HARTFORD LIFE INSURANCE COMPANY 200 HOPMEADOW STREET SIMSBURY, CT 06089 (a stock life insurance company, herein called "We", "Us", "Our")Life Insurance Contract • December 10th, 2009 • Hartford Life Insurance Co • Life insurance
Contract Type FiledDecember 10th, 2009 Company IndustrySURRENDER CHARGE: This charge is determined by multiplying the applicable rate specified below by the amount of the Full or Partial Surrender that exceeds the Annual Free Withdrawal Amount. This charge does not apply to: - [Transfers from the current Guarantee Period into a new Guarantee Period or into the Default Guarantee Period made at the end of the then current Guarantee Period. - Surrenders during the 30 day period at the beginning of a subsequent Guarantee Period; or - Annuitization; or - The Death Benefit; or - The Default Guarantee Period.] This charge varies according to initial and subsequent Guarantee Periods and equals:
LOGO] [THE HARTFORD] HARTFORD LIFE INSURANCE COMPANY 200 Hopmeadow Street Simsbury, CT 06089 (a stock life insurance company, herein called "We", "Us", "Our")Life Insurance Contract • February 12th, 2009 • Hartford Life Insurance Co • Life insurance
Contract Type FiledFebruary 12th, 2009 Company IndustrySURRENDER CHARGE: This charge is determined by multiplying the applicable rate specified below by the amount of the Full or Partial Surrender that exceeds the Annual Withdrawal Amount. This charge does not apply to: - [Surrenders during the 30 day period at the beginning of a subsequent Guarantee Period; or - Surrenders of Contract Value held in the Access Account, if applicable; or - Annuitization; or - The Death Benefit; or - Transfers from the current Guarantee Period into a new Guarantee Period made at the end of the then current Guarantee Period; - Permissible transfers from or to any of the Accounts.] This charge varies according to initial and subsequent Guarantee Periods and equals:
Valley Forge Life Insurance Company A Stock Company Administrative Office: Home Office: 100 CNA Drive 401 Penn St. Nashville, Tennessee 37214 Reading, Pennsylvania 19601 We agree to pay the benefits described in this contract in accordance with its...Life Insurance Contract • September 5th, 2001 • Valley Forge Life Insurance Co Variable Annuity Separate Acc
Contract Type FiledSeptember 5th, 2001 Company
1 Exhibit 4(a) PROVIDENT MUTUAL LIFE INSURANCE COMPANY Berwyn, Pennsylvania ANNUITANT: JOHN DOE CONTRACT DATE: 01/01/2000 CONTRACT NO.: 0200000000 MATURITY DATE: 01/01/2055 In this Contract, Provident Mutual Life Insurance Company is referred to as...Life Insurance Contract • July 17th, 2001 • Provident Mutual Variable Annuity Separate Account
Contract Type FiledJuly 17th, 2001 Company
1 EXHIBIT 4(a) PROVIDENT MUTUAL LIFE INSURANCE COMPANY Berwyn, Pennsylvania ANNUITANT: JOHN DOE CONTRACT NO.: 0200000000 CONTRACT DATE: 01/01/2000 MATURITY DATE: 01/01/2055 In this Contract, Provident Mutual Life Insurance Company is referred to as...Life Insurance Contract • July 17th, 2001 • Provident Mutual Variable Annuity Separate Account
Contract Type FiledJuly 17th, 2001 Company
1 Exhibit 4(a) Provident Mutual Life Insurance Company Berwyn, Pennsylvania ANNUITANT: JOHN DOE CONTRACT DATE: 01/01/2000 CONTRACT NO.: 9,000,000 MATURITY DATE: 01/01/2055 In this Contract, Provident Mutual Life Insurance Company is referred to as...Life Insurance Contract • April 5th, 2001 • Provident Mutual Variable Annuity Separate Account
Contract Type FiledApril 5th, 2001 Company
FLEXIBLE PREMIUM DEFERRED VARIABLE ANNUITY CONTRACT Flexible premiums as stated in the General Provisions. Contract Account Values are variable, except for amounts in the Guaranteed Account Options. Non-participating Contract. FOR INQUIRIES,...Life Insurance Contract • February 5th, 2001 • Provident Mutual Variable Annuity Separate Account
Contract Type FiledFebruary 5th, 2001 Company
1 EXHIBIT 4(a) PROVIDENT MUTUAL LIFE INSURANCE COMPANY Berwyn, Pennsylvania ANNUITANT: JOHN DOE CONTRACT DATE: 01/01/2000 CONTRACT NO.: 9000000 MATURITY DATE: 01/01/2055 In this Contract, Provident Mutual Life Insurance Company is referred to as "We",...Life Insurance Contract • February 5th, 2001 • Provident Mutual Variable Annuity Separate Account
Contract Type FiledFebruary 5th, 2001 Company
2- 3 CONTRACT SCHEDULELife Insurance Contract • April 25th, 2000 • Providentmutual Variable Annuity Separate Account
Contract Type FiledApril 25th, 2000 Company
ANNUITANT: CONTRACT DATE: CONTRACT NO.: MATURITY DATE:Life Insurance Contract • November 1st, 1999 • Providentmutual Variable Annuity Separate Account
Contract Type FiledNovember 1st, 1999 Company
Home Office Customer Service Center 300 Atlantic Street [P. O. Box 290680 Stamford, CT 06901 Wethersfield, CT 06109] [1-877-TEL-SAGE] PLEASE READ THIS CONTRACT CAREFULLY. This Contract is a legal contract between the Owner (you) and Sage Life...Life Insurance Contract • September 21st, 1999 • Sage Variable Life Account A
Contract Type FiledSeptember 21st, 1999 Company
Home Office Customer Service Center 300 Atlantic Street [P.O. Box 290680 Stamford, CT 06901 Wethersfield, CT 06109] [1-877-TEL-SAGE] PLEASE READ THIS CONTRACT CAREFULLY. This Contract is a legal contract between the Owner (you) and Sage Life Assurance...Life Insurance Contract • September 21st, 1999 • Sage Variable Life Account A
Contract Type FiledSeptember 21st, 1999 Company
1-877-TEL-SAGE PLEASE READ THIS CONTRACT CAREFULLY. This Contract is a legal contract between the Owner (you) and Sage Life Assurance of America, Inc. You have the rights described in the Contract. We agree to pay the Death Proceeds to the Beneficiary...Life Insurance Contract • September 21st, 1999 • Sage Variable Life Account A
Contract Type FiledSeptember 21st, 1999 Company
Home Office Customer Service Center 300 Atlantic Street [P. O. Box 290680 Stamford, CT 06901 Wethersfield, CT 06109] [1-877-TEL-SAGE] PLEASE READ THIS CONTRACT CAREFULLY. This Contract is a legal contract between the Owner (you) and Sage Life...Life Insurance Contract • September 21st, 1999 • Sage Variable Life Account A
Contract Type FiledSeptember 21st, 1999 Company
Executive Office: Home Office: CNA Plaza 401 Penn St. Chicago, Illinois 60685 Reading, Pennsylvania 19601Life Insurance Contract • August 18th, 1999 • Valley Forge Life Insurance Co Variable Annuity Separate Acc
Contract Type FiledAugust 18th, 1999 Company
READ YOUR CONTRACT CAREFULLY THIS IS A LEGAL CONTRACT We promise to pay, subject to the provisions of this contract, the benefits described by this contract. We make this promise and issue this contract in consideration of the application for this...Life Insurance Contract • May 21st, 1999 • Variable Annuity Account
Contract Type FiledMay 21st, 1999 Company
READ YOUR CONTRACT CAREFULLY THIS IS A LEGAL CONTRACT We promise to pay, subject to the provisions of this contract, the benefits described by this contract. We make this promise and issue this contract in consideration of the application for this...Life Insurance Contract • May 21st, 1999 • Variable Annuity Account
Contract Type FiledMay 21st, 1999 Company
CONTRACT INDEXLife Insurance Contract • March 3rd, 1999 • Variable Annuity Account
Contract Type FiledMarch 3rd, 1999 Company
Exhibit 4(a) READ YOUR CONTRACT CAREFULLY THIS IS A LEGAL CONTRACT We promise to pay, subject to the provisions of this contract, the benefits described by this contract. We make this promise and issue this contract in consideration of the application...Life Insurance Contract • March 3rd, 1999 • Variable Annuity Account
Contract Type FiledMarch 3rd, 1999 Company
CONTRACT INDEX Alphabetical Index to the Provision of Your ContractLife Insurance Contract • March 2nd, 1999 • Variable Annuity Account
Contract Type FiledMarch 2nd, 1999 Company
YOUR CONTRACT INFORMATION ----------------------------------------------------- ---------------------------Life Insurance Contract • March 1st, 1999 • Variable Annuity Account
Contract Type FiledMarch 1st, 1999 Company
s/Susan L. Harris /s/Eli Broad ----------------------- ------------------- Susan L. Harris Eli Broad Secretary President INDIVIDUAL FIXED AND VARIABLE ANNUITY CONTRACT NonparticipatingLife Insurance Contract • February 1st, 1999 • Variable Annuity Account Five
Contract Type FiledFebruary 1st, 1999 Company
SF 467 SAMPLE This contract is a legal contract between You, as the Owner, and Us, Principal Life Insurance Company. Your contract is issued based on the information You provided and the initial Purchase Payment shown on the initial Data Page. We will...Life Insurance Contract • September 15th, 1998 • Principal Mutual Life Insurance Company Separate Account B
Contract Type FiledSeptember 15th, 1998 Company
SF 468 SAMPLE This contract is a legal contract between You, as the Owner, and Us, Principal Life Insurance Company. Your contract is issued based on the information You provided and the initial Purchase Payment shown on the initial Data Page. We will...Life Insurance Contract • September 15th, 1998 • Principal Mutual Life Insurance Company Separate Account B
Contract Type FiledSeptember 15th, 1998 Company
Secretary President Registrar GROUP DEFERRED VARIABLE ANNUITY CONTRACT ALLOCATED PROVISION FOR FIXED AND VARIABLE ANNUITY PAYMENTSLife Insurance Contract • February 28th, 1996 • Minnesota Mutual Group Variable Annuity Account • Minnesota
Contract Type FiledFebruary 28th, 1996 Company Jurisdiction
Secretary President Registrar GROUP DEFERRED VARIABLE ANNUITY CONTRACT ALLOCATED PROVISION FOR FIXED AND VARIABLE ANNUITY PAYMENTSLife Insurance Contract • February 28th, 1996 • Minnesota Mutual Group Variable Annuity Account • Minnesota
Contract Type FiledFebruary 28th, 1996 Company Jurisdiction
Secretary President Registrar GROUP DEFERRED VARIABLE ANNUITY CONTRACT ALLOCATED PROVISION FOR FIXED AND VARIABLE ANNUITY PAYMENTSLife Insurance Contract • November 7th, 1995 • Minnesota Mutual Group Variable Annuity Account • Minnesota
Contract Type FiledNovember 7th, 1995 Company Jurisdiction
Secretary President Registrar GROUP DEFERRED VARIABLE ANNUITY CONTRACT ALLOCATED PROVISION FOR FIXED AND VARIABLE ANNUITY PAYMENTSLife Insurance Contract • November 7th, 1995 • Minnesota Mutual Group Variable Annuity Account • Minnesota
Contract Type FiledNovember 7th, 1995 Company Jurisdiction