0000940338-00-000005 Sample Contracts

|_| Male Social Annuitant Name |_| Female Security No._____________________ First Middle Last
Variable Annuity Contract • December 20th, 2000 • Kansas City Life Variable Annuity Separate Account
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ANNUITANT CONTRACT NUMBER JOHN A. DOE 9999999
Flexible Premium Variable Annuity Contract • December 20th, 2000 • Kansas City Life Variable Annuity Separate Account
Sample 1Sample 2Sample 3See All (4)
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