Prudential The Prudential ------------ Insurance Company of AmericaPrudential Qualified Individual Variable Contract Account/Nj • April 27th, 1999
PURCHASE AGREEMENTPurchase Agreement • April 27th, 1999 • Prudential Qualified Individual Variable Contract Account/Nj
FIXED ACCOUNTPrudential Qualified Individual Variable Contract Account/Nj • April 27th, 1999
JOHN DOE xx xxx xxx ----------------------------------------------------------- --------------------- The contract is amended at issue to include these provisions. They apply even though the contract may state otherwise:Prudential Qualified Individual Variable Contract Account/Nj • April 27th, 1999
Annuitant Contract No. --------------------------------------------------- ------------------------- LIMITATION PROVISIONS The contract is amended at issue to include these provisions. They apply even though the contract may state otherwise:...Prudential Qualified Individual Variable Contract Account/Nj • April 27th, 1999
Page 18 Variable Annuity Contract with Flexible Purchase Payments-Monthly annuity payments starting on Annuity Date. Payment as stated upon death before Annuity Date. Purchase payments payable during lifetime(s) of annuitant(s) until Annuity Date....Prudential Qualified Individual Variable Contract Account/Nj • April 27th, 1999
Variable Annuity Contract with Flexible Purchase Payments-Monthly annuity payments starting on Annuity Date. Payment as stated upon death before Annuity Date. Purchase payments payable during lifetime(s) of annuitant(s) until Annuity Date. Cash values reflect investment results.
The Prudential Insurance Company of America Corporate Office Newark, New JerseyPrudential Qualified Individual Variable Contract Account/Nj • April 27th, 1999
We will make monthly annuity payments starting on the Annuity Date we show in the window of this page. We make this promise subject to all the provisions of this contract.
Prudential The Prudential ---------- Insurance Company of America Annuitant Annuity Contract NumberPrudential Qualified Individual Variable Contract Account/Nj • April 27th, 1999
As required by Section 36.105 of Title ll0B of the Texas Revised Civil Statutes, the right to withdraw values may be exercised only in event of the annuitant's death, retirement, or termination of employment in all institutions of higher education as defined in Section 6 1.003 of the Texas Education Code. But contract values may be transferred to other contracts or other carriers during the period of the annuitant's participation in the Optional Retirement Program.
Prudential The Prudential ----------- Insurance Company of America Annuitant Annuity Contract No. Endorsed by attachment The Prudential Insurance Company of America By /s/ ISABELLA L. KIRCHNER Secretary Date Attest ------------ -------------------...Prudential Qualified Individual Variable Contract Account/Nj • April 27th, 1999
Supplement to the Application _The Prudential Insurance Company of America _Pruco Life Insurance Company A Subsidiary of The Prudential Insurance Company of America No.__________________________________________ A Supplement to the Application for a...Prudential Qualified Individual Variable Contract Account/Nj • April 27th, 1999
ENDORSEMENT (Only we can endorse this contract.) The provision of this contract entitled PURCHASE PAYMENTS is replaced at issue by the following: PURCHASE PAYMENTS Purchase Payments--Purchase payments made through payroll deductions or similar...Prudential Qualified Individual Variable Contract Account/Nj • April 27th, 1999
Purchase Payments--Purchase payments made through payroll deductions or similar arrangements with an employer must be at a rate of at least $300 during any 12-month period. Any other purchase payment must be at least $100.
NOTICE This contract is for use with plans intended to qualify under the Internal Revenue Code for tax favored status. Language contained in this contract referring to Federal tax statutes or rules is informational and instructional and this language...Prudential Qualified Individual Variable Contract Account/Nj • April 27th, 1999
This contract is for use with plans intended to qualify under the Internal Revenue Code for tax favored status. Language contained in this contract referring to Federal tax statutes or rules is informational and instructional and this language is not subject to approval or disapproval by the state in which the contract is issued for delivery.
Prudential The Prudential ---------- Insurance Company of AmericaPrudential Qualified Individual Variable Contract Account/Nj • April 27th, 1999
Option D may be chosen only if the period will not exceed the life expectancy, as we determine for persons of the same age and sex, of the Annuitant. If the Annuitant's then spouse is the contingent payee the period may not exceed their joint life and last survivor expectancy, as we determine for persons of the same age and sex.
The Prudential [LOGO] Annuitant Contract No. John Doe XX XXX XXX -------------------------------- --------------------- WAIVER OF WITHDRAWAL CHARGES Subject to all the provisions of this rider and of the rest of the contract, we will waive part or all...Prudential Qualified Individual Variable Contract Account/Nj • April 27th, 1999
