to the spousal
consent rules set forth in Section 3.06.
On the Transaction Date, we will pay the lesser of the Cash Value or the amount
of partial withdrawal requested to the person entitled to such payment as
designated in writing by the Owner. The amount paid plus any withdrawal charge
applicable pursuant to Section 2.08 will be withdrawn from the amounts you have
in the Divisions. Unless instructed otherwise, the amount withdrawn (including
any withdrawal charge) will be allocated among the Divisions in proportion to
the amounts that you have in such Divisions.
Upon any partial withdrawal payment, we will be released from any and all
liability payments with respect to the Contributions from which the amounts so
withdrawn arose. Partial withdrawal payments may be deferred by us in accordance
with the provisions of Section 4.07.
We may decline to accept a request for a partial withdrawal of less than $300.
If a withdrawal made under this Section would result in an Annuity Account Value
of less than $500, we will so advise the Owner and you and reserve the right to
pay the Annuity Account Value to the Owner, and terminate this Contract.
SECTION 2.08 CHARGES FOR PARTIAL WITHDRAWALS. There will be no partial
withdrawal charge if the amount of the partial withdrawal requested is not
greater than the Free Corridor Amount defined in Section 2.09.
However, if the amount of partial withdrawal requested is greater than the Free
Corridor Amount, we will (i) first withdraw from such Divisions an amount equal
to the Free Corridor Amount, and (ii) then withdraw an amount equal to the
excess of the amount requested over the Free Corridor Amount, plus a partial
withdrawal charge. Such partial withdrawal charge will be calculated in the
following manner:
(a) Withdrawals of Contributions made on your behalf during the current and
five prior Contract Years will be subject to a charge of 6% of the amount
withdrawn (including such charge).
(b) Withdrawals of other amounts will not be subject to any withdrawal
charges.
For purposes of determining withdrawal charges described in this Section,
amounts withdrawn up to the Free Corridor Amount will not be considered a
withdrawal of any Contributions. Any excess withdrawals, i.e., those pursuant to
items (ii) above, shall be considered withdrawals of Contributions in the order
received, with the older Contributions first.
With respect to partial withdrawals requested by the Owner, there will be no
partial withdrawal charge if you have completed at least five Contract Years and
have attained the age of 59 years and 6 months.
If withdrawals are made from this Contract prior to the Retirement Date, any
applicable tax charges we have paid with respect to this Contract may be
deducted. If we have previously deducted charges for applicable taxes from
Contributions pursuant to Section 2.01, we will not again deduct charges for the
same taxes on withdrawals, unless a change in applicable law has occurred with
respect to this Contract.
SECTION 2.09 FREE CORRIDOR AMOUNT. The term "Free Corridor Amount", means an
amount equal to the excess, if any, of (i) 10% of the sum of the Annuity Account
Value of the Stock Division, Balanced Division, Aggressive Stock Division, Money
Market Division and the Guaranteed Interest Division on the Transaction Date
over (ii) cumulative prior withdrawals made pursuant to Section 2.07 in the
current Contract Year.
SECTION 2.10 ANNUAL ADMINISTRATIVE CHARGE. As of the last day of each Contract
Year, if the Annual Account Value on that date is less than $10,000, we will
withdraw from the Divisions an Annual Administrative Charge equal to the lesser
of $30 or 2% of the Annuity Account Value including the amount of any
withdrawals pursuant to Section 2.07 during that Contract Year. The charge will
be allocated among the Divisions in proportion to the amounts in the Divisions.
No. 92UTRA Page 9
If the Annuity Account Value is less than $10,000 on (a) the date of the
application of the Annuity Account Value or Cash Value pursuant to Section 3.03
or (b) the date of Termination of this Contract pursuant to Section 2.06 or
2.11, we will prorate the Annual Administrative Charge applicable to the
completed portion of the Current Contract Year and withdraw such amount in lieu
of the full Annual Administrative Charge described in this Section for the
applicable part of that Contract Year.
If the Annuity Account Value is $10,000 or greater at the end of a Contract
Year, the Annual Administrative Charge is zero.
SECTION 2.11 DEATH BENEFIT. If the Owner reports to us, or if we otherwise
ascertain, upon receipt of due proof of your death, and subject to the terms of
the Plan, including the spousal survivor benefit rules set forth in Section 3.06
pay to the beneficiary designated to receive such payment, pursuant to Section
4.04 of this Contract, the amount of death benefit payable.
If the beneficiary under this Contract is the Trustee, the Trustee may, subject
to the terms of the Plan, change the beneficiary within 31 days after we receive
due proof of your death. The change shall be made in the same manner and subject
to the same provisions as apply to a change of beneficiary during your lifetime.
If the Trustee changes the beneficiary of this Contract after your death
according to the terms of the Plan, the Trustee may elect an Annuity Benefit on
any annuity form offered by us, subject to our rules then in effect, for the
benefit of your beneficiary. Your beneficiary may not revoke or change any
election made by the Trustee. If the Trustee does not make an election, your
beneficiary may make such election for your beneficiary's own benefit. Any
election for an Annuity Benefit must meet the minimum distribution requirements
under the Code as described in Section 3.05.
The amount of the death benefit is equal to the greater of (i) the Annuity
Account Value and (ii) the minimum death benefit. Such minimum death benefit is
the sum of all of your Contributions made pursuant to Section 2.01 (before
reduction for any applicable tax charge) less an adjustment for any withdrawals
made pursuant to Section 2.07. Any such withdrawal will reduce the minimum death
benefit (as adjusted by any previous such withdrawal) by an amount which is the
in the same proportion as the amount that was withdrawn is to the Annuity
Account Value.
Upon payment of the death benefit, the amount in the Divisions and the Annuity
Account Value shall be zero. We will be released from any and all liability for
payments with respect to the Contributions from which the Annuity Account Value
arose.
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PART III - ANNUITY BENEFITS
SECTION 3.01 FIXED ANNUITY BENEFIT. The term "Fixed Annuity Benefit" means an
Annuity Benefit under which the monthly payments are payable in a specified
dollar amount.
The amount of each monthly payment under any Fixed Annuity Benefit provided
under the terms of this Contract with respect to a payee is the amount provided
with respect to the payee pursuant to Section 3.03.
SECTION 3.02 VARIABLE ANNUITY BENEFIT. The term "Variable Annuity Benefit" means
an Annuity Benefit under which the dollar amount of the monthly payments with
respect to a payee may increase or decrease depending on the investment
experience of the Stock Division of the Separate Account.
Such Variable Annuity Benefit will increase if the average daily rate of
investment return in the Stock Division is equivalent to more than 6.75% or
5.25% annually and will decrease if it is equivalent to less than 6.75% or 5.25%
annually, depending on whether the applicable assumed base rate of Net
Investment Return referred to in Section 1.25 is 5% or 3.5%, respectively. The
daily rate of investment return is before deduction of charges, as described in
Section 1.24, not to exceed the maximum rate of 1.75% after any deductions to
provide for any applicable tax charges. These charges include a daily charge for
financial accounting, death benefits, mortality risk, expenses and expense risk,
plus the investment advisory fee charges and direct operating expense charges of
the Trust.
The amount of the first, second and third payments under any Variable Annuity
Benefit provided under the terms of this Contract with respect to a payee is the
monthly amount provided with respect to a payee pursuant to the fifth paragraph
of Section 3.04. The amount of the fourth and each subsequent payment under a
Variable Annuity Benefit will be equal to the number of Annuity Units with
respect to such benefit, multiplied by the Average Annuity Unit Value for the
second calendar month immediately preceding the due date of the payment. The
number of Annuity Units with respect to a benefit is the number determined by
dividing the amount of the first monthly payment by the Annuity Unit Value for
the Valuation Period which includes the due date of the first monthly payment.
(As described in Section 3.05, we will notify the payee how each Variable
Annuity Payment is determined.)
No. 92UTRA Page 10
SECTION 3.03 ELECTION AND COMMENCEMENT OF ANNUITY BENEFITS. Subject to the terms
of the Plan including the spousal consent and survivor rules designated in
Section 3.06, as of your Retirement Date, provided you are then living, the
Annuity Account Value shall be applied to provide the Normal Form of Annuity
Benefit, unless the Owner elects (i) to receive the Cash Value in a single sum
or (ii) to apply the Annuity Account Value or Cash Value, whichever is
applicable pursuant to the first paragraph of Section 3.04, to provide an
Annuity Benefit on any other annuity form offered by us, or one of our
affiliated or subsidiary life insurance companies, or (iii) to take partial
withdrawals in amounts and at times as required by the minimum distribution
rules of Section 401(a)(9) of the Code and applicable Treasury Regulations,
pursuant to Sections 2.07 and 3.05, subject to our rules then in effect and any
other applicable requirements under the Code.
We will provide notice and election forms to the Owner not more than six months
before your Retirement Date.
If the Owner elects to terminate this Contract pursuant to Section 2.06, an
election may be made to receive an Annuity Benefit in lieu of the Cash Value.
We will have the right to require the Owner to furnish pertinent information to
provide an Annuity Benefit, and will be fully protected in relying on such
information and need not inquire as to the accuracy or completeness thereof.
The applicable Annuity Benefit will be provided pursuant to Sections 3.04 and
3.05. We may offer annuity forms other than the Life Annuity Form or Joint and
Survivor Life Annuity Form issued by us or one of our affiliated or subsidiary
life insurance companies.
We will make payment of the Annuity Benefit, Partial Withdrawals or Cash Value
to a payee as the Owner designates in writing.
SECTION 3.04 AMOUNT OF ANNUITY BENEFITS. If, pursuant to the first or third
paragraph of Section 3.03, an election is made to have an Annuity Benefit in
lieu of the Cash Value, the amount applied to provide the Annuity Benefit paid
will be (i) the Annuity Account Value if the annuity form elected involves life
contingencies or (ii) the Cash Value if the payments under the annuity form
elected does not involve life contingencies.
The amount applied to provide an Annuity Benefit may be reduced by any
applicable tax charge on annuity considerations, as we determine. If we have
previously deducted any applicable tax charges from Contributions as provided in
Section 2.01, we will not again deduct charges for the same taxes before
application to provide an Annuity Benefit, unless a change in applicable law has
occurred with respect to this Contract. The balance shall purchase the Annuity
Benefit on the basis of either (i) the Table of Guaranteed Annuity Payments
shown below or (ii) our current individual annuity rates for payment of
proceeds, whichever rates would provide a larger benefit with respect to the
payee. Regardless of the basis used, your Contract will be governed by our
supplementary contract then in effect.
The amount to be applied to provide an Annuity Benefit will, in addition to any
tax charge reduction, be reduced by an administrative charge. The amount of such
charge will be determined from time to time in accordance with our general
practices applicable on a uniform basis to all contracts of the same type as
this Contract.
After the application of an amount to provide an Annuity Benefit the amounts in
the Divisions and the Annuity Account Value shall be zero.
The Tables of Guaranteed Annuity Payments set forth the minimum amount of
monthly income that $1,000 of Annuity Value will provide under the terms of this
Contract, as indicated, on either the Life Annuity Form or the Joint and
Survivor Life Annuity Form (with 100% of the amount of your payment continued to
your spouse). The amounts of income provided under the Fixed Annuity Benefit
payable on the Life Annuity Form is based on 3.5% interest and the 1983
Individual Annuity Mortality Table "a" adjusted to a unisex basis based on a
50-50 split of males and females. The amounts of income initially provided under
the Variable Annuity Benefit payable on the Life Annuity Form is based on a
50-50 split of males and females and an Assumed Base Rate of Net Investment
Return of 3.5% or 5%, whichever applies pursuant to Section 1.25.
Amounts required for ages or for annuity forms not shown in the Tables will be
calculated by us on 3.5% interest and the 1983 Individual Annuity Mortality
Table "a" adjusted to a unisex basis based on a 50-50 split of males and females
at age zero if such annuity form provides for a Fixed Annuity Benefit, and on
the projected 1983 Basic Table "a" adjusted to a unisex basis based on a 50-50
split of males and females at age zero and an Assumed Base Rate of Net
Investment Income Return of 5% or 3.5%, whichever applies pursuant to Section
1.25, if such annuity form provides for a Variable Annuity Benefit.
SECTION 3.05 PAYMENT OF ANNUITY BENEFITS. Your entire interest in this Contract
will be distributed or begin to be distributed, no later than the first day of
April following the calendar year in which you attain age 70 years and 6 months
("Required Beginning Date"). Your entire interest may be distributed, as you
elect, over (a) the life, or the lives of you and or your designated
beneficiary, or (b) a period certain not extending beyond your life expectancy,
or the joint and last survivor expectancy of you and your designated
beneficiary. Distributions
No. 92UTRA Page 11
must be made in periodic payments at intervals of no longer than one year. In
addition, payments must be either nonincreasing or they may increase only as
provided in Q&A F-3 of Section 1.401(a)(9)-1 of the proposed Treasury
Regulations, or any successor Regulation thereto.
All distributions made hereunder shall be made in accordance with the
requirements of Section 401(a)(9) of the Code, including the incidental death
benefit requirements of Section 401(a)(9)(G) of the Code, and applicable
Treasury Regulations, including the minimum distribution incidental benefit
requirement of Section 1.401(a)(9)-2 of the Proposed Treasury Regulations, or
any successor Regulation thereto.
Notwithstanding the above paragraphs and the following paragraphs of this
Section 3.05, while any distribution shall be subject to such requirements of
the Code and regulations, any distribution shall also be subject to the terms of
this Contract. This is, the forms of distribution shall be those which are made
available by us at the time of your election.
For purposes of determining the "period certain" referred to in the first
paragraph of this Section, life expectancy is computed by use of the expected
return multiples in Tables V and VI of Treasury Regulation Section 1.72-9.
Unless you otherwise elect prior to the time distributions are required to
begin, those life expectancies shall be recalculated annually. Such election
shall be irrevocable and shall apply to all subsequent years. The life
expectancy of a non-spouse beneficiary may not be recalculated. Instead, life
expectancy will be calculated using the attained age of such beneficiary during
the calendar year in which you attain age 70 years and 6 months, and payments
for subsequent years shall be calculated based on such life expectancy reduced
by one for each calendar year which has elapsed since the calendar year life
expectancy was first calculated.
If you die after distribution of your interest described in this Contract has
begun, the remaining portion of such interest will continue to be distributed at
least as rapidly as under the method of distribution being used prior to your
death.
If you die before distribution of your interest begins, distribution of your
entire interest shall be completed no later than December 31 of the calendar
year containing the fifth anniversary of your death, except to the extent that
an election is made to receive death benefit distributions in accordance with
(1) or (2) below:
(1) If your interest is payable to a designated beneficiary, then your entire
interest may be distributed over the life of, or over a period certain not
greater than the life expectancy of, the designated beneficiary. Such
distributions must commence on or before December 31 of the calendar year
immediately following the calendar year of your death.
(2) If the designated beneficiary is your surviving spouse, the date
distributions that are required to begin in accordance with (1) above shall
not be earlier than the later of (A) December 31 of the calendar year
immediately following the calendar year of your death or (B) December 31 of
the calendar year in which you would have attained age 70 years and 6
months.
For purposes of determining the "period certain" referred to in the
immediately preceding paragraph, life expectancy is computed by use of the
expected return multiples in Tables V and VI of Treasury Regulation Section
1.72-9. For purposes of distributions beginning after your death, unless
otherwise elected by the surviving spouse by the time distributions are
required to begin, life expectancies shall be recalculated annually. Such
election shall be irrevocable by the surviving spouse and shall apply to
all subsequent years. In the case of any other designated beneficiary, life
expectancies shall be calculated using the attained age of such beneficiary
during the calendar year in which distributions are required to begin
pursuant to this Section, and payments for any subsequent calendar year
shall be calculated based on such life expectancy reduced by one for each
calendar year which has elapsed since the calendar year life expectancy was
first calculated.
Distributions under this Section are considered to have begun if distributions
are made because you have reached your Required Beginning Date or if prior to
the Required Beginning Date distributions irrevocably commence to you over a
period permitted and in an annuity form acceptable under Section 1.401(a)(9)-1
of the Proposed Treasury Regulations or any successor Regulation thereto.
Evidence of each payee's survival must be furnished to us either by personal
endorsement of the check drawn for payment or by other means satisfactory to us.
If a benefit payment under the terms of this Contract was based on information
that is subsequently found to be incorrect, such benefit will not be
invalidated, but an adjustment on the basis of the correct information will be
made in the amount of the benefit payments, or any amount used to provide the
benefit, or any combination thereof. Overpayments by us will be charged against
and underpayments will be added to any payment thereafter falling due under the
terms of this Contract with respect to the payee, affecting as many such
payments as are necessary to correct the overpayment or underpayment. Our
liability, with respect to a payee, is limited to the correct information and
the actual amounts used to provide the benefits then in force with respect to
the payee under this Contract.
No. 92UTRA Page 12
If we receive evidence satisfactory to us that (i) a payee entitled to receive
any payment under the terms of this Contract is physically or mentally
incompetent to receive such payment or is a minor, (ii) another person or an
institution is then maintaining or has custody of such payee, and (iii) no
guardian, committee or other representative of the estate of such payee has been
appointed, we may, unless the Plan provides to the contrary, make the payments
(in the case of a minor, at a rate not exceeding $200 a month) to such other
person or institution, and will thereupon be fully discharged from all liability
with respect thereto.
If a variable annuity form made available by us provides for a period certain,
such as 120 or 180 months, and thereafter during the remaining lifetime of one
person, or of at least one of two persons, a payee for payments thereunder may
elect, without the concurrence of any other person, to receive the commuted
value of any remaining payments, provided no person upon whose life the income
depends is surviving.
Pursuant to Section 3.03, upon election by the Owner, on your behalf and if
applicable, your spouse, of an annuity form providing payments for a period
certain, such Owner may designate (with the right to change such designation, in
accordance with the terms of the Plan) a payee to receive any payments that may
become due after the death of the person or persons upon whose life or lives the
income may depend.
The payee may designate (with the right to change such designation and without
the concurrence of any other person, unless the Plan provides to the contrary) a
person or persons to receive any payments or installments payable after such
payee's death, if the absence of such a designation would result in a single sum
payment to such payee's estate in accordance with the following paragraph.
If at the death of any payee there is no designated person living entitled to
receive any remaining payments or installments, we will pay in a single sum to
such payee's estate the commuted value of any remaining payments or
installments.
The commuted value of any such remaining payments will be determined on the
basis of compound interest at the rate utilized in the actuarial rate basis
applicable in determining the annuity amount.
If the amount to be applied hereunder is less than $2,000, or would result in an
initial payment of less than $20, we may pay the amount to the payee in a single
sum instead of applying it under the annuity form elected pursuant to Section
3.03.
Payments under annuity forms with life contingencies terminate with the last
payment due before the death of the person or persons upon whose life the income
depends or the end of the certain period, whichever is later.
We will require satisfactory evidence of the age of any person upon whose life
an annuity form depends.
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TABLES OF GUARANTEED ANNUITY PAYMENTS
(Based On Age Nearest Birthday on Due Date of First Payment)
FIXED ANNUITY BENEFIT PAYABLE ON THE JOINT
AND SURVIVOR LIFE ANNUITY FORM
100% OF PAYMENT AMOUNT TO CONTINUE TO SPOUSE
(Minimum Monthly Income per $1,000 of Annuity Account Value)
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Age 60 61 62 63 64 65 66 67 68 69 70
-----------------------------------------------------------------------------------------------------------------------
60 4.52 4.56 4.60 4.64 4.68 4.71 4.75 4.79 4.82 4.85 4.88
61 4.60 4.65 4.69 4.73 4.77 4.81 4.85 4.89 4.92 4.96
62 4.69 4.74 4.78 4.83 4.87 4.92 4.96 5.00 5.03
63 4.79 4.84 4.89 4.93 4.98 5.03 5.07 5.11
64 4.89 4.94 5.00 5.05 5.10 5.14 5.19
65 5.00 5.06 5.11 5.17 5.22 5.27
66 5.12 5.18 5.24 5.29 5.35
67 5.24 5.31 5.37 5.43
68 5.37 5.44 5.51
69 5.52 5.59
70 5.67
ANNUITY BENEFIT PAYABLE
ON THE LIFE ANNUITY FORM
(Minimum Monthly Income per $1,000 of Annuity Account Value)
---------------------------------------------
VARIABLE ANNUITY BENEFIT PAYABLE
IF ASSUMED BASE
RATE OF NET INVESTMENT RETURN IS
AGE 3.5% 5.0%
---------------------------------------------
60 5.27 6.16
61 5.39 6.28
62 5.52 6.41
63 5.66 6.55
64 5.81 6.70
65 5.97 6.86
66 6.15 7.03
67 6.33 7.21
68 6.53 7.41
69 6.74 7.62
70 6.97 7.85
No. 92UTRA Page 13
We will, with respect to each payment under a Variable Annuity Benefit, notify
the payee of the number of Annuity Unites and the Average Annuity Unit Value
used in determining the amount of each variable payment. Such notice will be
mailed with each payment.
Any election, change, revocation or designation shall be made, and will take
effect on the Transaction Date, in the same manner as a change of beneficiary,
as described in Section 4.04.
If a commutation right under an Annuity Benefit is exercised, we may defer
payment in accordance with Section 4.07.
SECTION 3.06 SPECIAL ANNUITY AND SPOUSAL CONSENT PROVISIONS. If you are married,
your interest in this Contract shall be paid in the Normal Form joint and
survivor annuity, and if you are unmarried, your interest shall be paid in the
Normal Form life annuity, unless you elect otherwise as described in this
Section. If you are married and die before payment of your interest has
commenced, your interest shall be paid to your surviving spouse in the form of a
life annuity, unless at the time of your death there was a contrary election
made pursuant to this Section. The foregoing notwithstanding, your surviving
spouse may elect, before payment is to commence, to have payment made in any
form permitted under the terms of this Contract.
You may elect, at any time within the 90 consecutive day period before the first
day of the first period for which your interest is paid as an annuity or in any
other form, not to have your interest paid in the Normal Form, in which case it
shall be paid in any other form elected under the terms of this Contract. If
such interest is to be paid to your spouse upon your death, you may elect,
during the period beginning on the first day of the plan year of the Plan in
which you attain age 35 (or, if you separate from service prior to that plan
year, beginning on the date of separation) and ending with your death, for a
beneficiary other than your spouse to receive payment of the value of your
interest. In addition, if you will not yet attain age 35 by the end of any
current plan year, you may make a special qualified election to designate a
beneficiary other than your spouse to receive payment of the value of your
interest. Such special qualified election shall be effective for the period
beginning on the date of such election and ending on the first day of the plan
year in which you attain age 35. Amounts payable in accordance with this Section
will be automatically reinstated as of the first day of the plan year in which
you attain age 35 unless a new election designating a beneficiary other than the
spouse is made in accordance with the requirements of this Section.
Any election described in the foregoing paragraph must be consented to by your
spouse in writing before a notary public or a representative of the Plan, unless
you can prove that there is no spouse or that the spouse cannot be located.
Also, if you have become legally separated from your spouse or have been
abandoned (within the meaning of the local law) and have a court order to such
effect, spousal consent is not required unless a qualified domestic relations
order provides otherwise. Your election must designate a specific beneficiary
(including any class of beneficiaries or any contingent beneficiaries) that may
not be changed without further consent of the spouse, unless the spouse's
consent expressly permits designation by you without further consent of the
spouse. The spouse's consent under this Section shall acknowledge the effect of
the election. In addition, the spouse's consent (or the establishment that the
consent of the spouse may not be obtained) shall only be valid with respect to
such spouse. Your waiver of the Normal Form joint and survivor annuity shall not
be effective unless the election designates a form of benefit payment which may
not be changed without spousal consent (or the spouse expressly permits
designations by you without any further spousal consent). A consent that permits
designations by you without any requirement of further consent by such spouse
must acknowledge that the spouse has the right to limit consent to a specific
beneficiary, and a specific form of benefit where applicable, and that the
spouse voluntarily elects to relinquish either or both of such rights. If you
make an election under this Section you may revoke that election, without
spousal consent, at any time before the first day of the first period for which
an amount is paid as an annuity or in any other form.
The provision requiring spousal consent in this Section shall also apply with
regard to your election to terminate this Contract or make partial withdrawals
pursuant to Sections 2.06 and 2.07 and with respect to a beneficiary designation
set forth in Section 4.04.
If the Annuity Account Value applied to provide the spousal benefits on the date
payment is to commence is in the aggregate less than $3,500, we may choose to
make payment in a single sum rather than in the form of a Qualified Joint and
Survivor Annuity or Life Annuity as described herein. Upon any payment made
pursuant to this Section, we will be released from any and all liability for
payment with respect to the Contributions made for you.
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PART IV - GENERAL PROVISIONS
Section 4.01 CONTRACT. This Contract constitutes the entire Contract between the
parties and the terms of this Contract alone will govern with respect to our
rights and obligations. A copy of the application is incorporated in and made a
part of this Contract.
No. 92UTRA Page 14
This Contract may not be modified, nor may any of our rights or requirements be
waived, except in writing and by our authorized officer. The terms of this
Contract may be changed by amendment or replacement upon agreement between the
Owner and us without the consent of any other person provided that such change
does not reduce any Annuity Benefit.
SECTION 4.02 STATUTORY COMPLIANCE. We reserve the right to amend the terms of
this Contract without the consent of any other person in order to comply with
applicable laws and regulations. Such right shall include, but not be limited
to, the right to conform this Contract to reflect changes in the Code,
applicable Treasury Regulations, or regulations or published rulings of the
Internal Revenue Service so that this Contract will continue to be an Annuity
under a qualified plan.
SECTION 4.03 ASSIGNMENTS AND NONTRANSFERABILITY. No interest of yours or a
beneficiary under this Contract may be transferred to any person other than us
upon the surrender of this Contract. Except as permitted under Section
401(a)(13) of the Code, no right or interest of you or any other payee or
beneficiary in this Contract shall be (a) assignable; (b) subject to any lien;
or (c) liable for, or subject to, any obligation or liability of any person. The
preceding sentence shall not apply to any assignment, transfer or attachment
pursuant to a qualified domestic relations order, as defined in Section 414(p)
of the Code.
SECTION 4.04 BENEFICIARY. The Owner, as of the Contract Date, is to provide us
with an initial designation of your beneficiary entitled to receive any death
benefit payable with respect to you pursuant to Section 2.11. Subject to the
plan and the Spousal Consent and Survivor rules of Section 3.06, such
designation may be changed from time to time during your lifetime and while this
Contract is in force. If the Beneficiary is the Trustee, the Trustee will have
the right within 31 days of the day we receive due proof of your death and
pursuant to the provisions of the Plan, to change your beneficiary entitled to
receive the death benefits.
If the Trustee is not the beneficiary, the beneficiary will be your spouse as
provided in Section 3.06 of this Contract.
SECTION 4.05 DISQUALIFICATION. In the event that the Plan fails to qualify as a
Plan under Section 401(a) of the Code and applicable Treasury Regulations, we
reserve the right, upon receiving notice of such fact, to transfer the Annuity
Account Value under this Contract to another annuity contract issued by us on
your life, or one of our affiliated or subsidiary life insurance companies, or
to terminate this Contract and pay to the Owner the Annuity Account Value less
deduction for applicable taxes, solely at our option.
In the event that this Contract fails to qualify as an Xxxxxxx as described in
Section 1.02, we will have the right, upon receiving notice of such fact before
your Retirement Date, to terminate this Contract and pay at the direction of the
Owner the Annuity Account Value less a deduction for the appropriate part
attributable to the Owner of any Federal income tax payable which would not have
been payable if you had an Annuity.
SECTION 4.06 FUTURE CONTRIBUTIONS. Upon written notice to the Owner, we reserve
the right at our sole discretion to limit contributions to this Contract.
SECTION 4.07 DEFERMENT. Application of proceeds to a variable annuity, payment
of a death benefit and payment of any portion of your Annuity Account Value
(less any applicable withdrawal charge) will be made within seven days after the
Transaction Date. Payments or applications of proceeds from the Investment
Divisions can be deferred for any period during which (1) the New York Stock
Exchange has been closed or trading on it is restricted, (2) sales of securities
or determination of the fair value of an Investment Division's assets is not
reasonably practicable because of an emergency, or (3) the Securities Exchange
Commission, by order, permits us to defer payments in order to protect persons
with interests in the Investment Divisions. We can defer payments of any portion
of your Annuity Account Value in the Guaranteed Interest Division for up to six
months while you are living.
SECTION 4.08 ANNUAL NOTICE. At the end of each Contract Year, we will furnish
the Owner and you with a notice showing the following:
(1) The amount in the Guaranteed Interest Division,
(2) the total number of Accumulation Units in the Stock Division, Balanced
Division, Aggressive Stock Division and Money Market Division,
(3) the Accumulated Unit Values,
(4) the amount in the Stock Division, Balanced Division, Aggressive Stock
Division and Money Market Division,
(5) the Cash Value and
(6) the amount of the death benefit.
No. 92UTRA Page 15
We will also furnish any other reports required by the Code or applicable
Treasury Regulations.
After your Retirement Date, we will notify you of the number of Annuity Units
and the Average Annuity Unit Value used in determining the amount of each
Variable Annuity Benefit payment, if any.
SECTION 4.09 TRUSTEE'S RESPONSIBILITY. The Trustee shall hold this Contract on
your behalf and your beneficiaries as an asset of the Trust, unless this
Contract is distributed to you pursuant to the terms of the Plan. The Trustee
shall be responsible for transferring all payments made under this Contract to
you and your beneficiaries in accordance with the terms of the Plan and the
applicable provisions of the Code.
We shall make no payment hereunder without written instructions from the
Trustee, and we shall be fully discharged of any liability therefor, to the
extent such payments are made to and at the direction of the Trustee.
SECTION 4.10 AGE. If your age has been misstated, any benefits will be those
which would have been purchased at the correct age. Any overpayments or
underpayments made by us will be charged or credited with interest at the rate
of 6% per year, and such interest will be deducted from or added to benefits
falling due thereafter.
No. 92UTRA Page 16
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APPLICATION TO THE EQUITABLE LIFE ASSURANCE SOCIETY OF THE UNITED STATES
PROCESSING OFFICE: INDIVIDUAL ANNUITY CENTER, P.O. BOX 2996,
NEW YORK, NEW YORK 10116-2996
QUALIFIED VARIABLE ANNUITY CONTRACT APPLICATION FOR:
EQUITABLE'S INDIVIDUAL QUALIFIED DEFERRED VARIABLE ANNUITY
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TYPE OF PURCHASE (Complete One Plan Only)
A. |_| TSA PUBLIC SCHOOL (GV-PS-I)
B. |_| TSA 501(C)(3) ORGANIZATION (GV-501-I)
C. |_| TSA University (GV-PS-U-I)
D. |_| IRA Individual (Including IRA to IRA transfers) (XX-XXX 4971)
E. |_| IRA Unit Billed (Including IRA to IRA transfers) (XX-XXX 4971)
F. |_| IRA QUALIFIED PLAN ROLLOVER-- (QP IRA) (Distribution from a Qualified
Plan) (XX-XXX 4971-71)
G. |_| EDC (Public Employee Deferred Compensation) (GV-EDC 4991)
H. |_| EDC (Tax Exempt Organization) (GV-EDC 4991-SU-080)
I. |X| SEP (Simplified Employee Pension) (GV-SEP 4981)
J. |_| SARSEP (Salary Reduction SEP) _________________________________________
K. |_| CORPORATE TRUSTEED (GV-CORP 4941-41)
L. |_| XXXXX/HR-10 TRUSTEE (GV HR-10 4911-11)
(trustee owned)
M. |_| XXXXX/HR-10 (GV-HR-10 4911)
(not trustee owned) (issued to existing units only)
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DO NOT COMPLETE THIS SECTION IF 1.D OR 1.F CHECKED ABOVE
2. EMPLOYER/PLAN NAME
|A|B|C|_|C|O|M|P|A|N|Y|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
3. |_| EXISTING UNIT NO. |_|_|_|_|_|_|-|_|_|_|
|x| NEW UNIT |0|0|0|1|2|3|-|4|5|6|
(FOR NEW UNIT BILLED IRA, EDC, TSA, SEP, SARSEP, OR TRUSTEED PLANS. FORM
983-135B IS REQUIRED)
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4. PROPOSED ANNUITANT Print name to appear on Contract.
|J|O|H|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|D|O|E|_|_|_|_|_|
FIRST MIDDLE INITIAL LAST
A. |X| MR. |_| MRS. |_| MS. |_| OTHER ____
B. Date of Birth: Year 1954 Month JANUARY Day 27
---- ------- --
C. Age at Nearest Birthday: 38 D. |X| Male |_| Female
----
X. Xxxxxxxxx's Mailing Address: F. State of Residence: N.J.
----
No., St. |1|7|_|E|L|M|_|S|T|R|E|E|T|_|_|_|_|_|_|_|_|_|_|_|_|
City |A|N|Y|T|O|W|N|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|_|
State |U|S| Zip Code |0|2|0|0|0|-|0|0|0|1|
G. Telephone Number (101) 222 - 3456 |X| Home |_| Work
H. Social Security No. (Required): |1|2|3|-|4|5|-|6|7|8|9|
I. Are you associated with or employed by a member of National
Association of Securities Dealers, Inc.(NASD)? |_| Yes |X| No
5. OWNER (Print Name) -- If Trusteed or EDC Plan Print Name of Owner, for all
other Markets Print Name of Annuitant.
XXXX XXX
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a. Title ____________________________________________________________________
6. RETIREMENT AGE 65
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7. BENEFICIARY -- Include FULL NAME and RELATIONSHIP to Annuitant. (For Death
Benefit upon Xxxxxxxxx's death before Retirement Date.) (BENEFICIARY MUST
BE THE OWNER FOR EDC PURCHASES AND FOR MOST TRUSTEED PLANS.)
XXXX XXX - WIFE
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8. CONTRIBUTION ALLOCATION
Guaranteed Interest Division 20%
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Stock Division 20%
-----
Money Market Division 20%
-----
Balanced Division 20%
-----
Aggressive Stock Division 20%
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(PERCENTAGES IN WHOLE NUMBERS) Total 100%
9. CONTRIBUTIONS (NOT REQUIRED FOR 1.F)
A. Reminder Notice (Billing) Required |_| Yes |X| No
IF YES, COMPLETE B-C-D-E
B. REMINDER DATE Required for Individual IRA or otherwise must agree
with existing unit or attached 983-135B. MONTH _________ DAY __________
C. REMINDER FREQUENCY
|_| Annual |_| Semi-Annual
|_| Quarterly |_| Monthly
Available for TSA, EDC, SARSEP AND CORPORATE TRUSTEED AND UNIT BILLED IRA
ONLY:
|_| Semi-Monthly |_| Bi-Weekly
D. REMINDER AMOUNT $_________________________________
E. BILLING MONTHS TO BE EXCLUDED - TSA ONLY
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10.EXPECTED FIRST CONTRACT YEAR
Contribution. $1000
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IF AN ADVANCED BILLING AND/OR CONTRACT DATE ARE REQUESTED, COMPLETE #9B
AND #12.
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(FOR PROCESSING OFFICE USE)
Unit Name ___________________________ Reminder Date ___________________________
Cert. or App# _______________________ Amendment Required_______________________
EDC Emp. Add. _______________________ Emp. Fed. ID# ___________________________
Frequency ___________________________ Contract Date ___________________________
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Receipt Date Batch # Inquiry # Processor
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180-1000
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10. Did you receive the Separate Account Prospectus? |X| Yes |_| No
Date shown on Prospectus January 1, 1992
----------------------------------------------------
Date of any supplement to Prospectus _______________________________________
11. Items (a) through (f) are to be answered by the annuitant. We are
required by the NASD to ask these questions.
(a) Name of Employer: ABC Company
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(b) Address of Employer:
10 Main Street
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Anytown, NJ
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(c) Occupation Sales
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(d) Assuming the contract applied for will be issued, will any existing
insurance or annuity be replaced or changed (or has it been)?
| | Yes |X| No
(e) Estimated Family Annual Income $100,000
----------------------------------------
(f) Estimated Net Worth $250,000
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(g) Investment Objective: |_| Income |X| Income & Growth
|_| Aggressive Growth |_| Growth |_| Safety of Principal
12. SPECIAL INSTRUCTIONS
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13. Amount paid with this form: $1000
(If a check is submitted with this request, no advanced Contract Date is
permitted.) BACKDATING IS NOT PERMITTED.
NOTE: Xxxxxx paid will be credited upon receipt at Equitable's Processing
Office, subject to return if the certificate is not issued. The Contract Date
will be the date of receipt by Equitable of this application, properly signed
and completed, and Contribution at Equitable's Processing Office.
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AGREEMENT
All information and statements furnished in this application are true and
complete to the best of my knowledge and belief. I understand and acknowledge
that no Agent has the authority to make or modify any contract on Equitable's
behalf, or to waive or alter any of Equitable's rights and regulations.
IT IS UNDERSTOOD THAT THE ANNUITY ACCOUNT VALUE ATTRIBUTABLE TO ALLOCATIONS TO
THE INVESTMENT DIVISIONS OF THE SEPARATE ACCOUNT AND VARIABLE ANNUITY BENEFIT
PAYMENTS MAY INCREASE OR DECREASE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT.
UNDER THE PENALTIES OF PERJURY I (WE) CERTIFY THAT THE SOCIAL SECURITY NUMBER(S)
OR TAX IDENTIFICATION NUMBER(S) PROVIDED ON THIS FORM IS (ARE) TRUE, CORRECT AND
COMPLETE.
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LAWS IN YOUR STATE MAY MAKE IT A CRIME TO FILL OUT AN INSURANCE OR ANNUITY
APPLICATION WITH INFORMATION YOU KNOW IS FALSE OR TO LEAVE OUT MATERIAL FACTS.
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X__________________________________ Date_______ City __________ State __________
Signature of Annuitant
X__________________________________ Date_______ City __________ State __________
Signature of Authorized Individual (REQUIRED FOR EDC AND
TRUSTEED) OR OWNER
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AGENT'S SECTION
Will any existing insurance or annuity be replaced or changed (or has it been),
assuming the Contract will be issued? | | Yes | | No
|_| I (we) certify that a prospectus for the Contract has been given to the
proposed Annuitant and that no written sales materials other than those approved
by Equitable have been used.
EQUI-VEST issues must adequately reflect the commission interest of all Agents
on previous contracts.
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Print Agent's Name(s) Initial of Agent Agent Agency District Agent's
(Service Agent first) Last Name Number % Code Manager Code Signature
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FOR AGENCY COMPLIANCE FILE: INITIALS OF AGENCY EQS___ Date ___ District EQS ___
Date ____
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(FOR ASU USE)
ASU Code and App. No. __________________________________________________________
ASU Rec'd. _____________________________________________________________________
Date to Proc. Off. ________________________________________________ Campaign |_|
Agent(s) shown above is Equity Qualified and is licensed in the state where the
request is signed. Above Agent information verified by XXX (Registered Rep)
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Application reviewed by ________________________________________________________
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180-1000
