0000080019-15-000002 Sample Contracts

EX-99.B4.c. Variable and Index-Linked Deferred Annuity Contract
Allianz Life Insurance Co of New York • April 20th, 2015

Purchase Payments we receive for this contract accumulate to provide Annuity Payments or an incidental Death Benefit. This is a variable annuity contract with Contract Value increasing or decreasing depending on the experience of the Variable Account and Index Options. Investment in the contract may result in a loss of Purchase Payments. This contract is nonparticipating, with no dividends payable. Benefits available under this contract are not less than those required by New York statute.

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