Exhibit 24(b)(4)(a)(ii) JOHN HANCOCK LIFE INSURANCE COMPANY OF NEW YORK HOME OFFICE: [100 Summit Lake Drive, 2nd Floor (JOHN HANCOCK(R) LOGO) Valhalla, NY 10595] THIS IS A LEGAL CONTRACT - READ IT CAREFULLY. This Contract is issued in consideration of...Insurance Contract • May 18th, 2011 • John Hancock Life Insurance Co of New York Separate Account A
Contract Type FiledMay 18th, 2011 Company
CRC SELECT II PRODUCTInsurance Contract • October 30th, 2008 • Hartford Life Insurance Co • Life insurance
Contract Type FiledOctober 30th, 2008 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:
AMERICAN UNITED LIFE INSURANCE COMPANY(R) a ONEAMERICA(R) company CONTRACT NUMBER: [G XX,XXX] CONTRACTHOLDER: [ABC COMPANY] DATE OF ISSUE: [JANUARY 2, 2008] CONTRACT DATE: [JANUARY 1, 2008] FIRST CONTRACT ANNIVERSARY: [JANUARY 1, 2009] American United...Insurance Contract • May 2nd, 2008 • Aul American Unit Trust
Contract Type FiledMay 2nd, 2008 Company
AMERICAN UNITED LIFE INSURANCE COMPANY(R) a ONEAMERICA(R) company CONTRACT NUMBER: [G XX,XXX] CONTRACTHOLDER: [ABC COMPANY] DATE OF ISSUE: [JANUARY 2, 2008] CONTRACT DATE: [JANUARY 1, 2008] FIRST CONTRACT ANNIVERSARY: [JANUARY 1, 2009] American United...Insurance Contract • May 2nd, 2008 • Aul American Unit Trust
Contract Type FiledMay 2nd, 2008 Company
LOGO] PHL VARIABLE INSURANCE COMPANY [Home Office: Hartford, Connecticut 06102 Administrative Office: 9920 Corporate Campus Drive, Suite 1000, Louisville, Kentucky 40223 Telephone: 1-866-667-0561] A Stock Company PHL Variable Insurance Company (the...Insurance Contract • April 4th, 2008 • PHL Variable Accumulation Account II
Contract Type FiledApril 4th, 2008 Company
Exhibit 99(b)(4)(m) JEFFERSON NATIONAL LIFE INSURANCE COMPANY Home Office: Dallas, Texas 75201 Administrative Office: 9920 Corporate Campus Drive, Suite 1000, Louisville, Kentucky 40223 Telephone: 1-866-667-0561 A Stock Company Jefferson National Life...Insurance Contract • April 13th, 2007 • Jefferson National Life Annuity Account G
Contract Type FiledApril 13th, 2007 Company
EXHIBIT 99.(4)(j) JEFFERSON NATIONAL LIFE INSURANCE COMPANY Home Office: Dallas, Texas 75201 Administrative Office: 9920 Corporate Campus Drive, Suite 1000, Louisville, Kentucky 40223 Telephone: 1-866-667-0561 A Stock Company Jefferson National Life...Insurance Contract • April 28th, 2006 • Jefferson National Life Annuity Account G
Contract Type FiledApril 28th, 2006 Company
A Stock CompanyInsurance Contract • April 13th, 2005 • Jefferson National Life Annuity Account G
Contract Type FiledApril 13th, 2005 Company
A Stock Company THIS IS A LEGAL CONTRACT BETWEEN THE CONTRACT OWNER AND THE COMPANY READ YOUR CONTRACT CAREFULLY Jefferson National Life Insurance Company ("the Company") agrees with the contract Owner ("You/Your") to provide benefits to you, subject...Insurance Contract • May 5th, 2004 • Jefferson National Life Annuity Account K
Contract Type FiledMay 5th, 2004 Company
INDIVIDUAL FLEXIBLE PREMIUM DEFERRED ANNUITY CONTRACT FIXED AND VARIABLE ACCOUNTS NON-PARTICIPATINGInsurance Contract • May 5th, 2004 • Jefferson National Life Annuity Account J
Contract Type FiledMay 5th, 2004 Company
Exhibit 99.4(a) THE AMERICAN LIFE INSURANCE COMPANY OF NEW YORK Home Office: 435 Hudson Street, 2nd Floor, New York, New York 10014 This contract ("Contract") creates a legal agreement between The American Life Insurance Company of New York (the...Insurance Contract • May 4th, 2004 • American Separate Account 5
Contract Type FiledMay 4th, 2004 CompanyThis contract ("Contract") creates a legal agreement between The American Life Insurance Company of New York (the "Company," "we," or "us") and the Owner ("you" or "your"). The amounts that you contribute to this Contract and that we accept are your "Contributions." . As the purchaser of the Contract, you are both the Annuitant and the Owner, unless we accept a different arrangement that you have requested.
Exhibit 99.(4)(a) JEFFERSON NATIONAL LIFE INSURANCE COMPANY Home Office: Dallas, Texas 75201 Administrative Office: 9920 Corporate Campus Drive, Suite 1000, Louisville, Kentucky 40223 Telephone: 1-866-667-0561 A Stock Company Jefferson National Life...Insurance Contract • April 30th, 2004 • Jefferson National Life Annuity Account F
Contract Type FiledApril 30th, 2004 Company
INDIVIDUAL FLEXIBLE PREMIUM DEFERRED ANNUITY CONTRACT FIXED AND VARIABLE ACCOUNTS NON-PARTICIPATING TABLE OF CONTENTSInsurance Contract • April 30th, 2004 • Jefferson National Life Annuity Account I
Contract Type FiledApril 30th, 2004 CompanyJefferson National Life Insurance Company ("the Company") agrees with the contract Owner ("You/Your") to provide benefits to You, subject to the provisions set forth in this contract and in consideration of the Purchase Payments received.
INDIVIDUAL FLEXIBLE PREMIUM DEFERRED ANNUITY CONTRACT FIXED AND VARIABLE ACCOUNTS NON-PARTICIPATINGInsurance Contract • April 30th, 2004 • Jefferson National Life Annuity Account H
Contract Type FiledApril 30th, 2004 Company
Exhibit 99.4(a) JEFFERSON NATIONAL LIFE INSURANCE COMPANY Home Office: Dallas, Texas 75201 Administrative Office: 9920 Corporate Campus Drive, Suite 1000, Louisville, Kentucky 40223 Telephone: 1-866-667-0561 A Stock Company Jefferson National Life...Insurance Contract • April 30th, 2004 • Jefferson National Life Annuity Account G
Contract Type FiledApril 30th, 2004 CompanyJefferson National Life Insurance Company (the "Company") agrees with the Owner to provide benefits to the Owner, subject to the provisions set forth in this Contract and in consideration of Purchase Payments received from the Owner.
Pacific Life & Annuity Company 700 Newport Center Drive Newport Beach, CA 92660 A Stock Company READ YOUR CONTRACT CAREFULLY This is a legal contract between you (the "Owner") and Pacific Life & Annuity Company (hereinafter referred to as "we", "us",...Insurance Contract • August 1st, 2003 • Separate Account a of Pacific Life & Annuity Co
Contract Type FiledAugust 1st, 2003 Company
LOGO] Pacific Life Pacific Life Insurance Company 700 Newport Center Drive Newport Beach, CA 92660 A Stock Company --------------------------------------- ----------------------------------------- READ YOUR CONTRACT CAREFULLY This is a legal contract...Insurance Contract • June 30th, 2003 • Separate Account a of Pacific Life Insurance Co
Contract Type FiledJune 30th, 2003 Company
LOGO] PACIFIC LIFE Pacific Life Insurance Company 700 Newport Center Drive Newport Beach, CA 92660 A Stock Company --------------------------------------- ----------------------------------------- READ YOUR CONTRACT CAREFULLY This is a legal contract...Insurance Contract • June 30th, 2003 • Separate Account a of Pacific Life Insurance Co
Contract Type FiledJune 30th, 2003 Company
LOGO] PACIFIC LIFE Pacific Life Insurance Company 700 Newport Center Drive Newport Beach, CA 92660 A Stock Company --------------------------------------- ----------------------------------------- READ YOUR CONTRACT CAREFULLY This is a legal contract...Insurance Contract • June 27th, 2003 • Separate Account a of Pacific Life Insurance Co
Contract Type FiledJune 27th, 2003 Company
American United Life Insurance Company(R) Indianapolis, IN 46206-0368 CONTRACT NUMBER: [GA XX,XXX] CONTRACTHOLDER: [ABC CORPORATION] DATE OF ISSUE: [JANUARY 2, 2003] CONTRACT DATE: [JANUARY 1, 2003] FIRST CONTRACT ANNIVERSARY: [JANUARY 1, 2004]...Insurance Contract • April 30th, 2003 • Aul American Unit Trust
Contract Type FiledApril 30th, 2003 Company
CONTRACT NUMBER GA XX,XXX CONTRACTHOLDER John Doe DATE OF ISSUE January 2, 2001 CONTRACT DATE January 1, 2001Insurance Contract • April 30th, 2003 • Aul American Unit Trust
Contract Type FiledApril 30th, 2003 Company
American United Life Insurance Company(R) Indianapolis, IN 46206-0368 CONTRACT NUMBER: [GA XX,XXX] CONTRACTHOLDER: [ABC CORPORATION] DATE OF ISSUE: [JANUARY 2, 2003] CONTRACT DATE: [JANUARY 1, 2003] FIRST CONTRACT ANNIVERSARY: [JANUARY 1, 2004]...Insurance Contract • April 30th, 2003 • Aul American Unit Trust
Contract Type FiledApril 30th, 2003 Company
ANNUITANT: John Doe OWNER: John Doe CONTRACT NUMBER: 012345678 CONTRACT DATE:Insurance Contract • April 30th, 2003 • Carillon Account
Contract Type FiledApril 30th, 2003 Company
LOGO OF PACIFIC LIFE] Pacific Life Insurance Company 700 Newport Center Drive Newport Beach, CA 92660 A Stock Company READ YOUR CONTRACT CAREFULLY This is a legal contract between you (the "Owner") and Pacific Life Insurance Company (hereinafter...Insurance Contract • December 19th, 2002 • Separate Account a of Pacific Life Insurance Co
Contract Type FiledDecember 19th, 2002 Company
THE AMERICAN LIFE INSURANCE COMPANY OF NEW YORK Home Office: 435 Hudson Street, 2nd Floor, New York, New York 10014 This contract ("Contract") creates a legal agreement between The American Life Insurance Company of New York (the "Company," "we," or...Insurance Contract • September 19th, 2002 • American Separate Account 5
Contract Type FiledSeptember 19th, 2002 Company
ANNUITANT: John Doe OWNER: John Doe CONTRACT NUMBER: 01234567 CONTRACT DATE: April 05, 2001Insurance Contract • April 30th, 2002 • Carillon Account
Contract Type FiledApril 30th, 2002 Company
EX-99.4.3Insurance Contract • April 12th, 2002 • Variable Annuity Account B of Ing Life Ins & Annuity Co
Contract Type FiledApril 12th, 2002 Company
MODIFIED SINGLE PAYMENT VARIABLE LIFE INSURANCE CONTRACT NON-PARTICIPATINGInsurance Contract • March 14th, 2002 • Separate Account SPVL of First Allmerica Life Insurance Co
Contract Type FiledMarch 14th, 2002 Company
MODIFIED SINGLE PAYMENT VARIABLE LIFE INSURANCE CONTRACT NON-PARTICIPATINGInsurance Contract • March 14th, 2002 • Allmerica Sel Sep Acct Iii of Allmerica Fin Life in & Ann Co
Contract Type FiledMarch 14th, 2002 Company
A STOCK COMPANY POLICY NUMBER: ANNUITANT: JACKSON NATIONAL LIFE INSURANCE COMPANY ("the Company" or Jackson National) agrees to provide benefits to the Contract Owner subject to the provisions set forth in this Contract and in consideration of the...Insurance Contract • October 5th, 2001 • Jackson National Separate Account I
Contract Type FiledOctober 5th, 2001 Company
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...Insurance Contract • September 21st, 2001 • Valley Forge Life Insurance Co Variable Annuity Separate Acc
Contract Type FiledSeptember 21st, 2001 Company
Administrative Office: Home Office: 100 CNA Drive 401 Penn St. Nashville, Tennessee 37214 Reading, Pennsylvania 19601Insurance Contract • September 4th, 2001 • Valley Forge Life Insurance Co Variable Annuity Separate Acc
Contract Type FiledSeptember 4th, 2001 Company
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...Insurance Contract • August 24th, 2001 • Valley Forge Life Insurance Co Variable Annuity Separate Acc
Contract Type FiledAugust 24th, 2001 Company
Administrative Office: Home Office: 100 CNA Drive 401 Penn St. Nashville, Tennessee 37214 Reading, Pennsylvania 19601Insurance Contract • August 24th, 2001 • Valley Forge Life Insurance Co Variable Annuity Separate Acc
Contract Type FiledAugust 24th, 2001 Company
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...Insurance Contract • August 17th, 2001 • Valley Forge Life Insurance Co Variable Annuity Separate Acc
Contract Type FiledAugust 17th, 2001 Company