0001193125-12-195327 Sample Contracts

ASSIGNMENT AND AMENDMENT
Services Agreement • April 30th, 2012 • Farmers Annuity Separate Account A

THIS ASSIGNMENT AND AMENDMENT (“Assignment”) is made this 16th day of April, 2012 by and among PIMCO Variable Insurance Trust (the “Trust”), PIMCO Investments LLC (“PI”) and Farmers New World Life Insurance Company (“Authorized Firm”).

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Annuitant Jane Doe 001234567Z Contract Number
Individual Flexible Premium Variable Annuity Contract • April 30th, 2012 • Farmers Annuity Separate Account A

In this contract “we,” “us,” and “our” refer to Farmers New World Life Insurance Company. “You” and “your” refer to the Owner of this contract.

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