ContractInsured • March 1st, 2010 • Kansas City Life Variable Annuity Separate Account
Contract Type FiledMarch 1st, 2010 CompanyInsured [John A. Doe] Single Premium Variable Annuity Contract - Nonparticipating Contract Number [9999999] Agency [0001] Annuity proceeds payable at maturity date. Death proceeds payable in event of death of Annuitant prior to maturity date. The contract value of this contract may increase or decrease daily depending on the investment experience of the subaccounts. There is no guaranteed minimum contract value. Kansas City Life Insurance Company will pay the proceeds of this contract according to the provisions on this and the following pages, all of which are part of this contract. This contract is a legal contract between you and Kansas City Life Insurance Company. READ YOUR CONTRACT CAREFULLY. Signed for Kansas City Life Insurance Company, a stock company, at its Home Office, 3520 Broadway, PO Box 219139, Kansas City, MO 64121-9139. Secretary President 10-Day Right To Examine Contract Please examine this contract carefully. If you are not satisfied, you may return the contract to u