AMENDMENT NO. 2 TO PARTICIPATION AGREEMENT BY AND BETWEEN GOLDMAN SACHS VARIABLE INSURANCE TRUST, GOLDMAN, SACHS & CO. AND THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORKParticipation Agreement • April 29th, 2016 • Fs Variable Separate Account
This Amendment No. 2 to the Participation Agreement dated June 1, 1998 (the “Amendment”), is made and entered into this 29th day of April, 2016 by and between GOLDMAN SACHS VARIABLE INSURANCE TRUST, a statutory trust formed under the laws of Delaware (the “Trust”), GOLDMAN, SACHS & CO., a New York limited partnership (the “Distributor”), and THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (successor to American International Life Assurance Company of New York), a New York life insurance company (the “Company”), on its own behalf and on behalf of each separate account of the Company referred to herein.
ContractAnnuity Contract • April 29th, 2016 • Fs Variable Separate Account
The United States Life Insurance Company in the City of New York A STOCK COMPANY NEW YORK, NEW YORK CONTRACT NUMBER [P9999999999] ?1 OWNER [JOHN DOE] ?1 HOME OFFICE ANNUITY SERVICE CENTER One World Financial Center P.O. BOX 15570 200 Liberty Street ?2 AMARILLO, TX 79105-5570 ?2 NEW YORK, NEW YORK 10281 THE UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NEW YORK (“We”, “Us”, the “Company”, or “US Life”) agrees to provide benefits to the Owner in accordance with the provisions set forth in this Contract and in consideration of the Application and Purchase Payments We receive. The value of amounts allocated to the Separate Account during the accumulation and annuity periods is not guaranteed, and will increase or decrease in value based upon the investment experience of the Variable Portfolios You choose. The Separate Account Charge is charged against the assets of the Separate Account. This charge includes fees for mortality and expense risk and the distribution expense. On an annua
