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Annuitant Owner(s) | |[THOMAS J. DOE] [JOHN Q. DOE] | |Initial Premium Annuity Option Annuity Commencement Date | |[$10,000] [LIFE 10-YEAR CERTAIN] [JANUARY 1, 2026] | |Separate Account(s) Contract Number | |[THE MVA FIXED ACCOUNT] [123456] |

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