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ASSET ALLOCATION RIDER
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This Rider is attached to and made a part of this Contract as of the Contract
Date, or if later, the date shown below. Terms not defined in this Rider have
the meaning given to them in the Contract.
ASSET ALLOCATION
Prior to the Annuity Start Date, FSBL offers an Automatic Transfer option, known
as the Asset Allocation Option. Under this Option, FSBL will Transfer Contract
Value among the Accounts on a monthly, quarterly, semiannual or annual basis to
maintain a percentage allocation among the Accounts as instructed by the Owner.
To elect the Option, the Owner must submit a written request to FSBL. The
written request must set forth the specific Accounts, the percentage of Contract
Value to be allocated to each Account, and the time period.
Upon receipt of the written request, FSBL will make a Transfer or, in the case
of a new Contract, will allocate the first Purchase Payment, among the Accounts
based upon the percentages set forth in the written request. Thereafter, FSBL
will Transfer Contract Value to maintain that allocation on each monthly,
quarterly, semiannual or annual anniversary, as selected by the Owner, of the
date of FSBL's receipt of the written request in proper form (the "Option
Date"). The amounts Transferred will be credited at the price of the Account as
of the close of the Valuation Period during which the Option Date occurs.
Amounts Transferred from time to time under this Option are not included in the
14 Transfers per Contract Year that are allowed under the Contract.
From time to time, the Owner may submit a written request to change the
allocation of Contract Value among the Accounts. FSBL will change the allocation
as requested at the close of the Valuation Period during which the request is
Received by FSBL. After receipt of a request to change the allocation, FSBL will
Transfer Contract Value on each Option Date to maintain that allocation or such
other allocation as set forth in the most recent instructions from the Owner.
The Owner may cancel this Rider at any time by written request to FSBL. This
Rider will stop automatically on the Annuity Start Date. If the Rider is
canceled, the Contract Value in the Accounts that has not been Transferred will
remain in those Accounts regardless of the percentage allocation unless the
Owner instructs FSBL otherwise in writing. FSBL may discontinue the Option at
any time.
FIRST SECURITY BENEFIT LIFE INSURANCE
AND ANNUITY COMPANY OF NEW YORK
XXXXX X. XXXXX
Xxxxx X. Xxxxx
Secretary
Rider Start Date
(If Other Than Contract Date)
FSB225 (10-01)
