AXA EQUITABLE LIFE INSURANCE COMPANY FORM OF FUNDING AGREEMENT SPECIFICATION APPLICATION TERM SHEET
AXA EQUITABLE LIFE INSURANCE COMPANY
FORM OF FUNDING AGREEMENT SPECIFICATION APPLICATION TERM SHEET
| Owner: | [ABC Company] 1[ABC Bank FBO ABC Company] 1 | |
| Escrow Agent: | [N/A] 1[ABC Bank FBO ABC Company] 1 | |
| Beneficial Owner | [N/A] 1[ABC Company] 1 | |
| Interested Party: | [XYZ Company]1 &2[former securityholders of XYZ Company] 1&2 | |
| Authorized Representative: | [DEF Consultants] 1 | |
| Funding Agreement No.: | FA-[12345] 1 | |
| Effective Date: | [December 15, 2016] 1 | |
| Maturity Date: | [March 1, 2020] 1 | |
| General Escrow ([$100,000 minimum | ||
| Purchase Payment per Tranche] 4) | ||
| Tranche 1 |
||
| Purchase Payment: |
[$2,000,000] 1 | |
| Expiry Date: |
[September 1, 2017]1 | |
| Initial Crediting Rate: |
[0.55%] 5 | |
| [Tranche 2 |
||
| Purchase Payment: |
[$1,000,000]1 | |
| Expiry Date: |
[September 1, 2018]1 | |
| Initial Crediting Rate:] |
[0.65%] 5 | |
| [Tranche 3 |
||
| Purchase Payment: |
[$1,000,000] 1 | |
| Expiry Date: |
[March 1, 2019] 1 | |
| Initial Crediting Rate:] |
[0.75%] 5 | |
| [Tranche 4 |
||
| Purchase Payment: |
[$1,000,000] 1 | |
| Expiry Date: |
[September 1, 2019] 1 | |
| Initial Crediting Rate:] |
[0.85%] 5 | |
| [Tranche 5 |
||
| Purchase Payment: |
[$1,000,000] 1 | |
| Expiry Date: |
[March 1, 2020] 1 | |
| Initial Crediting Rate:] |
[0.95%] 5 | |
APP-MA2016
| [Special Escrow | [N/A] 1 | |
| Purchase Payment: |
[$1,000,000] 1 | |
| Initial Crediting Rate:] |
[0.15%] 5 | |
| Maximum Total of all Purchase Payments: |
[$50,000,000] 6 | |
| Potential Subsequent Purchase Payments: |
[$100,000] 1 [N/A] 1 | |
| Account Administrator: |
[DEF Company] 1 | |
| State of Issue: |
[Georgia] 7 | |
IMPORTANT:
The amounts and rates above are subject to change and are determined as of the date a Purchase Payment is made, and will be reflected on the Final Term Sheet.
A Purchase Payment must occur and the Funding Agreement must be issued no later than 60 days after the date this Application is signed.
| Executed at: [ ] 8 | Date: | |||
| [If Escrow Agent Is Applicable: | ||||
| By: | , the Escrow Agent, as Owner | |||
| (Signature and Title)] 9 | ||||
| [If Escrow Agent Is Not Applicable: | ||||
| By: | , the Owner | |||
| (Signature and Title) | ||||
| By: | , the Interested Party (or Authorized Representative) | |||
| (Signature and Title)] 10 | ||||
| By: | , AXA Equitable | |||
| (Signature and Title) | ||||
APP-MA2016
