[LOGO]
Mailing Address: Post Office Box 29564, Raleigh, North Carolina 27626-0564
Home Office: 0000 Xxxxxxxxxx Xxxxx, Xxxxxxx, Xxxxx Xxxxxxxx 00000
(000) 000-0000
LONDON PACIFIC LIFE & ANNUITY COMPANY (the "Company") in consideration of the
payment of the Contribution issued this Contract.
The Company will pay the benefits of this Contract, subject to all of its
provisions, terms and conditions.
RIGHT TO EXAMINE CONTRACT: Within 10 days of the date of receipt of this
Contract by the Owner, it may be returned by delivering or mailing it to the
Company at its Annuity Service Center. When this Contract is received by the
Company, it will be voided as if it had never been in force. A written request
for cancellation must accompany the contract. In such event, the Company will
refund the Contribution
THIS IS A LEGAL CONTRACT BETWEEN THE OWNER AND THE COMPANY
READ YOUR CONTRACT CAREFULLY
Xxxxxx X. Xxxxxxxxx, Xxx X. Xxxxxxxxx,
SECRETARY PRESIDENT
INDIVIDUAL FIXED AND VARIABLE SINGLE CONTRIBUTION IMMEDIATE ANNUITY CONTRACT
NONPARTICIPATING
ANNUITY PAYMENTS PROVIDED BY THIS CONTRACT ARE BASED ON THE INVESTMENT
EXPERIENCE OF A SUB-ACCOUNT AND WILL VARY IN ACCORDANCE WITH THE PERFORMANCE OF
THE SUB-ACCOUNT, EXCEPT TO THE EXTENT LIMITED BY THE GUARANTEED MINIMUM ANNUITY
PAYMENT FEATURE. DETAILS OF THE GUARANTEED MINIMUM ANNUITY PAYMENT FEATURE ARE
DESCRIBED UNDER ANNUITY PROVISIONS ON PAGE ____.
{policy #}
TABLE OF CONTENTS
PAGE
CONTRACT SCHEDULE
DEFINITIONS
CONTRIBUTION PROVISIONS
Contribution
Allocation of Contribution
SEPARATE ACCOUNT PROVISIONS
The Separate Account
Separate Account Charge
Guaranteed Minimum Annuity Payment Charge
Valuation of Assets
VALUATION PROVISIONS
Annuity Unit Value
Net Investment Factor
ANNUITY PROVISIONS
Annuity Date
Determination of Annuity Payments
Guaranteed Minimum Annuity Payments
SUSPENSION OR DEFERRAL OF PAYMENT PROVISIONS
OWNER, ANNUITANT, OWNERSHIP, ASSIGNMENT PROVISIONS
Owner
Annuitant
Assignment Of The Contract
PROCEEDS PAYABLE ON DEATH
Death Before Annuity Date
Distribution Requirements Before the Annuity Date
Death of Owner On or After the Annuity Date
Death of Annuitant On or After the Annuity Date
Non-Individual Owner
Beneficiary
Change Of Beneficiary
GENERAL PROVISIONS
The Contract
Misstatement of Age and Sex
Incontestability
Modification
Non-Participating
Evidence Of Survival
Proof Of Age
Protection Of Proceeds
Reports
Taxes
Regulatory Requirements
Substitution
Change in the Operation of the Separate Account
CONTRACT SCHEDULE
OWNER: [Xxxx Xxxxx]
ANNUITANT: [Xxxx Xxxxx] AGE AND SEX: [50 Male]
PAYEE: [Xxxx Xxxxx] BENEFICIARY: [Xxxx Xxxxx]
CONTRACT NUMBER: [12345] ISSUE DATE: [July 1, 1998]
CONTRIBUTION: [$100,000] ANNUITY DATE: [August 1,1998]
ASSUMED INVESTMENT RETURN: [3%] ANNUITY UNIT FACTOR [.999866]
ANNUITY PAYMENT FREQUENCY: [Monthly] PAYMENT FACTOR [5.5257]]
GUARANTEED MINIMUM ANNUITY FIXED ACCOUNT INTEREST RATE [4%]
PAYMENT [$552.57]
--------------------------------------------------------------------------------
PORTFOLIO OPTIONS:
------------------
THE CONTRIBUTION, WITH INTEREST, WILL BE ALLOCATED TO THE EQUITY 500 INDEX
SUB-ACCOUNT SPECIFIED BELOW 30 DAYS AFTER THE ISSUE DATE SPECIFIED ABOVE.
SEPARATE ACCOUNT:
-----------------
LPLA SEPARATE ACCOUNT ONE
SUB-ACCOUNT: BASED ON:
------------ ---------
Equity 500 Index BT Equity 500 Index Fund
SEPARATE ACCOUNT CHARGE
-----------------------
A daily charge at an annual rate of [1.25%] (0.0000347693 daily) of the assets
held in the Separate Account.
GUARANTEED MINIMUM ANNUITY PAYMENT CHARGE
-----------------------------------------
A daily charge at an annual rate of [1.75%] (0.0000486771 daily) of the assets
held in the Separate Account.
ANNUITY SERVICE CENTER:
-----------------------
LONDON PACIFIC LIFE & ANNUITY COMPANY OR LONDON PACIFIC LIFE & ANNUITY COMPANY
ANNUITY SERVICE CENTER ANNUITY SERVICE CENTER
P.O. BOX 29596 0000 XXXXXXXXXX XXXXX
XXXXXXX, XXXXX XXXXXXXX 00000 XXXXXXX, XXXXX XXXXXXXX 00000
(000) 000-0000
(000) 000-0000
DESCRIPTION OF ANNUITY BENEFIT:
-------------------------------
LIFE ANNUITY
AN ANNUITY PAYABLE ACCORDING TO THE ANNUITY PAYMENT FREQUENCY SELECTED DURING
THE LIFETIME OF THE ANNUITANT, CEASING WITH THE LAST PAYMENT DUE PRIOR TO THE
DEATH OF THE ANNUITANT. THE FIRST ANNUITY PAYMENT IS BASED ON THE ASSUMED
INVESTMENT RETURN, THE AGE AND SEX OF THE ANNUITANT, AND {TBD} PROJECTED TO YEAR
[__].
LIFE ANNUITY WITH PERIOD CERTAIN
AN ANNUITY PAYABLE ACCORDING TO THE ANNUITY PAYMENT FREQUENCY SELECTED DURING
THE LIFETIME OF THE ANNUITANT, CEASING WITH THE LAST PAYMENT DUE PRIOR TO THE
DEATH OF THE ANNUITANT. THE FIRST ANNUITY PAYMENT IS BASED ON THE ASSUMED
INVESTMENT RETURN, THE AGE AND SEX OF THE ANNUITANT, AND {TBD} PROJECTED TO YEAR
[__]. IF, AT THE DEATH OF THE ANNUITANT, PAYMENTS HAVE BEEN MADE FOR LESS THAN
THE [ ] YEAR PERIOD, THE REMAINING PAYMENTS WILL CONTINUE TO THE BENEFICIARY FOR
THE REMAINDER OF THE PERIOD.
CONTRACT SCHEDULE(CONTINUED)
PAYMENT FOR [25] YEARS CERTAIN
AN ANNUITY PAYABLE ACCORDING TO THE ANNUITY PAYMENT FREQUENCY SELECTED FOR A
FIXED PERIOD OF [25] YEARS. IF, AT THE DEATH OF THE ANNUITANT, PAYMENTS HAVE
BEEN MADE FOR LESS THAN THE [25] YEAR PERIOD, THE REMAINING PAYMENTS WILL
CONTINUE TO THE BENEFICIARY FOR THE REMAINDER OF THE PERIOD.
JOINT AND SURVIVOR LIFE ANNUITY
AN ANNUITY PAYABLE ACCORDING TO THE ANNUITY PAYMENT FREQUENCY SELECTED DURING
THE JOINT LIFETIME OF THE ANNUITANT AND THE JOINT ANNUITANT, CEASING WITH THE
LAST PAYMENT DUE PRIOR TO THE DEATH OF THE ANNUITANT OR JOINT ANNUITANT,
WHICHEVER DEATH IS LAST. THE FIRST ANNUITY PAYMENT IS BASED ON THE ASSUMED
INVESTMENT RETURN, THE AGES AND SEXES OF THE ANNUITANT AND JOINT ANNUITANT AND
{TBD} PROJECTED TO YEAR [___].
CONTRACT SURRENDERS:
--------------------
THE OWNER MAY NOT SURRENDER THE CONTRACT AFTER THE EXPIRATION OF THE RIGHT TO
EXAMINE PERIOD DESCRIBED ON THE FACE OF THIS CONTRACT.
DEFINITIONS
AGE: The age of any Owner or Xxxxxxxxx on his/her last birthday as of the
Annuity Date
ANNUITANT: The natural person on whose life annuity payments are based. On or
after the Annuity Date, the Annuitant shall also include any Joint Annuitant.
ANNUITY DATE: The date on which annuity payments begin. The Annuity Date is
shown on the Contract Schedule.
ANNUITY CALCULATION DATE: The date on which the first annuity payment will be
calculated. It will be no more than 5 days prior to the Annuity Date.
ANNUITY PAYMENT FREQUENCY: The frequency with which annuity payments will be
made. The frequencies available are monthly and annually. Once selected, the
Annuity Payment Frequency may not be changed.
ANNUITY PERIOD The period of time beginning with the Annuity Date during which
annuity payments are made.
ANNUITY SERVICE CENTER: The office indicated on the Contract Schedule of this
Contract to which notices, requests and the Contribution must be sent. All sums
payable to the Company under this Contract are payable only at the Annuity
Service Center.
ANNUITY UNIT An accounting unit of measure used in the calculation of annuity
payments.
ANNUITY UNIT FACTOR: The factor applied daily to neutralize the effect of the
Assumed Investment Return.
ASSUMED INVESTMENT RETURN: The investment return upon which the annuity payments
in the contract are based.
BENEFICIARY: The person entitled to receive benefits as per the terms of the
contract in case of the death of the Owner or the later death of the Annuitant
or Joint Annuitant, as applicable.
COMPANY: London Pacific Life & Annuity Company.
CONTRIBUTION: A payment made by or on behalf of an Owner with respect to this
Contract.
DUE PROOF OF DEATH: A certified copy of the death certificate, an order of a
court of competent jurisdiction, a statement from a physician who attended the
deceased or any other proof acceptable to the Company.
ELIGIBLE FUND(S): Currently the investment entity(ies) shown on the Contract
Schedule.
DEFINITIONS (CONTINUED)
FIXED ACCOUNT: An investment option within the General Account where the
Contribution is invested prior to the Annuity Date. The Fixed Account Interest
Rate is shown on the Contract Schedule.
GENERAL ACCOUNT: The Company's general investment account which contains all the
assets of Company with the exception of the Separate Account and other
segregated asset accounts.
GUARANTEED MINIMUM ANNUITY PAYMENT: The amount which is guaranteed as the
minimum annuity payment amount. This amount is payable regardless of the
performance of the Sub-Account.
ISSUE DATE: The date on which the Contract became effective. Similarly, Contract
years are measured from the Issue Date.
JOINT ANNUITANT: A person other than the Annuitant on whose continuation of life
annuity payments may be made. The contract will have a Joint Annuitant only if
the Description of Annuity Benefit on the Contract Schedule provides for a
survivor. The Joint Annuitant may not be changed.
OWNER: The person(s) or entity(ies) entitled to the ownership rights stated in
this Contract.
PAYEE: The person, designated by the Owner, to whom annuity payments will be
made.
PAYMENT FACTOR: The factor shown on the Contract Schedule which is used on the
Annuity Calculation Date to calculate the first annuity payment.
PORTFOLIO: A segment of an Eligible Fund which constitutes a separate and
distinct class of shares.
PREMIUM TAX: Any premium taxes paid to any governmental entity and assessed
against the Contribution. The Company will deduct the tax on the Issue Date.
SEPARATE ACCOUNT: An account established by the Company to separate the assets
funding the variable benefits for the class of Contracts to which this contract
belongs from the Company's other assets. The assets in the Separate Account are
not chargeable with liabilities arising out of any other business the Company
may conduct. The Separate Account and the Sub-Accounts are listed on the
Contract Schedule.
SUB-ACCOUNT: The subdivision of the Separate Account as shown on the Contract
Schedule.
VALUATION DATE: Each day on which the Company and the New York Stock Exchange
("NYSE") are open for business.
DEFINITIONS (CONTINUED)
VALUATION PERIOD: The period of time beginning at the close of business of the
NYSE on each Valuation Date and ending at the close of business for the next
succeeding Valuation Date.
WRITTEN REQUEST: A request in writing, in a form satisfactory to the Company,
which is received by the Annuity Service Center.
CONTRIBUTION PROVISIONS
CONTRIBUTION: The Contribution is shown on the Contract Schedule. This is a
single Contribution Contract. The Company reserves the right to reject any
Application or Contribution.
ALLOCATION OF CONTRIBUTION: The Contribution initially will be allocated to the
Fixed Account. The Contribution, with interest, will be allocated to the Equity
500 Index Sub-Account of the Separate Account shown on the Contract Schedule 30
days after the Issue Date shown on the Contract Schedule. Allocation of the
Contribution is subject to the terms and conditions imposed by the Company.
SEPARATE ACCOUNT PROVISIONS
THE SEPARATE ACCOUNT: The Separate Account is designated on the Contract
Schedule and consists of assets set aside by the Company, which are kept
separate from that of the general assets and all other separate account assets
of the Company. The assets of the Separate Account equal to reserves and other
liabilities will not be charged with liabilities arising out of any other
business the Company may conduct. The Separate Account assets are divided into
Sub-Accounts. The Sub-Account currently available under this Contract is listed
on the Contract Schedule. The assets of the Sub-Account are allocated to the
Eligible Fund(s) and Portfolio(s), if any, within an Eligible Fund shown on the
Contract Schedule.
Should the shares of the Eligible Fund become unavailable for investment by the
Separate Account, or the Company's Board of Directors deems further investment
in these shares inappropriate, the Company may limit further purchase of such
shares or substitute shares of another Eligible Fund or Portfolio for shares
already purchased under this Contract.
SEPARATE ACCOUNT CHARGE: Each Valuation Period, the Company deducts a Separate
Account Charge from the Sub-Account of the Separate Account which is equal, on
an annual basis, to the amounts shown on the Contract Schedule. The Separate
Account Charge compensates the Company for assuming the mortality and expense
risks under this Contract and the costs associated with the administration of
this Contract and the Separate Account.
GUARANTEED MINIMUM ANNUITY PAYMENT CHARGE: Each Valuation Period, the Company
deducts a Guaranteed Minimum Annuity Payment Charge from the Sub-Account of the
Separate Account which is equal, on an annual basis, to the amount shown on the
Contract Schedule. The Guaranteed Minimum Annuity Payment Charge compensates the
Company for the costs associated with providing the Guaranteed Minimum Annuity
Payment shown on the Contract Schedule.
VALUATION OF ASSETS: The assets of the Separate Account are valued at their fair
market value in accordance with procedures of the Company.
VALUATION PROVISIONS
ANNUITY UNIT VALUE: The value of an Annuity Unit for the Sub-Account of the
Separate Account will vary to reflect the investment experience of the
applicable Eligible Fund and will be determined by multiplying the value of the
Annuity Unit for the Sub-Account on the preceding day by the product of (a) the
Net Investment Factor for the Sub-Account for the day for which the Annuity Unit
Value is being calculated, and (b) the Annuity Unit Factor which neutralizes the
Assumed Investment Return. Both the Annuity Unit Factor and the Assumed
Investment Return appear on the Contract Schedule.
NET INVESTMENT FACTOR: The Net Investment Factor for the Sub-Account is equal
to:
(a) the value of a share of the corresponding Eligible Fund at the end of
the Valuation Period (plus the per share amount of any unpaid
dividends or capital gains by that Eligible Fund ); divided by
(b) the value of a share of the corresponding Eligible Fund at the
beginning of the Valuation Period: and
(c ) subtracting from that amount the daily Separate Account Charge and
the daily Guaranteed Minimum Annuity Payment Charge which are shown on
the Contract Schedule.
ANNUITY PROVISIONS
ANNUITY DATE: The Annuity Date must be the thirtieth (30th) day after the Issue
Date shown on the Contract Schedule. The Annuity Date is shown on the Contract
Schedule.
DETERMINATION OF ANNUITY PAYMENTS: The first annuity payment will be calculated
on the Annuity Calculation Date which will be no more than 5 days prior to the
Annuity Date. Annuity payments reflect the investment performance of the
Sub-Account of the Separate Account during the Annuity Period. On the Annuity
Calculation Date, a fixed number of Annuity Units will be purchased, determined
as follows:
The first annuity payment is equal to the Contribution, with interest, divided
first by $1,000 and then multiplied by the Payment Factor shown on the Contract
Schedule. In the Sub-Account the fixed number of Annuity Units is determined by
dividing the amount of the initial annuity payment determined for the
Sub-Account by the Annuity Unit Value on the Annuity Calculation Date.
Thereafter, the number of Annuity Units in the Sub-Account remains unchanged.
All calculations shall appropriately reflect the Annuity Payment Frequency
selected.
Once annuity payments have begun, the number of Annuity Units remains fixed. The
method of calculating the Annuity Unit Value is described under Valuation
Provisions.
The dollar amount of annuity payments for the Sub-Account after the first
annuity payment determined as follows:
1. The dollar amount of the first annuity payment is divided by the value
of an Annuity Unit for the Sub-Account as of the Annuity Date. This
sets the number of Annuity Units for each monthly payment for the
Sub-Account. The number of Annuity Units for the Sub-Account remains
fixed after the Annuity Calculation Date;
2. The fixed number of Annuity Units in the Sub-Account is multiplied by
the Annuity Unit Value for the Sub-Account for the last Valuation
Period. This result is the dollar amount of the payment for the
Sub-Account.
The Company guarantees that the dollar amount of annuity payments will not be
adversely affected by variations in the expense results and in the actual
mortality experience of Annuitants from the mortality assumptions, including any
age adjustment, used in determining the first monthly payment.
ANNUITY PROVISIONS (CONTINUED)
GUARANTEED MINIMUM ANNUITY PAYMENT : The Company will guarantee that the annuity
payment will be at least equal to 100% of the Guaranteed Minimum Annuity Payment
shown on the Contract Schedule. Each annuity payment will vary upwards or
downwards in accordance with the performance of the Sub-Account, unless the
annuity payment would be less than the Guaranteed Minimum Annuity Payment. Under
the terms of the Contract's guarantee, the Company will pay the Payee the
greater of; (a) the annuity payment amount determined by multiplying the number
of annuity units times the annuity unit value; or (b) the Guaranteed Minimum
Annuity Payment .
SUSPENSION OR DEFERRAL OF PAYMENT PROVISIONS
The Company reserves the right to suspend or postpone payments from the Separate
Account for a benefit payment or transfer:
(a) for any period during which the New York Stock Exchange is closed or
during which trading on the New York Stock Exchange is restricted;
(b) for any period during which an emergency exists as a result of which
(i) disposal of the securities held in the Sub-Account is not
reasonably practicable, or (ii) it is not reasonably practicable for
the value of the net assets of the Separate Account to be fairly
determined;
(c) for such other periods as the Securities and Exchange Commission may,
by order, permit for the protection of the contract owners. The
conditions under which trading shall be deemed to be restricted or any
emergency shall be deemed to exist shall be determined by rules and
regulations of the Securities and Exchange Commission.
OWNER, ANNUITANT, OWNERSHIP, ASSIGNMENT PROVISIONS
OWNER: The Owner has all interest and right to amounts held in his or her
Contract. The Owner is the person designated as such on the Issue Date, unless
changed.
The Owner may change owners of the Contract at any time prior to the Annuity
Date by Written Request. A Change of Owner will automatically revoke any prior
designation of Owner. The change will become effective as of the date the
Written Request is signed. A new designation of Owner will not apply to any
payment made or action taken by the Company prior to the time it was received.
Any change to the Owner of the Contract will be subject to the Company's
underwriting rules then in effect.
This Contract may be owned by Joint Owners. The Owners must jointly exercise all
of the rights contained in the Contract.
ANNUITANT: The Annuitant and Joint Annuitant is the person or persons on whose
life annuity payments are based. The Annuitant and Joint Annuitant is the person
or persons designated by the Owner at the Issue Date.
ASSIGNMENT OF THE CONTRACT: A Written Request specifying the terms of an
assignment of the Contract must be provided to the Annuity Service Center. Until
the Written Request is received, the Company will not be required to take notice
of or be responsible for any transfer of interest in the Contract by assignment,
agreement, or otherwise.
The Company will not be responsible for the validity or tax consequences of any
assignment. Any assignment made after the death benefit has become payable will
be valid only with the Company's consent.
If the Contract is assigned, the Owner's rights may only be exercised with the
consent of the assignee of record.
PROCEEDS PAYABLE ON DEATH
DEATH BEFORE ANNUITY DATE: If an Owner or an Annuitant dies before the Annuity
Date, the Company will pay the Beneficiary the death benefit described below.
The death benefit is calculated as of the date the Company receives written
notification of Due Proof of Death. The death benefit is equal to the
Contribution, with interest.
DISTRIBUTION REQUIREMENTS BEFORE THE ANNUITY DATE: The Beneficiary must elect
the death benefit to be paid under one of the options below:
(a) The entire interest in the Contract will be distributed within 5 years
of the date of death, or
(b) The Beneficiary elects to have the death benefit distributed over a
period that does not extend beyond such Beneficiary's life or life
expectancy and payments start within 1 year after the date of death,
or
(c) In the event of death of an Owner who is not an Annuitant, if the
designated Beneficiary is the spouse of the deceased owner, he or she
may elect to continue the Contract.
The death benefit will be paid after the death of the Owner, the Joint Owner, if
any, the Annuitant, or the Joint Annuitant, if any, whichever death is first.
Payment to the Beneficiary, other than in a single lump sum, may only be elected
during the sixty-day period beginning with the date of receipt of Due Proof of
Death.
DEATH OF OWNER ON OR AFTER THE ANNUITY DATE: If the Owner, or any Joint Owner,
dies on or after the Annuity Date any remaining payments as described on the
Contract Schedule will continue at least as rapidly as under the method of
distribution in effect at such Owner's death. Upon the Owner's death on or after
the Annuity Date the Beneficiary becomes the Owner.
DEATH OF ANNUITANT ON OR AFTER THE ANNUITY DATE: Upon the death of the Annuitant
on or after the Annuity Date, any remaining payments as described on the
Contract Schedule will continue at least as rapidly as under the method of
distribution in effect at such Annuitant's death.
NON-INDIVIDUAL OWNER: If the Owner is a non-individual then the death of an
Annuitant shall be treated as the death of the Owner for purposes of the
distribution of the death benefit.
BENEFICIARY: The Beneficiary designation in effect on the Issue Date will remain
in effect until changed. The Beneficiary is entitled to receive the benefits to
be paid at the death of the Owner, the Joint Owner, the Annuitant or the Joint
Annuitant.
Unless the Owner provided otherwise, the death benefit will be paid in equal
shares to the survivor(s) as follows:
1. to the Primary Beneficiary(ies) who survive the Owner's, the Joint
Owner's, the Annuitant's or the Joint Annuitant's, death, as
applicable; or if there are none
2. to the Contingent Beneficiary(ies) who survive the Owner's, the Joint
Owner's, the Annuitant's or the Joint Annuitant's death, as
applicable; or if there are none
3. to the Owner, or if deceased, to the estate of the Owner.
CHANGE OF BENEFICIARY: Subject to the rights of any irrevocable
Beneficiary(ies), the Owner and the Joint Owner, if any, may change the Primary
Beneficiary(ies) or Contingent Beneficiary(ies). A change may be made by Written
Request. The change will take effect as of the date the Written Request is
signed. The Company will not be liable for any payment made or action taken
before it records the change.
GENERAL PROVISIONS
THE CONTRACT: The entire Contract consists of this Contract, the Application, if
any, and any riders or endorsements attached to this Contract. It is intended to
qualify as an annuity contract for Federal Tax purposes. To that end, the
provisions of the Contract are interpreted and administered to ensure and
maintain such tax qualifications. This Contract may be changed or altered only
by the President and the Secretary of the Company. A change or alteration must
be made in writing. No modification will affect the amount or term of any
annuity begun prior to the modification unless it is required to conform the
contract to any Federal or State statute. No modification of the contract will
affect the method by which the Contract Value will be determined.
MISSTATEMENT OF AGE AND SEX: If the Age or sex of any Annuitant has been
misstated, any Annuity benefits payable will be the Annuity benefits provided by
the correct information. After Annuity Payments have begun, any underpayments
will be made up in one sum with the next Annuity Payment. Any overpayments will
be deducted from future Annuity Payments until the total is repaid.
INCONTESTABILITY: This Contract will not be contestable after it has been in
force for a period of two years from the Issue Date.
MODIFICATION: This Contract may be modified in order to maintain compliance with
applicable state and federal law.
NON-PARTICIPATING: This Contract will not share in any distribution of
dividends.
EVIDENCE OF SURVIVAL: The Company may require satisfactory evidence of the
continued survival of any person(s) on whose life Annuity Payments are based.
PROOF OF AGE: The Company may require evidence of Age of any Annuitant.
PROTECTION OF PROCEEDS: To the extent permitted by law, death benefits and
Annuity Payments shall be free from legal process and the claim of any creditor
if the person is entitled to them under this Contract. No payment and no amount
under this Contract can be taken or assigned in advance of its payment date
unless the Company receives the Owner's written consent.
REPORTS: The Company will furnish an annual report of the Portfolios or Funds
and any other notices, reports or documents required by law to be delivered to
the Owner and Joint Owner, if any. Reports will be sent to the last known
address of the Owner and Joint Owner, if any.
TAXES: Any taxes paid to any governmental entity relating to this Contract will
be deducted as incurred . The Company will, in its sole discretion, determine
when taxes have resulted from: the investment experience of the Separate
Account; receipt by Company of the Contribution; or commencement of Annuity
Payments. The Company will deduct any withholding taxes required by applicable
law.
The Company reserves the right to establish a provision for federal income taxes
if it determines, in its sole discretion, that it will incur a tax as a result
of the operation of the Separate Account. The Company will deduct for any income
taxes incurred by it as a result of the operation of the Separate Account
whether or not there was a provision for taxes and whether or not it was
sufficient.
REGULATORY REQUIREMENTS: All values payable under this Contract will not be less
than the minimum benefits required by the laws and regulations of the states in
which this Contract is delivered.
SUBSTITUTION: The Company reserves the right to substitute the shares of any
other registered investment company for the shares of any Portfolio already
purchased or to be purchased in the future by the Separate Account in accordance
with applicable law.
CHANGE IN THE OPERATION OF THE SEPARATE ACCOUNT: At the Company's election, in
accordance with applicable law, the Separate Account may be operated as a
management company under the Investment Company Act of 1940 or it may be
deregistered under the Investment Company Act of 1940 in the event registration
is no longer required. Deregistration of the Separate Account requires an order
by the Securities and Exchange Commission.
