The Penn Mutual Life Insurance Company
Founded 1847
Xxxxxxxxx Xxxxxxx Date
Contract Number Contract Date
The Penn Mutual Life Insurance Company will make monthly annuity payments and
other payments as set forth in this contract.
This is a legal contract between you and us. Please read the contract carefully.
VALUES AND PAYMENTS TO YOU UNDER THIS CONTRACT VARY ACCORDING TO THE INVESTMENT
EXPERIENCE OF A SEPARATE ACCOUNT AND ARE NOT GUARANTEED AS TO FIXED DOLLAR
AMOUNT.
TEN DAY RIGHT TO REVIEW CONTRACT: You may cancel this contract within ten days
after its receipt. Simply return or mail it to us or our agent. We will be
refund the contract value.
/s/ /s/
------------------------------ -----------------------------------
Secretary Chairman and
Chief Executive Officer
Individual Variable
Annuity Contract
Flexible Purchase Payments
o Annuity Payments payable on Annuity Date
o Flexible Purchase Payments payable until
Annuity Date
o Participating
The Penn Mutual Life Insurance Company, Independence Square, Philadelphia,
Pennsylvania 19172
DI-1182-V
Table of Contents
Page
Section 1 - Contract Specifications 3
Section 2 - Endorsements 4
Section 3 - Definitions 5
Section 4 - Purchase Payments 5
Section 5 - Charges and Deductions 5
Section 6 - The Separate Account 6
Section 7 - Accumulation Values 7
Section 8 - Annuity Payments 8
Section 9 - Annuity Options 9
Section 10 - Annuity Options Tables 10
Section 11 - Payment on Death 11
Section 12 - Transfer To Or From Another Contract 11
Section 13 - Withdrawal 11
Section 14 - Miscellaneous 12
Section 2 - Endorsements
This contract is amended as follows:
1. The following endorsement which has or may have been added to this contract
is rescinded and replaced in its entirety by this endorsement:
Endorsement No. 1447-805.
2. The following provision is added to Section 4 -- Purchase Payments:
Total purchase payments in any calendar year may not exceed $1,000,000
without our consent.
3. The first three paragraphs in Section 5--Charges and Deductions are changed
to read as follows:
Contract Administration Charge. This charge is the lesser of 2% of the
Contract Value at the end of the contract year or $30. It will be deducted each
year on the date specified n Section 1. It will also be deducted when the
Contract Value is withdrawn in full if withdrawal is not on t he date specified.
The charge will never exceed $30. The charge will not be on or after the Annuity
Date.
Expense Risk Charge. This charge is made to compensate us for guaranteeing
that the contract administration charge will never exceed $30. On an annual
basis it equals 0.5% of the daily net asset value of the e Separate Account.
Mortality Risk Charge. This charge is made to compensate us for the
mortality guarantees we make under this contract. On an annual basis it equals
0.75% if the daily net asset value of the Separate Account.
4. Section 11 -- Payment on Death is amended in its entirety to read as
follows:
Section 11 -- Payment on Death
Death payments described in this Section shall be payable upon the earlier
of:
(1) the death of the Annuitant, or
(2) the death of the Owner (other than the trustee of a Qualified Plan).
Death Before The Annuity Date. Upon receipt of due proof of death prior to
the Annuity Date, Penn Mutual will pay to the beneficiary the greater of:
(1) The sum of all Purchase Payments, adjusted for withdrawals and contract
transfers.
(2) The Contract Value on the date of receipt of such proof of death, or
(3) The Contract Value as of the Contract Date or, of later, the most
recent seven year anniversary of the contract occurring before the
Owner's 81st birthday, increased by subsequent Purchase Payments and
transfers to the contract and reduced by subsequent withdrawals and
transfers from the contract.
If the beneficiary is not the decedent's spouse, the beneficiary can choose
an Annuity Option for death payments. The Option must provide for payments over
the beneficiary's life or over a period not longer than the beneficiary's life
expectancy. Payments shall begin within one year after the date of death. If
payment is made in a lump sum, such payment shall be made within five years
after the date of death.
If the beneficiary is the decedent's surviving spouse, the surviving spouse
shall become the owner of this contract.
Death After The Annuity Date. If death occurs after the Annuity Date, the
amount payable, if any, will be according to the annuity option in force.
5. The first paragraph in Section 8 -- Annuity Payments is changed to read as
follows:
Annuity Date. Unless another Annuity Date was chosen in the application or
later written notification, the Annuity Date for Nonqualified Plans will be the
first day of the next month after the Annuitant's 85th birthday and for
Qualified Plans, the first day of April in the calendar year following the year
in which the Annuitant attained age 70 1/2.
Endorsement No. 1499-91
The Annuity Date must be on the first day of a month. You may change
the Annuity Date up to 30 days before the current Annuity Date.
6. Section 13 -- Withdrawal is amended in its entirety to read as follows:
Section 13 -- Withdrawal
Withdrawal. Prior to the earlier of the Annuity Date or the first death to
occur of the Owner or the Annuitant, the Owner may withdraw all or part of the
Contract Value. After the Annuity Date if Option 1 in Section 9 is in force, the
payee may withdraw the present value of the annuity payments remaining to be
made.
For full withdrawal, this contract must be surrendered to Penn Mutual. For
partial withdrawals of the Contract Value, the withdrawal must be at least $250.
The amount remaining under the contract must be at least $250.
Contingent Deferred Sales Charge. This charge will be make at withdrawal.
It will be the lesser of:
(1) 5% of the sum of the Purchase Payments made within 7 years prior to the
date of the withdrawal, or
(2) 5% of the amount withdrawn in excess of the free withdrawal amount.
The cumulative sum of such charges made within 7 years prior to the date of
withdrawal will never be more than 5% of the sum of all Purchase Payments
made during the same period.
Free Withdrawal. The Owner may at any time withdrawal all or any part of
the Contract Value free from Contingent Deferred Sales Charge if (i) the Owner
in a Nonqualified Plan, or the Annuitant in a Qualified Plan, is then disabled
as defined in Section 72(m)(7) of the Internal Revenue Code and as applied under
the Social Security Act, (ii) the disability began after the Contract Date, and
(iii) the disability had continued without interruption for four months has
continued without interruption for four months.
No charge will be made for that portion of the first withdrawal make in a
contract year which does not exceed 10% of the sum of all Purchase Payments
which were made one year or more prior to the date of withdrawal.
No charge will be made on the portion of the first withdrawal made in the
contract years set forth below which does not exceed the following percentages
of the Contract Value:
Contract Year Percentage
------------- ----------
Eighth 25%
Ninth 50%
Tenth 75%
No contingent deferred sales charge will be applicable after this contract
has been in force for ten years.
For purpose of this Section, if there has been a transfer from another
contract, the most recent Purchase Payments under that contract shall be deemed
to have been made under this contract to the extent of the amount transferred.
Payment of Withdrawals. Unless you notify us otherwise, partial withdrawals
prior to the Annuity Date and related charges, will be deducted from each
subaccounts of each investment account in the ratio of your interest in each
subaccount to your Contract Value. Withdrawals will be based on values for the
valuation period in which the notice, and contract if required, are received at
our designated service office.
7. Effective Date
The effective date of this endorsement is the Contract Date unless a later
date is shown below.
Philadelphia, Pennsylvania The Penn Mutual Life Insurance Company
/s/
-----------------------------------
Actuarys
Section 3 - Definitions
Owner: The person entitled to exercise all rights under the contract. In
this contract, the word "you" means Owner.
Purchase Payments: The money you pay us for this contract.
Annuitant: The person during whose life annuity payments are made.
Annuity Date: The date on which annuity payments are to start.
Accumulation Unit: An index used to compute the contract value prior to the
annuity date.
Annuity Unit: An index used to compute annuity payments.
Contract Value: The value of all accumulation units credited to the
contract.
Qualified Plan: A retirement plan that receives special tax treatment under
Sections 401, 403, 404, 408, 457 or any similar provisions of the Internal
Revenue Code.
Nonqualified Plan: A retirement plan other than a Qualified Plan.
Section 4 - Purchase Payments
First Purchase Payment. The first Purchase Payment must be made prior to
issue of the contract. The minimum first Purchase Payment is $250 for
Qualified Plans and $1,500 for Nonqualified Plans, or such lower minimum as
we may establish.
Subsequent Purchase Payment. Subsequent Purchase Payment may be made at any
time without prior notice to us. The minimum subsequent Purchase Payment is
$40 for Qualified Plans and $300 for Nonqualified Plans, or such lower
minimum as we may establish. Subsequent Purchase Payments are not required
to keep this contract in force.
Section 5 - Charges and Deductions
Contract Administration Charge. This charge of $30 will be deducted each
year on the date specified in Section 1. It will also be deducted when the
Contract Value is withdrawn in full if withdrawal is not on the date
specified. The charge will never increase. The charge will not be deducted
on or after the Annuity Date.
Expense Risk Charge. This charge is made to compensate us for guaranteeing
that the contract administration charge will never increase. On an annual
basis it equals 0.5% of the daily net asset value of the Separate Account.
Mortality Risk Charge. This charge is made to compensate us for the
mortality guarantees we make under this contract. On an annual basis it
equals 0.8% of the daily net asset value of the Separate Account.
Contingent Deferred Sales Charge. This charge may be deducted upon
withdrawal, in whole or in part, of the Contract Value or the present value
of remaining annuity payments (if applicable). See Section 13.
Premium Taxes. Any premium taxes imposed by a state or other government
will be deducted when due.
Deductions. The expense risk and mortality risk charge will be computed and
deducted from each subaccount of each investment account established under
the contract for each day the contract is in force. Other charges will be
deducted by canceling accumulation units or annuity units (if applicable)
of a value equal to the deduction. Unless you notify us otherwise,
cancellation of accumulation units will be in the ratio of your interest in
each subaccount to your Contract Value.
Section 6 - The Separate Account
The Separate Account: The name of the Separate Account is specified in
Section 1. It is a separate account of The Penn Mutual Life Insurance
Company. It is for this and other contracts. Your Purchase Payments will be
allocated to the Separate Account.
Investment of Separate Account Assets. Assets held in the Separate Account
will be invested in one or more eligible mutual funds. Current eligible
mutual funds are specified in Section 1.
For this and other contracts the Separate Account is divided into
investment accounts. There is an investment account for each eligible
mutual fund. For each investment account, there is a subaccount for
Qualified Plans and a subaccount for Nonqualified Plans.
You choose the investment account to which you want your Purchase Payments
allocated.
We own the assets held in the Separate Account. However, the portion of
such assets equal to the reserves and other contract liabilities with
respect to each subaccount of each investment account of the Separate
Account are not chargeable with liabilities arising out of any other
business we may conduct.
Upon notice to us, you may transfer part or all the value of the
Accumulation Units or Annuity Units credited under this contract from one
investment account to another. No more than two such transfers may be made
in a calendar year. Such investment account transfers, as well as all other
investments, are subject to the limits and rules applicable to each mutual
fund.
Substitution of Investment. If investment in a mutual fund should no longer
be possible or in our judgment becomes inappropriate to the purposes of the
contract, we may substitute another mutual fund. Substitution may be made
with respect to existing investments and the investment of future Purchase
Payments.
Section 7 - Accumulation Values
Number of Accumulation Units. For each subaccount of each investment
account of the Separate Account, the number of your Accumulation Units is
the sum of
Each Purchase Payment allocated to the subaccount
divided by
The value of an Accumulation Unit for that subaccount for the
valuation period in which we received the Purchase Payment.
The number will be adjusted for transfers, withdrawals and charges.
Adjustments will be made as of the valuation period in which we receive all
requirements for the transaction, as appropriate.
Value of Each Accumulation Unit. For each subaccount of each investment
account of the Separate Account, the value was arbitrarily set at $10 when
the subaccount was established. The value may increase or decrease from one
valuation period to the next. For any valuation period the value is
The value of an Accumulation Unit for the prior valuation period
multiplied by
The net investment factor for that subaccount for the valuation
period.
Net Investment Factor. As used in this contract, is an index used to
measure the investment performance of a subaccount from one valuation
period to the next. For any subaccount, the net investment factor for a
valuation period is found by dividing (a) by (b) and subtracting (c):
Where (a) is
The net asset value per share of the mutual fund held in the
subaccount, as of the end of the valuation period
plus
The per-share amount of any dividend or capital gain
distributions by the mutual fund if the "exdividend" date occurs
in the valuation period
plus or minus
A per-share charge or credit as we may determine, as of the end
of the valuation period, for tax reserves.
Where (b) is
The net asset value per share of the mutual fund held in the
subaccount as of the end of the last prior valuation period
plus or minus
The per-share charge or credit for tax reserves as of the end of
the last prior valuation period.
Where (c) is
The sum of the daily expense risk charge and the daily mortality
risk charge. See Section 5. On an annual basis, the sum of such
charges equals 1.30% of the daily net asset value of the Separate
Account.
Valuation Period. As used in this contract, this is the interval from one
valuation time to the next valuation time. Valuation time is the time as of
which each mutual fund determines the net asset value of its shares.
Section 8 - Annuity Payments
Annuity Date. The Annuity Date must be on the first day of a month. It may
not be later than the first day of the next month after the Annuitant's
85th birthday. You chose the Annuity Date in the application. You may
change the Annuity Date up to 30 days prior to the current Annuity Date.
Annuity Options. You or your surviving beneficiary may choose an annuity
option up to 30 days prior to the Annuity Date. An option not set forth in
the contract may be chosen if acceptable to us.
First Variable Annuity Payment. Any premium taxes will be deducted. The net
Contract Value as of the Annuity Date will be applied to the annuity table
for the option chose. The annuity tables show the amount of the first
payment for each $1,000 so applied, according to the age and sex at the
Annuity Date. The tables are based on the 1971 Individual Annuity Mortality
Table (set back one year) with interest at 4%. Adjusted ages are used in
entering those tables.
Subsequent Variable Annuity Payments. Payments after the first will vary in
amount according to the investment performance of the subaccount or
subaccounts you have chosen. The amount may change from month to month. The
amount of each subsequent payment is the sum of the following amounts
attributable to each applicable subaccount
The number of Annuity Units for the subaccount
multiplied by
The value of an Annuity Unit for that subaccount for the valuation
period in which payment is due.
We guarantee that the amount of each annuity payment after the first will
not be affected by variations in expense or mortality experience.
Minimum Annuity Payments. If the net Contract Value to be applied at the
Annuity Date is less than $5,000, we may pay such amount in a lump sum.
Annuity payments will be made monthly; but if any payment would be less
than $50, we may change the frequency so payments are at least $50 each.
Number of Annuity Units. The number of units for the subaccount of each
investment account you have chosen is
The amount of the first variable annuity payment attributable to that
subaccount
divided by
The value of Annuity Unit for the subaccount as of the Annuity Date.
The number is fixed except for adjustments for subaccount transfers.
Adjustments will be made as of the valuation period in which we receive all
requirements for the transfer, as appropriate.
Value of Each Annuity Unit. For each subaccount of each investment account,
the value was arbitrarily set at $10 when the subaccount was established.
The value may increase or decrease from one valuation period to the next.
For any valuation period the value is
The value of an Annuity Unit for the last prior valuation period
multiplied by
The net investment factor for that subaccount for the valuation period
multiplied by
An interest factor to neutralize the assumed investment rate of 4%
built into the annuity tables.
Section 9 - Annuity Options
Option 1 - Annuity for Specified Number of Years. Payments will be made for
a specified number of years, which may not be less than 5 or more than 30.
Option 2 - Life Annuity. Payments will be made for the life of the
Annuitant. Payments will cease with the last payment due prior to the
Annuitant's death.
Option 3 - Life Annuity With Payments Guaranteed for 10 Or 20 Years.
Payments will be made for the life of the Annuitant. A guaranteed payment
period of either 10 or 20 years may be chosen.
Option 4 - Joint and Survivor Life Annuity. Payments will be made during
the lifetimes of the Annuitant and a designated second Annuitant. Payments
will continue as long as either is living. The amount of such payments will
not change by reason of the death of the first Annuitant to die.
If the Annuitant dies prior to the end of the specified period under Option
1 or the guaranteed period under Option 3, the beneficiary may choose
either:
(1) To have the payments continue for the specified or guaranteed period,
or
(2) To receive at any time in lump sum the present value of the remaining
payments to be made over the specified or guaranteed period.
If a beneficiary dies while receiving annuity payments under this option,
the present value will be paid in a lump sum to the beneficiary's estate.
The present value will be (a) computed as of the valuation period in which
due proof of death is received at our designated service office, and (b)
commuted at the assumed investment rate of the annuity tables.
Payments. Payments will be made on the first day of each month starting
with the Annuity Date. Payments under all options will be made to the Owner
or to such person(s), designated by the Owner, except under Option 4. Under
Option 4, payments will be jointly payable while both Annuitants are alive.
Section 10 - Annuity Option Tables
The following tables show the amount of the first monthly income payment for
each $1,000 of value applied under a variable settlement option. "Age" as used
in the tables means an adjusted age determined in the following manner from the
actual age of the Annuitant on the birthday nearest the date of the first
payment.
Calendar Year of Birth Adjusted Age
Before 1900 Actual Age increased by 1
1900-1919 Actual Age
1920-1939 Actual Age decreased by 1
1940-1959 Actual Age decreased by 2
1960 and later Actual Age decreased by 3
Option 1 --Annuity for Specified Number of Years
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Number of Years 5 6 7 8 9 10 11 12 13 14 15
Monthly Income 18.32 15.56 13.59 12.12 10.97 10.06 9.31 8.69 8.17 7.72 7.34
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Number of Years 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Monthly Income $7.00 6.71 6.44 6.21 6.00 5.81 5.64 5.49 5.35 5.22 5.10 5.00 4.90 4.80 4.72
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Option 2 -- Life Annuity and Option 3 -- Life Annuity with Payments
Guaranteed for 10 or 20 Years
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Male Life 10 Years 20 Years Female Life 10 Years 20 Years
Age Xxxxxxx Xxxxxxxxxx Guaranteed Age Annuity Guaranteed Guaranteed
-----------------------------------------------------------------------------------------------------------
50 5.00 4.93 4.73 50 4.59 4.56 4.47
51 5.09 5.01 4.78 51 4.65 4.62 4.52
52 5.17 5.08 4.84 52 4.72 4.69 4.57
53 5.27 5.17 4.89 53 4.80 4.76 4.63
54 5.36 5.25 4.95 54 4.87 4.83 4.69
55 5.47 5.34 5.01 55 4.96 4.91 4.75
56 5.57 5.43 5.06 56 5.05 4.99 4.81
57 5.68 5.53 5.12 57 5.14 5.07 4.87
58 5.80 5.63 5.18 58 5.24 5.16 4.93
59 5.93 5.73 5.24 59 5.34 5.25 5.00
60 6.06 5.84 5.30 60 5.45 5.35 5.07
61 6.20 5.96 5.36 61 5.56 5.45 5.14
62 6.35 6.08 5.42 62 5.69 5.56 5.20
63 6.51 6.21 5.48 63 5.82 5.68 5.27
64 6.69 6.34 5.53 64 5.96 5.80 5.34
65 6.87 6.48 5.59 65 6.11 5.93 5.41
66 7.07 6.62 5.64 66 6.27 6.07 5.48
67 7.28 6.77 5.69 67 6.45 6.22 5.54
68 7.51 6.93 5.73 68 6.64 6.37 5.60
69 7.75 7.09 5.78 69 6.85 6.54 5.66
70 8.01 7.26 5.81 70 7.08 6.71 5.71
71 8.30 7.43 5.85 71 7.33 6.89 5.76
72 8.50 7.60 5.88 72 7.60 7.08 5.81
73 8.93 7.78 5.91 73 7.90 7.28 5.84
74 9.28 7.96 5.93 74 8.22 7.48 5.88
75 9.67 8.14 5.95 75 8.57 7.68 5.90
76 10.08 8.32 5.97 76 8.95 7.89 5.92
77 10.53 8.50 5.98 77 9.37 8.10 5.94
78 11.02 8.67 5.99 78 9.82 8.30 5.96
79 11.54 8.84 5.99 79 10.32 8.50 5.97
80 12.12 9.01 6.00 80 10.86 8.69 5.98
81 12.74 9.16 6.00 81 11.46 8.88 5.98
82 13.41 9.31 6.00 82 12.11 9.04 5.99
83 14.14 9.44 6.00 83 12.82 9.20 5.99
84 14.95 9.57 6.00 84 13.59 9.33 6.00
85 15.84 9.67 6.00 85 14.43 9.45 6.00
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Option 4 -- Joint and Survivor Life Annuity
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Female Male Age Female
----------------------------------------------------------------------------------------
Age 50 55 60 65 70 75 80 85 Age
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50 4.25 4.34 $4.41 $4.46 $4.51 $4.54 $4.56 $4.57 50
55 4.40 4.53 4.64 4.74 4.81 4.87 4.90 4.93 55
60 4.53 4.72 4.90 5.05 5.18 5.28 5.35 5.39 60
65 4.66 4.90 5.16 5.40 5.62 5.80 5.92 6.01 65
70 4.76 5.07 5.40 5.77 6.12 6.44 6.69 6.87 70
75 4.85 5.20 5.62 6.11 6.65 7.19 7.68 8.05 75
80 4.91 5.31 5.79 6.39 7.12 7.94 8.79 9.56 80
85 4.95 5.38 5.91 6.59 7.48 8.59 9.88 11.25 85
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Section 11 - Payment on Death
Death Before The Annuity Date. Upon receipt of due proof of the death of
the Annuitant prior to the Annuity Date, we will pay to the beneficiary the
greater of:
(1) The sum of all Purchase Payments, adjusted for withdrawals and contract
transfers, or
(2) The Contract Value for the valuation period in which we receive such
proof at our designated service office.
Payment will be in a lump sum or the beneficiary may choose an Annuity
Option under this contract. If we are issuing new contracts on this form at
the time of payment, the beneficiary may elect to apply for a new contract
and apply the payment as a transfer to the new contract.
Death After the Annuity Date. If the Annuitant dies after the Annuity Date,
the amount payable, if any, will be according to the Annuity Option in
force. See Section 9.
Section 12 - Transfer to or From Another Contract
Transfer to Another Annuity Contract You may transfer all or part of your
Contract Value to another annuity contract issued to you by us which
contains a reciprocal transfer provision. The Owner, contingent owner,
Xxxxxxxxx and beneficiaries of the other annuity contract must be the same
as under this contract.
Transfer to a new contract for a Nonqualified Plan must be at least $1,000
or such lower minimum as we may establish. Other contract transfers must be
at least $250. For partial transfers the remaining Contract Value for this
contract must be at least $250. For full transfers this contract must be
surrendered to our designated service office. A request to transfer must be
received by us and any other applicable requirement must be met prior to
the death of the Annuitant. No more than two transfers may be made to
another annuity contract in a calendar year. No transfer may be made after
the thirtieth day before the Annuity Date.
Transfers From Another Annuity Contract You may make transfers to this
contract from another annuity contract issued by us which provides for such
transfers, subject to the limits set forth in that contract.
Section 13 - Withdrawal
Withdrawal. Prior to the earlier of the Annuity Date or the death of the
Annuitant, you may withdraw all or part of the Contract Value. After the
Annuity Date and the election of Option 1 in Section 9, the payee may
withdraw the present value of the annuity payments remaining to be made.
The present value will be (a) computed as of valuation period in which
notice of the withdrawal is received at our designated service office and
(b) commuted at the assumed investment rate of the annuity tables.
For full withdrawal, this contract must be surrendered to our designated
service office. For partial withdrawals of the Contract Value, the
withdrawal must be at least $250. The amount remaining under the contract
must be at least $250.
Contingent Deferred Sales Charges. This charge will be made at withdrawal.
It will be the lesser of:
(1) 5% of the sum of the Purchase Payments made within 7 years prior to the
date of the withdrawal, or
(2) 5% of the amount withdrawn.
The cumulative sum of such charges made within 7 years prior to the day of
withdrawal will never be more than 5% of the sum of all Purchase Payments
made during the same period.
No charge will be made for that portion of the first withdrawal made in a
contract year that does not exceed 10% of the sum of all Purchase Payments
which were made more than one year prior to the date of withdrawal.
For purposes of this Section, if there has been a transfer from another
contract, the most recent Purchase Payments under that contract shall be
deemed to have been made under this contract to the extent of the amount
transferred.
Payment of Withdrawals. Unless you notify us otherwise, partial withdrawals
prior to the Annuity Date and related charges will be deducted from each
subaccount of each investment account in the ratio of your interest in each
subaccount to your Contract Value. Withdrawals will be based on values for
the valuation period in which the notice, and contract if required, are
received at our designated service office.
Section 14 - Miscellaneous
Beneficiary. The Beneficiary is the person who is to receive:
(1) Payment on death of the Annuitant prior to the Annuity Date or
(2) Guaranteed annuity payments, if any, on death of the Annuitant on or
after the Annuity Date.
You choose the beneficiary in the application. You may change the
beneficiary while the Annuitant is alive.
The estate or heirs of a beneficiary who dies before the Annuitant have no
rights under this contract. If no beneficiary survives the Annuitant,
payment will be made to you or your estate.
Ownership of Contract. The Annuitant is the owner unless another owner is
named in the application or an endorsement.
Only an Owner may name or change a contingent owner.
Upon notice to us you may assign the contract to a new Owner. The
assignment cancels a designation of contingent owner.
Deferment of Transfer and Payments. Transfers and payments of withdrawals
will be made within seven days. However, we may defer a transfer, a withdrawal,
the Annuity Date or annuity payments if:
(1) The New York Stock Exchange is closed (other than customary weekend and
holiday closings);
(2) Trading on the New York Stock Exchange is restricted;
(3) An emergency exists such that it is not reasonably practical to dispose
of securities held in the Separate Account or to determine the value
of its assets; or
(4) The Securities and Exchange Commission by order so permits for the
protection of security holders.
Conditions in (2) and (3) will be decided by, or in accordance with rules
of, the Securities and Exchange Commission.
Collateral Assignment. Upon notice to us you may make a collateral
assignment. It does not change contract ownership.
Restrictions of Qualified Plans. If the contract is issued pursuant to a
Qualified Plan, it may not be assigned, pledged or transferred unless permitted
by law.
Misstatement of Age or Sex. If the age or sex of the Annuitant or a joint
payee is misstated, annuity payments will be adjusted to reflect the correct age
and sex. If we have overpaid as a result of such misstatement, the amount will
be deducted from the next payments due under this contract. If we have
underpaid, the amount will be paid in full with the next payment due under this
contract.
Proof of Age Sex, or Survival. We may require satisfactory proof of correct
age or sex at any time. If any payment under this contract depends on the payee
being alive, we may require satisfactory proof of survival.
Incontestability. No statement made by the applicant will void the contract
unless it is contained in the written application attached to the contract. The
contract will be incontestable after it has been in force for 2 years from the
Contract Date.
The Contract. The contract, any endorsements, and its attached application
are the entire contract. It is issued in consideration of the application and
your Purchase Payments.
Only our President, a Vice President, Pension Actuary or Secretary may
change the contract. Any change must be in writing.
At any time we may make such changes in this contract as are required to
make it conform with any law or regulation issued by any government agency to
which it is subject.
Participating Contract. The contract may participate in our divisible
surplus. Divisible surplus, if any, to be apportioned to the contract shall be
apportioned annually and shall be paid in cash or credited to your Contract
Value at the end of the contract year. No divisible surplus is expected to be
apportioned to this contract in the foreseeable future.
Dates. Contract years and anniversaries are measured from the Contract
Date.
Notices, Changes and Choices. To be effective, all notices, changes and
choices you may make under the contract must be in writing, signed and received
by us at our designated service office. If acceptable to us, notices, changes
and choices relating to beneficiaries and ownership will take effect as of the
date signed unless we have already acted in reliance on the prior status. We are
not responsible for their validity.
Contract Payments. All sums payable to or by us are payable at our
designated service office. We may require return of the contract prior to making
payment.
Protection of Proceeds. Payments under this contract may not be assigned by
the payee prior to their due dates. To the extent allowed by law, payments are
not subject to legal process for debts of a payee.
Periodic Reports. At least once a year prior to the Annuity Date, we will
furnish you a report. It will set forth the current number of Accumulation
Units, the value per Accumulation Unit and the total Contract Value. Each person
with voting rights in the Separate Account will be furnished reports required by
the Investment Company Act of 1940.
This contract provides valuable benefits. Please contact Penn Mutual or its
agent if you have questions about this contract.
Please notify Penn Mutual promptly of any change in address.
Annual Election - Penn Mutual is a mutual life insurance company. It has no
stockholders. The Owner of this contract is a member of Penn Mutual while this
contract is in force during the life of the Annuitant before the Annuity Date
and before total withdrawal of the contract value. Members have the right to
vote in person or by proxy at the annual election of Trustees held at the Home
Office, Independence Square, Philadelphia, Pennsylvania, on the first Tuesday of
March. If more information is desired, it may be obtained from the Secretary.
VALUES AND PAYMENTS TO YOU UNDER THIS CONTRACT VARY ACCORDING TO THE INVESTMENT
EXPERIENCE OF A SEPARATE ACCOUNT AND ARE NOT GUARANTEED AS TO FIXED DOLLAR
AMOUNT.
Individual Variable
Annuity Contract --
Flexible Purchase Payments
o Annuity Payments payable on Annuity Date
o Flexible Purchase Payments payable until
Annuity Date
o Participating
The Penn Mutual Life Insurance Company, Independence Square, Philadelphia,
Pennsylvania 19172
DI-1182-V
