Exhibit 24(b)(4)(c)
Tax-Sheltered Annuity Endorsement (EA125NY)
AUSA LIFE INSURANCE COMPANY, INC.
TAX SHELTERED ANNUITY ENDORSEMENT
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This Endorsement is part of the Contract. This Contract is issued in connection
with a tax sheltered annuity plan described in section 403(b) of the Internal
Revenue Code of 1986, as amended (the "Code"). The following provisions apply
and replace any contrary Contract provisions. The Owner shall be responsible for
determining that contributions and distributions under this Contract comply with
the following provisions:
(1) This Contract may not be transferred, sold, assigned, discounted or
pledged either as collateral for a loan or as security for the
performance of an obligation or for any other purpose, to any person
other than the Company.
(2) The Annuitant shall be the sole Owner.
(3) Distributions shall commence no later than April 1 of the later of
calendar year following the calendar year in which the Owner attains
age 70 or retires; provided, however, that if the Owner is a five
percent Owner (as defined in Code Section 416) and this Contract is
not issued in connection with a government or church sponsored Section
403(b) annuity plan, the distributions shall commence no later than
April 1 of the calendar year following the calendar year in which the
Owner retires; and provided further, that distributions are not
required to commence under this Contract so long as distributions in
the required form and amount are received from any other Section
403(b) program maintained by the Owner.
(4) With respect to any amount which becomes payable under the Contract
during the lifetime of the Owner, such payment shall commence on or
before the date specified in paragraph 3 of this Endorsement and shall
be payable in a form and manner that accords with section 403(b)(10)
of the Code and the regulations thereunder.
(5) (a) If the Owner dies after distribution of his or her interest
in the Contract has commenced, the remaining interest in the
Contract will continue to be distributed at least as rapidly as
under the method of distribution being used immediately
preceding the Owner's death.
(b) If the Owner dies before distribution of his or her interest in
the Contract has commenced, the entire interest in the Contract
shall be distributed at a time and in a form and manner that
accords with Code section 403(b)(10) and the regulations
thereunder.
(6) Distributions shall not be made prior to the date the Owner attains
age 59 1/2, separates from service, dies, becomes disabled or incurs a
hardship within the meaning of Code section 403(b)(11), to the extent
such distribution is attributable to (a) contributions made pursuant
to a salary reduction agreement (except to the extent attributable to
assets held as of the close of the last year beginning before January
1, 1989) or (b) amounts transferred to this Contract from a contract
or account that were subject to such conditions. In the event of
hardship, income attributable to such contributions or amounts shall
not be distributed.
(7) If this Contract is issued under the Texas Optional Retirement
Program, distributions shall be made only on (a) termination of
employment in the Texas public institutions of higher education, (b)
retirement, or (c) death. The Owner (or the Owner's beneficiary, in
the event of the Owner's death) must provide to us a certificate of
termination from the employer or a certificate of death before
distributions will be made.
(8) Contributions made pursuant to a salary reduction agreement in
connection with the plan under which this Contract is purchased may
not in any taxable year exceed the amount specified in Code section
402(g)(4).
(9) This Contract shall be subject to and interpreted in conformity with
the provisions, terms and conditions of the tax-sheltered annuity plan
document of which this Contract is a part, if any, and with the terms
and conditions of section 403(b) of the Code, the regulations
thereunder, and other applicable law (including without limitation the
Employee Retirement Income Security Act of 1974, as amended, if
applicable), as determined by the plan administrator or other
designated plan fiduciary or, if none, the Owner. We shall be under no
obligation either (a) to determine whether any contribution,
distribution or transfer under the Contract complies with the
provisions, terms and conditions of such plan or with applicable law,
or (b) to administer such plan, including, without limitation, any
provisions required by the Retirement Equity Act of 1984.
(10) Notwithstanding any provision to the contrary in this Contract or the
tax-sheltered annuity plan of which this Contract is a part, if any,
we reserve the right to amend or modify this Contract or Endorsement
to the extent necessary to comply with any law, regulations, ruling or
other requirement necessary to establish or maintain the tax
advantages, protections or benefits available to such tax-sheltered
annuity under Code section 403(b) and any other applicable law.
(11) Notwithstanding any provision of this Endorsement to the contrary that
would otherwise limit a distributee's election under this section, a
distributee may elect, at the time and in the manner prescribed by Us,
to have any portion of an eligible rollover distribution paid directly
to an eligible retirement plan specified by the distributee in a
direct rollover.
For purposes of this section, the following definitions apply:
(a) ELIGIBLE ROLLOVER DISTRIBUTION. An eligible rollover is any
distribution of all or any portion of the contract values to the
credit of the distributee, except that an eligible rollover
distribution does not include: any distribution that is one of a
series of substantially equal periodic payments (not less
frequently than annually) made for the life (or life expectancy)
of the distributee or the joint lives (or joint life
expectancies) of the distributee and the distributee's
designated beneficiary, or for a specified period of ten years
or more; any distribution to the extent such distribution is
required to comply with the minimum distribution and incidental
death benefit requirements of section 401(a)(9) and 403(b)(10)
of the Code; and the portion of any distribution that is not
includible in gross income. An eligible rollover distribution
also does not include any other amounts that may be excluded
under regulations, procedures, notices, or rulings interpreting
the term eligible rollover distribution under sections
401(a)(31), 402, or 403(b) of the Code.
(b) ELIGIBLE RETIREMENT PLAN. An eligible retirement plan is an
individual retirement account described in section 408(a) of the
Code, an individual retirement annuity described in section
408(b) of the Code, or another 403(b) annuity or 403(b)(7)
custodial account, that accepts the distributee's eligible
rollover distribution. However, in the case of an eligible
rollover distribution to the surviving spouse, an eligible
retirement plan is an individual retirement account or
individual retirement annuity.
(c) DISTRIBUTEE. The Contract Owner is a distributee. In addition,
the Contract Owner's spouse, surviving spouse or former spouse
who is the alternate payee under a qualified domestic relations
order, as defined in section 414(p) of the Code, are
distributees with regard to the interest of the spouse or former
spouse.
(d) DIRECT ROLLOVER. A direct rollover is a payment by the plan to
the eligible retirement plan specified by the distributee.
We reserve the right to prescribe reasonable forms and
procedures for the election of direct rollovers under this
paragraph including, but not limited to, requirements that the
distributee provide Us with adequate information, including, but
not limited to: the name of the eligible retirement plan to
which the rollover is to be made; a representation that the
recipient plan is an individual retirement plan or a 403(b)
annuity, as appropriate; acknowledgment from the recipient plan
that it will accept the direct rollover; and any other
information necessary to make the direct rollover.
(12) In the event this Contract is purchased under a plan which provides a
salary reduction agreement, maximum elective deferrals may not exceed
the annual limit on elective deferrals permitted by Code Section
403(b)(1)(e) and the regulations thereunder.
Except as otherwise set forth above, this Endorsement is subject to
the exclusions, definitions and provisions of the Contract.
Signed for Us at our Office in Clearwater, Florida.
/s/ Xxxxx X. Xxxxxx /s/ Xxx X. Xxxxxxxxxxx
Secretary President
