CERTIFICATE


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Exhibit 4(c)


CERTIFICATE

CERTIFICATE NUMBER   EFFECTIVE DATE

OWNER 1
 
BIRTH DATE OF OWNER 1

OWNER 2
 
BIRTH DATE OF OWNER 2

ANNUITANT
 
BIRTH DATE OF ANNUITANT

BENEFICIARY
 
ANNUITY COMMENCEMENT DATE

CONTRACT HOLDER:    {Bankers Trust Company, NA}

CLASS OF ELIGIBLE OWNERS:    {Accountholders of Broker-Dealers having distribution agreements with Protective Life}

JURISDICTION:    This Contract is governed by the laws of the State of {Iowa}.

INITIAL PURCHASE PAYMENT:    {$100,000.00}

{ANNUAL BONUS:
{0.00%} on the {1st} through {7th} Contract Anniversary,
{0.50%} on the {8th} {through 16th} Contract Anniversary,
{0.00%} on the {17th} {through 24th} Contract Anniversary,
and {0.00%} on each Contract Anniversary thereafter.}

{MINIMUM GUARANTEED INTEREST RATE FOR THE GUARANTEED ACCOUNT:    {1.00%}}

{ANNUAL EFFECTIVE INTEREST RATES ON THE EFFECTIVE DATE:}
{FIXED ACCOUNT - 1.50%}
{DCA FIXED ACCOUNT 1 - 4.00%}
{DCA FIXED ACCOUNT 2 - 3.50%}
{DCA FIXED ACCOUNT 3 - 3.00%}

MORTALITY AND EXPENSE RISK CHARGE
{1.00%} per annum.

ADMINISTRATION CHARGE
{0.10%} per annum.

DEATH BENEFIT
{Return of Purchase Payments}

DEATH BENEFIT COST CALCULATION METHOD
{Asset Based Fee}

CONTRACT MAINTENANCE FEE:    {$35}
The contract maintenance fee is deducted prior to the Annuity Commencement Date on each Contract Anniversary, and on any day that the Contract is surrendered other than the Contract Anniversary. The contract maintenance fee will be deducted from the Allocation Options in the same proportion as their values are to the Contract Value. The contract maintenance fee will be waived by the Company in the event the Contract Value or the aggregate Purchase Payments reduced by surrenders equals or exceeds $50,000 on the date the contract maintenance fee is to be deducted.

TRANSFER FEE
{$25} per transfer in excess of 12 transfers per Certificate in any Contract Year.

3


SURRENDER CHARGE

Number of Full Years Elapsed Between
the Date the Purchase Payment was applied to
the Contract and the Surrender Date
   Surrender Charge Percentage
{0}   {7%}
{1}   {6%}
{2}   {6%}
{3}   {5%}
{4}   {4%}
{5}   {3%}
{6}   {2%}
{7+}   {0%}


ALLOCATION OPTIONS AVAILABLE ON THE EFFECTIVE DATE

{Protective Life Guaranteed Account}
        {Fixed Account}
        {DCA Fixed Account 1}
        {DCA Fixed Account 2}
        {DCA Fixed Account 3}		   {MFS Investment Management}
        {New Discovery SS}
        {Emerging Growth SS}
        {Investors Growth Stock SS}
        {Research SS}
        {Utilities SS}
        {Investors Trust SS}
        {Total Return SS}

Sub-Accounts of the
Protective Variable Annuity Separate Account:
 
 

{Xxxxxxx Xxxxx}
        {CORE Small Cap Equity}
        {International Equity}
        {Mid Cap Value}
        {Capital Growth}
        {CORE U.S. Equity}
        {Growth and Income}
 
{OppenheimerFunds}
        {Global Securities SS}
        {Aggressive Growth SS}
        {Capital Appreciation SS}
        {Main Street SS}
        {Strategic Bond SS}
        {High Income SS}
        {Money}

{Lord Xxxxxx}
        {Growth Opportunities}
        {Mid-Cap Value}
        {Growth and Income}
        {America's Value}
        {Bond-Debenture}
 
{Xxx Xxxxxx}
        {Aggressive Growth II}
        {Emerging Growth II}
        {Enterprise II}
        {Xxxxxxxx II}
        {Growth and Income II}
        {Government II}
        {UIF Equity and Income II}

4



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CERTIFICATE
SURRENDER CHARGE
ALLOCATION OPTIONS AVAILABLE ON THE EFFECTIVE DATE
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Filed: February 17th, 2004
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