CONTRACT DATA PAGES Contract Number definition

CONTRACT DATA PAGES Contract Number. [1234567890] Owner: [Xxxx Xxx] Owner Issue Age: [80] Joint Owner: [No Joint Owner] Joint Owner Issue Age: [N/A] Annuitant: [Xxxx Xxx] Annuitant Issue Age: [80] Joint Annuitant: [No Joint Annuitant] Joint Annuitant Issue Age: [N/A] Issue Date: [January 15, 2021] Issue State: [MI] Premium Amount: [$25,000] Income Date: [January 15, 2036] Primary Beneficiary(ies): [Xxxxx Xxx] Contingent Beneficiary(ies): [Xxxx Xxx] RILA282-CB1 3a CONTRACT DATA PAGES (CONT'D) FIXED ACCOUNT INFORMATION: Fixed Account Minimum Interest Rate (FAMIR): [1.00%] Fixed Account Minimum Value Percentage: [87.50%] Fixed Account Minimum Value Annual Expense Allowance: [$50] INTEREST RATE FOR ADJUSTMENTS DUE TO MISSTATEMENT OF AGE OR SEX: [1.00%] WITHDRAWALS: Withdrawal Charge Schedule: Contract Withdrawal Charge Year Percentage [1 8.00% 2 8.00% 3 7.00% 4 6.00% 5 5.00% 6 4.00% 7+ 0.00%] Please see Withdrawal Provisions for complete explanation of the determination of Withdrawal Charges. Minimum partial withdrawal amount unless as a scheduled part of an automatic withdrawal program: [$500] Minimum partial withdrawal amount as a scheduled part of an automatic withdrawal program: [$50] Minimum Contract Value remaining after a partial withdrawal: [$2,000] Free Withdrawal Percentage: [10%] RILA282-CB1 3b CONTRACT DATA PAGES (CONT'D) Waiver of Withdrawal Charge Due to Terminal Illness Eligibility Date: [October 1, 2021] Waiver of Withdrawal Charge Due to Terminal Illness Maximum Amount: [100%] of the Contract Value, not to exceed [$250,000] Waiver of Withdrawal Charge for Extended Care Eligibility Date: [October 1, 2021] Waiver of Withdrawal Charge for Extended Care Maximum Amount: [100%] of the Contract Value, not to exceed [$250,000] PREMIUM: Premium is money paid into this Contract for allocation into a Contract Option. This is a single Premium Contract. The Company may waive minimum and maximum Premium at any time, on a nondiscriminatory basis. Minimum Premium: [$25,000] Maximum Premium: [$1,000,000] SEPARATE ACCOUNT: [RILA Separate Account] RILA282-CB1 3c
CONTRACT DATA PAGES Contract Number. [1234567890] Owner: [Xxxx Xxx] Owner Issue Age: [35] Joint Owner: [Xxxx Xxx] Joint Owner Issue Age: [35] Annuitant: [Xxxx Xxx] Annuitant Issue Age: [35] Joint Annuitant: [Xxxx Xxx] Joint Annuitant Issue Age: [35] Initial Premium: [$50,000] Issue Date: [May 1, 2020] Issue State: NY Income Date: [May 1, 2080] Primary Beneficiary(ies): [Xxxxx Xxx] Contingent Beneficiary(ies): [Xxxx Xxx] VA720NY-CB1 3a CONTRACT DATA PAGES (CONT'D) FIXED ACCOUNT, INTEREST RATE AND CONTRACT CHARGE INFORMATION: Initial Fixed Account Minimum Interest Rate: [1.00%] The Company will re-determine the Fixed Account Minimum Interest Rate each January on the Redetermination Date. The Fixed Account Minimum Interest Rate is the guaranteed minimum interest rate under the Contract and may change each year on the Redetermination Date. Initial Base Interest Rate: [1.00% for the 1-Year Fixed Account Option Period 1.00% for the 3-Year Fixed Account Option Period 1.00% for the 5-Year Fixed Account Option Period 1.00% for the 7-Year Fixed Account Option Period] Initial Current Interest Rate: [1.00% for the 1-Year Fixed Account Option Period 1.00% for the 3-Year Fixed Account Option Period 1.00% for the 5-Year Fixed Account Option Period 1.00% for the 7-Year Fixed Account Option Period] Initial Current DCA+ Interest Rate: [6-month [X.XX%] [NOT CURRENTLY AVAILABLE] [12-month [X.XX%] [NOT CURRENTLY AVAILABLE] ONE OR BOTH OF THE DCA+ FIXED ACCOUNT OPTIONS MAY NOT BE AVAILABLE ON THE ISSUE DATE. AVAILABILITY IS INDICATED ABOVE. Maximum DCA+ Rate: [8.00%] over the net investment earnings rate. Interest Rate for Adjustments Due to Misstatement of Age or Sex: [1.00%] Annual Contract Maintenance Charge: [$30] The Company will deduct the Annual Contract Maintenance Charge from the Contract Value (but not the Remaining Premium) on each Contract Anniversary that occurs on or before the Income Date or when You withdraw the Contract Value in full on a date other than a Contract Anniversary. The Company will only deduct the Annual Contract Maintenance Charge from Contracts with a Contract Value less than [$50,000]. Core Contract Charge: [1.0000%] The Core Contract Charge is expressed as an annual percentage and is deducted daily from the Separate Account Contract Value (but not the Remaining Premium). The Company will reduce the Core Contract Charge to [0.9000%] if the Contract Value on the later of the Issue Date or the most recent Contract Quarterly Anniversary is greater than or equal to [$1,000,000]. If the...
CONTRACT DATA PAGES Contract Number. 1234567890 Owner: Xxxx Xxx Owner Issue Age: 35 Joint Owner: Xxxx Xxx Joint Owner Issue Age: 35 Annuitant: Xxxx Xxx Annuitant Issue Age: 35 Joint Annuitant: Xxxx Xxx Joint Annuitant Issue Age: 35 Initial Premium: $5,000 Issue Date: May 1, 2020 Issue State: MI Income Date: May 1, 2080 Primary Beneficiary(ies): Xxxxx Xxx Contingent Beneficiary(ies): Xxxx Xxx ICC19 VA680-CB1 3a

More Definitions of CONTRACT DATA PAGES Contract Number

CONTRACT DATA PAGES Contract Number. [1234567890] Owner: [Xxxx Xxx] Owner Issue Age: [35] Joint Owner: [Xxxx Xxx] Joint Owner Issue Age: [35] Annuitant: [Xxxx Xxx] Annuitant Issue Age: [35] Joint Annuitant: [Xxxx Xxx] Joint Annuitant Issue Age: [35] Initial Premium: [$5,000] Issue Date: [May 1, 2020] Issue State: NY Income Date: [May 1, 2080] Primary Beneficiary(ies): [Xxxxx Xxx] Contingent Beneficiary(ies): [Xxxx Xxx] VA680NY-CB1 3a
CONTRACT DATA PAGES Contract Number. [1234567890] Owner: [Xxxx Xxx] Owner Issue Age: [35] Joint Owner: [Xxxx Xxx] Joint Owner Issue Age: [35] Annuitant: [Xxxx Xxx] Annuitant Issue Age: [35] Joint Annuitant: [Xxxx Xxx] Joint Annuitant Issue Age: [35] Initial Premium: [$25,000] Issue Date: [September 1, 2019] Issue State: [Michigan] Income Date: [September 1, 2079] Primary Beneficiary(ies): [Xxxxx Xxx] Contingent Beneficiary(ies): [Xxxx Xxx] ICC18 VA775-RLC 3a
CONTRACT DATA PAGES Contract Number. [1234567890] Owner: [Xxxx Xxx] Owner Issue Age: [35] Joint Owner: [Xxxx Xxx] Joint Owner Issue Age: [35] Annuitant: [Xxxx Xxx] Annuitant Issue Age: [35] Joint Annuitant: [Xxxx Xxx] Joint Annuitant Issue Age: [35] Initial Premium: [$25,000] Issue Date: [February 1, 2019] Issue State: [Michigan] Income Date: [February 1, 2079] Primary Beneficiary(ies): [Xxxxx Xxx] Contingent Beneficiary(ies): [Xxxx Xxx] ICC18 VA785-FB1 3a CONTRACT DATA PAGES (CONT'D) CONTRACT CHARGES: Monthly Contract Charge: [$20] A monthly charge will be deducted on a pro-rata basis from the Investment Division(s) on each Contract Monthly Anniversary. Transfer Charge: [$25] The Company allows [25] free transfers between Investment Divisions in a Contract Year. The Company charges a fee for each transfer You make in excess of the [25] free transfers in any Contract Year. The Company deducts Transfer Charges from the amount You seek to transfer before allocation to the new Investment Division. The Company does not assess Transfer Charges on transfers under any of the Company's systematic investment programs, and the Company does not count those transfers against the [25] free transfers allowed in a Contract Year. Free transfers not utilized during a given Contract Year cannot be carried forward to subsequent Contract Years. Interest Rate for Adjustments Due to Misstatement of Age or Sex: [1.00%] WITHDRAWALS: Minimum partial withdrawal amount unless as a scheduled part of a systematic withdrawal program: [$500] Minimum partial withdrawal amount as a scheduled part of a systematic withdrawal program: [$50] Minimum Contract Value remaining after a partial withdrawal: [$2,000] TRANSFERS: Transfer among Investment Divisions. At any time, You may transfer all or a portion of Your Contract Value in any Investment Division to any available Investment Division(s). Transfer Effective Date: Transfers You request will be effective as of the end of the Business Day upon which the Company receives Your transfer request in Good Order at the Company's Service Center. Additional details on transfer restrictions are outlined in the Transfer of Funds Restrictions section of the General Provisions. ICC18 VA785-FB1 3b

Related to CONTRACT DATA PAGES Contract Number

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