SALES AGREEMENT THIS AGREEMENT is made by and between The Galaxy VIP Fund ("TRUST"), a Massachusetts business trust, and American Skandia Life Assurance Corporation ("SKANDIA"), a life insurance company organized under the laws of the State of...Sales Agreement • April 27th, 1998 • American Skandia Life Assur Corp Var Acct B Cla 3 Sub Acct • Massachusetts
Sex Male Female Date of Birth Sex Male Female Date of Birth Social Security/Tax I.D. No. Social Security/Tax I.D. No. --------------------------------------------------------------- -------------------------------------------------------------------...American Skandia Life Assur Corp Var Acct B Cla 3 Sub Acct • April 27th, 1998
Agreement-I/We represent to the best of my/our knowledge and belief the statements made in this application are true and complete; including, under penalty of perjury, the Social Security or Tax ID numbers provided. It is indicated and agreed that the only statements which are to be construed as the basis of the contract are those contained in this application or in any amendment to this application. I/WE HAVE ALSO RECEIVED A COPY OF THE PROSPECTUS AND I/WE UNDERSTAND THAT: (A) ANNUITY PAYMENTS OR SURRENDER VALUES, WHEN BASED ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND NOT GUARANTEED AS TO A DOLLAR AMOUNT; AND (B) ALL PAYMENTS AND VALUES BASED ON THE FIXED ACCOUNT ARE SUBJECT TO A MARKET VALUE ADJUSTMENT FORMULA, THE OPERATION OF WHICH MAY RESULT IN EITHER AN UPWARD OR DOWNWARD ADJUSTMENT.
