BILLING CONTACT: -------------------------------------------------------------- Telephone Number ( ) Fax Number ( ) ------------------------ ------------------------------------ MAIL BILLING STATEMENT TO (IF OTHER THAN THIRD PARTY ADMINISTRATOR (IF...Application for Group Flexible Premium Deferred Annuity Contract • May 6th, 1998 • Annuity Investors Variable Account B
IT IS FURTHER UNDERSTOOD THAT PAYMENTS AND VALUES PROVIDED UNDER EACH CERTIFICATE, WHEN BASED ON THE INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT, ARE VARIABLE AND ARE NOT GUARANTEED AS TO DOLLAR AMOUNT.
