RILA287 Jackson National Life Insurance Company® Thank you for choosing Jackson National Life Insurance Company, also referred to as "the Company" or "Jackson®." READ YOUR CONTRACT CAREFULLY. This annuity contract is issued by the Company and is a...

RILA287 Xxxxxxx National Life Insurance Company® Thank you for choosing Xxxxxxx National Life Insurance Company, also referred to as "the Company" or "Xxxxxxx®." READ YOUR CONTRACT CAREFULLY. This annuity contract is issued by the Company and is a legal agreement between the Owner ("You") and Xxxxxxx. PLEASE NOTE THAT THIS CONTRACT HAS REFERENCES TO AND UTILIZATION OF EXTERNAL INDEXES. WHILE THE CONTRACT VALUES MAY BE AFFECTED BY THE EXTERNAL INDEXES, THE CONTRACT DOES NOT DIRECTLY PARTICIPATE IN ANY STOCK OR EQUITY INVESTMENTS. AN INDEX ADJUSTMENT TO THE INDEX ACCOUNT IS NOT GUARANTEED AND MAY VARY BASED UPON THE PERFORMANCE OF THE INDEXES. WHEN ALL OR ANY PORTION OF THE INDEX ACCOUNT VALUE IS WITHDRAWN, ANNUITIZED, OR TRANSFERRED TO THE FIXED ACCOUNT, IT MAY BE SUBJECT TO A MARKET VALUE ADJUSTMENT (MVA) AS SET FORTH IN THE CONTRACT DATA PAGES. THE WITHDRAWAL VALUE AVAILABLE UNDER THIS CONTRACT IS EQUAL TO THE CONTRACT VALUE ADJUSTED FOR ANY APPLICABLE MVA. NOTICE OF RIGHT TO EXAMINE CONTRACT YOU MAY RETURN THIS CONTRACT TO THE FINANCIAL PROFESSIONAL WHO SOLD YOU THE CONTRACT OR THE COMPANY WITHIN [10] DAYS AFTER YOU RECEIVE IT ([30] DAYS AFTER YOU RECEIVE IT IF IT WAS PURCHASED AS A REPLACEMENT CONTRACT). THE COMPANY WILL REFUND THE PREMIUM PAID TO THE FIXED ACCOUNT, LESS THE AMOUNT OF ANY PARTIAL WITHDRAWALS FROM THE FIXED ACCOUNT, PLUS THE INDEX ACCOUNT VALUE WITHOUT DEDUCTION FOR ANY FEES AND CHARGES. RETURNED CONTRACTS ARE VOID. The Telephone Number for the [Issue State] Department of Insurance is [Insurance Department telephone number]. INDIVIDUAL SINGLE PREMIUM DEFERRED REGISTERED INDEX-LINKED ANNUITY. DEATH BENEFIT AVAILABLE. INCOME OPTION AVAILABLE. NON-PARTICIPATING. This Contract is signed by the Company President Secretary [Home Office: [Service Center: 0 Xxxxxxxxx Xxx P.O. Box 24068 Lansing, Michigan 48951 Lansing, MI 48909-4068 1-800-644-4565] xxx.xxxxxxx.xxx]

RILA287-FB1 3a CONTRACT DATA PAGES Contract Number: [1234567890] Owner: [Xxxx Xxx] Owner Issue Age: [80] Joint Owner: [No Joint Owner] Joint Owner Issue Age: [N/A] Annuitant: [Xxxx Xxx] Annuitant Issue Age: [80] Joint Annuitant: [No Joint Annuitant] Joint Annuitant Issue Age: [N/A] Issue Date: [January 15, 2021] Issue State: [MI] Premium Amount: [$25,000] Income Date: [January 15, 2036] Primary Beneficiary(ies): [Xxxxx Xxx] Contingent Beneficiary(ies): [Xxxx Xxx]

RILA287-FB1 3b CONTRACT DATA PAGES (CONT'D) FIXED ACCOUNT INFORMATION: Fixed Account Minimum Interest Rate (FAMIR): [1.00%] Fixed Account Minimum Value Percentage: [87.50%] Fixed Account Minimum Value Annual Expense Allowance: [$50] INTEREST RATE FOR ADJUSTMENTS DUE TO MISSTATEMENT OF AGE OR SEX: [1.00%] WITHDRAWALS: Minimum partial withdrawal amount unless as a scheduled part of an automatic withdrawal program: [$500] Minimum partial withdrawal amount as a scheduled part of an automatic withdrawal program: [$50] Minimum Contract Value remaining after a partial withdrawal: [$2,000] MVA Free Withdrawal Percentage: [10%] PREMIUM: Premium is money paid into this Contract for allocation into a Contract Option. This is a single Premium Contract. The Company may waive minimum and maximum Premium at any time, on a nondiscriminatory basis. Minimum Premium: [$25,000] Maximum Premium: [$1,000,000] SEPARATE ACCOUNT: [Xxxxxxx National RILA Separate Account I]

RILA287-FB1 3c CONTRACT DATA PAGES (CONT'D) MARKET VALUE ADJUSTMENT (MVA): An MVA is a positive or negative adjustment the Company applies to amounts You remove from an Index Account Option due to withdrawals, annuitizations or transfers to the Fixed Account during the MVA Period. In the event of a total withdrawal, any applicable MVA is applied to the Index Account value, less any MVA Free Withdrawal amount available at the time of the total withdrawal. MVA Period: First [six (6)] Contract Years. The MVA reflects the movement in the MVA Reference Rate since the Issue Date. The MVA may: 1. reduce the value of the amount paid, annuitized or transferred if the MVA Reference Rate on the date You remove Index Account value from an Index Account Option is greater than the MVA Reference Rate on the Issue Date of Your Contract; or 2. increase the value of the amount paid, annuitized or transferred if the MVA Reference Rate on the date You remove Index Account value from an Index Account Option is less than the MVA Reference Rate on the Issue Date of Your Contract. The Company applies the same MVA formula regardless of whether the formula results in an increase or decrease to amounts You remove from an Index Account Option. MVA formula. The Company calculates the MVA by multiplying the amount You withdraw less any applicable charges by the result of the formula below: where: I is the MVA Reference Rate on the Issue Date J is the MVA Reference Rate on the date of withdrawal m is the number of complete months remaining from the date of the removal to the end of the MVA Period. The Company will not apply an MVA to: 1. death benefit proceeds; 2. payment of charges or fees; 3. amounts You allocate to an Income Option that is life contingent or results in payments spread over at least five (5) years; 4. transfers within the Index Account; 5. exercise of Your Notice of Right to Examine Contract Provision; 6. withdrawals taken under the MVA Free Withdrawal provision; 7. withdrawals taken to satisfy the Required Minimum Distribution (RMD); 8. amounts You remove on the Latest Income Date; 9. amounts You remove from Your Contract after the end of MVA Period; or 10. withdrawals or transfers from the Fixed Account. -1 [1+ I ] (m/12) [1+ J ] (m/12)

RILA287-FB1 3d CONTRACT DATA PAGES (CONT'D) MARKET VALUE ADJUSTMENT (MVA) (continued): MVA Reference Rate: [Bloomberg Barclays U.S. Intermediate Corporate Bond Index Yield to Maturity] The MVA Reference Rate applied on any day will be the MVA Reference Rate published on the prior Business Day. If the MVA Reference Rate is not published on the Business Day before the MVA is calculated, the Company will use the MVA Reference Rate for the most recent Business Day it was published. Discontinuation of or Substantial Change to the MVA Reference Rate. In the event that the MVA Reference Rate is no longer published, is discontinued, or if the calculation is substantially changed on the date You remove Contract Value from Your Contract then the Company may substitute a comparable method for determining the MVA Reference Rate. The Company will obtain approval from Your state insurance department and will notify You and any assignee before using a substitute method to calculate the MVA.

RILA287-FB1 3e CONTRACT DATA PAGES (CONT'D) TABLE OF INCOME OPTIONS The following table shows income values for each $1,000 of net proceeds applied to the Income Option. UNDER OPTION 4 MONTHLY INSTALLMENTS UNDER OPTIONS 1 OR 3 No. of Monthly Install- ments Monthly Install- ments Age of Annui- tant No. of Mos. Certain Age of Annui- tant No. of Mos. Certain Age of Annui- tant No. of Mos. Certain Age of Annui- tant No. of Mos. Certain Male Life 120 240 Male Life 120 240 Female Life 120 240 Female Life 120 240 60 17.09 40 2.33 2.32 2.31 68 4.72 4.57 4.02 40 2.22 2.22 2.21 68 4.36 4.26 3.86 72 14.31 41 2.37 2.36 2.35 69 4.90 4.72 4.09 41 2.26 2.26 2.25 69 4.52 4.40 3.94 84 12.33 42 2.41 2.41 2.39 70 5.09 4.89 4.16 42 2.30 2.30 2.29 70 4.69 4.55 4.02 96 10.84 43 2.45 2.45 2.43 71 5.31 5.06 4.23 43 2.34 2.34 2.32 71 4.87 4.70 4.09 108 9.68 44 2.50 2.50 2.47 72 5.54 5.24 4.29 44 2.38 2.38 2.36 72 5.06 4.87 4.16 120 8.76 45 2.55 2.54 2.52 73 5.79 5.43 4.34 45 2.42 2.42 2.40 73 5.28 5.04 4.22 132 8.00 46 2.60 2.59 2.56 74 6.06 5.63 4.39 46 2.47 2.47 2.45 74 5.51 5.23 4.28 144 7.37 47 2.65 2.64 2.61 75 6.35 5.83 4.43 47 2.52 2.51 2.49 75 5.76 5.42 4.34 156 6.84 48 2.71 2.70 2.66 76 6.67 6.04 4.47 48 2.57 2.56 2.54 76 6.03 5.62 4.38 168 6.38 49 2.77 2.76 2.71 77 7.02 6.26 4.50 49 2.62 2.61 2.59 77 6.33 5.83 4.43 180 5.98 50 2.83 2.82 2.76 78 7.40 6.48 4.52 50 2.67 2.67 2.64 78 6.65 6.04 4.46 192 5.64 51 2.89 2.88 2.82 79 7.81 6.70 4.54 51 2.73 2.72 2.69 79 7.01 6.26 4.49 204 5.33 52 2.96 2.94 2.88 80 8.27 6.92 4.56 52 2.79 2.78 2.74 80 7.40 6.48 4.52 216 5.06 53 3.03 3.01 2.94 81 8.76 7.13 4.57 53 2.85 2.84 2.80 81 7.83 6.70 4.54 228 4.82 54 3.10 3.08 3.00 82 9.30 7.34 4.58 54 2.92 2.91 2.85 82 8.29 6.92 4.56 240 4.60 55 3.18 3.16 3.06 83 9.89 7.53 4.58 55 2.99 2.98 2.91 83 8.80 7.13 4.57 252 4.40 56 3.26 3.23 3.13 84 10.54 7.72 4.59 56 3.07 3.05 2.98 84 9.35 7.33 4.58 264 4.22 57 3.35 3.32 3.19 85 11.26 7.88 4.59 57 3.14 3.12 3.04 85 9.95 7.52 4.58 276 4.06 58 3.44 3.40 3.26 86 12.05 8.03 4.59 58 3.23 3.20 3.11 86 10.59 7.70 4.59 288 3.90 59 3.54 3.49 3.34 87 12.91 8.17 4.59 59 3.31 3.29 3.18 87 11.28 7.87 4.59 300 3.77 60 3.64 3.59 3.41 88 13.86 8.28 4.60 60 3.40 3.37 3.25 88 12.03 8.02 4.59 312 3.64 61 3.74 3.69 3.48 89 14.88 8.38 4.60 61 3.50 3.46 3.32 89 12.84 8.15 4.59 324 3.52 62 3.86 3.79 3.56 90 15.99 8.46 4.60 62 3.60 3.56 3.40 90 13.71 8.27 4.60 336 3.41 63 3.98 3.91 3.64 91 17.17 8.53 4.60 63 3.71 3.66 3.47 91 14.66 8.37 4.60 348 3.31 64 4.11 4.02 3.71 92 18.43 8.58 4.60 64 3.82 3.77 3.55 92 15.70 8.45 4.60 360 3.21 65 4.24 4.15 3.79 93 19.78 8.63 4.60 65 3.95 3.88 3.63 93 16.86 8.53 4.60 66 4.39 4.28 3.87 94 21.20 8.66 4.60 66 4.07 4.00 3.71 94 18.13 8.58 4.60 67 4.55 4.42 3.95 95 22.67 8.68 4.60 67 4.21 4.12 3.79 95 19.53 8.63 4.60 Note: Due to the volume of relevant information, the Table does not provide income values for Option 2 described in the Income Provisions. Those values are available from the Company's Service Center upon request. You may contact the Company's Service Center as shown on the cover page of the Contract. BASIS OF COMPUTATION. The [2012 Individual Annuity Mortality Period Table, with an interest rate of 1.00% and a 0% expense load], provides the actuarial basis for the Table of Income Options. The Table of Income Options does not include any applicable tax.

RILA287 5 DEFINITIONS (CONT'D) FIXED ACCOUNT MINIMUM VALUE (FAMV). The FAMV is equal to all amounts allocated to the Fixed Account, net of applicable taxes, multiplied by the Fixed Account Minimum Value Percentage, and; 1. reduced by partial withdrawals and transfers from the Fixed Account, and the Fixed Account Minimum Value Annual Expense Allowance; then 2. accumulated at the FAMIR. FIXED ACCOUNT MINIMUM VALUE ANNUAL EXPENSE ALLOWANCE. An annual deduction from the FAMV. On each Contract Anniversary, the Company will deduct the Fixed Account Minimum Value Annual Expense Allowance from the FAMV. The Fixed Account Minimum Value Annual Expense Allowance is shown on the Contract Data Pages. FIXED ACCOUNT MINIMUM VALUE PERCENTAGE. The Fixed Account Minimum Value Percentage is multiplied by Premiums and transfers allocated to the Fixed Account in the determination of the FAMV. The Fixed Account Minimum Value Percentage is shown on the Contract Data Pages. GOOD ORDER. The Company's receipt of all Premium, information, documentation, and/or instructions the Company requires before it will issue the Contract, credit any interest, or execute any transaction. INCOME DATE. The date on which Income Payments are scheduled to begin as described in the Income Provisions. The Income Date is shown on the Contract Data Pages. INCOME OPTION. Payment options as provided under the Income Provisions. INDEX(ES). A benchmark used to determine the Index Adjustment, if any, for a particular Index Account Option. See the Supplemental Contract Data Pages for the available Indexes as of the Issue Date. INDEX ACCOUNT. A Contract Option in which amounts are subject to an Index Adjustment for a specified period of time. See the Supplemental Contract Data Pages and Crediting Method Endorsements for detailed descriptions of the Index Account Options within the Index Account. Index Account Option availability is subject to change at the discretion of the Company on a non-discriminatory basis. INDEX ACCOUNT OPTION. An option within the Index Account for allocation of Contract Value. Each Index Account Option is defined by its term, Index and Crediting Method. INDEX ACCOUNT OPTION ANNIVERSARY. The Business Day concurrent with or immediately following each anniversary of the Issue Date.

RILA287 6 DEFINITIONS (CONT'D) INDEX ACCOUNT OPTION TERM ANNIVERSARY. The Business Day concurrent with or immediately following the end of an Index Account Option term. INDEX ADJUSTMENT (IA). The adjustment amount to an Index Account Option on the Index Account Option Term Anniversary. This adjustment can be positive or negative, depending on Index performance and Crediting Method. INDEX ADJUSTMENT FACTOR(S). Parameters used to determine the Index Adjustment. These parameters are specific to the applicable Crediting Method(s). See the Supplemental Contract Data Pages and Crediting Method endorsements for additional details. INTERIM VALUE. The quantity used to adjust the Index Account Option value for withdrawals prior to the end of the Index Account Option term. The Interim Value uses prorated Index Adjustment Factors based on the elapsed portion of the Index Account Option term and the Interim Value Proration Factor (IVPF). For detailed information on the Interim Value, see the Crediting Method endorsements and the Supplemental Contract Data Pages. ISSUE DATE. The date the Company issued the Contract. The Issue Date is shown on the Contract Data Pages. JOINT ANNUITANT. Each of multiple Annuitants. JOINT OWNER. Each of multiple Owners. LATEST INCOME DATE (LID). The Contract Anniversary on which You will be 95 years old, or such earlier date required by a Qualified Plan, law or regulation. MARKET VALUE ADJUSTMENT (MVA). A positive or negative adjustment to amounts You remove from an Index Account Option due to withdrawals, annuitizations or transfers to the Fixed Account during the MVA Period. The MVA formula and the MVA Period are shown on the Contract Data Pages. NON-QUALIFIED PLAN. A retirement plan which does not qualify for favorable tax treatment under Sections 401, 403, 408, or 408A of the Internal Revenue Code, as amended. OWNER ("YOU," "YOUR"). The natural person(s) or legal entity(ies) that has all rights under the Contract, and is shown on the Contract Data Pages, or by subsequent designation. In this Contract, "You" and "Your" also mean the Owner. References to the Owner include all Joint Owners, if applicable. PREMIUM. Money paid into this Contract for allocation into the Contract Options. QUALIFIED PLAN. A retirement plan which qualifies for favorable tax treatment under Sections 401, 403, 408, or 408A of the Internal Revenue Code, as amended.

RILA287 10 GENERAL PROVISIONS (CONT'D) PROOF OF AGE, SEX AND/OR SURVIVAL. The Company may require proof of age and/or sex, satisfactory to the Company, at any time. If any payment required by this Contract depends on a living Annuitant, Owner, or Beneficiary, the Company may require proof of that person's survival, satisfactory to the Company. PROTECTION OF PROCEEDS. A Beneficiary may not assign Contract proceeds before the proceeds are payable. Contract proceeds are not subject to the claims of creditors or to legal process unless required by applicable law. REPORTS. The Company will send a report to Your last address in the Company's records at least annually before the Income Date. In the case of Joint Owners, the Company will send reports only to the primary Owner's address. If You have elected electronic delivery, a report may be provided in the form of an email to Your last email address in the Company's records, or a notice to You of a document's availability on the Company's website. Each report will provide at least the following information: 1. the dates that begin and end the reporting period; 2. the Contract Value at the beginning and at the end of the current reporting period prior to the application of any MVA; 3. the Withdrawal Value at the end of the reporting period; 4. the MVA amount the Company used to determine the Withdrawal Value; 5. the amounts the Company has credited to and deducted from the Contract Value during the reporting period; 6. the death benefit at the end of the reporting period; and 7. any other information state and federal law require. You may receive copies of reports the Company provides upon request at no additional charge. You will receive a confirmation statement for certain transactions at the time they occur. SEPARATE ACCOUNT. The Company holds certain investments supporting the assets allocated to the Index Account in a non-insulated, non-unitized Separate Account. The Separate Account is established pursuant to the laws of the Company's domiciliary state solely for the purpose of supporting obligations under the Contract. You do not directly participate in the performance of assets held in the Separate Account; and do not have any direct claim on them. Assets of the Separate Account are chargeable with the claims of any of the Company's contract owners as well as the Company's creditors and are subject to the liabilities arising out of any other business the Company conducts. The Separate Account is not registered under the Investment Company Act of 1940. The name of the Separate Account is shown on the Contract Data Pages. TAXES. This Contract is intended to be treated as an annuity contract for federal income tax purposes. Accordingly, for all Non-Qualified Contracts all provisions of this Contract shall be interpreted and administered in accordance with the requirements of Section 72(s) of the Internal Revenue Code. The Company will deduct any taxes attributed to the Contract and payable to a government entity from the Contract Value. The Company reserves the right to deduct any amounts the Company might advance to pay taxes from the Contract Value. The Company will withhold taxes required by law from any amounts payable from this Contract.

RILA287 11 GENERAL PROVISIONS (CONT'D) WRITTEN NOTICE. Written information or instructions You intend to give the Company must be in Good Order and delivered to the Company's Service Center, unless the Company advises You otherwise. Instructions included in the Written Notice will take effect on the date the Company receives the notice in Good Order at the Company's Service Center, unless otherwise provided in the notice or in this Contract, or unless the Company advises You otherwise. The Company will deliver any notice or communication to Your last address in the Company's records unless You request otherwise in writing. If You have elected electronic delivery, communication may be provided in the form of an email to Your last email address in the Company's records, or a notice to You of a document's availability on the Company's website. You are responsible for notifying the Company of any address change, email address change, or any error in a Company notice sent to You. In the case of Joint Owners, the Company will send notices and other communications to the primary Owner's address.

RILA287 19 INCOME PROVISIONS INCOME DATE. Income Payments begin on the Income Date. If You do not select an Income Date, the Income Date is the LID. You may change the Income Date to any date that is not later than the LID by submitting Written Notice in Good Order to the Company's Service Center at least seven (7) days before the Income Date. INCOME PAYMENT. On or before the Income Date, You may elect payment in a single lump- sum. A single lump-sum payment is considered a total withdrawal and terminates the Contract. The Company will make payment to You or another payee You specify. Alternatively, You may elect an Income Option to begin on the Income Date. The Company will apply the Contract Value, less applicable taxes, adjusted for any applicable MVA, to provide You income according to Your selected Income Option. INCOME OPTIONS. You may elect payment as provided in Options 1, 2, 3, or 4 below. You may elect an Income Option up to thirty (30) days before the Income Date by submitting Written Notice in Good Order to the Company's Service Center. The Company will make payment to You or another payee You specify. If You do not select an Income Option the Company will make payments as provided in Option 3 below, with 120 months certain. The Company will make payments monthly, quarterly, semiannually or annually as You elect. However, if the Contract Value on the Income Date is less than $2,000, the Company may pay out the Contract Value in one (1) lump-sum payment instead of providing Income Payments according to the Income Option You elect. If the first monthly payment provided would be less than $20, the Company may make payments quarterly, semiannually or annually to achieve an initial payment of at least $20, or the Company may pay out the Contract Value in one (1) single lump-sum payment. At the time of their commencement, Income Payments will not be less than those that would be provided by the application of an equivalent amount to purchase a single premium immediate annuity contract from the Company at purchase rates the Company offered on the Income Date to annuitants in the same class as the Annuitant. YOU MAY NOT TAKE WITHDRAWALS DURING ANY PERIOD THE COMPANY IS MAKING PAYMENTS FOR AN ANNUITANT'S LIFETIME. OPTION 1 - LIFE INCOME. A monthly payment for the Annuitant's lifetime. All payments end upon the Annuitant's death. However, in the event of the Annuitant's death before the first monthly payment, the Company will pay the amount allocated to this Income Option to You or, if You are deceased, to Your Beneficiary. No MVA applies to Contract Value applied to Option 1. OPTION 2 - JOINT AND SURVIVOR INCOME. A monthly payment for the longer of the Annuitant's lifetime or that of a second person You designate. Upon the occasion of the first person to die, monthly payments continue during the survivor's lifetime at either the full amount previously payable or as a percentage (either one-half or two-thirds) of the full amount, as You select at the time You elect the Income Option. All payments end upon the death of the last surviving Annuitant. However, in the event of the deaths of the Annuitant and the designated second person before the first monthly payment, the Company will pay the amount allocated to this Income Option to You or, if You are deceased, Your Beneficiary. No MVA applies to Contract Value applied to Option 2.

RILA287 21 INCOME PROVISIONS (CONT'D) BENEFICIARY'S ENTITLEMENT TO INCOME PAYMENTS AFTER THE INCOME DATE. Upon the death of any Owner, the Company will pay any remaining Income Payments due to Primary Beneficiaries or, if none exist, to the Contingent Beneficiaries, in equal shares (the "default allocation") unless You have designated otherwise (the "designated allocation"). A Beneficiary that dies before or within ten (10) days (or different period as prescribed by applicable law) of Your death is not entitled to remaining Income Payments due; in that circumstance, the Company will pay any remaining Income Payments due the deceased Beneficiary to surviving Beneficiaries in the same proportion as the designated allocation or, if applicable, the default allocation. If no Beneficiary survives You, the Company will pay remaining Income Payments to Your estate.

RILA287 22 TERMINATION PROVISIONS This Contract terminates and all Contract benefits, will end on the earlier of: 1. the date You take a total withdrawal; 2. the date the Contract Value is reduced to zero for any reason, or; 3. the date upon which the Company receives Due Proof of Your (or any Joint Owner's) death and all Beneficiaries' election of a death benefit payment option in Good Order at the Company's Service Center, unless the Contract is continued by the spouse under the Spousal Continuation Option.