0001193125-12-195327 Sample Contracts

ASSIGNMENT AND AMENDMENT

Assignment and Amendment • April 30th, 2012 • Farmers Annuity Separate Account A

• Contract Type
  Assignment and Amendment
• Filed
  April 30th, 2012
• Company
  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”).

Annuitant Jane Doe 001234567Z Contract Number

Your Contract • April 30th, 2012 • Farmers Annuity Separate Account A

• Contract Type
  Your Contract
• Filed
  April 30th, 2012
• Company
  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.