PAGE 1
Deferred Annuity Contract
This is a deferred annuity contract. It is a legal contract
between you, as the owner, and us, American Enterprise Life
Insurance Company, a Stock Company, Indianapolis, Indiana. PLEASE
READ YOUR CONTRACT CAREFULLY.
If the annuitant is living on the Retirement Date, we will begin to pay you
monthly annuity payments. Any payments made by us are subject to the terms of
this contract. The owner and beneficiary are as named in the application unless
they are changed as provided for in this contract.
We issue this contract in consideration of your application and the payment of
the purchase payments.
Signed for and issued by American Enterprise Life Insurance Company in
Indianapolis, Indiana, as of the contract date.
ACCUMULATION VALUES, WHEN BASED ON THE INVESTMENT RESULTS OF THE
SEPARATE ACCOUNTS, ARE VARIABLE AND NOT GUARANTEED AS TO FIXED
DOLLAR AMOUNT. SEE PAGE 11 FOR VARIABLE PROVISIONS.
RIGHT TO CANCEL. you may cancel this contract by delivering or mailing a written
notice or sending a telegram to us or our agent before midnight of the 10th day
after you receive the contract. If you give us notice and return the contract by
mail, the notice and returned contract must be postmarked, properly addressed
and postage prepaid. Our address is American Enterprise Life Insurance Company,
X.X. Xxx 000, Xxxxxxxxxxx, XX 00000. Within 10 days of receiving your notice and
this contract, we will return an amount equal to the sum of: (1) the contract
value; and (2) any premium tax charges paid. This contract will then be
considered void from its start.
Secretary
Xxxxxxx X Xxxxxxxxxx
President
Xxxxxxx Xxxxxxxx
o Flexible Purchase Payments
o Optional Fixed Dollar or Variable Accumulation Values and
Annuity Payments
o Annuity Payments to Begin on the Retirement Date
o This Contract is Nonparticipating - Dividends Are Not Payable
37220
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GUIDE TO CONTRACT PROVISIONS
Definitions Important words and xxxxxxxx.Xxxx 2
General Provisions Entire contract; Annuity tax
qualification; Contract
modification; Incontestability;
Benefits based on incorrect data;
State laws; Reports to owner;
Evidence of survival; Protection
of proceeds; Payments by us;
Voting rights................Page 4
Ownership and Beneficiary Owner rights; Change of ownership;
Beneficiary; Change of beneficiary;
Assignment...................Page 5
Payments to Beneficiary Describes options and amounts
payable upon death...........Page 6
Purchase Payments Purchase payments amounts; Payment
limits; Allocations of purchase
payments.....................Page 8
Contract Value Describes the fixed and variable
account contract values; Interest to
be credited; Contract administrative
charge; Premium taxes; Transfers of
contract values..............Page 9
Fixed and Variable Accounts Describes the fixed account;
Describes the variable subaccounts,
accumulation units and values; Net
investment factor; Mortality and
expense risk charge; Variable
account administrative charge;
Annuity unit value...........Page 11
Withdrawal Provisions Contract withdrawal for its
withdrawal value; Rules for
withdrawal;..................Page 13
Annuity Provisions When annuity payments begin;
Different ways to receive annuity
payments; Determination of payment
amounts......................Page 16
Tables of Annuity Rates Tables showing the amount of the
first variable annuity payment and
the guaranteed fixed annuity
payments for the various payment
plans........................Page 18
PAGE 3
CONTRACT DATA
Upon issuance of this contract your initial purchase payment has been applied to
the fixed and variable accounts as shown below. You may make additional payments
and change the purchase payment allocation as provided in this contract. Refer
to the purchase payments provision on Page 8.
Purchase Payment
Variable Subaccounts/Funds Allocation Percentage
--------------------------- ---------------------
IDSL Managed 10%
IDSL Capital Resource 10%
IDSL Special Income 10%
IDSL Moneyshare 10%
IDSL Aggressive Growth 10%
Xxxxxx VT Diversified Income 10%
Xxxxxx VT Growth/Income 10%
Xxxxxx VT Voyager 10%
Xxxxxx VT Global Growth 0%
Xxxxxx VT New Opportunities 10%
Fixed Account 10%
Withdrawal Charge: If you withdraw all or a portion of this contract, a
withdrawal charge may apply. A withdrawal charge applies if all or part of the
contract value withdrawn is from payments received during the six contract years
before withdrawal.
Contract Years
From Payment Receipt Withdrawal Charge
-------------------- -----------------
1 7% of purchase payment withdrawn
2 6% of purchase payment withdrawn
3 5% of purchase payment withdrawn
4 4% of purchase payment withdrawn
5 3% of purchase payment withdrawn
6 2% of purchase payment withdrawn
Thereafter 0% of purchase payment withdrawn
After the first contract year you may withdraw up to 10 percent of your prior
contract anniversary contract value each contract year without incurring a
withdrawal charge. Refer to the withdrawal charge provision on Page 13 for
additional withdrawal charge information.
Contract Administrative Charge: See Page 10.
The Maximum Total Contract Purchase Payments (cumulative total all contract
years) is $1,000,000. We reserve the right to increase this maximum.
The Guaranteed Minimum Effective Interest Rate to be credited to the fixed
account is 3%.
CONTRACT DATA
Contract Number: 9920-SAMPLE Contract Date: March 5, 1997
Initial Purchase Payment: $10,000.00 Retirement Date: Xxxxx 0, 0000
Xxxxxxxxx: Xxxx X. Customer Contract Type: Non-qualified
Contract Owner: Xxxx X. Customer
PAGE 4
DEFINITIONS
The following words are used often in this contract. When we use these words,
this is what we mean:
Accumulation Unit
An accumulation unit is an accounting unit of measure. It is used to calculate
the contract value prior to settlement.
Annuitant
The person or persons on whose life monthly annuity payments depend.
Annuitization
The application of the contract value of this contract to provide annuity
payments.
Annuity Unit
An annuity unit is an accounting unit of measure. It is used to calculate the
value of annuity payments from the variable account on and after the retirement
date.
Code
The Internal Revenue Code of 1986, as amended.
Contract Anniversary
The same day and month as the contract date each year that the contract remains
in force.
Contract Date
It is the date from which contract anniversaries, contract years, and contract
months are determined. Your contract date is shown under Contract Data.
Contract Value
The sum of the:(1) Fixed Account Contract Value; and (2) Variable Account
Contract Value.
Fixed Account
The fixed account is made up of all our assets other than those in any separate
account.
Fixed Annuity
A fixed annuity is an annuity with payments which are guaranteed by us as to
dollar amount during the annuity payment period.
XXX Contract
A contract used in or under a retirement plan or program that is intended to
qualify as an Individual Retirement Annuity under Section 408(b) of the Code.
XXX Required Minimum Distributions
Code Section 408(b)(3) requires XXX required minimum distributions to be
distributed from an XXX, beginning not later than the April 1 following the
calendar year you reach age 70 1/2.
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DEFINITIONS (continued)
Non-qualified Contract
A contract used primarily for retirement purposes that is not intended to
qualify as an XXX contract.
Retirement Date
The date shown under Contract Data on which annuity payments are to begin. This
date may be changed as provided in this contract. You will be notified prior to
the retirement date in order to select an appropriate annuity payment plan.
Systematic Investment Plan
A payment method you set up with your bank to automatically make monthly
payments to your annuity from your bank account.
Valuation Date
A valuation date is each day the New York Stock Exchange is open for trading.
Valuation Period
A valuation period is the interval of time commencing at the close of business
on each valuation date and ending at the close of business on the next valuation
date.
Variable Account
The variable account is a separate investment account of ours. It consists of
several subaccounts. Each subaccount is named under Contract Data.
Variable Annuity
A variable annuity is an annuity with payments which are not predetermined or
guaranteed as to dollar amount and vary in amount with the investment experience
of one or more of the variable subaccounts.
We, Us, Our
American Centurion Life Assurance Company
Written Request
A request in writing signed by you and delivered to us at our administrative
office.
You, Your
The owner of this contract. The owner of a nonqualified contract may be someone
other than the annuitant. The owner is shown in the application unless the owner
has been changed as provided in this contract.
PAGE 6
GENERAL PROVISIONS
Entire Contract
This contract form, any endorsements and the copy of the application attached to
it are the entire contract between you and us.
No one except one of our corporate officers (President, Vice President,
Secretary or Assistant Secretary) can change or waive any of our rights or
requirements under this contract. That person must do so in writing. None of our
representatives or other persons has the authority to change or waive any of our
rights or requirements under this contract.
Annuity Tax Qualification
This contract is intended to qualify as an annuity contract under Section 72 of
the Code for Federal income tax purposes. To that end, the provisions of this
contract are to be interpreted to ensure or maintain such tax-qualification,
notwithstanding any other provisions to the contrary.
Contract Modification
We reserve the right to modify this contract to the extent necessary to:
1. qualify this contract as an annuity contract under Section 72
of the Code and all related laws and regulations which are in
effect during the term of this contract; and
2. if this contract is purchased as an XXX contract, to qualify this contract
as such an XXX contract under Section 408(b) of the Code and all related
laws and regulations which are in effect during the term of this contract.
We will obtain the approval of any regulatory authority for the modifications.
Incontestable
This contract is incontestable from its date of issue.
Benefits Based on Incorrect Data
Payments under the contract will be based on the annuitant's birthdate and sex.
If the annuitant's birthdate or sex has been misstated, payments under this
contract will be adjusted. They will be based on what would have been provided
at the correct birthdate and sex. Any underpayments made by us will be made up
immediately. Any overpayments made by us will be subtracted from the future
payments.
State Laws
This contract is governed by the law of the state in which it is delivered. The
values and benefits of this contract are at least equal to those required by
such state. Any paid up annuity, cash withdrawal or death benefits available
under the contract are not less than the minimum benefits required by any
statute of the state in which the contract is delivered.
PAGE 7
General Provisions (continued)
Reports to Owner
At least once a year we will send you a statement showing the contract value and
the cash withdrawal value of this contract. This statement will be based on any
laws or regulations that apply to contracts of this type.
Evidence of Survival
Where any payments under this contract depend on the recipient or annuitant
being alive on a given date, proof that such condition has been met may be
required by us. Such proof may be required prior to making the payments.
Protection of Proceeds
Payments under this contract are not assignable by any beneficiary prior to the
time they are due. To the extent allowed by law, payments are not subject to the
claims of creditors or to legal process.
Payments By Us
All sums payable by us are payable at our administrative office. Any payment of
a variable annuity or withdrawal based on the variable contract value shall be
payable only from the variable account.
Voting Rights
So long as federal law requires, we will give certain voting rights to contract
owners. As contract owner, if you have voting rights we will send a notice to
you telling you the time and place of a shareholder meeting. The notice will
also explain matters to be voted upon and how many votes you get.
PAGE 8
OWNERSHIP AND BENEFICIARY
Owner Rights
As long as the annuitant is living and unless otherwise provided in this
contract, you may exercise all rights and privileges provided in this contract
or allowed by us.
If this is an XXX contract, during the life of the annuitant you will have the
sole and absolute power to receive and enjoy all rights under the contract. Your
entire interest is non- forfeitable.
Change of Ownership
If this is an XXX contract, your right to change the ownership is restricted.
This contract may not be sold, assigned, transferred, 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 as may be required or permitted under
Section 408 of the Code, or under any other applicable section of the Code. Your
interest in this contract may be transferred to your former spouse, if any,
under a divorce decree or a written instrument incident to such divorce.
If this is a nonqualified contract, you may change the ownership.
Any change of ownership as provided above must be made by written request on a
form approved by us. The change must be made while the annuitant is living. Once
the change is recorded by us, it will take effect as of the date of your
request, subject to any action taken or payment made by us before the recording.
Beneficiary
Beneficiaries are those you have named in the application or later changed as
provided below, to receive benefits of this contract if you or the annuitant die
while this contract is in force.
Only those beneficiaries who are living when death benefits become payable may
share in the benefits, if any. If no beneficiary is then living, we will pay the
benefits to you, if living, otherwise to your estate.
Change of Beneficiary
You may change the beneficiary anytime while the annuitant is living by
satisfactory written request to us. Once the change is recorded by us, it will
take effect as of the date of your payment made by us before the recording.
Assignment
If this is an XXX contract, you may not assign this contract as collateral.
PAGE 9
Ownership and Beneficiary (continued)
If this is a non-qualified contract, you can assign this contract or any
interest in it while the annuitant is living. Your interest and the interest of
any beneficiary is subject to the interest of the assignee. An assignment is not
a change of ownership and an assignee is not an owner as these terms are used in
this contract. Any amounts payable to the assignee will be paid in a single sum.
A copy of any assignment must be submitted to us at our administrative office.
Any assignment is subject to any action taken or payment made by us before the
assignment was recorded at our administrative office. We are not responsible for
the validity of any assignment.
PAGE 10
PAYMENTS TO BENEFICIARY
Death Benefits Before Annuitization
If you or the annuitant die before annuitization while this contract is in
force, and both you and the annuitant were age 75 or younger on the contract
date, and all withdrawals you have made from this contract have been without
withdrawal charge, we will pay to the beneficiary the greater of:
1. the contract value; or
2. total purchase payments paid less any amounts withdrawn; or
3. on or after the fifth contract anniversary, the death benefit as of the
most recent fifth contract anniversary; adjusted by adding any purchase
payments since that most recent fifth contract anniversary and by
subtracting any amounts withdrawn since that most recent fifth contract
anniversary.
If either you or the beneficiary were age 76 or older on the contract date, and
you have made withdrawals from this contract with withdrawal charge, we will pay
the beneficiary the contract value.
Any amounts payable or applied by us as described in the sections below will be
based on the contract value as of the valuation date on or next following the
date on which due proof of death is received at our administrative office.
Payment of Nonqualified Contract
Death Benefit Before Annuitization
The above death benefit will be payable in a lump sum upon the receipt of due
proof of death of you or the annuitant, whichever occurs first. The beneficiary
may elect to receive payment anytime within five years after the date of death.
The above death benefit will also be made upon the first to die if ownership is
in a joint tenancy except where spouses are joint owners with right of
survivorship and the surviving spousal joint owner elects to continue this
contract.
In lieu of a lump sum, payments may be made under an Annuity Payment Plan,
provided:
1. the beneficiary elects the plan within 60 days after we
receive due proof of death; and
2. The plan provides payments over a period which does not exceed
the life or life expectancy of the beneficiary; and
3. Payments must begin no later than one year after the date of
death.
For Annuity Payment Plans, the reference to "annuitant" in the Annuity
Provisions shall apply to the beneficiary.
PAGE 11
Payments to Beneficiary (continued)
Payment of XXX Contract
Death Benefit Before Annuitization
The above death benefit will be payable in a lump sum upon the receipt of due
proof of your death. Payment options other than lump sum may be available to you
beneficiary depending on whether or not you had reached the XXX required minimum
distribution beginning date (the April 1 of the calendar year following the year
in which you would have attained age 70 1/2) before your death.
If you reached the XXX required beginning date before your death, your
beneficiary must continue using the same method, or faster, than that you were
using for your required minimum distributions, to receive the death benefit. If
you had not reached the XXX required beginning date before your death, your
beneficiary may take one or more distributions so that the entire death benefit
is received within five years of your death, or in lieu of taking payments
within five years, payments may be made under an Annuity Payment Plan, provided:
1. the beneficiary elects the plan within 60 days after we receive
due proof of death; and
2. the plan provides payments over a period which does not exceed
the life or life expectancy of the beneficiary; and
3. payments must begin no later than one year after the date of
death in the case of a non-spouse beneficiary, or by December
31 of the year in which you would have turned age 70 1/2 in the
case of a spouse beneficiary.
Payment amounts and durations must comply with Section 401(a)(9) of the Code and
regulations thereunder.
For Annuity Payment Plans, the reference to "annuitant" in the Annuity
Provisions shall apply to the beneficiary.
PAGE 12
Spouse's Option to Continue Contract
For non-qualified contracts: If you die prior to the annuitization and your
spouse is the sole beneficiary or co-owner of the contract, your spouse may keep
the contract in force as owner and may make additional purchase payments to the
contract.
For XXX contracts: If you die prior to your required beginning date and your
spouse is the sole beneficiary, your spouse may keep the contract in force as
his or her own XXX. As owner, your spouse may make additional XXX payments to
the contract. As owner, your spouse's life will determine the XXX required
beginning date and minimum distribution amounts. If you die after your required
beginning date, spousal continuation of this contract is not available.
Death After Annuitization
If you or the annuitant die after annuitization, the amount payable to the
beneficiary, if any, will be as provided in the Annuity Payment Plan then in
effect.
PAGE 13
PURCHASE PAYMENTS
Purchase Payments
Purchase payments are the payments you make for this contract and the benefits
it provides. Purchase payments must be paid or mailed to us at our home office
or to an authorized agent. If requested, we'll give you a receipt for your
purchase payments. Upon payment to us, purchase payments become our property.
Net purchase payments are that part of your purchase payments applied to the
contract value. A net purchase payment is equal to the purchase payment less any
applicable premium tax charge.
Initial Purchase Payment
The minimum initial purchase payment you must pay when applying for this
contract is $2,000. However, if you are concurrently establishing a systematic
investment plan to make payments of at least $50 per month to your contract, we
will waive the minimum initial purchase payment requirement.
Additional Purchase Payments
Additional purchase payments may be made until the earlier of:
1. the date this contract terminates by withdrawal or otherwise;
or
2. the date on which annuity payments begin.
Additional purchase payments are subject to the "Payment Limits Provision"
below.
Payment Limits Provision
Maximum Purchase Payments - The maximum total contract purchase
payments may not exceed the amounts shown under Contract Data. We
reserve the right to increase the maximums.
Additional Purchase Payments - You may make additional purchase payments of at
least $50.
In addition, if this is an XXX contract, except as otherwise provided in this
paragraph, the total purchase payments for any taxable year may not exceed
$2,000 or as otherwise provided in the Code and all related laws and regulations
which are in effect during the term of this contract. In the case of a rollover
contribution described in Sections 402(c), 403(a)(4), 403(b)(8), or, 408(d)(3)
of the Code, there is no limit on the amount of your purchase payment.
All purchase payments must be made in cash. If you die before the entire
interest in this contract has been distributed to you, and your beneficiary is
other than your surviving spouse, no additional purchase payments will be
accepted from your beneficiary under this contract.
PAGE 14
Purchase Payments (continued)
Cancellation
We reserve the right to cancel this contract if all the following conditions
exist at the same time:
1. your initial payment was less than $2,000; and
2. you established a systematic investment plan to make payments
to this contract; and
3. you stopped making systematic investment plan payments for six
consecutive months; and
4. your contract value is less than $2,000.
In this event, we will give you 30 days written notice of our intent to cancel
this contract. Upon such cancellation, we will pay you the contract value in one
lump sum. The contract will then terminate.
Allocation of Purchase Payments
You instruct us on how you want your purchase payments allocated among the fixed
account and variable subaccounts. Your choice for each variable subaccount may
be made in any whole percent from 0% to 100%. No allocation may be made that
would result in a fixed account or variable subaccount value of less than $5.
Your allocation instructions as of the Contract Date are shown under Contract
Data.
By written request, or by another method agreed to by us, you may change your
choice of accounts or percentages. The first net purchase payment will be
allocated as of the end of the valuation period during which we make an
affirmative decision to issue this contract. Subsequent purchase payments will
be allocated as of the end of the valuation period during which we receive the
payment at our administrative office.
PAGE 15
Contract Value
Contract Value
The contract value at any time is the sum of:
1. the Fixed Account Contract Value; and
2. the Variable Account Contract Value.
If:
1. part or all of the contract value is withdrawn; or
2. charges described herein are made against the contract
value;
then a number of accumulation units from the variable subaccounts and an amount
from the fixed account will be deducted to equal such amount. For withdrawals,
deductions will be made from the fixed or variable subaccounts that you specify.
Otherwise, the number of units from the variable subaccounts and the amount from
the fixed account will be deducted in the same proportion that your interest in
each bears to the total contract value.
Variable Account Contract Value
The variable account contract value at any time will be:
(1) the sum of the value of all variable subaccount accumulation units under
this contract resulting from purchase payments so allocated, or transfers
among the variable and fixed accounts; less
(2) the value of any units deducted for charges or withdrawals.
Fixed Account Contract Value
The fixed account contract value at any time will be:
1. the sum of all purchase payments credited to the fixed
account, plus interest credited; plus
2. any amounts transferred to the fixed account from any variable
subaccount, plus interest credited; less
3. any amounts transferred from the fixed account to any variable
subaccount; less
4. any amounts deducted for charges or withdrawals.
Interest to be Credited
We will credit interest to the fixed account contract value. Interest will begin
to accrue on the date the purchase payments which are received in our home
office become available to us for use. Such interest will be credited at rates
that we determine from time to time. However, we guarantee that the rate will
not be less than a 3% effective annual interest rate.
PAGE 16
Contract Value (continued)
Table of Fixed Account Guaranteed
Minimum Values
Per $2,000 Annual Payments
Allocated 100% to the Fixed Account
Based on the 3% Minimum Interest Rate
Guaranteed Guaranteed
End of minimum minimum
contract fixed account fixed account
year contract values withdrawal values
1 $ 2,030.00 $ 1,886.00
2 4,120.90 3,853.14
3 6,274.53 5,903.49
4 8,492.76 8,038.96
5 10,777.55 10,261.49
6 13,130.87 12,593.09
7 15,554.80 15,039.18
8 18,051.44 17,575.04
9 20,622.99 20,186.59
10 23,271.68 22,880.69
11 25,999.83 25,659.81
12 28,809.82 28,518.41
13 31,704.11 31,466.36
14 34,685.24 34,499.50
15 37,755.80 37,623.58
16 40,918.47 40,835.21
17 44,176.02 44,139.54
18 47,531.30 47,521.93
19 51,017.24 51,017.24
20 54,607.76 54,607.76
If there are any additional payments, transfers to or from the variable
subaccounts, withdrawals or premium tax adjustments, the above values will be
adjusted as described in this contract.
Variable subaccount contract and withdrawal values are not guaranteed and cannot
be projected.
PAGE 17
Contract Administrative Charge
We charge a fee for establishing and maintaining our records for this contract.
The charge is $30 per year and is deducted from the contract value at the end of
each contract year. The charge deducted will be prorated among the variable
subaccounts and the fixed account in the same proportion your interest in each
bears to the total contract value.
We waive the annual contract administrative charge for any contract year where
the contract value immediately prior to the deduction of the contract
administrative charge is $50,000 or more.
We will also waive the annual contract administrative charge for any contract
year where the contract value immediately prior to the deduction of the contract
administrative charge is less than $2,000, if you are then making systematic
investment plan payments.
If you fully withdraw this contract, we deduct the full $30 contract
administrative charge at the time of full withdrawal regardless of contract
value.
The charge does not apply after settlement of this contract.
Premium Tax Charges
A charge will be made by us against the contract value of this contract for any
premium taxes not previously deducted.
Transfers of Contract Values
While this contract is in force prior to the annuitization, transfers of
contract values may be made as outlined below.
1. You may transfer all or a part of the values held in one or more of the
variable subaccounts to another one or more of the variable subaccounts.
Subject to item 2 below, you may also transfer values held in one or more
of the variable subaccounts to the fixed account.
2. On or within the 30 days before or after a contract anniversary you may
transfer values from the fixed account to one or more of the variable
subaccounts. If such a transfer is made, no transfers from a variable
subaccount to the fixed account may be made for six months.
You may make a transfer by written request. There is no fee or charge for these
transfers. However, the minimum transfer amount is $500, or if less, the entire
value in the subaccount or in the fixed account from which the transfer is being
made, or other such minimum amounts agreed to by us. This transfer privilege may
be suspended or modified by us at any time.
PAGE 18
FIXED AND VARIABLE ACCOUNTS
The Fixed Account
The fixed account is our general account. It is made up of all of our assets
other than:
1. those in the variable account; and
2. those in any other segregated asset account.
The Variable Account
The variable account is a separate investment account of ours. It consists of
several subaccounts which are named under Contract Data. We have allocated a
part of our assets for this and certain other contracts to the variable account.
Such assets remain our property. However, they may not be charged with the
liabilities from any other business in which we may take part.
Investments of the Variable Account
Purchase payments applied to the variable account will be allocated as specified
by the owner. Each variable subaccount will buy, at net asset value, shares of
the fund shown for that subaccount under Contract Data or as later added or
changed.
We may change the funds the variable subaccounts buy shares from if laws or
regulations change, the existing funds become unavailable or, in the judgment of
American Enterprise Life, the funds are no longer suitable for the subaccounts.
If any of these situations occur, we would have the right to substitute funds
other than those shown under Contract Data. We may also add additional
subaccounts investing in other funds.
We would first seek approval of the Securities and Exchange Commission and,
where required, the insurance regulator of the state where this contract is
delivered.
Valuation of Assets
Fund shares in the variable subaccounts will be valued at their net asset value.
Variable Account Accumulation Units
The number of accumulation units for each of the variable accounts is found by
adding the number of accumulation units resulting from:
1. purchase payments allocated to the subaccount; and
2. transfers to the subaccount;
and subtracting the number of accumulation units resulting from:
1. transfers from the subaccount; and
2. withdrawals (including withdrawal charges) from the
subaccount; and
3. contract administrative charge deductions from the subaccount.
PAGE 19
FIXED AND VARIABLE ACCOUNTS (continued)
The number of accumulation units added or subtracted for each of the above
transactions is found by dividing:
1. the amount allocated to or deducted from the subaccount; by
2. the accumulation unit value for the subaccount for the respective
valuation period during which we received the purchase payment or transfer
value, or during which we deducted transfers, withdrawals, withdrawal
charges or contract administrative charges.
Variable Account Accumulation Unit Value The value of an accumulation unit for
each of the variable subaccounts was set at $1 when the first fund shares were
bought. The value for any later valuation period is found as follows:
The accumulation unit value for each variable account for the last prior
valuation period is multiplied by the net investment factor for the same
subaccount for the next following valuation period. The result is the
accumulation unit value. The value of an accumulation unit may increase or
decrease from one valuation period to the next.
PAGE 20
FIXED AND VARIABLE ACCOUNTS (continued)
Net Investment Factor
The net investment factor is an index applied to measure the investment
performance of a variable subaccount from one valuation period to the next. The
net investment factor may be greater or less than one; therefore, the value of
an accumulation unit may increase or decrease.
The net investment factor for any such subaccount for any valuation period is
determined by: dividing (1) by (2) and subtracting (3) and (4) from the result.
This is done where:
1. is the sum of:
a. the net asset value per share of the fund held in the
variable subaccount determined at the end of the current
valuation period; plus
b. the per share amount of any dividend or capital gain
distribution made by the fund held in the variable
subaccount, if the "ex-dividend" date occurs during the
current valuation period; and
2. is the net asset value per share of the mutual fund held in
the variable subaccount, determined at the end of the last
prior valuation period; and
3. is a factor representing the mortality and expense risk
charge; and
4. is a factor representing the variable account administrative
charge.
Mortality and Expense Risk Charge
In calculating accumulation unit values we will deduct a mortality and expense
risk charge from the variable subaccounts equal, on an annual basis, to 1.25% of
the daily net asset value. This deduction is made to compensate us for assuming
the mortality and expense risks under contracts of this type. The deduction will
be:
1. made from each variable subaccount; and
2. computed on a daily basis.
Variable Account Administrative Charge
In calculating accumulation unit values, we will deduct a variable account
administrative charge from the variable subaccounts equal, on an annual basis,
to 0.15% of the daily net asset value. This deduction is made to compensate us
for certain administrative and operating expenses for contracts of this type.
The deduction will be:
1. made from each variable subaccount; and
2. computed on a daily basis
PAGE 21
FIXED AND VARIABLE ACCOUNTS (continued)
Annuity Unit Value
The value of an annuity unit for each variable account was arbitrarily set at $1
when the first fund shares were bought. The value for any later valuation period
is found as follows.
1. The annuity unit value for each variable account for the last prior
valuation period is multiplied by the net investment factor for the
account for the valuation period for which the annuity unit value is being
calculated.
2. The result is multiplied by an interest factor. This is done to neutralize
the assumed investment rate which is built into the annuity tables on page
18.
PAGE 22
WITHDRAWAL PROVISIONS
Withdrawal
By written request and subject to the rules below you may:
1. withdrawal this contract for the total withdrawal value; or
2. partially withdrawal this contract for a part of the
withdrawal value.
Rules for Withdrawal
All withdrawals will have the following conditions.
1. You must apply by written request or other method agreed to by
us:
a. while this contract is in force; and
b. before the earlier of beginning an annuity payment plan
or the death of the annuitant or owner.
2. You must withdraw an amount equal to at least $500. Each variable
subaccount value and the fixed account value after a partial withdrawal
must be either $0 or at least $500.
3. The amount withdrawn, less any charges, will normally be mailed to you
within seven days of the receipt of your written request and this
contract, if required.
For withdrawals from the fixed account, we have the right to defer payment
to you for up to 6 months from the date we receive your request.
4. For partial withdrawals, if you do not specify from which account the
withdrawal is to be made, the withdrawal will be made from the variable
subaccounts and the fixed account in the same proportion as your interest
in each bears to the contract value.
5. Any amounts withdrawn and charges which may apply cannot be
repaid.
Upon withdrawal for the full withdrawal value this contract will terminate. We
may require that you return the contract to us before we pay the full withdrawal
value.
Withdrawal Value
The withdrawal value at any time will be:
1. the contract value; minus
2. the full $30 contract administrative charge; minus
3. any withdrawal charge.
PAGE 23
Withdrawal Provisions (continued)
Withdrawal Charge
If you withdrawal all or part of your contract, you may be subject to a
withdrawal charge. A withdrawal charge applies if all or part of the contract
value you withdraw is from payments received during the six contract years
before withdrawal. Refer to Waiver of Withdrawal Charges for situations when
withdrawal charges are not deducted.
We determine your withdrawal charge by multiplying each of your payments by the
applicable withdrawal charge percentage, and then adding the total withdrawal
charges.
The withdrawal charge percentage depends on the number of contract years since
you made the payment(s):
Contract Years From
Payment Receipt Withdrawal Charge Percentage
1 8%
2 7%
3 6%
4 5%
5 4%
6 2%
Thereafter 0%
PAGE 24
Waiver of Withdrawal Charges
Withdrawal charges are waived for all of the following.
1. Withdrawals during the year totaling up to 10% of your prior
contract anniversary contract value.
2. Contract earnings - if any - in excess of the annual 10% free
withdrawal amount.
3. Withdrawals made if both you and the annuitant were under age 76 on the
contract date, and you provide proof satisfactory to us that, as of the
date you request the withdrawal, you or the annuitant are confined to a
hospital or nursing home, and have been for the prior 60 days.
To qualify, the nursing home must:
a. be licensed by an appropriate licensing agency to provide
nursing care; and
b. provide 24-hour-a-day nursing services; and
c. have a doctor available for emergency situations; and
d. have a nurse on duty or on call at all times; and
e. maintain clinical records; and
f. have appropriate methods for administering drugs.
4. XXX required minimum distributions, for those amounts required
to be distributed from this contract only.
5. Annuity payment plan payments.
6. Payments made in the event of the death of the owner or
annuitant.
Withdrawal Order
We use this order to determine withdrawal charges.
1. First, withdrawals up to 10% of your prior anniversary contract value not
previously withdrawn during this contract year.(No withdrawal charge.)
2. Next, withdrawals are from contract earnings - if any - in excess of the
annual 10% free withdrawal amount.(No withdrawal charge.)
3. Next, withdrawals are from purchase payments received seven or more
contract years before the withdrawal and not previously withdrawn.(No
withdrawal charge.)
4. Last, withdrawals are from purchase payments received in the
six contract years before the withdrawal. There is a
withdrawal charge on these payments.
PAGE 25
Withdrawal Provisions (continued)
Withdrawal Charge Calculation
We determine your withdrawal charge by multiplying each of your payments by the
applicable withdrawal charge percentages, and then summing the total withdrawal
charges.
For example, the withdrawal charge on a total withdrawal request for a contract
with this history:
o The contract date is July 1, 1997 with a contract year of July 1 through
June 30 and with an anniversary date of July 1 each year;
o We received these payments - $10,000 July 1, 1997, $8,000 December 31,
2003 and $6,000 February 20, 2005;
o The owner withdraws the contract for its total withdrawal value of $38,101
on August 5, 2007 and had not made any other withdrawals during that
contract year;
o The prior anniversary July 1, 2007 contract value was $38,488;
is calculated this way:
Withdrawal
Charge Explanation
$ 0 $3,848.80 is 10% of the prior anniversary account
value withdrawn without withdrawal charge; and
$ 0 $10,252.20 is contract earnings in excess of the 10%
free withdrawal amount withdrawn without withdrawal
charge.
$ 0 $10,000 initial payment on 7-1-97 payment was
received seven or more contract years before
withdrawal, withdrawn without withdrawal charge;
and
$320 $8,000 payment on 12-31-03 is in its fifth contract
year from receipt, withdrawn with a 4% withdrawal
charge; and
$300 $6,000 payment on 2-20-05 is in its fourth contract
year from receipt, withdrawn with a 5% withdrawal
charge; and
----
$620
Note: If you take a full withdrawal, the $30 contract
administrative charge will be deducted in addition to any
applicable withdrawal charge.
PAGE 26
WITHDRAWAL PROVISIONS (continued)
Suspension or Delay in Payment of Withdrawal We have the right to suspend or
delay the date of any withdrawal payment from the variable subaccounts for any
period:
1. When the New York Stock Exchange is closed; or
2. When trading on the New York Stock Exchange is restricted; or
3. When an emergency exists as a result of which:
a. disposal of securities held in the variable subaccounts is
not reasonably practical; or
b. it is not reasonably practical to fairly determine the
value of the net assets of the variable subaccounts; or
4. During any other period when the Securities and Exchange
Commission, by order, so permits for the protection of
security holders.
Rules and regulations of the Securities and Exchange Commission will govern as
to whether the conditions set forth in 2 and 3 exist.
PAGE 27
ANNUITY PROVISIONS
Annuitization
When annuitization occurs, the contract value will be applied to make annuity
payments. The first payment will be made as of the retirement date. This date is
shown under Contract Data. Before payments begin we will require satisfactory
proof that the annuitant is alive. We may also require that you exchange this
contract for a supplemental contract which provides the annuity payments.
Change of Retirement Date
You may change the retirement date shown for this contract. Tell us the new date
by written request. If you select a new date, it must be at least 30 days after
we receive your written request at our administrative office.
The maximum retirement date on an XXX contract is the later of:
1. the April 1 following the calendar year in which the annuitant
attains age 70 1/2; or
2. such other date which satisfies the minimum distribution
requirements under the Code, its regulations, and/or
promulgations by the Internal Revenue Service; or
3. such other date as agreed upon by us.
Notwithstanding the above, and for all non-qualified contracts, the maximum
retirement date is the later of:
1. the annuitant's 85th birthday; or
2. the 10th contract anniversary.
Annuity Payment Plans
Annuity payments may be made on a fixed-dollar basis, a variable basis or a
combination of both. You can schedule receipt of annuity payments according to
one of the Plans A through E below or another plan agreed to by us.
If this is an XXX, any such plan will be calculated in accordance with the Code
and must:
1. provide for payments over the life of the annuitant or over
the life of the annuitant and a joint annuitant; or
2. provide for payments over a period which does not exceed the
life expectancy of the annuitant and or the life expectancy of
the annuitant and a joint annuitant; and
3. if selected by a nonspouse beneficiary, meet the minimum
incidental death benefit requirements under the Code and all
related laws and regulations which are then in effect.
PAGE 28
ANNUITY PROVISIONS (continued)
Plan A - This provides monthly annuity payments during the lifetime of the
annuitant. No payments will be made after the annuitant dies.
Plan B - This provides monthly annuity payments during the lifetime of the
annuitant with a guarantee by us that payments will be made for a period of at
least five, 10 or 15 years. You must select the guaranteed period.
Plan C - This provides monthly annuity payments during the lifetime of the
annuitant with a guarantee by us that payments will be made for a certain number
of months. We determine the number of months by dividing the amount applied
under this plan by the amount of the first monthly annuity payment.
Plan D - Monthly payments will be paid during the lifetime of the annuitant and
a joint annuitant. When either the annuitant or the joint annuitant dies we will
continue to make monthly payments during the lifetime of the survivor. No
payments will be paid after the death of both the annuitant and joint annuitant.
Plan E - This provides monthly fixed dollar annuity payments for a period of
years. The period of years may be no less than 10 nor more than 30.
You may select the plan by written request to us at least 30 days before the
retirement date. If at least 30 days before the retirement date we have not
received at our administrative office your written request to select a plan, we
will make fixed-dollar payments according to Plan B with payments guaranteed for
10 years.
If the amount to be applied to a plan would not provide a monthly payment of at
least $20, we have the right to change the frequency of the payment or to make a
lump sum payment of the contract value.
PAGE 29
Fixed Annuity
A fixed annuity is an annuity with payments that are guaranteed by us as to
dollar amount. Fixed annuity payments remain the same. At annuitization, the
fixed account contract value will be applied to the applicable Annuity Table.
This will be done in accordance with the Payment Plan chosen. The amount payable
for each $1,000 so applied is shown in Table B on page 19.
Variable Annuity
A variable annuity is an annuity with payments which:
1. are not predetermined or guaranteed as to dollar amount; and
2. vary in amount with the investment experience of the variable
accounts.
Determination of First Variable Annuity Payment At annuitization, the variable
account contract value will be applied to the applicable Annuity Table. This
will be done:
1. on the valuation date on or next preceding the seventh
calendar day before the retirement date; and
2. in accordance with the payment plan chosen. The amount
payable for the first payment for each $1,000 so applied is
shown in Table A on page 18.
Variable Annuity Payments After the First Payment Variable annuity payments
after the first payment vary in amount. The amount changes with the investment
performance of the variable accounts. The dollar amount of variable annuity
payments after the first is not fixed. It may change from month to month. The
dollar amount of such payments is determined as follows:
1. The dollar amount of the first annuity payment is divided by the value of
an annuity unit as of the valuation date on or next preceding the seventh
calendar day before the retirement date. This result establishes the
number of annuity units for each monthly annuity payment after the first
payment. This number of annuity units remains fixed during the annuity
payment period.
2. The fixed number of annuity units is multiplied by the annuity unit value
as of the valuation date on or next preceding the seventh calendar day
before the date the payment is due. This result establishes the dollar
amount of the payment.
We guarantee that the dollar amount of each payment after the first will not be
affected by variations in expenses or mortality experience.
PAGE 30
Annuity Provisions (continued)
Exchange of Annuity Units
Annuity units of any variable account may be exchanged for units of any of the
other variable accounts. This may be done no more than once a year. Once annuity
payments start no exchanges may be made to or from any fixed annuity.
PAGE 31
Tables of Annuity Rates
Table A below shows the amount of the first monthly variable annuity payment,
based on a 5% assumed investment return, for each $1,000 of value applied under
any payment plan. The amount of the first and all subsequent monthly fixed
dollar annuity payments for each $1,000 of value applied under any payment plan
will be based on our fixed dollar Table of Settlement Rates in effect at
annuitization. Such rates are guaranteed to be not less than those shown in
Table B. The amount of such annuity payments under Plans A, B, and C will depend
upon the sex and adjusted age of the annuitant at annuitization. The amount of
such annuity payments under Plan D will depend upon the sex and the adjusted age
of the annuitant and joint annuitant at annuitization. Adjusted age shall be
equal to the age nearest birthday minus an "adjustment" depending on the
calendar year of birth of the annuitant as follows:
Calendar
Year of
Annuitant's
Birth Adjustment
Prior to 1920 0
1920 through 1924 1
1925 through 1929 2
1930 through 1934 3
1935 through 1939 4
1940 through 1944 5
1945 through 1949 6
1950 through 1959 7
1960 through 1969 8
1970 through 1979 9
1980 through 1989 10
After 1989 11
PAGE 32
Tables of Annuity Rates (continued)
TABLE A Dollar Amount of First Monthly Variable Annuity Payment Per $1,000 Applied
PLAN A PLAN B PLAN C PLAN D - Joint and Survivor
Adjusted Age of Joint Annuitant
Life 5 Years 10 Years 15 Years With Adj.
Adj. Income Certain Certain Certain Refund Male 10 years 5 years Same 5 years 10 years
Age* M F M F M F M F M F Age* Younger Younger Age Older Older
-----------------------------------------------------------------------------------------------------------------------------
45 5.16 4.87 5.15 4.87 5.12 4.86 5.07 4.84 5.06 4.82 45 4.45 4.54 4.63 4.72 4.81
46 5.21 4.91 5.20 4.91 5.17 4.90 5.12 4.88 5.11 4.86 46 4.47 4.56 4.66 4.76 4.85
47 5.28 4.96 5.26 4.96 5.23 4.94 5.17 4.92 5.16 4.91 47 4.50 4.59 4.69 4.80 4.90
48 5.34 5.01 5.33 5.00 5.29 4.99 5.23 4.96 5.21 4.95 48 4.52 4.62 4.73 4.84 4.94
49 5.41 5.06 5.39 5.05 5.35 5.04 5.28 5.01 5.27 4.99 49 4.55 4.65 4.76 4.88 5.00
50 5.48 5.12 5.46 5.11 5.41 5.09 5.34 5.06 5.33 5.04 50 4.57 4.68 4.80 4.93 5.05
51 5.55 5.17 5.53 5.17 5.48 5.14 5.40 5.11 5.39 5.09 51 4.60 4.72 4.85 4.98 5.11
52 5.63 5.23 5.61 5.23 5.55 5.20 5.46 5.16 5.46 5.15 52 4.63 4.75 4.89 5.03 5.17
53 5.71 5.30 5.69 5.29 5.63 5.26 5.53 5.22 5.53 5.20 53 4.66 4.79 4.94 5.09 5.23
54 5.80 5.37 5.77 5.36 5.70 5.33 5.60 5.28 5.60 5.26 54 4.70 4.84 4.99 5.15 5.30
55 5.89 5.44 5.86 5.43 5.79 5.40 5.67 5.34 5.68 5.33 55 4.73 4.88 5.04 5.21 5.38
56 5.99 5.52 5.96 5.51 5.88 5.47 5.74 5.40 5.76 5.39 56 4.77 4.93 5.10 5.28 5.46
57 6.10 5.60 6.06 5.59 5.97 5.54 5.82 5.47 5.84 5.47 57 4.81 4.98 5.16 5.35 5.54
58 6.21 5.69 6.17 5.68 6.07 5.62 5.90 5.54 5.94 5.54 58 4.85 5.03 5.23 5.43 5.63
59 6.33 5.79 6.29 5.77 6.17 5.71 5.98 5.62 6.03 5.62 59 4.90 5.09 5.30 5.52 5.73
60 6.46 5.89 6.42 5.87 6.28 5.80 6.07 5.69 6.13 5.70 60 4.94 5.15 5.37 5.61 5.83
61 6.60 6.00 6.55 5.97 6.40 5.90 6.16 5.78 6.24 5.79 61 5.00 5.21 5.45 5.70 5.95
62 6.75 6.11 6.69 6.08 6.52 6.00 6.25 5.86 6.36 5.89 62 5.05 5.28 5.54 5.81 6.07
63 6.91 6.23 6.84 6.20 6.64 6.11 6.34 5.95 6.48 5.99 63 5.11 5.35 5.63 5.92 6.20
64 7.09 6.37 7.01 6.33 6.78 6.22 6.43 6.04 6.61 6.10 64 5.17 5.43 5.73 6.04 6.34
65 7.27 6.51 7.18 6.47 6.91 6.34 6.52 6.14 6.74 6.21 65 5.23 5.52 5.83 6.17 6.49
66 7.47 6.66 7.36 6.61 7.06 6.47 6.62 6.24 6.88 6.33 66 5.30 5.61 5.95 6.30 6.65
67 7.68 6.82 7.56 6.77 7.21 6.60 6.71 6.34 7.04 6.46 67 5.38 5.70 6.07 6.45 6.82
68 7.91 7.00 7.76 6.93 7.36 6.74 6.81 6.44 7.19 6.60 68 5.46 5.80 6.20 6.61 7.01
69 8.15 7.19 7.98 7.11 7.52 6.89 6.90 6.54 7.36 6.74 69 5.54 5.92 6.34 6.79 7.21
70 8.41 7.39 8.21 7.31 7.68 7.04 6.98 6.65 7.54 6.90 70 5.63 6.03 6.49 6.97 7.42
71 8.69 7.62 8.46 7.51 7.84 7.21 7.07 6.75 7.73 7.06 71 5.73 6.16 6.65 7.17 7.66
72 8.99 7.86 8.71 7.74 8.01 7.38 7.15 6.86 7.92 7.24 72 5.84 6.30 6.83 7.39 7.90
73 9.31 8.12 8.98 7.98 8.18 7.56 7.23 6.96 8.13 7.42 73 5.95 6.44 7.02 7.62 8.17
74 9.65 8.41 9.27 8.23 8.35 7.74 7.30 7.06 8.35 7.63 74 6.07 6.60 7.22 7.87 8.46
75 10.02 8.72 9.57 8.51 8.52 7.93 7.37 7.15 8.58 7.84 75 6.19 6.77 7.44 8.14 8.77
------------------------------------------------------------------------------------------------------------------------------
* Adjusted age of annuitant. M = Male F = Female
------------------------------------------------------------------------------------------------------------------------------
Table A above is based on the "1983 Individual Annuitant Mortality Table A."
Annuity rates for any age, or any combination of age and sex not shown above,
will be calculated on the same basis as those rates shown in the table above.
Such rates will be furnished by us upon request.
PAGE 33
Tables of Annuity Rates (continued)
TABLE B Dollar Amount of Each Monthly Fixed Dollar Annuity Payment Per $1,000 Applied
PLAN A PLAN B PLAN C PLAN D - Joint and Survivor
Adjusted Age of Female Joint Annuitant
Life 5 Years 10 Years 15 Years With Adj
Adj. Income Certain Certain Certain Refund Male 10 Years 5 Years Same 5 Years 10 Years
Age* M F M F M F M F M F Age* Younger Younger Age Older Older
-----------------------------------------------------------------------------------------------------------------------------
45 3.93 3.63 3.92 3.63 3.90 3.63 3.87 3.61 3.80 3.57 45 3.17 3.28 3.39 3.50 3.61
46 3.99 3.68 3.98 3.68 3.96 3.67 3.92 3.66 3.85 3.61 46 3.20 3.31 3.43 3.55 3.66
47 4.05 3.73 4.05 3.73 4.02 3.72 3.98 3.71 3.90 3.66 47 3.23 3.35 3.47 3.59 3.71
48 4.12 3.79 4.11 3.79 4.09 3.77 4.04 3.76 3.96 3.70 48 3.26 3.38 3.51 3.64 3.76
49 4.19 3.84 4.18 3.84 4.15 3.83 4.10 3.81 4.01 3.75 49 3.29 3.42 3.56 3.69 3.82
50 4.27 3.90 4.26 3.90 4.22 3.89 4.17 3.86 4.08 3.80 50 3.32 3.46 3.60 3.75 3.88
51 4.34 3.97 4.33 3.96 4.29 3.95 4.23 3.92 4.14 3.86 51 3.36 3.50 3.65 3.80 3.94
52 4.43 4.03 4.41 4.03 4.37 4.01 4.30 3.98 4.20 3.91 52 3.39 3.54 3.70 3.86 4.01
53 4.51 4.10 4.50 4.10 4.45 4.08 4.37 4.04 4.27 3.97 53 3.43 3.59 3.76 3.93 4.08
54 4.60 4.18 4.59 4.17 4.54 4.15 4.45 4.11 4.35 4.03 54 3.47 3.64 3.82 3.99 4.16
55 4.70 4.25 4.68 4.25 4.62 4.22 4.53 4.18 4.42 4.10 55 3.51 3.69 3.88 4.06 4.23
56 4.80 4.34 4.78 4.33 4.72 4.30 4.61 4.25 4.50 4.17 56 3.56 3.74 3.94 4.14 4.32
57 4.91 4.42 4.89 4.41 4.82 4.38 4.69 4.32 4.58 4.24 57 3.60 3.80 4.01 4.22 4.41
58 5.03 4.52 5.00 4.50 4.92 4.47 4.78 4.40 4.67 4.31 58 3.65 3.86 4.08 4.30 4.51
59 5.15 4.61 5.12 4.60 5.03 4.56 4.87 4.48 4.76 4.39 59 3.70 3.92 4.15 4.39 4.61
60 5.28 4.72 5.25 4.70 5.14 4.66 4.96 4.57 4.86 4.48 60 3.76 3.99 4.24 4.49 4.72
61 5.42 4.83 5.39 4.81 5.26 4.76 5.06 4.66 4.96 4.56 61 3.81 4.06 4.32 4.59 4.83
62 5.57 4.95 5.53 4.93 5.39 4.86 5.16 4.75 5.07 4.66 62 3.87 4.13 4.41 4.70 4.96
63 5.74 5.07 5.69 5.05 5.52 4.98 5.26 4.85 5.19 4.75 63 3.94 4.21 4.51 4.81 5.09
64 5.91 5.21 5.85 5.18 5.66 5.10 5.36 4.95 5.30 4.86 64 4.00 4.29 4.61 4.94 5.24
65 6.10 5.35 6.03 5.32 5.81 5.22 5.46 5.05 5.43 4.97 65 4.07 4.38 4.72 5.07 5.39
66 6.29 5.51 6.21 5.47 5.96 5.36 5.56 5.16 5.56 5.08 66 4.15 4.48 4.84 5.21 5.55
67 6.50 5.67 6.41 5.63 6.11 5.50 5.66 5.26 5.70 5.20 67 4.23 4.58 4.97 5.36 5.73
68 6.73 5.85 6.62 5.80 6.28 5.65 5.76 5.37 5.85 5.33 68 4.31 4.69 5.10 5.53 5.92
69 6.97 6.04 6.84 5.98 6.44 5.80 5.86 6.49 6.00 5.47 69 4.40 4.80 5.25 5.70 6.12
70 7.23 6.25 7.07 6.18 6.61 5.96 5.96 6.60 6.16 5.61 70 4.50 4.93 5.40 5.89 6.34
71 7.51 6.47 7.32 6.39 6.78 6.14 6.05 6.71 6.33 5.76 71 4.60 5.06 5.57 6.10 6.57
72 7.80 6.71 7.58 6.62 6.96 6.31 6.14 6.83 6.51 5.93 72 4.71 5.20 5.75 6.31 6.82
73 8.12 6.97 7.85 6.86 7.14 6.50 6.23 6.94 6.70 6.10 73 4.83 5.35 5.94 6.55 7.09
74 8.45 7.26 8.14 7.12 7.32 6.69 6.31 6.04 6.90 6.28 74 4.95 5.51 6.15 6.80 7.37
75 8.82 7.56 8.44 7.39 7.49 6.89 6.38 7.14 7.11 6.48 75 5.08 5.68 6.37 7.07 7.68
------------------------------------------------------------------------------------------------------------------------------
* Adjusted age of annuitant. M = Male F = Female
------------------------------------------------------------------------------------------------------------------------------
Table B above is based on the "1983 Individual Annuitant Mortality Table A"
assuming a 3% annual effective interest rate. Annuity rates for any age, or any
combination of age and sex not shown above, will be calculated on the same basis
as those rates shown in the table above. Such rates will be furnished by us upon
request. Amounts shown in the Table below are based on assuming a 3% annual
effective interest rate.
PLAN E Dollar Amount of Each Monthly Fixed Dollar Annuity Payment Per $1,000 Applied
Years Monthly Years Monthly Years Monthly
Payable Payment Payable Payment Payable Payment
------- ------- ------- ------- ------- -------
10 $ 9.61 17 $ 6.23 24 $ 4.84
11 8.86 18 5.96 25 4.71
12 8.24 19 5.73 26 4.59
13 7.71 20 5.51 27 4.47
14 7.26 21 5.32 28 4.37
15 6.87 22 5.15 29 4.27
16 6.53 23 4.99 30 4.18
-------------------------------------------------------------------------------------------------------------
PAGE 34
Deferred Annuity Contract
American Administrative Offices:
Express 00 Xxxxx Xxxxxx Xxxxxx
P.O. Box 534
American Minneapolis, MN 55440
Enterprise
Life
o Flexible Purchase Payments
o Optional Fixed Dollar or Variable Accumulation Values
and Annuity Payments
o Annuity Payments to Begin on the Retirement Date
o This Contract is Nonparticipating - Dividends Are Not Payable
