0000912057-04-000471 Sample Contracts

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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

Jefferson 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.

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