Single Premium Deferred Modified Guaranteed Annuity Contract Sample Contracts

GOLDEN -------AMERICAN ---------LIFE INSURANCE -----COMPANY SINGLE PREMIUM DEFERRED MODIFIED GUARANTEED ANNUITY CONTRACT
Single Premium Deferred Modified Guaranteed Annuity Contract • February 5th, 2018 • VOYA INSURANCE & ANNUITY Co • Life insurance

This is a legal Contract between its Owner and us. Please read it carefully. In this Contract you or your refers to the Owner shown above. We, our or us refers to Golden American Life Insurance Company.

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Annuitant Owner(s) | |[THOMAS J. DOE] [JOHN Q. DOE] | |Initial Premium Annuity Option Annuity Commencement Date | |[$10,000] [LIFE 10-YEAR CERTAIN] [JANUARY 1, 2026] | |Separate Account(s) Contract Number | |[THE MVA FIXED ACCOUNT] [123456] |
Single Premium Deferred Modified Guaranteed Annuity Contract • February 5th, 2018 • VOYA INSURANCE & ANNUITY Co • Life insurance

This is a legal Contract between you and us. Please read it carefully. In this Contract you or your refers to the Owner shown above. We, our or us refers to Golden American Life Insurance Company. You may allocate this Contract's Accumulation Value among the Divisions offered under the Separate Account, as shown in the Schedule.

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