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EXHIBIT 4(i)
[SAFECO LETTERHEAD]
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INDIVIDUAL VARIABLE ANNUITY CONTRACT
SAFECO Life Insurance Company, a stock company with its Home Office in Redmond,
Washington, (hereafter called SAFECO), in consideration of the payment of the
Purchase Payments as provided herein, agrees to provide an Annuity and other
benefits in accordance with the Contract provisions.
10-DAY 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 SAFECO or to the agent through whom it
was purchased. When this Contract is received by SAFECO, it will be voided as if
it had never been in force, and SAFECO will refund the Contract Value. This may
be more or less than Purchase Payments. In states where required SAFECO will
refund the Purchase Payments rather than the Contract Value. SAFECO reserves the
right to allocate all payments to the Money Market Sub-Account until the
expiration of 15 days from the date the first Purchase Payment is received. If
SAFECO so allocates payments, SAFECO will refund the greater of Purchase
Payments or the Contract Value.
Signed for the Company
/s/ X.X. XXXXXXX /s/ R.E. Xxxxxx
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X.X. Xxxxxxx, Xx. Vice President and Secretary R.E. Xxxxxx, President
BRIEF DESCRIPTION
Individual Variable Annuity, Flexible Premium Deferred Annuity,
Non-Participating, Monthly Income at Annuity Date, Cash Value Payable at Death
of Owner before Annuity Date.
VALUES PROVIDED BY THIS CONTRACT ARE BASED ON THE INVESTMENT EXPERIENCE OF A
SEPARATE ACCOUNT AND ARE, THEREFORE, VARIABLE AND NOT GUARANTEED AS TO DOLLAR
AMOUNT. SEE SECTION D OF YOUR CONTRACT FOR DETAILS REGARDING THE SEPARATE
ACCOUNT PROVISIONS.
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LPC-412 7/93 (R) Registered trademark of SAFECO Corporation
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INDEX
SECTION A: DEFINITIONS. . . . . . . . . . . . . . . . . . . . . . . . . . 1
Annuitant . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Annuity Date . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
SECTION B: GENERAL PROVISIONS . . . . . . . . . . . . . . . . . . . . . 1
Contract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Contract Amendments . . . . . . . . . . . . . . . . . . . . . . . 1
Communications . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Annual Report . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Misstatement of Age . . . . . . . . . . . . . . . . . . . . . . . 2
Evidence of Survival . . . . . . . . . . . . . . . . . . . . . . . 2
Beneficiary Designation . . . . . . . . . . . . . . . . . . . . . 2
Change of Beneficiary . . . . . . . . . . . . . . . . . . . . . . 2
Non-Assignment . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Termination of Contract . . . . . . . . . . . . . . . . . . . . . 2
SECTION C: PURCHASE PAYMENTS . . . . . . . . . . . . . . . . . . . . . . 3
Place and Form of Purchase Payments . . . . . . . . . . . . . . . 3
Purchase Payments . . . . . . . . . . . . . . . . . . . . . . . . 3
Change in Purchase Payments . . . . . . . . . . . . . . . . . . . 3
Allocation of Purchase Payments . . . . . . . . . . . . . . . . . 3
Application of Purchase Payments to Eligible Investments . . . . . 3
SECTION D: SEPARATE ACCOUNT PROVISIONS E . . . . . . . . . . . . . . . . 3
The Separate Account . . . . . . . . . . . . . . . . . . . . . . . 3
Non-Participation in Surplus . . . . . . . . . . . . . . . . . . . 3
Value of Accumulation Units . . . . . . . . . . . . . . . . . . . 3
Net Investment Factor . . . . . . . . . . . . . . . . . . . . . . 4
SECTION E: SETTLEMENT OPTIONS AND DEATH BENEFITS . . . . . . . . . . . . 4
Selection and Change of Settlement Option . . . . . . . . . . . . 4
Payment of Benefits . . . . . . . . . . . . . . . . . . . . . . . 4
State Required Minimum Benefits . . . . . . . . . . . . . . . . . 4
Frequency and Amount of Annuity Payments . . . . . . . . . . . . . 4
Death of Annuitant . . . . . . . . . . . . . . . . . . . . . . . . 5
Death of Owner Prior to Annuity Date . . . . . . . . . . . . . . . 5
Death of Owner After Annuity Date . . . . . . . . . . . . . . . . 5
Settlement Options . . . . . . . . . . . . . . . . . . . . . . . . 5
Automatic Option . . . . . . . . . . . . . . . . . . . . . . . . . 6
Annuity Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Variable Annuity Payment Calculation . . . . . . . . . . . . . . . 6
Mortality and Expense Risk Guarantee . . . . . . . . . . . . . . . 6
SECTION F: WITHDRAWALS AND TRANSFERS . . . . . . . . . . . . . . . . . . 6
Minimum Withdrawal . . . . . . . . . . . . . . . . . . . . . . . . 6
Minimum Transfer . . . . . . . . . . . . . . . . . . . . . . . . . 6
Systematic Withdrawal . . . . . . . . . . . . . . . . . . . . . . . 6
Automatic Transfers . . . . . . . . . . . . . . . . . . . . . . . . 7
Deferral of Withdrawal Payment . . . . . . . . . . . . . . . . . . 7
SECTION G: CHARGES AND DEDUCTIONS . . . . . . . . . . . . . . . . . . . 7
Deduction for Annual Administration Maintenance Charge . . . . . . 7
Deduction for Asset Related Administration Charge . . . . . . . . . 7
Deduction for Contingent Deferred Sales Charge . . . . . . . . . . 8
Deduction for Withdrawal Charge . . . . . . . . . . . . . . . . . 8
Deduction for Transfer Charge . . . . . . . . . . . . . . . . . . 8
Deduction for Mortality and Expense Risk Premium . . . . . . . . 8
Taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
SECTION H: VARIABLE ANNUITY PURCHASE RATE TABLE . . . . . . . . . . . . 9
Mortality Tables Used . . . . . . . . . . . . . . . . . . . . . . . 9
Variable Annuity Purchase Rate Table . . . . . . . . . . . . . . . 9
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SECTION A: DEFINITIONS
A1 Accumulation Unit: An accounting unit of measure used to calculate the
value of a Sub-Account prior to the Annuity Date.
A2 Annuitant: The natural person on whose life Annuity payments are
payable in accordance with this Contract. This Contract will not be
issued if the Annuitant is 76 years of age or older on the Contract
Date.
A3 Annuity: Any series of payments starting on the Annuity Date, payable
in accordance with this Contract.
A4 Annuity Date: The date selected by the Owner for commencing Annuity
payments under this Contract. The day of the month on which the
payments will be made will be determined by SAFECO. The Annuity Date
cannot be later than the date the Annuitant attains age 85.
A5 Annuity Unit: An accounting unit of measure used to calculate Annuity
payments after the Annuity Date.
A6 Beneficiary: The person or persons entitled to receive benefits under
this Contract upon the death of the Owner.
A7 Contract: This Individual Variable Annuity Contract by and between
SAFECO and the Owner.
A8 Contract Anniversary: Any anniversary of the Contract Date.
A9 Contract Date: The date on which the initial Purchase Payment is
allocated to the Separate Account, as shown on the Contract Data Page.
A10 Contract Value: The sum of the Owner's interest in the Sub-Accounts of
the Separate Account.
A11 Contract Year: The twelve month period which commences on the Contract
Date and each succeeding twelve month period thereafter.
A12 Eligible Investments: An investment entity shown on the Contract Data
Page.
A13 Net Purchase Payment: Purchase Payment less any premium taxes.
A14 Owner: The person or persons named in the Application who has all
rights under this Contract. Joint Owners are allowed only if the joint
Owners are spouses. Each joint Owner shall have equal ownership rights
and must jointly exercise those rights.
A15 Purchase Payments: Payments made to purchase Accumulation Units.
A16 SAFECO: SAFECO Life Insurance Company.
A17 Separate Account: The separate investment account of SAFECO, as shown
on the Contract Data Page.
A18 Sub-Account: A segment of the Separate Account, as shown on the
Contract Data Page.
A19 Withdrawal: Withdrawal is any payment, including Contract charges and
deductions, from the Contract.
SECTION B: GENERAL PROVISIONS
B1 Contract: The entire contract between SAFECO and the Owner consists of
this Contract, any Riders or Endorsements, and the Application, a copy
of which is attached to the Contract.
B2 Contract Amendments: The terms and conditions of this Contract may be
amended by written agreement between SAFECO and the Owner by written
endorsement or amendment. All agreements made by SAFECO will be signed
by the President or one of the Vice Presidents. No other person has
power on behalf of SAFECO to amend or modify this Contract, extend any
due date, or waive any proof required by this Contract.
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SAFECO may unilaterally amend the provisions of this Contract as
required to conform to any state or federal law which affects this
Contract. The Owner may reject any such amendment by notifying SAFECO
of such rejection within 10 days after receiving the amendment.
B3 Communications: All communications to SAFECO shall be made to the
office of SAFECO shown on the Contract Data Page.
B4 Essential Data: The Owner shall furnish to SAFECO any information
necessary for the administration of this Contract.
B5 Annual Report: SAFECO will provide the Owner with an annual calendar
year report showing the Contract Value, and any other information
required by law. Reports will be sent to the last known address of the
Owner.
B6 Misstatement of Age: SAFECO may require proof of the age of the
Annuitant before making any Life Annuity payment provided for by this
Contract. If the age of the Annuitant has been misstated, the amount
payable will be the amount that the Contract Value would have provided
at the correct age.
Once Annuity payments have begun, any underpayment will be made up in
one sum with the next Annuity payment. Any overpayment will be
deducted from future Annuity payments until the total is repaid.
B7 Evidence of Survival: If any benefits under this Contract are
contingent upon the Annuitant being alive on a given date, SAFECO may
require evidence satisfactory to SAFECO that such condition continues
to be met.
B8 Beneficiary Designation: The Owner may designate a Beneficiary in the
Application to receive any proceeds payable due to the death of the
Owner. Unless the Owner provides otherwise, the death benefit will be
paid in equal shares to all surviving primary Beneficiaries. If the
Owner has not provided otherwise and there are no surviving primary
Beneficiaries, the death benefit will be paid in equal shares to all
surviving contingent Beneficiaries. If the Owner has not provided
otherwise and there are no surviving primary or contingent
Beneficiaries, the death benefit will be paid to the estate of the
Owner.
B9 Changes of Beneficiary: If the Owner has made an irrevocable
Beneficiary designation, no change of Beneficiary is permitted. If the
Owner has not made an irrevocable Beneficiary designation, the Owner
may file a signed request with SAFECO to change the Beneficiary
designation. The change of Beneficiary will be effective upon recording
by SAFECO at its Home Office. SAFECO shall not be liable for any
payments made or other action taken by SAFECO before the change in
Beneficiary was recorded by SAFECO at its Home Office. A recorded
change of Beneficiary will revoke any prior Beneficiary designations.
SAFECO will pay any death proceeds to the most recently recorded
Beneficiary.
B10 Contract Settlement: Unless otherwise designated in writing by SAFECO,
all sums payable under this Contract are payable at SAFECO's Home
Office. This Contract must be returned to SAFECO upon any settlement.
B11 Substitute Payee: If SAFECO determines that any person is incapable of
personally receiving and giving a valid receipt for any payment due
under this Contract and no claim has been made by a duly appointed
guardian, SAFECO may make such payment to any person or institution
that SAFECO determines has assumed the care and support of such person.
Such payment shall completely discharge the liability of SAFECO with
respect to the amount so paid.
B12 Non-Assignment: To the extent permitted by law, this Contract and the
benefits or payments under this Contract are not assignable or
otherwise transferable. This Contract may be assigned for purposes of
an Internal Revenue Code Section 1035 exchange.
B13 Termination of Contract: All benefit provisions under this Contract
continue in force until the Contract Value is completely Withdrawn.
Discontinuance of Purchase Payments will not result in termination of
the Contract.
This Contract will terminate and cease to be of any further force or
effect at the close of the first day upon which SAFECO has completed
all of the duties and obligations which have arisen under this
Contract.
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SECTION C: PURCHASE PAYMENTS
C1 Place and Form of Payments: All payments to SAFECO under this Contract
shall be payable at the office of SAFECO as shown on the Contract Data
Page.
All amounts to be paid under this Contract, whether payable to SAFECO
or by SAFECO, shall be paid in lawful money of the United States of
America.
C2 Purchase Payments: The initial Purchase Payment is due on the Contract
Date. The minimum initial and subsequent Purchase Payments are shown
on the Contract Data Page. SAFECO reserves the right to reject any
Application or Purchase Payment.
C3 Change in Purchase Payments: Subject to the minimum shown on the
Contract Data Page, the Owner may increase or decrease or change the
frequency of subsequent Purchase Payments.
C4 Allocation of Purchase Payments: The allocation of the initial Purchase
Payment is elected by the Owner on the Application. Unless the Owner
elects otherwise, subsequent Purchase Payments are allocated in the
same manner as the initial Purchase Payment. Allocation of the
Purchase Payments is subject to the terms and conditions imposed by
SAFECO.
C5 Application of Purchase Payments to Eligible Investments: Purchase
Payments applied to the Separate Account are allocated to Sub-Account
of the Separate Account.
SECTION D: SEPARATE ACCOUNT PROVISIONS
D1 The Separate Account: SAFECO has established a Separate Account for
this and other similar Contracts. A portion of SAFECO's assets has been
allocated to the Separate Account for this and other similar Contracts.
The assets of the Separate Account are the property of SAFECO and are
not chargeable with liabilities arising out of any other business
SAFECO may conduct. The investments of the Separate Account will be
valued at their fair market value in accordance with the procedures
approved by the Board of Directors of SAFECO and the Separate Account
committee.
The Separate Account is divided into Sub-Accounts with the assets of
each Sub-Account invested as set forth on the Contract Data Page.
The assets of the Sub-Accounts are allocated to the Eligible
Investments and the portfolios, if any, within Eligible Investments
shown on the Contract Data Page. SAFECO may, from time to time, add
Eligible Investments or portfolios, or remove Eligible Investments or
portfolios. If the shares of any Eligible Investment or portfolio
within an Eligible Investment become unavailable for investment by the
Separate Account, or SAFECO's Board of Directors deems further
investment in these shares inappropriate, SAFECO may substitute shares
of another Eligible Investment or portfolio for shares already
purchased under this Contract.
D2 Non-Participation in Surplus: The Variable Annuity portion of this
Contract will not share in any distribution of profits, losses, or
surplus of SAFECO.
D3 Valuation Dates and Periods: A Valuation Date is each day the New York
Stock Exchange is open for business. A Valuation Period is the period
commencing at the close of business on each Valuation Date and ending
at the close of business for the next succeeding Valuation Date.
D4 Value of Accumulation Units: Each Purchase Payment is allocated to a
Sub-Account and is converted into Accumulation Units. The number of
Accumulation Units in a Sub-Account credited to this Contract is
determined by dividing each Net Purchase Payment by the value of an
Accumulation Unit for that Sub-Account. Accumulation Units for each
Sub-Account are valued separately. The Accumulation Unit value for each
Sub-Account was arbitrarily set at $10 when the Sub-Account was
established. The Accumulation Unit value for any later Valuation Period
is determined by multiplying the Accumulation Unit value for the
Sub-Account, as of the immediately preceding Valuation Period, by the
Net Investment Factor for the current Valuation Period.
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D5 Net Investment Factor: The Net Investment Factor for any Sub-Account
for any Valuation Period is determined by dividing (a) by (b) and
subtracting (c) and (d) from the result, where:
(a) is the net result of:
(i) The net asset value per share of the portfolio set out
on the Contract Data Page as the investment of the
Sub-Account, determined as of the current Valuation
Period, plus
(ii) The per share amount of any dividend or capital-gain
distribution made by the portfolio if the
"ex-dividend" date occurs during the current Valuation
Period, plus or minus
(iii) A per share credit or charge, which is determined by
SAFECO, for changes in tax reserves resulting from
investment operations of the Sub-Account.
(b) is the net result of:
(i) The net asset value per share of the portfolio
determined as of the immediately preceding Valuation
Period, plus or minus
(ii) The per share credit or charge for any changes in tax
reserves for the immediately preceding Valuation
Period.
(c) is the percentage factor equal to the Mortality and Expense
Risk Premium. Such factor is equal on an annual basis to a
percentage of the daily net asset value of the Sub-Account, as
shown on the Contract Data Page.
(d) is the percentage factor equal to the Asset Related
Administration Charge. Such factor is equal on an annual basis
to a percentage of the daily net asset value of the
Sub-Account, as shown on the Contract Data Page.
The Net Investment Factor may be greater or less than one.
Therefore, an Accumulation Unit value may increase or decrease.
SECTION E: SETTLEMENT OPTIONS AND DEATH BENEFITS
E1 Selection and Change of Settlement Option: The Owner may select or
change the Settlement Option or Annuity Date by written notification to
SAFECO at its Home Office. In order to be effective, the written
notification must be received by SAFECO prior to any Annuity Date
previously selected.
E2 Payment of Benefits: Subject to the provisions of this Contract, SAFECO
will, upon the written direction of the Owner, issue an Annuity or
make a cash distribution to any person who is entitled to such
benefits.
SAFECO shall not be obligated to issue an Annuity or to make a cash
distribution until it receives written direction from the Owner
containing the terms and conditions of the Annuity or cash
distribution.
SAFECO may rely on the written direction of the Owner and shall not be
liable because of any failure to question or challenge such direction
regarding the issuance of an Annuity or payment of a cash distribution.
E3 State Required Minimum Benefits: The death benefit, the surrender
value, and the Settlement Options under this Contract will not be less
than the minimum benefits required by any statute of the state in which
this Contract is delivered.
E4 Frequency and Amount of Annuity Payments: Except as described below,
Annuity payments will be paid monthly. If the amount available to
apply under any Settlement Option is less than $5,000, SAFECO shall
have the right to pay such amount in a lump sum cash distribution. If
Annuity payments would be or become less than $250, SAFECO shall have
the right to change the frequency of payments to such intervals as will
result in payment of at least $250.
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E5 Death of Annuitant:
(a) If the Annuitant dies before a Settlement Option has commenced,
the Owner must designate a new Annuitant. If no designation is
made within 30 days of the death of the Annuitant, the Owner
will become the Annuitant.
(b) If the Contract is owned by a non-natural person, the death of
the Annuitant will be treated as the death of the Owner.
E6 Death of Owner Prior to Annuity Date:
(a) Guaranteed Death Benefit: If the Owner dies before a Settlement
Option has commenced, the amount of the death benefit will be
the greater of:
(i) Net Purchase Payments less any prior Withdrawals,
including applicable charges; or
(ii) The Contract Value determined as of the Valuation
Period next following the date both proof of death and
an election of single sum payment or a Settlement
Option is received by SAFECO.
(b) Election Period: The election must be made by the Beneficiary
during the sixty day period commencing with the date of receipt
by SAFECO of notification of death. If no election is made
within the sixty day period, then a single sum payment will be
made to the Beneficiary.
(c) The death benefit must be distributed:
(i) By the fifth anniversary of the Owner's death; or
(ii) Over a designated Beneficiary's life or over a period
not extending beyond the Beneficiary's life
expectancy, in equal or substantially equal payments,
with payments beginning within one year of the death
of the Owner.
(d) If the Beneficiary is the spouse of the Owner, the Contract may
be continued by the spouse, and the spouse will become the
Owner.
(e) Upon the death of a joint Owner, the surviving Owner will be
the designated Beneficiary. Any other named Beneficiary shall
be a contingent Beneficiary.
E7 Death of Owner After Annuity Date: If the Owner dies on or after a
Settlement Option has commenced, payments must continue at least as
rapidly as under the method of distribution in effect prior to the
Owner's death.
E8 Settlement Options: An Annuity may be issued in any of the forms
described below, or such other forms which SAFECO agrees to issue under
this Contract. Options (a), (b), and (c) are irrevocable once they have
begun. Option (d) is irrevocable for the first eight Contract Years,
and then may be changed. The Annuitant will become the Owner on
commencement of a Settlement Option.
(a) Variable Life Annuity: Monthly payments are made to the
Annuitant commencing on the Annuity Date, if he or she is then
living, and the last payment is that payment due immediately on
or before the Annuitant's death. No death benefit is payable
under this option.
(b) Variable Life Annuity with 120 or 240 Monthly Payments
Guaranteed: Monthly payments are made to the Annuitant
commencing on the Annuity Date. If at the death of the
Annuitant the guaranteed number of payments has not been
received by the Annuitant, payments will be made to the
Beneficiary for the remainder of the guarantee period. The
Beneficiary may elect to have the present value of the
guaranteed Annuity remaining as of the date the notice of death
is received by SAFECO commuted at the assumed investment rate
of 4% and paid in a single payment.
(c) Variable Joint and Survivor Life Annuity: Monthly payments are
made to the Annuitant commencing on the Annuity Date. After the
death of the Annuitant, payments will be continued to the
co-annuitant for as
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long as he or she lives. The written request for this option
must specify the percentage value of monthly payments to
continue to the co-annuitant.
(d) Systematic Withdrawal Income Plan: A specified number of whole
or partial Accumulation Units are liquidated for payment to the
Annuitant on a monthly, quarterly, or annual basis. The number
to be liquidated during a given year shall be a sufficient
number so as to be expected to deplete the Contract over the
life expectancy of the Annuitant or the joint life expectancy
of the Annuitant and Beneficiary, with at least 50% of the
payments expected to be made during the Annuitant's life.
E9 Automatic Option: If, as of the Annuity Date, a Settlement Option has
not been selected, SAFECO will make payments under Section E8(d).
E10 Annuity Unit: The value of an Annuity Unit was arbitrarily set at $10
when each Sub-Account was established. The value of the Annuity Unit
for any subsequent Valuation Period is determined by multiplying the
value of the Annuity Unit for the immediately preceding Valuation
Period by the Net Investment Factor for the Valuation Period for which
the value is being calculated (as described in Section D5), and
dividing the result by the Assumed Investment Factor for such Valuation
Period (as described in Section E11).
E11 Assumed Investment Factor: The Assumed Investment Factor for a one day
Valuation Period is 1.00010746. This factor neutralizes the assumed
investment return of 4% in the Variable Annuity Purchase Rate Table in
Section H2.
E12 Variable Annuity Payment Calculation: A Variable Annuity is an Annuity
with payments which are not predetermined as to dollar amount. Payments
will vary in accordance with the net investment results of the Separate
Account. The dollar amount of the first monthly Variable Annuity
payment under Section E8(a), E8(b), or E8(c) will be determined by
applying the Contract Value (after deduction for premium taxes, if
applicable), as of the 15th day of the preceding month, to the Variable
Annuity Purchase Rate Table in Section H2. The number of Annuity Units
to be credited to the Annuitant will be determined by dividing the
first monthly payment by the Annuity Unit value calculated as of the
15th day of the preceding month. This number of Annuity Units remains
fixed during the Annuity payment period. The dollar amount of each
Variable Annuity payment after the first shall be determined by
multiplying the number of Annuity Units credited to the Annuitant by
the Annuity Unit value as of the 15th day of the preceding month.
E13 Mortality and Expense Risk Guarantee: SAFECO guarantees that the dollar
amount of each Variable Annuity payment made after the first payment
will not be affected by variations in mortality experience or expenses.
SECTION F: WITHDRAWALS AND TRANSFERS
F1 Minimum Withdrawal: The minimum Withdrawal is as shown on the Contract
Data Page, or the Contract Value, if less. Except as otherwise
provided in this Contract, the Owner may, at or prior to the Annuity
Date, withdraw all or part of the Contract Value.
F2 Minimum Balance After Withdrawal: If any Withdrawal reduces the
remaining balance in a Sub-Account to less than $500, the remaining
balance will also be Withdrawn.
F3 Minimum Transfer: The minimum Transfer from a Sub-Account must be at
least $500, except for the Automatic Transfers described in Section F7.
If the Sub-Account from which the Transfer is being made is less than
$500, the entire Sub-Account will be Transferred.
The minimum Transfer into a Sub-Account must be at least $50.
F4 Systematic Withdrawal: The Owner may elect a Systematic Withdrawal
program under which the Owner will receive cash distributions from the
Contract in a predetermined amount on a predetermined frequency.
Payments under this election will be made directly to the Owner by
SAFECO, and will not be made more often than monthly.
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F5 Withdrawal of Accumulation Units: Upon a Withdrawal, the number of
Accumulation Units remaining under this Contract will be reduced by the
number of such units equal to the total of the Withdrawal, including
applicable charges and taxes, including income taxes withheld, if
applicable.
F6 Transfer of Accumulation Units: Upon Transfer from a Sub-Account, the
number of Accumulation Units remaining under that Sub-Account will be
reduced by the number of such units equal to the total of the requested
Transfer, including applicable charges, and taxes.
F7 Automatic Transfers: The Owner may elect pre-established automatic
monthly or quarterly Transfers of a single dollar amount of at least
$250 from a Sub-Account. The Automatic Transfers will continue until
the Owner requests discontinuance or there are no funds left in the
Sub-Account to Transfer.
F8 Minimum Balance After Transfer: If any Transfer reduces the remaining
balance in a Sub-Account to less than $500, the remaining balance will
also be Transferred.
F9 Deferral of Withdrawal Payment:
(a) Except as provided in Section F7(b), payments by SAFECO from
the Contract will be made within seven days after receiving a
Withdrawal request.
(b) SAFECO reserves the right to suspend or postpone payments for a
Withdrawal or Transfer for any period when:
(i) The New York Stock Exchange is closed (other than
customary weekend and holiday closings);
(ii) Trading on the New York Stock Exchange is restricted,
as determined by the rules and regulations of the
Securities and Exchange Commission;
(iii) An emergency exists as a result of which disposal of
securities held in the Separate Account is not
reasonably practicable or it is not reasonably
practicable to determine the value of the Separate
Account's net assets, as determined by the rules and
regulations of the Securities and Exchange Commission;
or
(iv) During any other period when the Securities and
Exchange Commission, by order, so permits for the
protection of Owners.
SECTION G: CHARGES AND DEDUCTIONS
G1 Deduction for Annual Administration Maintenance Charge: There is no
annual fee if the Contract Value is $50,000 or above. If the Contract
Value is below $50,000, SAFECO deducts the fee shown on the Contract
Data Page for each Contract Year, or any portion thereof, for general
administrative expenses. This fee is deducted on the last day of each
Contract Year, and in the event of a complete Withdrawal.
The Sub-Account from which the Annual Administration Maintenance Charge
is deducted is determined by the hierarchical order of the Sub-Accounts
as shown on the Contract Data Page.
Prior to the Annuity Date the fee for general administrative expenses
is not guaranteed and may be changed for future years. However, the
Annual Administration Maintenance Charge may never exceed $35 per
Contract Year.
G2 Deduction for Asset Related Administration Charge: SAFECO deducts an
amount computed on a daily basis as compensation for administration of
the Sub-Accounts. The Asset Related Administration Charge shall be a
percentage of the average daily net asset value of the Separate Account
on an annual basis, as shown on the Contract Data Page.
-7-
10
G3 Deduction for Contingent Deferred Sales Charge:
(a) A Contingent Deferred Sales Charge will be assessed against any
Withdrawal or Transfer, based upon the following schedule:
CONTRACT YEAR CHARGE
1 8% of amount Withdrawn
2 7% of amount Withdrawn
3 6% of amount Withdrawn
4 5% of amount Withdrawn
5 4% of amount Withdrawn
6 3% of amount Withdrawn
7 2% of amount Withdrawn
8 1% of amount Withdrawn
After 8 0% of amount Withdrawn
(b) A Contingent Deferred Sales Charge will not be deducted:
(i) On Transfers between Sub-Accounts;
(ii) On the sum of Withdrawals taken in any Contract Year
which does not exceed 10% of the Contract Value;
(iii) On Withdrawals made under a Settlement Option;
(iv) On Systematic Withdrawals over the life expectancy of
the Owner or the joint life expectancy of the Owner
and Beneficiary;
(v) On Withdrawals made pursuant to the death of the
Owner; or
(vi) On Withdrawals for payment of the Annual
Administration Maintenance Charge.
G4 Deduction for Withdrawal Charge: The first Withdrawal each Contract
Year will have no Withdrawal Charge assessed. All further Withdrawals
each Contract Year will be subject to a Withdrawal Charge as shown on
the Contract Data Page, which will be deducted from the amount being
Withdrawn. Settlement Options and Systematic Withdrawal will have no
Withdrawal Charge assessed.
G5 Deduction for Transfer Charge: SAFECO reserves the right to assess a
Transfer Charge for Transfers in excess of twelve Transfers per
calendar year, as shown on the Contract Data Page. Automatic Transfers
that continue for at least six months will not be counted for purposes
of deduction of the Transfer Charge.
G6 Deduction for Mortality and Expense Risk Premium: SAFECO deducts an
amount computed on a daily basis as compensation for assuming the
mortality and expense risk. The Mortality and Expense Risk Premium
shall be a percentage of the average daily net asset value of the
Separate Account on an annual basis, as shown on the Contract Data
Page.
G7 Taxes: Any premium taxes or other taxes levied by any governmental
entity which SAFECO, in its sole discretion, determines have resulted
from the establishment or maintenance of this Contract or any portion
of this Contract, the receipt by SAFECO of Purchase Payments, or the
commencement of Annuity payments, will be deducted from the Contract.
The Sub-Account from which the taxes are deducted is determined by the
hierarchical order of the Sub-Accounts as shown on the Contract Data
Page.
-8-
11
SECTION H: ANNUITY PURCHASE RATE TABLE
H1 Mortality Tables Used: The rates in the Variable Annuity Purchase Rate
Table are based upon the 1983a Mortality Table Projected 20 Years with
Projection Scale G; 50% Male and 50% Female. An age setback of 1 year
will be used if the Annuity payment begins in the year 2000-2009, 2
years if the Annuity payment begins in the year 2010-2019, and an
additional 1 year setback for each additional ten years. The effective
interest rate assumed in the Variable Annuity Purchase Rate table is
4.00%.
H2 Variable Annuity Purchase Rate Table:
CONSIDERATION REQUIRED TO PURCHASE $1 OF MONTHLY ANNUITY*
Life Joint & Survivor Annuity**
Annuity
Age of Life 120-Months 100% 50%
Annuitant Xxxxxxx Xxxxxxx Xxxxxxx Xxxxxxx
--------- ---------- ---------- ---------- ----------
55 $208.85 $210.55 $233.18 $221.02
56 205.59 207.42 230.40 218.00
57 202.23 204.22 227.53 214.88
58 198.76 200.94 224.55 211.66
59 195.20 197.58 221.47 208.34
60 191.54 194.16 218.29 204.91
61 187.79 190.67 215.00 201.39
62 183.95 187.12 211.61 197.78
63 180.01 183.53 208.11 194.06
64 176.00 179.88 204.51 190.25
65 171.91 176.20 200.80 186.36
66 167.75 172.50 197.00 182.38
67 163.53 168.77 193.09 178.31
68 159.25 165.04 189.08 174.16
69 154.90 161.31 184.98 169.94
70 150.50 157.59 180.77 165.64
71 146.05 153.89 176.48 161.26
72 141.55 150.23 172.10 156.82
73 137.02 146.62 167.63 152.32
74 132.46 143.09 163.09 147.78
75 127.90 139.63 158.49 143.19
*The consideration shown refers to the net value used to purchase an Annuity,
after premium taxes or other applicable charges are deducted.
**Annuitant and co-annuitant are assumed to be the same age.
Age is to be taken for the exact number of years and completed months. Values
for fractional ages are obtained by simple interpolation.
Consideration for ages or combination of lives not shown will be furnished by
SAFECO upon request.
-9-
12
CONTRACT DATA PAGE
PRODUCT: SPINNAKER NQ FLEX
OWNER: XXXX XXX
000 XXXXXXX XXXX
XXXXXXX XXXX, XX 00000-8888
ANNUITANT: XXXX XXX
CONTRACT NUMBER: LP12345678
CONTRACT DATE: 11/01/1995
ANNUITANT'S AGE ON CONTRACT DATE: 35
ANNUITY DATE: 01/01/2030
DELIVERED IN THE STATE OF WASHINGTON AND GOVERNED BY ITS LAWS.
MINIMUM INITIAL PURCHASE PAYMENT: $2,000.00
MINIMUM SUBSEQUENT PURCHASE PAYMENT: $250.00
ANNUAL ADMINISTRATION MAINTENANCE CHARGE: $30 each Contract Year, waived if
Contract Value is $50,000 or more. Guaranteed never to exceed $35.
ASSET RELATED ADMINISTRATION CHARGE: Equal on an annual basis to .15% of the
average daily net asset value of the Separate Account
MORTALITY AND EXPENSE RISK CHARGE: Equal on an annual basis to 1.25% of the
average daily net asset value of the Separate Account
TRANSFER CHARGE: The lesser of $10 or 2% of amount transferred, for each
Transfer in excess of twelve per Contract Year
MINIMUM WITHDRAWAL: The lesser of $250 or the Contract Value
CONTINGENT DEFERRED SALES CHARGE:
CONTRACT YEAR CHARGE
1 8% of amount withdrawn
2 7% of amount withdrawn
3 6% of amount withdrawn
4 5% of amount withdrawn
5 4% of amount withdrawn
6 3% of amount withdrawn
7 2% of amount withdrawn
8 1% of amount withdrawn
After 8 0% of amount withdrawn
Total Contingent Deferred Sales Charges will not exceed 8.5% of the Purchase
Payments and Deposits made under this Contract
WITHDRAWAL CHARGE: The lesser of $25 or 2% of the amount withdrawn, for each
Withdrawal in excess of one per Contract Year
ELIGIBLE INVESTMENTS:
1. SAFECO Resource Money Market Sub-Account
2. SAFECO Resource Bond Sub-Account
3. Federated Utility Sub-Account
4. Federated Corporate Bond Sub-Account
5. Xxxxxxx Variable Life Investment Fund Balanced Sub-Account
6. Lexington Natural Resources Sub-Account
7. Xxxxxxx Variable Life Investment Fund International Sub-Account
8. Federated International Stock Sub-Account
9. Lexington Emerging Markets Sub-Account
10. SAFECO Resource Equity Sub-Account
11. SAFECO Resource Northwest Sub-Account
12. SAFECO Resource Growth Sub-Account
13. SAFECO Fixed Account Annuity Rider
SEPARATE ACCOUNT: SAFECO Separate Account C
ANNUITY SERVICE OFFICE:
HOME OFFICE: MAILING ADDRESS:
SAFECO Life Insurance Company SAFECO Life Insurance Company
Pension Department Pension Department
00000 XX 00xx Xxxxxx X.X. Box 34690
Redmond, Washington 98052 Seattle, Washington 00000-0000
Telephone: 0-000-000-0000
Fax: 000-000-0000
LPC-410/EP 9/95
13
CONTRACT DATA PAGE
PRODUCT: SPINNAKER Q
OWNER: XXXX XXX
000 XXXXXXX XXXX
XXXXXXX XXXX, XX 00000-8888
ANNUITANT: XXXX XXX
CONTRACT NUMBER: LP12345678
CONTRACT DATE: 11/01/1995
ANNUITANT'S AGE ON CONTRACT DATE: 35
ANNUITY DATE: 01/01/2028
DELIVERED IN THE STATE OF WASHINGTON AND GOVERNED BY ITS LAWS.
MINIMUM INITIAL PURCHASE PAYMENT: $30.00
MINIMUM SUBSEQUENT PURCHASE PAYMENT: $30.00
ANNUAL ADMINISTRATION MAINTENANCE CHARGE: $30 each Contract Year, waived if
Contract Value is $50,000 or more. Guaranteed never to exceed $35.
ASSET RELATED ADMINISTRATION CHARGE: Equal on an annual basis to .15% of the
average daily net asset value of the Separate Account
MORTALITY AND EXPENSE RISK CHARGE: Equal on an annual basis to 1.25% of the
average daily net asset value of the Separate Account
TRANSFER CHARGE: The lesser of $10 or 2% of amount transferred, for each
Transfer in excess of twelve per Contract Year
MINIMUM WITHDRAWAL: The lesser of $250 or the Contract Value
CONTINGENT DEFERRED SALES CHARGE:
CONTRACT YEAR CHARGE
1 8% of amount withdrawn
2 7% of amount withdrawn
3 6% of amount withdrawn
4 5% of amount withdrawn
5 4% of amount withdrawn
6 3% of amount withdrawn
7 2% of amount withdrawn
8 1% of amount withdrawn
After 8 0% of amount withdrawn
Total Contingent Deferred Sales Charges will not exceed 8.5% of the Purchase
Payments and Deposits made under this Contract
WITHDRAWAL CHARGE: The lesser of $25 or 2% of the amount withdrawn, for each
Withdrawal in excess of one per Contract Year
ELIGIBLE INVESTMENTS:
1. SAFECO Resource Money Market Sub-Account
2. SAFECO Resource Bond Sub-Account
3. Federated Utility Sub-Account
4. Federated Corporate Bond Sub-Account
5. Xxxxxxx Variable Life Investment Fund Balanced Sub-Account
6. Lexington Natural Resources Sub-Account
7. Xxxxxxx Variable Life Investment Fund International Sub-Account
8. Federated International Stock Sub-Account
9. Lexington Emerging Markets Sub-Account
10. SAFECO Resource Equity Sub-Account
11. SAFECO Resource Northwest Sub-Account
12. SAFECO Resource Growth Sub-Account
13. SAFECO Fixed Account Annuity Rider
SEPARATE ACCOUNT: SAFECO Separate Account C
ANNUITY SERVICE OFFICE:
HOME OFFICE: MAILING ADDRESS:
SAFECO Life Insurance Company SAFECO Life Insurance Company
Pension Department Pension Department
00000 XX 00xx Xxxxxx X.X. Box 34690
Redmond, Washington 98052 Seattle, Washington 00000-0000
Telephone: 0-000-000-0000
Fax: 000-000-0000
LPC-407/EP 9/95
