Protective Life Insurance Company Nashville, Tennessee (A Stock Insurance Company) GROUP FLEXIBLE PREMIUM DEFERRED {FIXED AND} VARIABLE ANNUITY CONTRACT (Non-Participating)Protective Variable Annuity Separate Account • February 25th, 2004
Protective Life Insurance Company agrees to provide the benefits described in this Contract. The Contract alone governs the rights of the parties. A copy of the Contract will be furnished with each Certificate issued. The Certificate is pages 3 and 4 of the document prepared for the Participant.
SCHEDULEProtective Variable Annuity Separate Account • February 25th, 2004 • Iowa
CONTRACT MAINTENANCE FEE {$30} The contract maintenance fee is deducted prior to the Annuity Commencement Date on each Contract Anniversary, and on any day that the Contract is surrendered other than the Contract Anniversary. The contract maintenance fee will be deducted from the Allocation Options in the same proportion as their values are to the Contract Value. The contract maintenance fee will be waived by the Company in the event the Contract Value or the aggregate Purchase Payments reduced by surrenders equals or exceeds $50,000 on the date the contract maintenance fee is to be deducted.
